funny feet part 2

I first wrote about Eli's birth defects here.  He was born with an extra digit (the correct medical term is type B postaxial polydactyly) on his pinky and a syndactyly of his big and index toes on the left side.  Very shortly after he was born, we visited a plastic surgeon at Primary Children's Hospital in Salt Lake to talk about having them "fixed."  I went back and forth on this a lot.  While this surgery would help him feel and look more "normal," it wasn't necessary for his overall health and development, and would put him at risk for a bad reaction to anesthesia, infection, and further deformation from a botched job.  We scheduled the surgery anyway.  They advised we wait until after six months, up to a year if possible, but before he was walking.  Based on TJ's 9-month precedent, we decided 8 months was a good time.  This was a good choice, because Eli was already nearly walking and has started taking shuffling steps and standing on his own.

As the surgery approached, I felt increasingly apprehensive.  However, an incident a few weeks ago helped strengthen my resolve.  We were at church.  Eli was standing on the pew, holding onto the back, and looking at the kids behind us.  His finger with the growth was clearly visible.    The kids started whispering and saying things about his extra digit, like "That is gross!" and "I don't want to look at that!"  It was a firm reminder that kids are brutally honest.  It broke my heart.  The kids weren't being mean, his pinky growth is pretty freaky-looking.  It just hurts to hear things like that said about my baby.

Then, last Tuesday, I took Eli in because he was sooo fussy.  He had an ear infection.  We called the surgeon's office and the hospital anesthesiologist to make we could still operate.  Got the go ahead.  On Monday, I took both the boys in - Eli, to make sure the infection was clearing up, and TJ because he had been pulling at his ears and saying ow.  Neither boys had infected ears, but the pediatrician we saw detected heart murmurs in BOTH boys.  Keeping in mind the fact that these had never, ever been heard before, I would not have been concerned at all except Eli was having surgery.  A heart issue could really complicate things, and the pediatrician recommended we try to see a cardiologist before the surgery.  I began running around like a chicken with it's head cut off trying to sort things out.  At this point, I was committed to the surgery and had no desire to reschedule.  Thankfully, we got in to see our regular pediatrician the next day.  She ordered an EKG (I can't figure out why the other doctor didn't do this).  EKG's are standard for most adults going into surgery, and it was not a huge deal to head over to the hospital where Eli was born and have one done.  It came back totally normal.  All that stress for nothing!

Waiting for an EKG

They let us know the day before that Eli's report time was 9:00 am.  My father-in-law was going to have TJ for the day, and Tyler had two attendance-based classes that he couldn't miss, so it was just me and Eli.  We left the house at 7:30 and didn't arrive at until 8:50.  Rush hour traffic is brutal!  I showed up at University of Utah hospital, because the plastic surgery team works at both places and I was told to go to the same place I went for our consult appointments.  Lo and behold, the surgery was actually at Primary Childrens.  They are right next door, so it wouldn't have been a huge deal, but parking is a nightmare and ahhhhh!  So we were ten minutes late.

We waited for about fifteen minutes then went through all the pre-op discussions with the nurses.  They took me to a second waiting room, where I talked to the surgeon and anesthesiology.  The anesthesiologist walked us down the hall to the surgical entrance, then took Eli and sent me on my way.  I thought I would be there when they put him under, so watching him go wide awake and waving at me was the last straw on the stressed-out-of-my-mind cake and I cried all the way down the hall, down the elevator, and into the family waiting room.  It was totally embarrassing.  Then the wait.

All gowned up for surgery

The surgeon came to talk to me around 12:30 and told me everything was fine.  They took a skin graft from the place where his thigh and abdomin meet, so he has three surgical wounds.  The graft was to help make sure there was enough skin to close up both toes completely.  They also cut into his finger slightly, instead of just snipping the growth off, to remove any remnant cartilage that had formed there.

Just as he got up and left they called me to go upstairs to be with him.  I could hear babies crying, but I did not recognize Eli's cry at all.  I didn't even think he was crying until I saw his face.  His voice was all messed up from being intubated and he was a mess.  He was flailing and crying, but definitely wasn't awake.  His eyes didn't even open for another forty-five minutes.  I took him from the nurse and let him latch and nurse/snooze on me until he was ready to sit up and look around.  Not long after that I realized that the wound on his finger was completely uncovered!  They had wrapped his whole hand and pinky, but he had managed to work his pinky out of it's wrapping.  They wrapped it three more times, and each time he pulled it off or it fell off.  He was super mellow, they had given him some narcotics, so mostly he just wanted me to hold him.  I was loving how snuggly he was.

They sent a tech to help me get out to our car, since I had come alone, but we had to pick up the rest of his painkillers and antibiotics at the pharmacy, so she just left me there.  It stressed me out to no end.  I had only brought a comfortable, short-sleeve onesie for Eli because I wasn't sure what his foot and hand dressings would be like.  I had wanted to leave him with her while I pulled the car around, but I ended up just wrapping him up and running to the car.  He slept the whole hour drive home, and spent the rest of the night in a tired, crabby haze.  We woke him up every few hours for pain meds, and for the most part, he is back to his old self today.

Waiting for drugs - it took 10 minutes, but he just sat like this the whole time.  

He is happy and giggly, and surprisingly unhindered by his cast.  He is already crawling again.  He can stand on it, but we try not to let him because that can interfere with the skin graft.  When I put him in his walker, he uses his good foot to push himself around while his gimp foot drags behind.  It's adorable and so sad.  We are having a really hard time keeping his finger covered, and the wound is super gross to look at.  The stitches freak me out!  He's taking tons of antibiotics, but I'm worried that all the exposure will lead to infection.  It turns out surgery was the easy part!

The big wrapping is needed because anything smaller, babies can kick out of.  It ensure that the skin graft takes by keeping it safely in the same place.  It isn't a proper cast, just lots of thick wrappings and (I think) some kind of foam or form underneath, because the part from the knee down is quite firm.