No, this is not the recruitment poster for the Ku Klux Klan. The “K” is for Kirshner, their last name. The KKK stands for the Kirshner Kleeining Krew. It was part of the Purim fun they had last year. I wanted to post a picture of what Reuven's entire family looked like in calmer times. The truth is that my daughter and her family are handling this quite well and if a similar picture were taken today, they would be smiling just as brightly.This coming Monday morning, November 20th, Reuven will embark on the most traumatic portion of his treatment: major surgery. A cancerous growth like the one Reuven has requires surgical removal. And this is not a simple matter in Reuven’s case. The tumor is embedded in the left humerous, the bone of the left upper arm. Excising the tumor means removal of the bone it is attached to. In the past this has meant amputation.
But this, God willing will not be Reuven’s fate. In order to retain his arm and the full use thereof, he will require an extraordinarily complex surgery that is so rare, it has never been performed in the entire Midwest. In fact one of the surgeons who will perform it, Dr. Boyer, has traveled to Italy in to consult with a doctor there who has performed a handful of surgeries like this on children and to observe the procedure there. Dr. Boyer has performed this procedure on adults but never on a child.
It will be an eight hour procedure. There will be two surgeons in effect performing two surgeries on Reuven. One surgeon, Dr. McDonald, will work on the arm and Dr. Boyer on the leg. The arm will have the entire portion of the bone that has the tumor attached… sectioned out. Dr Boyer, will remove the fibula (one of the two leg bones… the thinner one) from one of Reuven’s legs. It will be cut to size and grafted to the arm in the two places it was cut.
This surgery, made all the more delicate because of Reuven’s age and size, entails carefully reattaching blood vessels and nerves if normal use is to be achieved. There is also the matter of the growth gradient of the bone in the arm versus the leg. Doctors will have to insure that the growth plate remain intact when they cut the fibula down to size. We have been told that the growth gradient of the fibula will convert to the growth gradient of the arm achieving a normal rate of growth to a normal arm size. This truly shows both the wonder of God’s creation and the wonder of modern medicine. The leg bone should actually become the arm bone if the surgery is done right. The arm should be fully functional achieving normal usage. Simply amazing!
The arm should require no permanent cast. The leg will require a cast for a six to eight week period. Reuven should be able to start walking in about two weeks. The leg, too, should achieve full and normal usage.
Reuven will require a three to four day stay in the hospital. Two weeks later the chemotherapy should resume.
This is a lot for Reuven to handle. He has been handling his illness quite well up to this point. This one will be a real hurdle… for him, for his parents, brothers, and grandparents. He still needs our teffilos. Please continue to keep him your prayers and in your hearts this Monday.
