The Perfect Hands Doctor

The doctor's office had a rectangular shape with three pale-yellow painted walls and a vibrant-burgundy one. By the door, to the left, was a computer sitting on a shelf, and next to it a counter with a tiny sink. The examination bed was against the corner, opposite to the door. There was only one painting, a colorful one, which had the big task of uplifting the visitors’ spirit while waiting for the doctor; in this case the visitors were Natacha, Valeria and I visiting Shriners Hospital for Children the first time in the cold month of March. The abstract painting, which resembled a puzzle with each piece of different color, was falling short in its purpose, but fortunately that changed when Dr. Dan A. Zlotolow, MD came in to the office.

Dr. Zlotolow  a hand surgeon of about 50 years old, with salt and pepper curly hair brought the energy the room was missing. His assistant, a tall man in his early thirties, joined him.

Dr. Zlotolow was eager to teach us as much as possible about Valeria’s case, for example he mentioned that in cases when a baby is born without thumbs, or mirror hands, he also has mirror forearms. That means that instead of having one radius and one ulna bone, he has the same bone duplicated. The elbow is not designed for that, so the baby has problems rotating the forearm. We turned to see Valeria, and she was throwing away big Lego pieces like a pitcher, so clearly her forearm bones were fine.

Then Dr. Alburger—the foot surgeon—entered the room; I felt honored to be in front of those two brilliant doctors, and seeing them discussing logistics like when the surgery could take place. Dr. Zlotolow said he could operate when Valeria turns a year and a half old. Dr. Alburger said he could operate right away.

"Are you saying you're so important you don't want to operate with me?" asked Dr. Zlotolow to Dr. Alburger who seemed not to enjoy the joke.

"That's what he meant right?" said Dr. Zlotolow talking to me.

"Yeah, that he meant." I responded, smiling.

Dr. Alburger left the room without smiling though, and I was just hoping I didn’t offend the man who was going to open the flesh of my precious daughter.

Dr. Zlotolow explained that waiting for the surgery was necessary because babies lack firm muscles in their hands when they’re less than 18 months old; their muscles are like spider webs, not strong enough for the stitches.

“Be patient,” said Dr. Zlotolow, "to operate her hands, I need you to give me a hand."

We smiled at this play of words; though Dr. Zlotolow s assistant didn't. I guessed he had heard the joke way too many times.

Dr. Alburger did his part in May with great results on Valeria’s feet—he was even smiley and supportive in the following visits. The postoperative period was extremely difficult though. In January is Dr. Zlotolow s turn to do his part; I know the postoperative period won’t be easy since Valeria uses her hands a lot, but having gone through the previous experience, we’re ready to stand up to anything.

Valeria taking Greta for a ride

African Spell

Natacha was with Valeria, playing at the Brooklyn Public Library's babies’ area; it was in plain winter before Valeria had feet surgery. Inside the building, which has an extremely tall entrance, inspired by ancient Egyptian architecture, a nanny approached her with strong interest; she was an older lady from Africa, who noticed Valeria's hands.

"Her feet, are they also like that?" asked the lady to Natacha enthusiastically.

"Yes, and she's having surgery very soon", responded Natacha.

"She doesn't need surgery; she's having surgery because you want to," said the lady in a firm tonality, turning upset.

"She's a blessed baby," added the lady. "In Africa, babies who are born with extra fingers are admired; they become great strong persons, destined to control their own future".

I found it extremely peculiar that somebody questioned whether Valeria really needed the surgeries. The lady’s beliefs went against the general common sense. It was a possibility that had never been brought up to the table.

Still, one has to be pragmatic, and ponder what’s best in the long run. In term of her feet; although Valeria was able to stand up with easiness; they were different from each other, and were going to cause her to walk unevenly, affecting her hip; one leg was going to put more pressure than the other. That might be fine for a short period of time, but after thirty years it'd definitely would have taken a toll on her.

In term of the hands, although she’s able to hold things without difficulty, she's going to have a wider range to grasp objects.

The conversation with that lady should have passed as unnoticed if it wasn't because Valeria had never gotten sick before the surgery. She was nine months old when she went into the operating room, and by then I had never seen her falling ill. I felt fortunate, especially because my first son, Gianluca, now fourteen years old, had fallen ill a few times by then, which was normal.

Two months after the surgery, Valeria has gotten the cold twice, and an ear infection once; in a way. I know she needs to get sick in order to get her immune system up to date to defend herself from the germs of the world, but I'm still somewhat amazed that she previously had never gotten sick. I hope that by removing what made her special I didn't remove any spell that gave any magical protection.

Happy father's day!

Natacha, Valeria, Greta and Gianluca. The joy of being a father.

A big hug to all the fathers on our day

Valeria's Progress

If part of my feet’s bones were cut off, I'd be crying to my mom that I'd never walk again, but Valeria, like most babies, is resilient, and completely unaware that she went through surgeries.

Her progress was moving quicker than I anticipated.

Since she accidentally removed the casts off her feet, only a week after the surgery, she's tried to stand up. Silly me, I didn't ask that Friday when we went to see the doctor whether we could allow Valeria to stand up if she tried, and I paid for that.

