Pre-Op Write Up

After the two hour drive to Charlottesville, we were pleasantly surprised when not only did they get us back to our appointment early but we also got to as all of our questions to Dr. Jane and his nurse practitioner, not just the nurse practitioner.

Dr. Jane went into detail about Abby's specific tether and the surgery. Turns out the surgery won't be as easy as he had originally planned. See, most peoples spinal cord stop at about the L1 or L2. A lot of tethered spinal cord patients tether is still in the lumbar area--not Abby's. Her's is very low, as Dr. Jane kept putting it. He says that hers is tethered in the sacral vertebrae area which will make the surgery significantly more difficult.

His main goal in the surgery is to separate the spinal cord nerves from the fat in which they are tethered. He will start from the lumbar area and work his way downward, hoping to free as many nerves as possible. While it would seem like the nerves, once freed, should spring back up in to normal position, this is not the case. Abby's spinal cord will always and forever be too long, putting her at risk of retethering.

Dr. Jane also let us know that Abby's sacrum goes out instead of inward and that we will most likely be having to schedule another surgery with an orthopedic surgeon to reconstruct the area. This area seems to cause her pain as it is right where the dimple is and the skin is very thin.

We are told at this point that the surgery will be around 5 hours from goodbye to hello. The first night will be spent in the PICU (Pediatric Intensive Care Unit) and the next day we will be transferred to the regular pediatric ward, where we will probably spend a good three days--if not more. Dr. Jane says that he doesn't like to send a patient home unless he is sure that they are ready to go home, and I appreciate that.

It sounds as if they will try to keep Abby as still as possible for the first 24 hours, but that they realize that she is only a toddler and that there is only so much that they can restrain her. After the first day, she will pretty much limit herself in her activities. Ken and I will eliminate things at home that could potentially cause her to get injured, like her table and chair set that she likes to climb on top of.

All in all, I'm very confident in Dr. Jane. Obviously I would not choose to have the surgery done at all, but since it needs to be, I'm glad that he is Abby's doctor.

I'm sure I will be adding to this as I realize things that I have forgotten. Please bear with me, it has been a long day.