Botox Happened

And it was no big deal.

We left before the sun was up both for pre-op and for the procedure.

Eva wasn't stoked about being in a medical facility, but she kept pretty calm for the most part.  When we were home for about six months, I took her to a local women and children's clinic to do some baseline blood work and even the NICU surgeon couldn't get a good stick for enough blood for the labs.  It was a nasty, painful, frustrating, teary business.  So naturally, our sweet, long-remembering Eva is a little bit antsy at medical facilities.  I don't blame her. 

Our primary nurse told me she liked Eva's name, Evalena.  She said they had a doctor on staff with that name, too.  The doctor is from Russia.  Seriously.  Eva ended up with a culturally appropriate name after all. 

One of the OR nurses sews up these sweet little scrub hats for the kids.  Eva chose the Little Mermaid.  She definitely rocked her hat.  

I talked to Eva's orthopaedic surgeon about my anesthesia concerns and also with her anesthesiologist.  My concerns were: malignant hyperthermia and getting the line in for the IV.  We all agreed that while the chances for malignant hyperthermia (MH) were very small, the MH protocol should be used.  The nurse was kind and said that I was a "thorough parent."  I think we all know what that means.

If you are a nerd, like me, you might enjoy reading these two articles.  They provide a good explanation of anesthesia methods used with AMC.

Anesthetic management of a neonate with arthrogryposis multiplex congenita for emergency laparotomy


Anaesthetic Management Of A Child With Arthrogyroposis Multiplex Congenita

The procedure itself went very smoothly per Eva's surgeon and actually all the staff.  There were several people in the OR: her surgeon, the anesthesiologist, two nurse anesthetists, and an OR nurse.  They all were very thoughtful and doting on our little miss.

When Eva woke up from the procedure, they called me back to see her.  Oh my goodness.  It was so good to hold her.  Daniel and I joke that she's my little koala bear, always on my hip.  It just feels weird without her. 

This is inebriated Eva, post-op in the parking lot.  She was very sweet and very dazed.  She enjoyed watching the first DVD of BBC's Pride and Prejudice on the way home.

Now our plan is to let Eva rest and do some intensive therapy.  We will monitor her range of motion (ROM), positioning in her stander, strength, and active limb use as they will be indicators of the injections' efficacy.  That will let us know if Botox will be an effective treatment for Eva.  We're excited!