Tenotomy

We arrived at Shriners this morning right on time, and within just a few minutes were up in a room waiting for the doctor. The fellow came in and asked us some questions while examining Elias. Through talking with the fellow, we found out that the doctor we would be seeing that day actually specializes in Arthrogryposis. He asked us what the current plan was for correcting his feet. We shared with him what our doctor back in Boston is planning to do, and he went on his way to share what he learned with the doctor. We went into the casting room and waited for a bit for the doctor. One of the things we always do is try and time out Elias' bottles around his castings. While they are applying the cast, I feed him the bottle, and he doesn't cry or fuss...hes totally distracted, works like a charm! So at this point he was getting pretty fussy as it was time for his bottle. The doctor came in and the fellow explained to him Elias' issues. The doctor then proceeded to tell us what he wanted to do...and it wasn't just to put a new cast on...

He said he wanted to do a tenotomy on his achilles tendon (cutting the tendon). Now, this is a procedure that our doctor was planing on doing toward the end up Elias' series of casting. This doctor however said that in his studies, he's found that by doing the tenotomy in the beginning of treatment for the clubbed foot, he acheieves much higher levels of success, and most don't need any other surgeries. Our goal (and our doctor in Bostons goal) all along has been to try and avoid surgery as much as possible. So what this doctor was saying made sense. But we weren't prepared to make a decision like that so quickly. We knew the tenotomy would happen eventually, but right then and there?! With a doctor we hardly even know and will probably not see again? Kevin and I told the doctor we weren't comfortable making a decision like that without conferring with our doctor first. So they called up to Boston and were able to get ahold of our doctor. The doctor explained to our doctor what he had found in his studies and shared his opinion of what treatment should be like. I got on the phone afterwards, and my doctor reassured me that we were in good hands. Apparently the doctors actually knew each other, which was nice. I was afraid our doctor back in Boston would feel underminded. But our doctor explained that this doctor knows what he's doing, and if he has a way that will help Elias achieve greater mobility in his feet, then we should do it.

So with that said, we gave consent to have the tenotomy done right then and there in the room. First then numbed the skin with some numbing cream for about 25 minutes. Then Kevin and I left the room while they gave him another novicane shot and then did the tenotomy. We were back in the room with him within 5 minutes. He was a trooper! He was upset, but we calmed him down relatively quick. They then put a plaster cast on to continue to turn his foot to get it positioned correctly. Immediately after the tenotomy, even with the cast on top, there is already noticeable improvement. Its amazing how much that tendon was holding back his foot from making much progress.  They took before and after pictures, so as soon as I get those in my email I'll post them.