The Strickland Family Blog

Hello everyone,
Paris had surgery yesterday, March 15, 2011 at Childrens Memorial Hospital to place growing rods along her spine. We arrived at the hospital at 6am and I took  her back at 8:20.  She fell asleep quickly through the cherry flavored gas that filled her little mask.  I walked away debating with myself; questioning and debating “am I or am I not doing the right thing”.  I just kept telling myself all the factors that favor doing it now and every specialist had recommend it to avoid a more significant curve and ultimately to avoid a permanant deformity.   The thought of surgery near the spine just overwhelmed my mind with the what if something goes wrong and the decision I made to help her actually risks her ability to be mobile and causes her not to be able to walk.   The thought of being just one nerve away from making a mistake, the thought of this is the first surgery that is not the removal of a tumor, the thought that I actually had time to plan this surgery rather than be told ” we found a tumor and tomorrow we are going to have surgery to remove it leaving me no time to process it-just react.  So as I left her with a million thoughts racing in my mind as I walked 2 feet down the hallway I reached the waiting room and met my family who surrounded Ralph and I.  The  4-6 hour wait began.  Tick tock…tick tock…have you ever noticed that the time moves so slow when your waiting for something.    I received the first call at 10:20 which said that they made the first incision and that the spine was exposed.  The OR nurse said that she was fine and asked if I had any questions.  The calls are similar to a secret service call- your on the phone for less that 1 minute given a brief update and a confirmation that they will call you back.  At 1:04 I received the 2nd call that said that they were placing the hardware (screws and plates) and at 3:08 got the 3rd call that said they were placing the rods and that it would be another 2 hours to complete.  The 3rd phone call indicatetd that her nerve monitoring throughout the process did not indicate anything unusual during surgery.  The surgeon called us at 5:15 and said that she was recovering in ICU and that the surgery went well with no complications.  He noticed an immediate improvement approximately 20-30 degrees (I think he was surprised himself), which was unexpected as he said during our consultation the week before not to expect to notice any changes right away that it would be a slow progress slightly noticable every 6 months when they adjust the rods.  Needless to say it was a long 10 hours.  He changed his placement ideas once he had her spine exposed.  He decided to shave off some of her own unneeded vertebrae to use as bone graphing material to sotter the rods to ensure a secure placement in addition to artificial bone which added to the surgery time.
Paris looks great, moving her legs/toes and is in ICU and recovering on morphine every 10  minutes, watching disney movies, eating popsicles and is resting.  She has commented that “her back has an ouchie” but then doses back to sleep as she pushes the pain button.  They will do an X ray to determine exactly how much of an improvement there was later this week.
Paris will be inpatient for another 4-5 days and have to wear the TLSO brace for stability and protection.  The team will assess her and Im sure I’ll get a list of restrictions.  She will then have the rods adjusted every 6 months to expand her spine to hopefully a even more straighter degree.
Thanks for everyones thoughts and prayers….once again she came through with the best possible outcome.

Hello everyone,

I just wanted to give you all an update on Paris as we have decided to go ahead with another much needed surgery to place growing rods in attempts to correct her spine.  She will undergo adjustments every 6 months to improve the curve approx. 20 degrees over a span of 4-5 years ( a slow process) from tumor impact upon diagnosis.  Her surgery date is scheduled for Tuesday March 15 here in Chicago at Childrens.  The surgery will be between 4-6 hours and the approximate recovery time is 5 days inpatient and 3 weeks to fully recover.  Curves to her degree are usually seen in older individuals, but since hers is very significant (56 degrees) therefore needs to be corrected before the bones harden and it causes a permanent deformity…plus I have to try to squeeze it in between our every 3 months scans.  Please keep Paris in your thoughts and prayers next week as she again faces another surgery.

More specific information about the surgery is below if interested to hear about the details ect…

We had Paris’ final consultation with the orthopedic surgeon yesterday evening and discussed the procedures regarding her upcoming surgery. The surgery is scheduled for March 15. She will have growing rods placed, allowing the spine to be expanded every 6 months rather than fuse together with a permanent rod. She will have titanium rods placed most likely inserted along through the muscle and will  most likely attached the screws ect.  to the ribs which will do downward and connect to the pelvic area, packing some bone to bone graph to fuse the screws so that they will be more solid in place.  However since she is so small he will have to decide exactly which method of connection works well when he is with her in surgery.  I think he is still unsure of how he wants to anchor the rods and trying to decide which way of connecting the devise is best for her.  Over all she will be inpatient for 4-5 days and then discharged. She is expected to have to wear a full time TLSO brace.  He said she will be sore, swollen and will be on pain medication but kids her age are very resilient as well.  He expects that she will be out of school approximately for 4 weeks after surgery; however that number is a generic time frame and will be determined by him more specifically after he assess her after the week to come after surgery and will advice on specific PT needs after surgery after he assesses her and determines her needs as well. Overall the surgery is another necessary step for Paris in attempts to correct her curve over time.  He anticipates that there will be an over improvement of 20 + degrees taking it from 56 to approx 32. He is unsure if we will see a noted change right away. She will go in every 6 months to have the rods adjusted and do this procedure until she is approximately 9, to then obtain the permanent rod to fuse the spine. The structure itself will be able to be felt and mildly seen underneath the skin. One concern is that the actual may break or crack over time. He compared it to a paperclip wiggling due to her being a normal active young child and if you bend it so much it becomes flimsly and can weaken which then would need to be replaced.  He stated that you may not even know the structure is cracked or weakened but would tell if she complained more of back pain or it arises on x ray.  This is why he stated that he would like her back braced with the TLSO for additional support and the area towards the bottom of the spine sottered with additional bone graphing material to better hold the screws and rods in place.  

Overall its not cancer related…so I said before I’ll take whatever comes.