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Cassidy's Story
CHAPTER SEVEN
Third Surgery
Triple Pelvic Osteotomy
This next surgery was a whopper! It was a relatively new procedure for Australian surgeons and one of Britain's top orthopeadic surgeons flew over to teach the procedure to our surgeons and some other international visiting surgeons. Of course we were delighted that Cassidy (and a few others) would benefit from this expertise but the drawback was that he did it in his Christmas holidays which meant we faced the prospect of Christmas in the hospital. It was 2003 and Cassidy was 12 years old and on her annual holidays from Secondary College.
The procedure, called a 'Triple Pelvic Osteotomy' involved three cuts to the pelvis -the ilium, pubis, and ischium bones. This allowed the acetabulum to be rotated to create more depth to accommodate the femoral head. Cassidy's right hip had not been mentioned for some time and we assumed it had progressed well. It was the left hip that would be operated on.
With the continuing coverage by our local and district newspapers of Cassidy's progress since the first operation, we headed off once again to the RCH, laden with Christmas presents.
Once again Cassy was an old pro at this hospital stuff and had even seemed excited. We walked next to her trolley as they wheeled her into pre-op and this time it was Daddy's turn to stay with her as she 'dropped off'. (Hospital policy allows only one person to accompany the child so we took it in turns.) According to David, our little princess smiled a big floppy smile and said "Night-night Daddy" as the anaesthetic sent her to sleep. It's really quite sudden when they drop off to sleep, one minute they're awake, the next -boom, snoring away!
After a team of surgeons worked on her for practically the whole day, we were called into recovery. Lachy (9 years old) took a break from being endlessly entertained in the Starlight Express room and played on the Playstation just outside the recovery room while both of us went in. The nurse told us that Cassy was the calmest child she had ever seen in the recovery ward. Apparently she was a joy to nurse and didn't struggle when waking up, as most children do. I believe this was because we had discussed everything with Cassy before surgery and she had realised that it was all 'normal', was not frightened and didn't fight the feelings she was having.
Once again there was no spica or brace and this time no traction. There were three scars -two, which almost joined, along the same scar as the first operation's scar and the third scar across her bottom. She mostly slept (on her right side) for the first 2 days and pain relief was via an epidural block, which left her legs numb and temporarily paralysed. She was fine until the epidural block came out. Her previous angelic behaviour deteriorated as the discomfort of staying on one side made her quite grumpy. It was very painful to move, despite adequate pain relief and she was torn between laying uncomfortably on her right side and the pain of turning onto her back to prevent bed sores.
Cassidy experimented with biofeedback during this stage. She had a heart rate monitor on and if the rate got a little high (ie, when she was stressed or hurting) she would watch the monitor and concentrate on bringing the rate down, and it would come down! She also used mental imagery in the form of imagining there were heaps of kittens sitting on her hip, purring and making it better.
Being 12 years old, Cassidy had started developing and I felt very sorry for her to have to sacrifce her privacy and dignity at this sensitive stage as the nurses and I helped her to toilet and bathe. But in true Cassidy fashion, she accepted it as necessary and just got on with it, knowing that Mums and nurses are used to that sort of stuff! It was certainly a Mother-Daughter bonding situation!
With this pioneering surgery, weight-bearing was expected to begin almost immediately. So after only a few days, Cassidy was sent down to physiotherapy to stand up and begin her recovery!
