Sunday, February 22, 2009

Casting

Sorry to take so long in updating. I was hoping to post some photos alongside the latest news but have misplace a necessary cable. Oh well, I will do my best to add those as soon as possible.

On Wednesday the 18th, I took Maxim to Grand Rapids for his first visit with the specialists. Dr. Donnie Reinhart is in charge of his care on the road ahead but is part of a team who will review all of the x-rays and work together in deciding the best approaches for helping Maxim.

Daniel and I knew before we even went to Ukraine that Maxim has club feet and issues of some sort with his hips. Obviously, through the x-rays, we have a much more detailed vision of Maxim's condition.

First of all, the doctor could see, with the x-rays and scars on Maxim's feet and heel-cord areas, that surgery was attempted at some point in Ukraine but was not successful. We had noticed some, but not all, of the scars and wondered about this.
Dr. Reinhart says that the techniques used were probably done with the best of intentions but without the knowledge available in more advanced medical communities, and therefore was of no benefit to Maxim. It is actually now to Maxim's disadvantage because it created scar tissue that our local doctors will have to work through/around at some point later this year.

None of our translated medical history papers from Ukraine noted any surgeries so we will never know whether certain papers were never transferred from the baby house to the orphanage or if certain details were "conveniently left out" of Maxim's history by the people we dealt with in Ukraine. Either one is a real possibility but it's okay if we never know the answer. It is enough to just start from what we know now and look to the Great Physician for wisdom, strength, and healing for Maxim.

After seeing the x-rays taken, Dr. Reinhart spelled out for me that Maxim has severe club feet, a condition in both knees causing certain parts to be pushed to the outer side of each one, a slightly dislocated left hip, and a severely dislocated and mal-formed right hip.

Dr. Reinhart explained that the best approach with the club feet is to cast Maxim's feet repeatedly into progressively more correct position, and then do surgery after as much as possible has been accomplished through the casting manipulation. Because there was a time spot available that same day, Daniel and I decided to go ahead and let them start the casting process on Wednesday. So Maxim is now in full leg casts and will have them taken off and reapplied in a slightly different position every Wednesday morning for the next four weeks at least. During these weeks, Dr. Reinhart and the rest of the team will be evaluating how Maxim's feet are progressing and the maximum amount of correction that can be made for Maxim's feet, knees and hips under one anesthesia when surgery is done later this spring.

As expected, Maxim had trouble sleeping very well the first few nights. Uncomfortable from the casts themselves and likely experiencing some muscle spasms due to his feet being forced into a little different position. Wednesday night I put him on the living room couch and slept on the floor next to him. He woke up every half hour to hour, hurting. I had explained to him that the casts would be on for many days and then the doctor would take them off and build new ones. Several times, Maxim asked if maybe he could just have the casts on for one day and I had to explain again that many days were necessary. Thursday night, we put him in his usual bottom bunk in the room he shares with Joel and when I woke up on Friday I realized I had not heard a sound out of him during the night. I figured he must have rested well. However, Joel told me Maxim had once again wakened several times during the night and Joel, not wanting to disturb Daniel and I, had comforted Maxim over and over through the night. I felt bad that the boys didn't sleep well, but really proud of Joel for being so thoughtful to Daniel and I, and encouraging to Maxim. I felt like that was such a mark of maturity in Joel. He is really growing up. Certainly, imperfect like all of us, but some pleasant evidence of taking the initiative on being more responsible. Good job, Joel!

Friday and Saturday nights, Maxim slept so much better. During the days, he has been pretty much himself and quite the trouper. The casts are heavy, of course, so this slows him down but the fact that they are full casts in a slightly bent position (properly bent about twenty degrees so he can still sit easily) is actually allowing him to be pretty active. He won't be enjoying boats in the bathtub for awhile but still has a good time scooting around to gently "wrestle" or play tag.

We have really noticed an increase over the last week in how many English words Maxim remembers and repeats. Toilet paper, shampoo, dishwasher, dancing (he loves to watch Brina and Cyan practice), car, van, church, "Come on, Ninny" (calling our dog, Sydney), etc. I keep telling myself I need to get more of his voice on video and/or our digital voice recorder. It will be so neat to listen to later.

2 comments:

ArtworkByRuth said...

Glad to hear that treatment has started, so sorry his prior surgeries were botched! The lack of information is common, we found that even knowing that a surgery may have been done, there are not details to be given or understood. The doctors at the orphanage are not necessarily surgeons, orthopedists or even pediatricians...I have heard some being allergy specialists, or other non-related fields.
Praying for complete healing! God Bless!

junglemama said...

It's good to hear he is getting used to the casts. Pretty soon this will be a thing in the past.