Pre-Op

Today was Hip Chick's pre-op appointment and what a day it was!  This was a far more extensive pre-op experience than for her closed reduction (rightfully so) and resulted in a five hour affair.  First, however, a bit of play was in order.

Scottish Rite provides an inviting, colorful playground and Hip Chick has begged to romp in it all year.  Mostly due to her traction, surgery, and casting, the answer has always been no, so today seemed to be her best opportunity.  Mommy also suspected a little play would help soften her for the long day ahead, so we arrived a half hour early. 

She drove a choo-choo train and played "peek-a-boo though playhouse windows.  She slid and climbed.  She soaked up a little extra morning sun.  Best decision to start her day with a little joy.

We popped downstairs into the newly renovated admissions area.  We hardly had enough time to appreciate the installation of their animated mobile before we were whisked away to our series of appointments.  

After completing standard paperwork (consents, privacy notices), we progressed to Radiology.  Hip Chick was in a chipper mood and insisted we march to our destination.  After a brief wait, she impressed all with her best behavior during xrays to date!  Neither tear nor tantrum was shed (Mommy suspects it may have been the Curious George cartoon playing in the room).  Her imaging showed little change in her hip's condition since July- all parties were unsurprised.

Phlebotomy was a different story.  I often joke that the one piece missing from those "What to Expect" pregnancy and parenting books is the not-so-tiny detail that being a parent means you have to help restrain your child for the scary medical procedures.  For Hip Chick, this usually means two to three people using all of their strength to hold her for xrays.  Today, this meant me holding her in my lap and restraining her free hand and torso during blood draws.  She earned a half dozen sheets of stickers for that stop.  Three vials were drawn, for a complete blood count, blood typing, and blood bank.  As she is too young to bank her own blood and it is unsafe to bank an adult's blood for someone her age, the hospital will have a small amount reserved for her from their bank.

Our next stop was a consult with her surgeon.  We revisited the surgical plan, discussed expectations, and explored risks.  We were thrilled to learn that she may not require the straight-leg spica... she may be casted in a different type of "bent leg" position.  Of course, nothing is certain until her surgery, but we would be relieved if she was able to sit up by any means!  

Her two biggest risks are:

1) The need for more surgery

2) Avascular Necrosis, or AVN

AVN is the disturbance of blood flow to the femoral head.  Her surgeon explained that over 50 percent of children who have these surgeries experience AVN to some degree, but that younger children tend to experience better outcomes with this.  A worst case scenario

includes the need for surgery to address damage to the femoral head from AVN.

After our clinic visit, we stopped by Pharmacy.  We discussed any recurring medications and pre-ordered what we want them to dose while admitted, to include any over-the-counter medications.  This was followed by a conference in Anesthesiology.  We discussed her medications, medical history, and the anesthesia plan.

Next, we progressed to the actual room she will stay in during her admittance.  We thought it a smart practice on behalf of Scottish Rite to allow her time for exploration.  She pushed all of the buttons she wanted to, climbed on and off her hospital bed as many times as she wanted, and roamed freely.  She exclaimed to us about the tall buildings outside her window.  It was ideal timing, as Hip Chick was growing ancy and needed to burn energy.  

We paused long enough for lunch in their Crayon Cafe.  Daddy and I have eaten breakfast on site several times, but only one lunch.  They offered an array of wraps, paninis, pastas, stir frys, salads, soups, pizzas, burgers, and desserts.  Dietary also reminded us that patients can order breakfast all day.  How could anyone go hungry there?

We returned to her room and met with her nurse, Dietary, Child Life (Play Therapy/Psych), and Occupational Therapy.  As she may be admitted for up to three days, their playroom will be open to us twice daily.  They also have animal therapy once weekly and will bring a dog to play with her on her third day, if still admitted.  Lastly, they requested a short list of her favorite toys to have them ready for her- she will be able to listen to music and have tea parties to her heart's desire!

Occupational Therapy measured her for a wheelchair.  We are undecided between the wagon or wheelchair, so they will let us decide after surgery- but at least we know a wheelchair will be on reserve.  

After this extended carousel of introductions, conferences, and arrangements, we capped off the day with another visit to their playground.  Mommy and Daddy were so proud of her today!  She was rather relaxed during nearly all of the poking she received today (save Phlebotomy) and was asking for personnel to listen to her heartbeat by the day's end.  Such a brave girl.  Soon, she will be tasked to be brave again... it may be hard at first, but she will do great.