View Full Version : 1st Cast Thurs
21st February 2005, 09:23 PM
I did not want to hijack Andreas post so here is our update.
we saw Mr. Mc Manus this morning, even though she should not have been seen again for about 3 weeks, but with travel plans looming and a suspician on my part that her ribs were getting worse I managed to bring the appointment forward.
He took one look at her x-ray and bluntly said that she needed to be casted. When I mentioned that I was hoping to travel to the US next week, he said no problem it will be done on Thursday. Quite a lot sooner than I expected. So basically it is into a cast on Thursday, possible changing the cast after 3 weeks and if we do have to relocate to the US for the couple of months he is going to get a brace made for her so we won't have to travel back and forth to get the cast changed. The brace is only a temporary option, not a long term solution, just to get us over the few months we will be away.
He did measure the curve for me but with all the information overload I forgot to ask him what it was, I will find out on Thursday.
I am a bit all over the place to be honest, in one way I am really disappointed that the curve did not resolve itself despite the signs that it was early on, in another way I am glad that we are doing something proactive, that will yield results.
I posted her picture again, and I got a message this time to say it had been recieved. The quality is not too good because I had to reduce the resolution to make the file small enough.
Will keep you updated after Thursday,
Thanks for all the kind messages
21st February 2005, 09:35 PM
I've just put your pic through.Thanks so much for sharing.You're in a very safe pair of hands with frank mcManus.I remember him well from my days in Cappagh and he's the most experienced surgeon in the country.The brace is a great idea and will be better for the summer.I hope it all goes well.Having seen the picture I can certainly see why he casted her with such urgency.
21st February 2005, 09:50 PM
Hiya, great news that Niamh's going to be cast so fast! I had braces in the summer months and casts in the winter months as a child, which worked out really well. Please don't worry, little children just get on with everything that's thrown at them, I speak from experience when I say that she'll be just fine :-)
21st February 2005, 10:04 PM
I'm sure she'll cope well with the cast so please don't worry about that. I'm sure it's harder on us mums than it is on the children themselves as they just seem to accept what they've got and get on with it, while we worry and fuss about it.
Best of luck for Thursday. It's great that you're able to get her casted so quickly - hope it all goes well.
Take care :squeeze:
22nd February 2005, 02:05 AM
Having been a child who went through it, I can say with absolute certainty that Andrea's right: It's harder on the moms than it is on the children. I probably was momentarily scared while in the cast room, but overall I have very happy memories of my childhood.
Plus, no matter how bad it seems now, your daughter was born at a great time. There are so many options for her. The cast almost always works to at least put off surgery until her spine is roughly adult-length. And even if it doesn't, the surgical options today are not nearly as radical as they were when I was a child. No matter what happens, your little girl will have a happy, bright future. Chin up.
22nd February 2005, 09:36 AM
I can also vouch for Mr McManus. He was in Cappagh but not my surgeon when I had my fusion in 1979 and he is my consultant now. I see him every two years and I trust his judgement one hundred per cent.
Niamh will take all of this in her stride. As a kid, I also had open heart surgery and a few nasty illnesses like pneumonia and I think my mind was always on the usual kiddy concerns like when was I going to get a story read or when I might get a treat to eat, etc. I do remember being a bit scared sometimes but as long as my mum or dad (or a nice nurse/ward sister) were there to hold my hand, nothing was traumatic. And while it takes a little while to adjust to wearing a brace or cast, a child really will adapt very quickly.
Good luck. :niceone:
(based in Dublin)
22nd February 2005, 10:24 AM
Niamh and Mom, It sounds like you're going to the right guy wiith McManus and then add in all our good wishes and some hugs and you'll do fine. We all wish you the best.
22nd February 2005, 12:41 PM
Thanks all for your kind words and support.
I am feeling a lot more positive about it all today. Niamh is such a good little girl that I am sure she will take it all in her stride, it will just me that will be a mess!!.
Will let you know how it goes on THursday.
24th February 2005, 09:43 AM
Best of luck.Hope it all goes well today.Fingers crossed for a good correction and that she's comfy in her cast.
27th February 2005, 09:52 PM
Sorry it has taken me so long to update, but it has been a long weekend.
