Saturday, November 23, 2013


Peter had his tenotomy procedure yesterday!

His surgery was scheduled for 8:30am, and we had to be there at 6:30am. When Dr. Segal's assistant called to schedule the surgery, she told me that Peter could not have any breastmilk after 4:30am, so I set my alarm for 4am so I could be sure to feed him before he had to be cut off. However, he woke up at 3am to eat and nursed off and on until 4:30am (and I was so nervous I couldn't get any more sleep).

My father-in-law came over about 4:45am to stay with the older kids and take them to daycare later in the morning. Collin and I got ready to go, switched the carseat base over to our other vehicle, gave my FIL some last-minute instructions, etc. It was pouring rain (unusual for Phoenix) so we tried to leave early but ended up not getting out the door until nearly 5:30am.

The rain was so heavy that we had to backtrack twice due to flooded roads. (Thank God Collin is such a good driver!) Peter slept the entire time, thankfully. It was a little better once we finally got to the interstate, but it was still slow going due to morning rush hour traffic. I called the hospital to let them know we were delayed due to the heavy rain and flooded roads. The person I spoke to in Admitting said, "Oh... according to my records his surgery isn't until 1:30pm. Didn't anyone call you?"

I was incredulous, as I'd been told on Monday and Wednesday - by two different people - that surgery was 8:30am. I told her we'd figure it out when we (eventually) got there.

We didn't arrive until 6:45am and went straight to Admitting. Eventually we found out that surgery was indeed at 8:30am, not 1:30pm -- there had been a miscommunication somewhere.

Once we registered at Admitting, we were sent up to the 4th floor. I'd only ever been on the 2nd floor (that's where the Orthopedics department is located) so it was interesting to see another part of the hospital. I was amused to see that Toy Story 2 was playing on the waiting room TV, as we sometimes call Peter "Stinky Pete" (especially when he has a dirty diaper!).

We were greeted by a volunteer and only had to wait a few minutes before a nurse came to take us to our pre-op room. There was a basket of Beanie Babies for kids to hold and snuggle, and I picked out a teddy bear for Peter. The nurse went over some questions with us -- was Peter allergic to anything, had anyone in our family ever had a bad reaction to anesthesia, etc. -- and took his vital signs. She gave us an infant-sized hospital gown and we changed him into it.

All dressed up and ready to go!

Peter was awake by this time and antsy because he wanted to eat, and it broke my heart that I couldn't nurse him. We had a pacifier for him to suck and that helped a little bit. The nurse told us that Dr. Segal and the anesthesiologist would be in to speak with us. While we waited I held Peter and paced the room, and he actually fell asleep again, without nursing! That made waiting easier, and I was grateful to get some snuggle time in before the surgery.

Dr. Segal came in around 8:10 or so, and was able to meet Collin for the first time. He used a special marker to write his initials on each of Peter's upper thighs to indicate that the tendon in each heel would be cut. He gave us a brief overview of the surgery, why it was necessary, etc. (mostly for Collin's benefit, as I'd already read everything I could get my hands on about it).

Dr. Segal left, and shortly afterwards the anesthesiologist, Dr. Dado (pronounced Day-doe), came in. She explained, thoroughly, what the general anesthesiology entailed. It would be administered as a gas, through a breathing mask, and Peter's vital signs would be closely monitored throughout the procedure. (She told me what drug would be used, but I can't remember what it was.) He'd also have an IV in his hand to give him fluids so he wouldn't get dehydrated. She assured us that he would completely exhale the anesthesia before we were discharged and that there shouldn't be any lingering effects. We also discussed pain management post-discharge, and she told us the exact dosage of infant Tylenol or Motrin to use if needed.

She came across as very capable and confident, which made me feel a lot better. She thought Peter was adorable and commented that "he looked like a Peter" (she also told us that Peter was her father's name, which is why she liked it so much). 

After Dr. Dado left, Dr. Segal's resident, Dr. Schmidt, came in to tell us that he was going to observe the surgery and wished us luck. Finally, the assisting nurse, Tim, came in to take Peter to the OR. He was awake by this time and starting to get fussy again. We kissed him goodbye and watched as he was wheeled away. I cried a little but managed to compose myself pretty quickly.

We went back to the waiting room to settle in. I went down to the cafeteria to grab some breakfast (one "decision-maker" had to remain in the waiting room at all times, just in case, so we couldn't go down together). I had that day's special, a Monte Cristo breakfast sandwich and fried potatoes, and it was delicious!  I had to eat in the cafeteria since food and drink weren't allowed in the surgical waiting room.

By the time I got back upstairs, nearly an hour had passed, and the volunteer came over to usher us to a conference room to meet with Dr. Segal. He came in a few minutes later and told us the surgery had gone smoothly, Peter was already conscious, and that we should call to make an appointment in three weeks to take off the casts for the final time.

A few minutes later we were taken back to a recovery area to see Peter! I could hear him fussing as we approached the curtained area, and when we came in a nurse had him wrapped in a blanket and was cooing to him. I took him in my arms and kissed his pudgy cheeks, then sat down to nurse him right away. He latched on immediately and nursed well. He still had the IV in his hand, as well as a cord connected to his finger to monitor his vital signs. I could see how his heart rate went down as he started nursing (it had been slightly elevated while he was fussing).