In my mind she was in pain, so she would never try it; in her mind she was finally free of those casts, so she would only crawl, jump, and walk. I emailed the doctor asking my concern, but it was the weekend, so he didn't reply until Monday.

Loly, my mother-in-law, Natacha and I ended up exhausted trying to hold her and distract her from wanting to lean on her feet. We listened constantly the Gummy Bear song and Mickey's Hot Dog song, let her play with all the cel phones and remote controls of the house, and took turns, carrying her back and forth in our small NY size apartment. Finally on Monday, Dr. Alburger responded, "it's ok for her to stand up; it's a good sign."

Since then, the floor has been her kingdom.

Three weeks later, we went back to Philly to Shriners Hospital for Children to remove the bandages and get the final discharge. Dr. Alburger showed up to his office with his assistant, and holding a brand new package with scissors and bandages in his hand. He sat in front of Valeria, who started crying, and began unrolling the bandages until the feet appeared in front of us.

They had the right amount of fingers, and almost had the right shape. They were still swollen, and, because of the bandages, the top parts were almost live skin. Dr. Alburger used the scissor to remove the stitches from each edge, but the rest of the stitches were inside Valeria’s skin; her body was going to absorb them. The shapes of the feet were 90% as expected, but the x-rays were 100% perfect.

Seeing the before-surgery and after-surgery x-rays was extremely comforting, and gave me a moment of peace. I told Natacha, “after all this, we need a good vacation.”

I now see Valeria’s feet, and I’m amazed by their new look; it’s gladly unexpected after being used to seeing the old foot, the mirror foot.

We prepared for months for this moment, and were joyful that we took the right action. We had been very patient though; especially when we wanted to do something since that moment in the ultrasound room, over a year ago, when Valeria was growing in Natacha’s womb, and the ultrasound technician was telling us that everything was normal with the baby. Suddenly she stopped smiling, printed some images, and left the room. She came back with a doctor, a matured woman, who sat in front of us, and told us, “your baby has an extra digit.”

Valeria's brand new feet work perfectly fine

The Sisters

Valeria and her furry sister 

Casts Slipped Off Valeria's Feet

“Gino, this is urgent; one of Valeria's casts slipped off,” said Natacha on the phone, reaching me at work at about 6 pm. “I’ve talked to the hospital, and they’re calling the doctor; just be prepared for anything,” she added.

I was afraid this would happen. Just 6 days prior, when Valeria was being discharged from the hospital, her surgeon, Dr. Alburger, had prevented us, “Casts sometimes come off, so try to keep Valeria’s feet up.”

Dr. Alburger and Valeria, the day after her surgery 

Another doctor from the hospital—Shriners Hospital for Children in Philadelphia—returned the call since Dr. Alburger was in surgery. He directed Natacha on how to put on a temporary bandage, and recommended we be at the hospital the day after.

Valeria wasn’t in pain, on the contrary; she was smiling like she hadn’t done it in days; she must have felt relieved without the cast.

When I got home from work at about midnight, Loly and Natacha were trying to distract Valeria, and preventing her from moving. I noticed the top of the other cast, which was still on, was by the ankle; that seemed odd; it originally was right below the knee. Valeria was anxious for someone to carry her, and Loly did; Valeria started swinging her legs, and that’s when I heard a big bang on the wooden floor. The other cast had slipped off too.

Seeing her foot was shocking; I couldn’t believe this was really happening; I felt like I was a spectator watching the scene from a movie. The cut from the surgery was from her ankle to her toe, and still healing; it was swollen, and bruised. This was the extremity treated of mirror foot; so basically, it was the foot that had been cut off in two to get rid of the mirrored half.

Valeria wasn’t in pain for this foot either, but Natacha started crying, and couldn’t bear to see the foot. I was breathing heavily. Fortunately, Loly was able to calm us down.

Moments later; once we were able to put ourselves together—Natacha gained her strength back, and was able to see the injury without feeling affected—we put a sock on the foot, taped it, and decided to leave to Philadelphia right away; that way we would stay in a hotel close to the hospital, and be at the door at 7:30 am when the hospital staff arrived.

I went for the rental car, came back for the family, and we all left Brooklyn at about 1 am. Valeria slept all the way to Philadelphia; on the way there, nobody said a single word; nobody put the radio; nobody asked to stop for a bathroom break; nobody wanted to wake up Valeria.

At about 3:30 am, we got to Philly. Valeria kept sleeping in the hotel and for the whole night; something she hadn’t done since before the surgery.

The morning after, arriving at the hospital was a relief, and being finally in front of Dr. Alburger even more. He examined Valeria’s feet, and said, “she’s healing well; there’s no sign of infection; I need to see her in two weeks to remove the stitches.” He didn’t put another cast on the feet, but covered them with bandages. When he called to make his voice report before leaving the office, he said, “Valeria Ginocchio, she had surgery 7 days ago; casts came off; she’s healing well; mom did a good job covering the feet.”

Finally at Shriner Hospital for Children waiting to see the doctor

We left the hospital, feeling much alleviated after a frantic night. We then went to Geno’s to eat their famous Philly Cheese Steaks. Sitting in the sun, Natacha, Loly and I were able to join Valeria in smiling.

Valeria's casts

Valeria the Champ

 

Valeria the Champ after conquering the surgery at Rocky Steps, Philadelphia