Niamh had her first cast successfully fitted on Thursday. The cast is a lot heavier than I anticipated, it is just plaster of paris and is really bulky. Niamh was very upset when she came out of her anaesthetic, and it did take her a while to settle down. She eventually did calm down and had a drink ans=d something to eat, but was very agitated because she could not balance herself to stand or sit.
We were let out after a few hours, well a bit longer than usual because she threw up all over me just as they were getting ready to release us, so we had to stay in for another while. By the time we got home, she was starting to try a few steps holding on to me for support. The next morning she was feeling much braver and was running around the place again, although getting into a sitting position, standing up and bending down are still problems for her. They assured me that this was normal and she would figure her out a new way of doing these things again herself. I have to say I am amazed at how well she is coping with it all, she is almost back to her happy sunny self today, the nights are the most difficult as she is finding it hard to find a comfortable position to sleep in, but we will get there soon I am sure.
Our next big hurdle is an 11 hour flight to LA on Wednesday for a holiday, so hopefully everything will be o.k till then.
As a matter of interest does anyone have experience of flying with a cast? The hospital have given me a letter to say it is o.k to fly but I have heard that some airlines can make a fuss about people flying with casts. Apparantly there are risks with flying with limb casts, for DVTs I presume.
Anyway thank you again for all your kind wishes, will keep you updated,
27th February 2005, 10:36 PM
It must be good to have that part over and done with.
Andrea's friend had their little girl fly from australia to Uk with her cast newly fitted and I think a letter was all that was required.Andrea will fill you in on the details I'm sure.
I know it's very stressful at the moment to have to see her try to learn to live with the cast but Toni and Kim will testify that they coped very well as toddlers with their casts.Give it a few weeks and you'll be fine.
I presume you had it done in temple street? Do you have any idea if casting is a regular treatment or something a bit unusual?
Any idea if the spine corrected will under the anaesthetic?
28th February 2005, 12:52 PM
Glad to hear it all went well. Just about to dash to lunch, but will write more later re adjustment, flying etc.
28th February 2005, 05:06 PM
Its good to hear she did so well. How did Mom do? I know it can't be easy for you. Kids adjust so quickly she'll be fine so please take a few minutes for yourself call it sanity minutes and have a bath or a drink or a prayer or a walk and just let your head get centered - You're doing a great job Mom.
28th February 2005, 08:06 PM
I know it may be asking a bit much since you're flying out on Wednesday, but
could you get a picture of the cast ? I don't know about the others, but I'm dying
to see what it looks like :-D Oh, what kind of correction did you get ? Sorry for
being so inquisitive (or is that nosy ? :-P)
28th February 2005, 08:25 PM
Just got little un off to bed, so I'm back again. Firstly, you've got over the most difficult part now - the first cast. Subsequent ones will seem like a walk in the park compared to the emotions and adjustment you go through with the first. You may find the cast lightens up a little, or has done so already. Initially it contains a lot of water, which gradually evaporates to make it lighter. I'm surprised it is all POP as Erin's is mostly fibreglass, which is lighter than POP. However, there may have been reasons why it is all POP. I'm sure Niamh will get used to the heavier weight, and then will feel really odd when it's taken off. Each time she has it replaced the adjustment time gets shorter. Erin takes about half an hour from waking up now until she's running around like a lunatic as normal.
As for sleeping, you reminded me of how tough this was in the beginning. Is she in a bed or a cot? Erin found she didn't have enough room in a cot and the cast prompted us to move her to a bed. For the first week, or perhaps even longer, I slept on the floor of her room and everytime she stirred I got up and turned her in her sleep. She just couldn't roll over initially. It's not something you generally have to do after every cast change, but may be worth considering if sleeping is still difficult for her.
As far as flying goes, we haven't experienced long distance yet, but as Sins says, I have a friend who flies to London from Brisbane to have her child casted. To be honest, I think she actually hides the fact that Bridget is in a cast so as not to create a fuss, but if you have a letter saying it is ok to fly, I can't see there being any problems. You might want to take a pillow or blanket so that she can lie down comfortably, but I imagine you've thought about all of that.
Hope all is well. If I think of anything else, I'll post it up.
28th February 2005, 09:47 PM
Andrea thanks for all that, she is getting used to it, slowly but surely and she had a good night last night. I am not sure what her correction was or even if they measured it afterwards Sealy, the registrar just told me that they were really pleased with how they got it on, so I am assuming they got her straight enough. She does look taller though, to me but that could just be my imagination. I was trying to take a picture of her cast this evening to send to her Dad who is in the US at the moment but she wouldn't stay still so they are all blurry, I will try again tomorrow.
