Two Year Orthopedist Update

Last week Owen had his 2 year-old follow-up with his orthopedic surgeon. The appointments start out with x-rays that require Owen to stand flat footed (with his left leg on a block, making it even with his right leg) with his back against a board containing the x-ray film. The board also has sort of a height chart to make it easier to measure his bones. As with any x-ray, he can't move. Reminder: he is two so he moves a lot, plus he HATES these x-rays so it always takes several attempts. Oh yes, the most fun part is that I can only hold him still in a very specific way. I can hold onto his upper body (sort of pinning him against the back board) and I can put my hand on his knee. I am not allowed to touch any other part of his lower body. Doing so will obstruct the view of his other bones and joints (hips, femur, tibia) which are very important for the doctor to see.

To make a long story short, the appointment was pretty much status quo. Allow me to share the "news" with you utilizing bullet points or this could turn into a novel.

-Hips look good. Both in the socket, growing the way they should be and providing an excellent foundation for Owen's lower extremities, which is vital.

-No need for a heel lift for his left shoe. He is getting around fine, just like any "typical" kid and his compensation for the length discrepancy is not doing any harm to his back, hips, muscles, etc.

-His left tibia is still just a tiny bit short. That discrepancy seems to have stayed about the same and the doctor still does not expect to have to lengthen his tibia.

-Owen's left femur continues to grow and is proportionately shorter than the right femur, which is what makes his left leg shorter. We have known since very early on in this process that the discrepancy in his two legs would increase, but that the discrepancy should remain proportional. His left foot hits at about his right ankle. According to the measurements at last week's appointment, the discrepancy is now just a bit less than 4.5 cm. Last year it was 3.5 cm. I knew this would be the case. I was prepared as much as I could have been to expect a larger difference. That doesn't mean it made me happy. I had hope that maybe it would slow down and his left leg would catch up a bit. The doctor never gave me any reason to hope for that, but look at everything that Owen has done so far and all of the ways that he has proven the doctors wrong. I have been praying for another miracle, and I will continue to do so.

-The unofficial plan was originally that Owen would probably have 2 surgeries to lengthen his leg, one around age 8 and the second around age 14. In the past year, pediatric orthopedic surgeons have begun performing the first lengthening surgery around the age of 4 in some patients. Last year Owen's doctor told us she wasn't convinced that was a great approach. I don't like the idea either, but for more practical "mommy reasons". The possibility was discussed again last week. Owen's doctor seems to have partially embraced the idea, but doesn't use the approach with every LLD patient. After much discussion we decided it was not the best plan for Owen.

-Owen's doctor showed me the x-rays of one of her LLD patients that just went through her first lengthening surgery. It was terrible, awful, heartbreaking, overwhelming and literally almost made me get sick. I can't even get into what is done and how the x-ray looked right now. It is too much. I told the doctor that I hate thinking about this, let alone seeing it on an x-ray. Her words: "I know, that is why I am going to keep showing it to you until it is time to lengthen Owen's leg." I love her. She is wonderful and understanding and knows just how to help me get through this extremely difficult situation.

So that is it in a nutshell. It is hard going to the follow-ups and hearing the measurements. We are lucky that Owen will be able to have his leg fixed, that he is doing so well in spite of his LLD and that it is not life threatening. Still, each orthopedist is like a slap in the face. A reminder that yes this is a reality and even though it can be fixed it will be a difficult process. I am thankful we don't have to do it again until next year.