Whitney's surgery to repair her myelomeningocele took about four hours today. As we mentioned yesterday, Whitney's lesion was a little larger than a half dollar. It was slightly wider than it was long. The area under the skin was somewhat larger yet. I took the picture to the right shortly after Whitney was born. You can see that there is a membrane over the lesion and that there is no cerebro-spinal fluid escaping from the site. That was good news. From birth until the surgery, the nurses in the NICU kept the lesion moist.
Our pediatric neurosurgeon operated to place the spinal cord back in the spine. That part of the operation took about two hours. The pediatric plastic surgeon took the better part of an additional two hours to close the skin and muscle over the wound. You can see what Whitney's repair looks like in the picture on the right. The doctors said that Whitney will not be able to lay on her back for about two weeks to allow the wound time to heal. Because of the heat from the incubator, the wound is covered with a piece of moist gauze to keep it cool.
Both surgeons gave us positive reports. The pediatric neurosurgeon reported that the injury to Whitney's spinal cord started around L3-L4 (lumbar vertebrae 3 & 4 or roughly near her waist), which is slightly lower than we expected. She retains a small measure of nerve function below that point. The pediatric plastic surgeon reported that the skin closure went well. If Whitney did not have enough skin around the lesion, the plastic surgeon would have had to make additional incisions to gather more skin from Whitney's sides or use skin grafts. Praise God that the plastic surgeon was able to pull her skin together without resorting to either process. In the picture above, you can see wrinkles in Whitney's skin (they look like they're covered with plastic). The doctor assured us that those wrinkles will disappear as the wound heals.
Whitney is back in the NICU. Shortly before the surgery, her IV malfunctioned and they had to remove it from her hand (again). They were unable to start it in her hand or arm, so they had to place it in her head after shaving a small amount of her hair. We were warned this might happen, but it still made us feel queasy. After the surgery, she remained on a ventilator until about 8:30. We were told to expect that Whitney would be on the ventilator for up to 48 hours. So we were very pleased that she was off it in less than 4.
Whitney continues to lie in the ventilator with small rolled towels under her waist to prop her up. Her feet are angled up against her legs, and her knees are locked into a shallow "V" position. Her hips, as we mentioned yesterday, are slightly drawn towards her. She seems comfortable now, but we will be taking her to physical therapy to hopefully loosen her legs. We were told to expect that she will need pediatric orthopedic surgery to improve her comfort and the stability of her hips. No idea when that will be yet, but we'll find out soon enough. Frankly, I'm going to try to get out of the scheduling business because the Lord has taken all of that firmly in hand over the last few days!