Sins, yes we had it done in Temple St. The nurses on the day ward told me that they have a couple of children who come in regularly to have their casts changed, however I think there is a bigger scoliosis clinic in Crumlin. I did come across one mum on another website whose baby was initially diagnosed with a curve in Crumlin but on follow up was found to have improved so he didn't need to be casted.
Thanks amazed for the suggestions, I am on my own with Niamh for the last couple of weeks as her dad had to go to the US with work but we are flying over on Wednesday to see him and I fully intend to put my feet up for a few days!!
15th March 2005, 02:21 PM
just to give an update on Niamh. I cannot believe how well she has adjusted to her cast. She really does not seem to notice it at all now, with the exception of turning in her cot at night, but that is all a matter of time.
We made it to and back to the US in one piece, thankfully. The flights were fine. I had booked a seat for her and brought her car seat on the plane so she was a bit more comfortable than sitting on my lap for 10 1/2 hours. I did not mention about her cast at all to the airlines and nobody seemed to notice at all so thankfully we did not have any problems in that respect. We had a lovely time and Niamh was up to her usual antics.
We are going to Cappagh this afternoon to have her measured for her removable brace/cast, not too sure which it is as both have been mentioned.
So overall it is all very positive, although I am finding it a bit sad that hugs just are not the same any more :( .
15th March 2005, 04:50 PM
Glad to hear all is well. Hugs and cuddles are the one thing that I miss the most too - they are just not the same. Sharing a bed is a bit tricky (and painful too) if there's not much room. I also miss just picking her up normally (under the arms) and swinging her about, and get really sad when I see other children being swung about in parks and stuff, but it's part of a new life that we have, that's all.
I'm a bit confused about her treatment now. Is the cast she is in only temporary then? And how do they measure her for a brace with a cast on? I'd be interested to hear what her consultant has planned for her.
Hope your trip went well today.
16th March 2005, 11:34 AM
I am not surprised you are confused, I am competely addled at the moment.
Mr. Mc Manus's treatment plan for Niamh is serial plaster casts for an indefinite period of time. However, my husband is being relocated with work to the US for a few months and we are going to join him out there for about 4 months. Mr. Mc Manus suggested therefore to make a removable brace so we did not have to travel in the middle of that to have her cast replaced.
So yesterdays trip was to get a mould made for the removable brace. This was done in a different hospital than we usually attend, and I was surprised that they had suggested that they would remove the cast and tape it back on temporairly until the brace is ready. I rang the orthopaedic nurses in our usual hospital and they said that this was fine. Needless to say the cast would not go back on once it had been opened, so we are now out of the cast and I am fairly pi**ed off. :nut:
I rang the nurses first thing this morning and explained the disaster, but as mr Mc Manus only does theatre on Thursdays, and tomorrow is our national holiday there is no surgery tomorrow. The brace will be ready on the 1st April so if we get it on the following week it will only be on for a week and they don't think the trauma of going through a general anaesthetic is worth it for a week. I can understand this, but I am so disappointed that we had gone through the initial trauma and she had gotten used to it and now we have nothing for two weeks.
Sorry for the rant,
16th March 2005, 12:42 PM
You rant away! I think you have every reason to. Even if the cast had gone back on, how did they think it would apply the correct amount of pressure to a wilful spine growing in the wrong direction with TAPE? Ok, so I imagine it's not the run-of-the-mill tape, but I still can't see how that would have worked. I imagine you're asking yourself the same thing, but why didn't they take a mould before she was casted? I'm really cross on your behalf that you've gone through all this for nothing. You poor things.
I agree that the GA wouldn't be worth it for a week, it is a lot for them to go through. Fingers crossed that the brace will be ready in time and it fits her well and she adjusts really quickly. Do you know when you are going to the US?