We sat and chatted with the nurse as he ate; she told us what symptoms were expected (fussiness, gas, perhaps some vomiting due to swallowed air), and what symptoms meant we should call the doctor (excessive vomiting, elevated fever). She showed us the mask that had been used to administer the anesthesia - it was so little and cute!

Once he was almost done eating, she removed his IV and the monitor, and we changed him out of the hospital gown and into his onesie. The casts were still a little damp so I wrapped a towel around them. We signed paperwork, loaded him into his carseat, and left the hospital around 10:30am - a mere two hours after the surgery took place!

It was still raining but the drive home was much more peaceful. Peter did spit up quite a bit right after we left, but slept most of the way home. Once home we spent the rest of the day snuggling and even took a nap together. He was fussier than usual that evening and I did give him the recommended dose of Tylenol, which seemed to help.

Today (Saturday) he's pretty much back to normal. He had a vomiting episode earlier this morning (ew) but has kept down his feedings since then. I'm so glad that the surgery is over, and I'm looking forward to getting into the boots and bar. I return to work on December 2nd (boo) so I'm glad we got the surgery over with before I went back.

I hope our transition to the boots and bar isn't too rough - in my FB support group, a lot of moms say that their kids screamed for weeks on end when they first got the brace. I'm not looking forward to sleepless nights followed by a long commute if our experience is similar. However, Peter has been pretty mellow throughout the process so far, so I'm hopeful that will continue.

Tuesday, November 19, 2013

Sixth Casts

Peter's sixth casts were applied on last Thursday (November 14). As Dr. Segal said, they were the last casts for which he was awake - we've scheduled his tenotomy procedures for Friday, November 22 at 8:30am! If you could spare a prayer for him, and us, I'd be grateful.

I'm looking forward to having them over and done with, but I'm feeling pretty anxious as he'll be put under general anesthesia. Some doctors use local anesthesia or numbing cream, but Dr. Segal prefers general anesthesia, especially for babies with bilateral clubfeet, since it's so important that they stay perfectly still - a strong jerk of the foot at the wrong time could be disastrous.

After the tenotomies, he'll get another set of casts and will be in those for three weeks. Once they are removed, he'll start the 23/7 brace wear.

I was hoping he'd be into his boots and bar before I go back to work (probably December 2), but it looks like that won't happen. I hope he adjusts well to the brace, because enduring a few sleepless nights will be that more difficult if I have to get up at 5am and drive 43 miles. Luckily, he's a mellow little guy so far and has adjusted really well to the casts.

Peter's feet prior to round 6 of casting

Peter's feet prior to round 5 of casting

Peter's feet prior to round 4 of casting
(couldn't get a better pic because he was kicking a lot!)
Peter's feet prior to round 3 of casting

Peter's feet prior to round 2 of casting

Peter's feet at birth

Saturday, November 9, 2013

Fifth Casts

Peter got his fifth casts on Thursday, November 7, his one month birthday!

One month old!

Dr. Segal said he wants Peter to have one more set, and then we'll set the surgery date for his tetonomies. I'm pretty apprehensive about that since he'll have to go under general anesthesia for them, but I'm also glad to know that his feet are very nearly fully corrected. We're almost to the boots and bar!

I actually very much enjoyed his casting appointment - he sucked in his bottle the entire time, no fussing, and I played music on my iPhone. Dr. Segal, his assistant, and I kept up a conversation the whole time about our favorite musicians.

When Peter and I went into the casting room, Dr. Segal was in the process of putting casts on the legs of a tiny baby girl with a ton of dark hair. Her name was Emory. (Not sure of the spelling.) Her mom and I talked a bit; I showed her a picture of Peter's feet when he was born, and then showed her how much they had improved since then. She was encouraged, I think. :)

Peter's feet prior to round 5 of casting

Peter's feet prior to round 4 of casting
(couldn't get a better pic because he was kicking a lot!)

Peter's feet prior to round 3 of casting

Peter's feet prior to round 2 of casting

Peter's feet at birth

Saturday, November 2, 2013

Fourth casts

Peter had his fourth round of casting on October 31. Dr. Segal commented that he was pleased with his progress - he said Peter's feet were very stiff prior to the first cast, but they're a lot more flexible now. He estimates that Peter will need 2-3 more casts, and then he'll perform a tetonomy on both feet.

Casting went very well this week. Peter was very hungry before we started, so he was too busy wolfing down the bottle I had ready to fuss during the casting. I also met another clubfoot mom in the waiting room, from Queen Creek, AZ. Her little girl was 9 weeks and already in the boots and bar brace.

Oh, and I had yet another random clubfoot mom sighting this week! We were at a Chinese buffet with my mother-in-law, and an older lady walked by, saw Peter's casts, and asked if his feet were clubbed. When I said yes, she remarked that her daughter had been born with one clubbed foot.

Peter's feet prior to round 4 of casting
(couldn't get a better pic because he was kicking a lot!)

Peter's feet prior to round 3 of casting

Peter's feet prior to round 2 of casting

Peter's feet at birth