Thursday, August 14, 2014

Another Perspective

Today was Hannah's appointment with Texas Children's orthopedics department.  I am thankful that we were able to get an appointment so close to the Shriner's appointment while all the information is still fresh on our minds.   The appointment was @ 2pm in Sugar Land so we took the boys to Bryan's parents' house around lunch time.  We were then able to get on the new Grand Parkway toll road that took us all the way from Cypress to Sugar Land in around 45 minutes with no traffic.  It was fantastic and so much less stressful than driving to the Medical Center!

We were taken back to an exam room at 2pm but unfortunately the doctor did not come in until around 3:15.  Luckily we had "bee bee" aka Hannah's baby, snacks and Mickey Mouse Clubhouse on YouTube.

Waiting in the exam room with Daddy

A pretty sweet set up for our little 2 year old:
"bee bee", a snack cup, and Mickey Mouse on YouTube

Tired of waiting- trying to escape!

Coloring on the exam table paper to pass the time
Of course bee bee had to be sitting next to her

When the doctor came in we were up front about the evaluation she already had at Shriners and that we had also sought out the opinion of Dr. Van Bosse in Philadelphia.  This new doctor agreed wholeheartedly that the surgeries planned at Shriners were not the correct path of treatment.   In fact, he mentioned that the surgeries planned for Hannah have been proven to yield 'fair' and 'good' results-- but never 'excellent' results.  His suggestion for Hannah was to do serial casting:  weekly casts for 5-7 weeks.  This would help to get her foot/ankle into a straight position.  However, there is a lot of tension in her foot coming from her Achilles tendon that is keeping it from being flat.  He recommended a minor procedure to release the tension in both tendons.   The goal of all of this would be a flat, brace-able foot which is exactly what we are hoping for.

This new surgeon's plan is perfectly in line with the recommendations of Dr. van Bosse in Philadelphia and with what most people agree is the best approach for club foot caused by arthrogryposis.  While Hannah's feet may look like a typical presentation of club foot, the underlying issues in her anatomy will mean that her feet will always fight to go back to this position.  She will likely always need some kind of orthotic or bracing at night to keep her feet corrected.

We felt like the surgeon today was optimistic about Hannah's prognosis and realized that we were there to make a decision for our daughter.  He encouraged us to think over his plan and do what we felt was best for her.  We were not surprised to hear that we are not the first patients who have come to him after having a less than pleasant experience with the other surgeon.  This new doctor also emphasized that casting is a great way to start because it is essentially 'no harm, no foul'.  We can't do any harm by casting her feet, but we could do lots of harm by rushing to the OR and cutting up the structure of her foot!  At the end of her exam the doctor dictated his note for her chart in front of us.  This was a good way for us to listen again and get the full recap of his assessment of Hannah.  Hannah was less than interested in what he had to say and whined to get Bryan to let her use the hand sanitizer mounted on the wall. He gave in just to keep her quiet and she proceeded to sanitize her hands at least 20 times while the doctor spoke 90 to nothing doing his dictation.  I had a hard time not laughing.

Leaving these kind of appointments is tough because it is like drinking from a fire hydrant.  It takes me awhile to process everything and I'm always so thankful I have Bryan to talk through everything.  Bryan and I discussed our experience today and have decided to pursue treatment at Texas Children's.   We want to research the specific tendon release this doctor suggested to make sure we are comfortable with it, but other than that this feels like a good fit for us.  The scheduler is supposed to call me tomorrow morning to set up Hannah's 5-7 consecutive appointments for casting.  We are not sure how soon they will fit us in but trust God is sovereign over the timing of Hannah's treatment.

We feel so much better about the plan for Hannah now that we have another opinion and new opportunity for treatment!  While wearing double leg casts is going to be no fun, we are hopeful and excited to see the results of this treatment.  It's our hope that Hannah will make great progress towards walking after she's received treatment from Texas Children's!

Wiped out after a long appointment & missing her nap


  1. Love Texas Children's!!! I am always impressed with their approach! Your girl is precious! Miss seeing you guys on Facebook, but I am too busy to keep up. Prayers for the casting to do its job! Hugs!

  2. It's wonderful you were able to find a doctor who listened to your concerns and were able to find a different approach.

  3. So glad you trusted your gut and received more opinions. Its so hard to make decisions regarding our children, Bravo to you for being a great voice for your girl!!