Big hugs to you guys - and you make sure you get lots of cuddling in while she's cast/brace-free. :squeeze:
16th March 2005, 12:56 PM
Very Very Interesting,
This is exactly what they told me regarding Deirdre's brace. They said that the cast would be sawed off to get the mold for the brace and then re-taped. I thought that sounded kind of weird. So I guess the best thing is for her to go under general anesthesia one more time, get the brace mold while she is under and then hope to God that it still fits once she comes out of the cast !!! You know, she has had so much trouble with the anesthesia, it would be so nice if they could apply the cast without it. Her curve is so low now that her spine doesn't have to be manipulated that much. Her doctor refuses to apply the cast without anesthesia - what a pain !!!!! :-(
16th March 2005, 09:53 PM
Have calmed down a bit now. Andrea, I guess the reason they did not do the mould for the brace initially was that they want the brace to be as close to the shape of the correction the cast was giving, if you know what I mean. I was actually very surprised in that i can see and feel a marked improvement already with her rib hump and that is only after less than 3 weeks. I suspect though that this may have relaxed out again by the time the brace goes on, but at least the brace will try and force her back to that correction. I hope I am making sense here. I am going to ring and see if they can speed up making the brace, at least if we had her in that as soon as possible i would feel happier.
Sealy how long will Deirdre have her cast on before they will try to cut it of? I suspect that Niamh went through a major growth spurt in the last week or so (possibly the result of indulging in a few too many bagels whilst on hols ) and that was one of the reasons that the cast just would not close on her. I also am really sorry but I never got to take a photo for you, but it looks really like Deirdre's. I will definitely take a photo of the brace which is going to look quite cool. red with bees and flowers.
We are probably heading to the US around the 10th of April, so at least it will be all sorted out by then.
16th March 2005, 11:37 PM
I am just an absolute wreck right now. Deirdre has been in her cast for close to five months due to the fact that the cast is in very good shape AND loose but still holding the curve at 10 degrees... everyone is happy. The next meeting with the doctor will take place in about a month or so - no clinic appointment yet. I am planning to beg (my way of being persuasive ;-) ) that he cast her without anesthetic. The thought of cutting off the cast and then re-taping it will not do my heart any good - she has been in casts for three years - the thought of having her walking around without any support for two weeks will probably send me into cardiac arrest !!! We've worked so hard to get her down to a reasonable level that two weeks without support could ruin everything.
The last three times she has gone under general anesthesia, she has experienced something called laryngospasms - this alone scares the cr**p out of me. I am trying to convince our doctor to cast her without anesthesia, he says that the whole procedure will scare her. What can I do ???? I wish I didn't have to deal with this. Why can't things be more straight forward ?
I am so sorry that your daughter is without support for two weeks !! You must be going absolutely nuts :woe:
17th March 2005, 07:40 AM
Odd. I was casted without general anesthesia. I remember it. It was intimidating because I didn't know if that was going to be one of the times that they hurt me (I'd had two surgeries already), or not. Adults in white coats were so unpredictable when I was little. But once I saw that they weren't hurting me, I calmed down.
17th March 2005, 07:57 AM
I think it's the traction and manipulation of the spine that is deemed to scare them. I know Erin would certainly freak out about it, but they manipulate her a lot and she is only 2. When i asked our doc at what point she would be able to tolerate it without a GA, he said she would be straight by then, but that was before they kind of admitting we weren't actually getting anywhere! There was a girl on the ward who was casted without a GA, but I think it was casting for a brace, which I think is a different technique.
Sealy, would you be able to try without a GA and then, if she gets too distressed, let her have one? Five months is a long time, but it's great the curve is holding. I get really keen to have Erin's off after about 2 months because I know the curve will be getting worse again.
Nicola - best of luck with getting the brace made quicker.
17th March 2005, 08:27 AM
When they cast for a brace, there is no traction. The patient sits up on a stool and the orthotist uses his hands to get correction as the cast dries.
17th March 2005, 01:24 PM
If they're unwilling to cast without a general, is worth asking them to consider rather than doing it with nothing, doing it with a sedative and perhaps muscle relaxant? That's just a top-of-the-head suggestion though, and I know a lot of docs are very reluctant to use sedatives, although I'm not entirely sure why.
17th March 2005, 01:26 PM
Jonny - this might not be the case for children's brace casts. I certainly had traction and stuff applied when I was casts for my braces, in exactly the same manner as when I had the plaster applied for a body cast. The only difference was that they cut it off once it had dried :-)
I never had GA's either.....and like I said, I did get put into traction, but I guess it's likely that they did not have the techniques to rigorously manipulate the spine that they have these days.
