Monday, July 19, 2004

Our meeting with Dr. Moore – orthopedists – did not go as expected. Unlike previous meetings where hip replacement had been described as a relatively straight forward procedure, we heard “this will be a very difficult 6 to 7 hour operation with no real way to guarantee the outcome”. He cited three complicating issues; the extensive history of infection, the considerable hardware (screws, plates and anti-biotic balls) which remained in the hip area, and the significant shortening of the leg as a result of the girdlestone operation (see http://www.eng.auburn.edu/~sfh/4-20-04.htm).

Additionally, we were blind sided by Dr. Moore’s announcement that he was leaving his practice at Piedmont Hospital. He introduced us to his colleague, Dr. McDonald, who would be taking Stevie on as a patient. Dr. Moore assured us that he would assist in Stevie’s surgery(ies) but it would be Dr. McDonald providing all pre and post surgical consultations, as well as taking the lead in the surgery(ies). We were comforted somewhat when told that Dr. McDonald assisted Dr. Moore during the girdlestone operation suggesting he has a full understanding of Stevie’s case.

Though both Dr. Moore and Dr. McDonald seemed undecided on this point, the procedure might best be broken into two operations; the first to clean out the now useless hardware and the second to replace the hip. This would ease the difficulty of the procedure but add to the risk of complications – two major surgeries instead of one – and require two recovery periods.

Regardless of the number of surgeries, after hip replacement, the ball and socket will not be aligned. After the girdlestone operation, the muscles and tendons pulled the shortened femur up toward the hip. Ten to fourteen days of in-hospital traction will be required to stretch the leg, aligning the new ball and socket allowing the ball to be seated.

The needle biopsy -- to see if there is any remaining infection in the hip -- we understood would be taken this meeting was instead given as an order for EAMC (local hospital) to fill along with several other blood tests. These tests must come after Stevie is completely over her GI tract C-Dif infection for which a course of antibiotics has four more days to run. Given that she has had two relapses of C-Dif, we plan to wait several weeks before the biopsy.

The now elongated and very sketchy time-table puts the “clean-out” surgery at the earliest in November followed by a six month recovery before hip replacement. If they decide to do it all in one operation then the earliest appears to be January.

Stevie, now fully cognizant, shared Susan and my disappointment.

Upon leaving Dr. Moore and Dr. McDonald, we crossed Peachtree Street to the Shepherd Center. Waves of memories hit Stevie with every corner we turned – both in and out of the center. She describes the memories as being like those of a dream – but none-the-less memories.

We had the fortune of seeing Dr. Bilsky, her rehab doctor, who, along with her nurses was absolutely amazed and excited by her progress: A wonderfully positive ending to the day.

Susan and I remain acutely aware of our fortune in Stevie being with us in mind, spirit and mending body. Our disappointment is momentary, fading as we realign our expectation. Our faith remains strong.