They let me go into the operating theatre with him to stay with him while he got his anaesthetic. It’s a pretty harrowing experience to watch, so it must have been quite scarey for the young fellow.
He was brave. I asked him if he was scared and he said “No”. I said it was ok to be scared, then he admited that he was a bit fearful.
We clowned around in the waiting room before going in. Then, to take his mind of the whole thing, I asked him to name some capital cities while they gave him that horrible gas. (It’s a bit more creative than counting down). He managed Somalia, Sudan and Nigeria, but passed out before we got to the capital of Mongolia, but I’m sure he knew the answer anyway 🙂
It went well. The doc says they didn’t need to take any cells from his pelvis. They got some from the other bone in his forearm (ulna). The damged bone (radius) is wired together again now, and will start on the the Pamindronate therapy in a couple of weeks.
Liz is staying in the ward with him this evening. Hopefully they’ll be out tomorrow.
He broke his radial head (end of the forearm bone near elbow) in June. We were worried that the lack of circulation to the broken end of bone would stop it healing.
A nuclear scan led us to beleive that the bone had good circulation, but it was wrong. A later MRI scan showed that there was no blood getting to the broken bit of bone. That’s why it didn’t heal. So after more than 6 weeks, Harrison’s broken bone hasn’t joined back up.
MRI’s have a much higher resolution, so it was much easier to see what was going on after Harrison had the MRI. The attached image is a sample MRI of an elbow joint. It’s not Harrison’s elbow, because the hospital doesn’t give out MRI’s but it gives you an idea of the much better resolution that’s available.
Since the bone isn’t healing, our doctor has recommended a bone graft. They’re going to take a small amount of bone from Harrison’s pelvis, put it into the break in his arm, and wire it together.
The scarey thing is that they’re going to give him a drug called Pamidronate. It slows down the natural breakdown of the bones. In most of us, our bones are in a state of equilibrium – bone cells get created while others get broken down. When you take Pamidronate, your bone cells don’t break down. They just keep growing. There can be some nasty side effects like Kidney failure, seizures, breathing problems etc. But if it works, it will encourage the bone graft to take, and hopefully heal Harrison’s elbow.
Because of the seriousness of the drug, Harrison will have to go into Hospital for a full day of tests every month while they he’s receiving the drug.
This is hard work for all of us. But it will be worth it if Harrison’s arm heals. The alternative for a growing seven year old isn’t very nice. The bit of bone that broke is a “growth plate”. It’s where his forearm bone would normally grow from over the next decade. This won’t happen if that bit of bone dies, and he’d need an artificial “spacer” to replace the dead bit of non-growing bone.
A lot of kids break their arms, but this was a bad break for a number of reasons.
1. The bone was completely broken right the way thru.
2. The break was at the top of his radius, i.e. on his forearm up near his elbow.
3. The periosteum (coating on the bone) was about 75% to 80% stripped away. This coating is necessary to supply blood to the bone. Without the coating, the bone dies and stops growing.
4. (To top it all off) He dislocated the bone as well.
The doctor put a k-wire (metal pin) in his arm to hold the bones together, then plastered him up. His assessment was that there was about an 80% chance that the damage to Harrison’s arm would cause the bone to die.
Four weeks later, they removed the cast (and the metal pin) and did a bone scan. That involved putting Harrison under a camera that could detect nuclear radiation, then injecting him with a radioactive dye that would circulate through his blood, and eventually get into his bones a couple of hours later. By recording how much of the dye was absorbed by his bones, they could tell if there was enough blood supply to his elbow, and whether or not it was healing.
The process is amazing to watch. At first the screen is black, because we’re not naturally radioactive. Then as the dye is injected, you see a bright streak on the screen as it passes through the veins to the heart, and then diffuses throughout the body via the arteries in a matter of seconds. The image that is formed is a bit like the one on the left (except that’s not Harrison, just an example I found on google).
The good news is that after spending hours getting it, the scan shows that there is plenty of blood flow to Harrison’s injured arm, and he’s going to be ok.
Liz and I are very happy, and grateful to the amazing staff at RBWH. We’ve been in there quite a few times with the kids, and we know that they’re in safe hands.
We’re also very grateful for Harrison. He had a precarious start to life, seven years ago, and we almost lost him. He’s beaten the odds again, and we’re so glad he’s here.