Upcoming Surgeries

So yesterday (4/22), Trent went in for several appointments, (1) Orthopedic, (2) Urology and (3) general Surgery.  It was definitely a hectic day.  Aside from the visit, he also had X-ray on his hip, and Ultrasound on his kidneys.  Couple this with a last second visit for his twin Brother on a bad cough with a pediatrician.  All in all I'd say it was a good day with positive comments from all his doctors.

His Orthopedic surgeon was very please on how Trent's hip socket has actually improved rather than get worse.  We think its attributed with all his physical activities he's been doing to mimic his twin brother (crawling, trying to stand and climbing over stuff).  His orthopedic surgeon compared his xray from when Trent was 6 months and 1 year and it actually showed improvement, his hip socket was actually forming relatively well.  Although not the normal development, it was considerably better and favorable.  On the other hand it WILL still require surgery to completely correct and thus orthopedic surgery can be scheduled for as soon as when Trent turns 17 months old.  This surgery will entail the forming and rounding of his hip socket and re-positioning it followed by six weeks of being in a cast (this will suck).

Shortly after his ortho visit, he went in for his ultrasound of his kidneys, and a visit with his Urologist Dr. Kennedy (of LPCH).  Dr. Kennedy was please with how his kidneys are doing and also said it is growing quite nicely.  He emphasize how important this is because children with bladder exstrophy tends to need to pay closer attention to their kidneys.   With this news, Trent is now one step closer to his epispadius surgery.  Dr. Kennedy does want to perform a visual scope of his bladder (putting a camera through his urethra and checking to ensure all is well).  If this goes well, he will be ready for the surgery sometime this summer (July/August).

So now is the scheduling dilemma,  The epispadius surgery requires a 6 month recovery and cannot include any other procedures.  So this would put the recovery completion at Dec/Jan.  And thus the hip surgery cannot occur until next year.  The hip surgery cannot occur until Trent is at 17 months of age at the earliest and so would also push the epispadius surgery out to next spring as well.

We will inquire for a medical opinion, but will pursue the epispadius surgery as a priority.  It will facilitate him being in cast for 6 weeks better than having the hip surgery first and things going the other way.

On a side note, we also saw his general surgeon for a general visit and status on the baby steps to evaluating if Trent would be a candidate for a "pull thru".  He'll have a MRI first on his lower abdominal region and buttocks area to check for muscles and reflex.