surgery and final casts!!

Alder is sleeping off his anesthesia from his surgery this morning and is really doing well. He underwent a procedure called a tenotomy, where incisions are made in the achilles tendon. Former manipulations and castings turned the feet out for proper orientation respective of leg position. The tenotomy drops the heel so that the feet become 'flatter' relative to the ground and gives him normal heel flexibility. This final step in the manipulations is often done with the subject awake and with a local anesthetic. However, our doctor prefers use of general anesthesia because the local anesthesia can sometimes inflame the tissues around the achilles tendon, making it difficult to find the tendon. While again, this surgery was a tough reality to swallow, we trusted our doctor with years of experience and success with this approach.

We arrived at the hospital at 6am and they took him from us at 7:30 just as he woke up from his typical long night's sleep (we are so lucky...)., and I was feeding him in recovery by 9am. He was very hungry and alert enough to get a good feeding in...what a relief. His cries and movements are a bit weak today, but they are getting stronger and more normal as the day goes on. It was a much easier process than I had anticipated and we are very grateful for this. The hardest part is behind us.

This last cast is constructed to be more durable than the previous three, with an extra layer of fiberglass wrapping, similar to casts typical of broken limbs. Despite us asking them to make them lower to make cloth diapering easier, these casts are still very high and will likely limit this for another 3 weeks. Here is Alder sleeping soundly today:

Alder will wear these casts for three weeks, rather than only one. When we return to see the doc in 3 weeks, he will get these last casts off and he will start wearing a Mitchell AFO brace (see this link for a photo:
http://www.c-prodirect.co.uk/shop.htm#brace) for 23 hours a day for 3 months. This will likely be another tough transition for him to get accustomed to, but it should not take more than a couple of days.

Grammy and Paw Paw have been here for the weekend and have been a big help. I feel like I am constantly feeding or pumping these days so the extra hands are very nice to have around, whether they be holding Alder, hanging clothes on the line, or cooking dinner! On Sunday they were an enormous help by hanging ceiling fans in two of our bedrooms as well as a new light fixture in our dining room (to replace an ugly brass one). The fans are super because it is starting to get hot! This picture does not really show how pretty the new light is: