Saturday, September 5, 2015

No Strangers to Disappointment, But Still...

For those who have been waiting...

We are no strangers to disappointment on this journey. My Timehop app has proved that over the last couple of weeks, as I've relived the nightmare of Kennedy's second ear reconstruction and the MRSA that destroyed all hope of her having a permanent ear four years ago. And that's only one example. We're never ready for disappointment, and we're never equipped to handle it gracefully. But we do what we have to do to get through it and get her healthy and do the best we can for her. 

Once again, disappointment has reared its ugly head. And once again we weren't ready and I'm struggling with how to deal with it. Goldenhar is complex to say the least. It involves many body parts and systems and there is never really much rhyme of reason as to when the next major hurtle presents itself. 

In February, we went to visit Kennedy's orthopedic surgeon and I knew it wasn't going to be great news. Last August had been the best x-rays of Kennedy's recent years, down to a scoliosis curve of 28* and her rib cage still growing on its own. Going into that February appointment, I knew her "good" shoulder blade was sifting which most likely meant her spine was shifting. The February x-rays showed that the curve had worsened to 38*, that the spine was starting to twist, and that her shoulder blade was being shifted. It was time to brace. Kennedy has been wearing her torture device almost every night since, trying to keep things stable and pull her shoulder blade back into place. 

I knew it wasn't working...you could tell by just looking at her. But in the meantime, we had taken her surgeon's suggestion to visit a chiropractor, to see if he could help loosen things up and try to gain more mobility and flexibility. He took x-rays so he knew what he could and couldn't move, what had a chance of benefiting from chriopractic techniques. A couple of days later, we went in to discuss the x-rays and hear his plan for moving forward. As he brought the x-rays up, Kennedy listened to him explain what we were looking at and how he was going to help her. I couldn't even listen to his word...I was looking at the x-rays thinking HOLY SHIT. They were so much worse than her February x-rays. Not only was the scoliosis curve measuring at 60*, her rib cage was also shifting and her lung and heart were clearly in danger. 

Which brought us to Friday's appointment. I emailed the x-rays off to her orthopedic surgeon and he agreed that there was reason for concern. So Katie and I went in to see him Friday morning. He sat in his office with us, answering all my questions. He tried to be optimistic, but bottom line is that surgery is inevitable. Highlights, if you can call them that (and I'm probably forgetting some):

- The spinal curve itself isn't the big concern. But it is causing many other issues that are huge concerns. Because she has always dealt with spinal issues, he thinks this is a blessin as she isn't in constant pain like other girls her age would be who are just developing scoliosis. 
- Because of the curve, her rib cage on the left has shifted drastically. This is causing her heart and lung to be moved/squeezed/in danger. Kennedy has always had lower capacity than most kids her age, but we have noticed this worsening over the last few months. 
- In addition to the shift of the rib cage, he is also afraid that the left rib cage is also starting to collapse inwards. There is no easy fix for this. 

Her doctor is not performing surgeries right now so we meet with a Duke doctor on Thursday. It will be his ultimate decision on what needs to happen and when. But it sounds like:

- A spinal fusion will be done to straighten the spine as much as they can. This may get her down to the 20s, but it also depends on how flexible her spine is once they would get in there. 
- She will most likely have to do respiratory function testing and nerve mapping before undergoing surgery.
- Spinal fusion means at least a week in the hospital, some of this in PICU. There is a chance that the surgeon will decide to go a different route, which means she could be stuck in the hospital for months in traction, between two different surgeries.
- Her current doctor is worried about the huge shift this will cause on her rib cage/lung/heart all at once and she may not be able to be extubated until at least 24 hours post-surgery. With her history of extubation, this scares the hell out of me. 
- Spinal fusion would mean missing 4-6 weeks of school, and 3-6 months to return to regular activities. She will have to learn how to move in a whole new way. 
- Her spine will quit growing where it is fused. However, he thinks she will gain at least one inch upon straightening. 

Timing is a huge question right now. Her current doctor isn't sure she can wait till summer, which is when they try to schedule these due to the school aspect. And we're not sure that would be the best choice anyway...she starts high school next August and stressing over healing in time for that may be too much for all of us. With her increasing shortness of breath and fatigue, he is thinking it will probably need to be sooner rather than later. This will cause some extra heartache due to some things that are in the works, including a possible trip to Disney and a trip to the Bahamas so she can scuba with a renowned shark expert. But no time is a good time. 

I hate Goldenhar Syndrome with all of my being.

For now, I've had the blessing of keeping all of this from Kennedy. With the death of a friend from cancer (something else I hate with all of my being) and his celebration of life today, she has had enough heartache to handle at the moment. But between now and Thursday, I must fill her in. Those who have lived through the age of 13 with a girl can only imagine how this is going to play out. At a time when we have to work to bring her out of her teenage moods, we were warned that this will probably make that even worse. Life will be a nightmare for awhile in the Hendershott/Goodwin household. 

In the end, we will depend on the love and support of Team Kennedy. What would we do without you?

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