I'd have neck traction applied with my head pulled back in a halter, my feet would be pulled up so bthey sloped towards the ceiling, my arms would be outstretched at either side, and I'd be lying on a thin strip of canvas. They'd shove a long straight thing down my back and bind the stockingnette around it, then one of the plaster technicians would hold my hips in place whilst another one put the plaster on. Afterwards the long thing would be removed.
Does that sound much different to what they do now? I met a 14 year old on Jonny's ward when we went to visit him last summer, and she said that she'd always had GAs for plaster casts, even at the age of 8 or 9 (she was diagnosed at 7), which makes me think that the level of manipulation that they apply to the spine these days must be a lot more rigorous and uncomfortable.
Also, I never got much correction in my casts or braces.....they were just there to hold my spine in place, rather than correct it. My medical notes do say that my curves were extremely inflexible though.
17th March 2005, 05:07 PM
I did suggest that he use a sedative to relax her and he flatly refused, saying that if something went wrong that it's best to have her intubated so therefore G.A. I was reading that intubating can cause problems such as laryngospasms in young children and that there is alternative to intubation called a Laryngeal Mask Airway ( I have no idea how this works ). I don't know enough about anesthesia to suggest it. They do use sedatives in Dental offices on young children - I've seen it many times. I don't know what the big deal is ! Considering laryngospasms can be life threatening, one would think that he would want to try something a little different. He doesn't have to manipulate her spine that much, although he did say she would be suspended in mid air on a frame, and THIS could scare her. Also, he is about 6 foot 3 inches tall and weighs about 230 pounds - this could scare her as well.
Anyway we have an appointment April 26, I'll let you know how it goes.
17th March 2005, 05:27 PM
How old is Deirdre, Sealy? If you're there, I am sure it would not be too frightening for her. It sounds like the same procedure as I went through, it's not pleasant but you get used to it and I cannot remember being frightened, just uncomfortable.
18th March 2005, 12:04 PM
Love your picture by the way ! :-) Deirdre is four years and five months old. I did suggest that I go in with her - he refused saying that he doesn't think I would be allowed back there. The fact that so many people - including you - have had casts applied without general anesthesia leads me to believe that it is NOT such a big deal. I think that our doctor is just accustomed to doing things a certain way and the thought of changing the way things are done upsets his equilibrium. I'm going to give it another go next time I see him. Thanks for all the suggestions, it's made things a little more clear for me.
Andrea, just keep up with the casting. One of these days things may turn around.
18th March 2005, 01:07 PM
Hi Sealy, thank you! :D I'm sure my mother was allowed into the plaster theatre with me - obviously she couldn't stand right next to the frame whilst they were working on the plaster, but she was there in the background somewhere. The procedure didn't take very long - ten minutes max, I would imagine - as obviously plaster dries so quickly. There's a big rush to put it on (it goes on in the form of plaster-soaked bandages, this is true of both plaster of paris and the fibreglass "scotchcast" stuff - I've had both) and then you have to lie there for a minute whilst it hardens. It feels very hot and tight for a minute or two as it does this, but it's not unbearable.
Maybe most children would freak out at this and I was just very sedate, I've no idea! I might have learned to be independent and get along with things, as I'd stay in hospital for 3 days every 2 months and my parents would just drop me off and pick me up again 3 days later without visiting me in between. My mother's a lot different to the mums I have met here - she seemed more ashamed of my scoliosis and refused to acknowledge it. Maybe parents of her generation had a much different attitude then, and were less hands-on, I don't know.
18th March 2005, 02:34 PM
Erin is in the theatre for about an hour for her casting, but this includes the time for cutting the plaster round the arms, neck and the tummy hole. I guess it depends on what the cast looks like and how much trimming it needs.
Toni, not that I would dream of doing it, but I'm not sure they'd let me drop her off and pick her up again 3 days later! 3 days is a long time to be in there - no wonder you have such vivid memories of the place. The most we spend in there now is 10 hours. Not sure I could cope with 3 days. I'm sure it wasn't shame that your mum experienced Toni. Sometimes I think that if I don't face something head-on then it isn't really happening. If I look the other way then it won't be so bad. Perhaps she just felt she couldn't do it, couldn't cope. I think us mums all feel like that sometimes. I may be totally reading it wrong, so apologies if I am. Obviously you know her more than anyone.
Sealy - good luck with the quest! Keep at them until they give in, if only to quieten you.
