We've just gone through an open reduction and femoral osteotomy on my 17-month-old. Happy to share any stories. Have tried to keep a record of the experience on Facebook intentionally.
Here are some of the potentially helpful salient points:
We were scheduled for a 7:30 surgery and had to reach the hospital for pre-registration at 6:10 am. To prep for the surgery, I made sure she ate later the previous night. 8:00 pm solids dinner, 9:30 bottle of 8oz formula, 11:45 another 8oz bottle. For some reason she woke up at 2:45 am and stayed awake until the car ride at 5:00. We should've gotten more sleep during the previous day.
We reached on time despite the inclement weather. She was in good spirits, my little curious girl. After registration, we went down to the pre-op area. We had the room to ourselves so she had fun exploring the odds and ends there. The anesthesiologist and the ortho surgeon came in to talk to us just before the surgery. We changed her into her very becoming hospital gown. They gave her what seems to be a stronger dose of Tylenol codeine. The OR nurse put her in her lap, in a wheelchair and my happy girl went whee-ing into the OR.
Prior to the surgery the doctor and the nurses confirmed the consent form we had signed at the doc's last appointment. The form effectively informed us that: the doctor would try the least invasive of procedures starting with a closed reduction, an open incision and/or an osteotomy to get the bone and socket to fit as they should, an arthrogram may be performed to check the tissues surrounding the joint, and it would be followed with casting that will be left on for about 6-8 weeks.
We left her and went to the waiting area. It had a phone where the nurses could ring up status updates - it was sometimes attended by a staff person and sometimes we had to receive the calls ourselves. The area also had a general status board indicating 4 stages: registration, pre-op, intra, recovery. Each OR patient was assigned a unique number that you could look up on that board. This was pretty much useless to us as we were going to be with her through all but the intra (in the OR) stages.
Our optimism led us to believe we'd be out of there very quickly, that it would be a simple closed reduction. The surgery effectively began at 8:00 a.m. We received our first update call at 9:00 to let us know the doctor had to do an open incision. It was two hours later that we received our next update - by then we had guessed he had had to cut the bone. In the end, including casting, the procedure took about 4.5 hours, before the doc came out to see us.
The doc explained the procedure he had had to use. It was an open reduction with femoral osteotomy. He also explained the she'd still be in the cast only for the 3 months. We would not be able to sit her upright for a few days to ensure there's no weight on the incision. And she couldn't be on her stomach until he cleared it too. But he was very happy with the outcome of the surgery. Usually even after surgery the femur bone can easily come out of the socket, but in her case it was sitting nice and snug. Also post osteotomy her leg lengths were good almost equal. So the prognosis was very positive. But given the invasive procedure she would have to stay overnight.
At the Valley hospital you cannot 'book' a private room in advance. Though our doctor had informed them and reserved the potential need for one, when the time came it was a long wait before we were moved to the pediatric ward. Her surgery had taken place in the general OR and recovery was in the general recovery ward. So the nurses were not specialized. They were awesome and helpful, but no real help. I was beginning to feel concerned about receiving much coaching - especially with the diaper changes et al. Frankly I think the information I received from Moms on support groups has been more useful. Also, the UK NGO Steps has some of the best resources out there on the Internet. Their YouTube channel has highly informative videos by regular parents caring for babies in a spica cast.
I didn't get much sleep during the overnight stay. It took me a while to realize that she would find her own way to deal with the muscle spasms. It wasn't until the next day that I stopped jumping up every time she cried out in her sleep. Disney channel was a big help as was Stella and Sam on the iPad/iPhone. My iPhone 6 plus was the perfect size for her to maneuver herself. I've a lot of friends and family spread out around the world who were really concerned and wanted updates. I used Facebook very effectively for this, so I didn't have to give them individually.
I have to say my post emergency C experience from the time she was born was a huge help. The whole hospital stay experience seemed very familiar to me as a result, as did her pain management protocol.
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