James' Spring Surgery

The day after Christmas 2013, just as we were ending James' stay in the NICU, I had a discussion with one of the neonatologists concerning the shape of his head. Apparently some of the nurses suspected that he may have a premature suture closure. The doctor assured me that he had only seen a handful of cases in 20+ years in the medical field. I felt confident that he was fine and perhaps the symptoms were coincidental.

They weren't. 

James, 2.5 weeks before surgery

James, 2 days before surgery

Two weeks later, James, Brian and I met with Dr. Ian Heger and Dr. Jack Yu at Georgia Regents Health to discuss how to tackle his sagittal craniosynostosis. Both said that there was the traditional method--separating the skull at the closure and wearing the helmet for about a year, but that there was a newer, less invasive procedure which involved placing springs in his skull, also known as endosopic spring cranioplasty. Unfortunately, the manufacturer of the springs had not released them yet and Yu and Heger were not sure if they would be available for James' surgery.

We went ahead and scheduled the surgery for February 26 and were prepared for either procedure. The day before surgery, we met with Dr. Yu who informed us that the springs were available and that James would be the first person to ever receive this surgery from a manufactured source. The engineer for the spring would actually be in the operating room during his surgery.

 

On the day of surgery we reported to the operating room, eagerly anticipating the procedure that was about to take place. Letting go of him outside the operating room was not easy, but my confidence in the doctors was strong, but my faith in God to care for him was even stronger.

 

We waited. And waited and waited. The actual surgery only lasted about an hour, but the prep time took a while because they had to go very slow with the anesthesia. He had trouble breathing after the surgery and required a breathing tube for about 24 hours. He spent two nights in the PICU, one night more than expected due to the breathing tube. He was also very swollen all over his body post-surgery, but Dr. Yu assured me that was very normal for any surgery.


 

While on the breathing tube they kept him pretty sedated with morphine. After the tube was removed, they began administering acetomeniphen for pain. We were a little shocked that they would go from something so strong to a much weaker drug, but he did well and only required a few doses. 

That is until they removed the bandages. Once the cushy padding was gone, it was fairly painful for him to lie down. The doctors really wanted him to lie with his head flat on the bed (not turned on the side) to prevent the skull from reshaping abnormally. This really hurt him. Through Loritab and placing a pillow under his head we were able to make him comfy and hold his head in position. 

Overall the surgery has already proven successful. We can already see a huge improvement in his forehead and are starting to see a difference in the back of his head. The springs are very visible through the skin but easily covered with a hat. I am not sure how long they will be visible but he will have them completely removed in June. The removal could be done as an outpatient procedure, but because he will only be 7 months in June, we will have to spend one night in the hospital to make sure nothing happens after the removal. 

Five days post-op.