Right, off into the garden as Erin wants me to get the "hairy" spiders out of her playhouse. Oh what fun!! :D
18th March 2005, 10:19 PM
I know that our surgeon point blank refuses to allow parents anywhere near the theatre, even in the anaesthesia room. The reason for this is it is the same theatre that is used for open surgery and the risk of infection for orthopaedic surgery must be kept to the absolute minimum, so only theatre staff are allowed in. Maybe this is the same reason in your hospital. One thing occurs to me though, is it not up to the anaethesia team as to what type of anaesthetic is used during surgery, could you get in contact with them and see if there is an alternative that can be used for Deirdre?
Toni, I am sure it was probably very difficult for your Mother to leave you like that but I think there was much less emphasis put on parent participation in a child's treatment in the past. I have heard stories of parents who were basically told to leave their children on the hands of the "professionals". In those days parents did not have the same access to information and resources that we are so lucky to have now, such as you lot!!
19th March 2005, 07:24 PM
I had a similar experience when I was younger. At the age of nine, I twisted my wrist and had to stay in the hospital for five days. My arm was in a cast and had to remain elevated similar to a broken leg. The whole time I was there, my mom rarely visited me. I was in a ward with other children and with the exception of one child whose mom stayed constantly with him, all were left alone. My mom only visited me 15 minutes each day, some days she didn't even show up. It was a very depressing time for me and to this day, I have never felt the same way about her - I think I felt abandoned. I'm one of four children so I guess she was busy with the other kids. This is just my experience.
I've never been ashamed of Deirdre's scoliosis. I just want to help her get through this.
I think our doctor already considers me a bit of a trouble maker :-D
I have an appointment with the anesthesia clinic in early April. Hopefully they will be able to shed more light on this. They don't seem to have a problem with me going in with Deirdre when they put her under. I have to wear something similar to a space suit - it's quite comical. As far as going in with her to have the cast applied, I don't know what the policy is - I'll have to find out. I do feel that because of the problems she has had with general anesthesia, alternative arrangements should be made.
21st March 2005, 12:40 PM
best of luck with the appointment, surely it would make their lives easier not to go through the risk of putting Deirdre under general again.
I can only imagine how worried you must be every time it comes up.
21st March 2005, 01:58 PM
It's so hard for me. I'm there when she is put under general anesthesia and it's quite a struggle for her. It's very hard for me to watch - the thought that she may never wake up again or suffer brain damage is too overwhelming.
21st March 2005, 04:06 PM
That really is the hardest part isn't it? Last time I actually got through it without crying and thought that was a major achievement as I usually end up in floods. Erin absolutely hates the mask. When you say we're going to hospital, it's the first thing she'll mention and she gets herself into such a state over it. Unfortunately she's not old enough to have the anaesthesia any other way so we just have to deal with it until she is. Strangely enough, I don't have to wear anything special when I go in with her.
Let us know how it goes with the clinic in April. It will be interesting to hear what they say.
23rd March 2005, 01:46 PM
I am not allowed in with Niamh so in one way I am spared that trauma Andrea.
They gave Niamh a pre-med before hand on the ward which they said would make her forget the experience!!
Anyway best of luck Sealy with the appointment.
23rd March 2005, 09:45 PM
Yes, it IS the hardest part. It makes things very very tense. I already have my list of questions for the anesthesiologist when I go for clinic in April. I'll let you all know how it goes.
BTW Erin looks so cute in the pink glasses. :-D
Have you received the brace yet ?
4th April 2005, 01:46 PM
We got our brace on Friday and it fits her really well.
Niamh is getting on grand with it and does not really notice it except when we take it on and off and then there is war!!! It is a lot neater than the cast, and all her old clothes fit her again, and we can tickle her tummy!!
Will try and take a photo to post for you during the week.
We are mad busy trying to pack up to go to the US, we are off on Friday for 16 weeks.
I will ahve internet access over there so will try to keep up to date with everyone.
Sealy if we are not in contact before your appointment with the anaesthesiologist, the very best of luck,
4th April 2005, 02:31 PM
That's good to know Nicola.Any news regarding the progress of the curve or is it too soon to have any indication?
4th April 2005, 10:30 PM
The appointment with the anesthesiologist has been rescheduled for April 25 and the ortho clinic appointment is the following day :D
Have fun in the States ! Is this an all expenses paid trip ? If so, live it up !!! 8)
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