Sara's Second Surgery

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" height=95 BGCOLOR="#003399" TEXT="#080000" bgproperties="fixed" background="048005f0erkjxk.png"> <div> <FONT SIZE="5" COLOR="#FFFFFF" FACE="Arial" ><B>Kentucky Spellmans</B></FONT><B>     </B><B>|     </B><A HREF="index.htm" TARGET="_top" TITLE="Kentucky Spellmans"><U><B>home</B></U></A></div> <div> <A HREF="id79.htm" TARGET="_top" TITLE="Birth to Three Months"><U>Birth to Three Months</U></A>   |   <A HREF="id82.htm" TARGET="_top" TITLE="Three to Nine Months"><U>Three to Nine Months</U></A>   |   <A HREF="id84.htm" TARGET="_top" TITLE="Sara 9 to 12 Months"><U>Sara 9 to 12 Months</U></A>   |   <A HREF="id96.htm" TARGET="_top" TITLE="Sara 1218 Months"><U>Sara 12-18 Months</U></A>   |   <A HREF="id80.htm" TARGET="_top" TITLE="Saras Birth Injury"><U>Sara's Birth Injury</U></A>   |   <A HREF="id92.htm" TARGET="_top" TITLE="Saras Primary Surgery"><U>Sara's Primary Surgery</U></A>   |   <B>Sara's Second Surgery</B>   |   <A HREF="id97.htm" TARGET="_top" TITLE="Sara 18 to 24 Months"><U>Sara 18 to 24 Months</U></A></div> <div> </div> </td> </tr><tr> <td valign="top" height=385 BGCOLOR="#003399" TEXT="#080000"> <div> Sara's Second Surgery</div> <div> Even though Sara recovered wonderfully from her first surgery we knew that a second surgery was inevidable.  Sara seemed to have recovered considerable sensation in her arm following the initial surgery.  She also seemed to have a fairly stable shoulder, some strenth in her triceps muscle, and we were starting to see flickers of some biceps muscle movement.  However, because of an imbalance of strength in her muscle groups she had developed a very tight shoulder with a restricted range of motion.  Her shoulder was also internally rotated in a fashion very commonly seen in association with this injury.  The goals of the second surgery were to increase her range of motion to the shoulder, as well as reducing some of the mismatch between muscle groups.  In fact some of the stronger muscles were moved to increase her strength in the shoulder.</div> <bR> <div> So on February 16th, 2004 we journied back to Houston for a second surgery.  Sara seems to handle these trips better than Julie and I do.  I guess she's not burdened with the knowledge of what lies ahead.  On the morning of Feb. 17th she had her second surgery known as the Mod-Quad.  </div> <bR> <div> There are four parts to this procedure (thus producing the "Quad" name):</div> <bR> <div> <B>1</B>, latissimus dorsi muscle transfer for external rotation and abduction </div> <div> <B>2</B>. teres major muscle transfer for scapular stabilization </div> <div> <B>3</B>. subscapularis muscle release </div> <div> <B>4</B>. axillary nerve decompression and neurolysis). Depending on the individual child, other nerve decompressions or muscle/ tendon transfers (such as pectoralis muscle releases) might be performed at the same time (the modified quad or "Mod Quad" procedure). </div> <bR> <div> The procedure was performed by Dr. Nath.  He is one of a team of physicians at Texas Children's Hospital who are very dedicated to caring for children with Sara's injury.  If you click on the following link it will take you to Dr. Nath's web page.  His page has extensive information about the injury and the surgeries to correct it.</div> <DIV ALIGN="LEFT"></DIV> <div> <A HREF="http://www.drnathbrachialplexus.com" TARGET="_top" TITLE="http://www.drnathbrachialplexus.com"><U><IMG SRC="6a6b4680.jpg" border=0 width="180" height="104" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></U></A></div> <bR> <div> This surgery was much shorter than the initial surgery, only about 1 hour.  Sara did excellent.  She had a bit of a hoarse voice and upset stomach the first day.  In fact, she got sick on Julie a couple of times.  The first time the nurses gave Julie a scrub top to wear.  After the second episode Julie ended up in a hospital gown until I could get to our bags and get her some clean clothes.  Sara was quiet the first few hours after surgery but didn't take long to get back to her energetic little self.</div> <DIV ALIGN="LEFT"></DIV> <div> <IMG SRC="6a85ee90.jpg" border=0 width="350" height="233" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> <IMG SRC="6aa5ee90.jpg" border=0 width="350" height="233" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <bR> <div> As you can see she came out of surgery wearing a temporary splint which keeps her arm extended out to her side and raised above shoulder level.  This was replaced the next day with a form-fitting plastic splint that she will wear full time for the next 3 weeks and at night for the following 3 weeks.  You might think that such a contraption might slow her down but nothing could be farther from the truth.  Early the day after surgery Sara was clean, dressed and then took a short nap before it was time to get fitted for her splint.</div> <DIV ALIGN="LEFT"></DIV> <div> <IMG SRC="6b0df4e0.jpg" border=0 width="223" height="334" ALIGN="BOTTOM" HSPACE="0" VSPACE="0">  <IMG SRC="6aeb9260.jpg" border=0 width="441" height="294" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <bR> <div> Once she had the new splint it was time to run.  Julie and I spent the rest of the day after surgery chasing Sara around the floor where she was staying.  There were several fish tanks that we frequented and Sara also spent some time entertaining the nurses with her dancing.  Ultimatly, if we weren't moving she wasn't happy.</div> <DIV ALIGN="LEFT"></DIV> <div> <IMG SRC="6b25ee90.jpg" border=0 width="350" height="233" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> <IMG SRC="6b45ee90.jpg" border=0 width="350" height="233" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <div> <IMG SRC="6b65ee90.jpg" border=0 width="350" height="233" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> <IMG SRC="6b85ee90.jpg" border=0 width="350" height="233" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <div> <IMG SRC="6bacf360.jpg" border=0 width="207" height="310" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> <IMG SRC="6bccf360.jpg" border=0 width="207" height="310" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <div> <IMG SRC="6c05ee90.jpg" border=0 width="350" height="233" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> <IMG SRC="6c25ee90.jpg" border=0 width="350" height="233" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <bR> <div> On the second morning after surgery the surgeon pulled the little drain that was in her wound and we were discharged.  We gathered our things together, visited the fish tanks one last time and then made our way to the airport.  Sara is becoming quite the experienced flier.  She does OK on the airplane but trying to hold her still was a challenge for Julie.  Fortunately for all of us she did sleep most of the way home.</div> <DIV ALIGN="LEFT"></DIV> <div> <IMG SRC="6c45ee90.jpg" border=0 width="350" height="233" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> <IMG SRC="6c85ee90.jpg" border=0 width="350" height="233" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <div> <IMG SRC="6ca5ee90.jpg" border=0 width="350" height="233" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <bR> <div> So now we're back home and trying to return to buisness as usual.  It seems to be more of an adjustment for the rest of us than it does Sara.  She continues to run and play.  Because her arm sticks out to the side she is bumping into lots of things.  I don't think it will take too long before she adjusts to her new personal space.  She has already taken several spills wearing the splint.  She gathers herself and pops right back up.  Even wearing the large splint she is able to roll over and get up on her own.  The biggest adjustment for her has been being forced to sleep on her back because of the splint.  </div> <DIV ALIGN="LEFT"></DIV> <div> <IMG SRC="6cc5ee90.jpg" border=0 width="350" height="233" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"> <IMG SRC="6ce5ee90.jpg" border=0 width="350" height="233" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <bR> <div> Overall, the surgeon was very optimistic about Sara's chances of having a normal appearing arm and a highly functional arm.  Julie and I have already seen a few new movements.  We are cautiously optimistic about the results of this procedure but only time will tell.</div> <bR> </td> </tr></table></body>