Orthopedic Check-up

This morning Owen had a check up with Dr. Casey after four weeks. He has been getting around very well with his walker so I was very confident. Still, because of the number of times that I have been no-so-pleasantly surprised during an appointment, I couldn't help but be a touch nervous. Luckily everything looked wonderful and the doctor was thrilled with his progress. There was a great deal of increased healing. The bone that was already looking good a month ago had calcified even more. The few parts that hadn't shown much calcification yet looked quite a bit better. As she has said before, the doctor referred to Owen as a "super healer". He has graduated from physical therapy, which was perhaps the biggest surprise to me. He is now WBAT, or weight bearing as tolerated. As is the case with most almost-five-year-old boys, Owen is certainly pushing the envelope. His leg doesn't hurt him anymore, and he is certainly on the move! He is certainly pushing it with his new weight-bearing rules. Dr. Casey obviously has a plan for this. We have told Owen one set of rules, and when he pushes a bit I let him push a certain amount and pretend not to notice. He can walk a bit without his walker, but I certainly don't cheer him on. That would cause him to push further. She feels that when we go back in another four weeks it will be sans walker. I predict that it will happen within two weeks. 

I am so thrilled that Owen is doing so well, and I am beyond proud of my little man and how hard he has worked to get to this point.

Such a happy day!

Back from my Hiatis

If you are a regular reader here at the Hive, you've noticed that I have been absent lately. Things have been crazy here for the past several months. This is a long story short type of situation. Owen had surgery on November 29 to begin the lengthening of his right femur. In case you forgot, he was born with a leg length discrepancy. Specifically, a congenital short femur. The orthopedist performed an osteotomy and placed an external fixation device for the purpose of lengthening. There was a tool that looked a lot like an allen wrench, which I had to use to turn a part on the device four times each day. Each turn lengthened his femur by 1/4 mm. That means by the end of the day, his femur had been lengthened by 1 mm. This went on for 42 days, and we gained 4.2 cm of length. Unfortunately, about 3 weeks before she had planned to remove the fixation device, Owen got a bone infection. It had to be removed early. During that surgery, once the device was removed his femur broke. This was not an anticipated complication, but his hip flexor muscle was so tight that it slammed down and broke the bone. About four days after surgery when we went for his post-op appointment, the x-ray showed that the fracture of his femur had been seriously displaced. Emergency surgery was scheduled for a few days later. The surgeon fixed that break, set it and place a femoral plate and interlocking screws. Again, a few days later something was clearly wrong. Owen, who is such a tough guy and has hardly complained at all through everything, became very uncomfortable and experienced pain each time I moved him. As it turned out, his leg broke again above the existing plate. Another emergency surgery. This time the bone was harder to set and she had to sacrifice a centimeter of the length that we had gotten. She had to put in a much larger plate and 12 interlocking screws for internal fixation. She also released several of his tendons to relieve some of the tightness. He was then outfitted with a half-Spica cast, which he sported for 6 weeks. After those four surgeries and the time in the cast, he made a lot of progress and there was a lot of bone growth. After not having been able to walk since before Easter, he finally graduated back to his walker on June 14. He is doing GREAT! He gets around amazingly well on his walker. His spirit is truly amazing and he is such a trooper! He has taught me so much, and made me so much stronger in the process.

We see the orthopedist tomorrow, which will be the six week mark since the cast came off. I am both excited and anxious to see the x-rays and hear what the next steps will be. I am so proud of my sweet little man and how well he has weathered this storm.

We Should Do This More Often...

Meaning that I should write blog posts so you can read 'em. I can't believe it has been so long since I have posted. A lot has been going on and I've just felt too emotional to write. Usually writing is a great outlet for me, but I have come to realize that sometimes it isn't the appropriate outlet. That being said, I'm back. I'd say a bullet-point style update on all members of the family is in order.

Wes:

- He is training for a tri-athalon. He is a runner and has completed a marathon, so that part shouldn't be a problem. Next he started biking, but that doesn't come as naturally to him as running. Swimming. That is the part making him nervous. He has improved a lot since starting his practice at the Y, but still finds it the most difficult aspect. I can't do any of it well so I'm impressed already.

- He has had some changes at work. Confusing and difficult to explain. Basically he is now helping to manage 4 companies instead of just 1. Same job, same goals, just a bit of reorganization. Also, he is the owner of one of the companies. I am very proud of him.

Dara:

- As you may know I have had chronic kidney stones since I was pregnant with Owen. My most recent battle with my kidney has been going on for about 6 months now. I had quite a few tests ordered by my urologist. He found something minor, but nothing that really explained the stones. He referred me to a nephrologist. At my second visit I was told that my citrate level was dangerously low. Normal people should produce 600-750 mg/day and my level was 124 mg/day. He put me on a medication to hopefully increase my citrate level. It is a powder/crystal substance that I have to stir into 6 oz. of water and drink once a day. It is gross and makes me very nauseous. As of right now I am passing another stone and in a great deal of pain. The problem with the citrate deficiency is that it alone causes kidney pain when the level is so low because my kidney is working way too hard to do its job. Citrate is an element in the kidneys that is supposed to bind to waste and help remove it from the body. Since I don't have enough of it, my kidney is essentially trying to use what it does have to remove waste. The result is pain and the formation of kidney stones. I have a follow-up appointment with my nephrologist on Wednesday. I have lots of questions for him.

- I am starting back to work part-time on Monday. I am so not ready. I set the date maybe a month or so ago and now it is almost here. I will be going back to the same job I had before Owen was born. It is nice to have the flexibility to start out part time and very nice that I will be working with family. I went back to work half days after my maternity leave after Owen was born, but quickly realized that it wasn't going to work out. Owen was so sick and his health care was a full time job. I am so lucky that my mom is going to be watching him. He is doing well, but I still have so many issues myself with him having been so ill. We all went through so much and it is just not something that is easy to get over. I trust my mom implicitly. She loves him and he loves being with her. Most importantly, she knows what happened to him and what dangerous signs to look for. I don't expect that anything will happen, but if it did she would be about as likely to know it as me. My boys and I are very lucky to have her. Even still, it is going to be so hard for me to leave him. This is a huge life change and I don't do so well with change.

Carter:

- A few months ago he had his regular appointment with the ENT. The doctor found that he had 60% fluid behind his right ear, which is the one that the ear tube has fallen out of. The doctor thought it may be as a result of allergies and put him on an allergy/decongestant medicine. He was on that for a month and just recently had his follow-up visit. He had a sinus infection, which we had no idea about because Carter very rarely acts sick. His nose had been runny, but we attributed it to allergies since he had no fever, wasn't acting any differently and hadn't complained of not feeling well. When the doctor examined his ears, he still had at least 60% fluid in the right ear, if not more. Off to the Audiology department he went for a hearing test, which he passed with flying colors. All of the results were above normal. The doctor told us to discontinue the allergy/decongestant medication since it didn't seem to make a difference. Since his hearing is fine all we do now is wait and hope that ear doesn't get infected. If he starts having infections again, or if he gets a really bad infection he will need to have another tube placed. The doctor said if that occurs they will also take his adenoids out at that time. I am praying we don't end up going down that road.

- Carter had an ongoing issue with one of the other boys in his class at school. He has known this boy for a long time, as he went to the last school Carter went to as well. This child, we'll call him Joe, used to be the quietest little thing. I think while Carter was at the last school I heard Joe talk maybe twice. Fast forward to the past month and Carter started coming home telling us that Joe was saying bad words at school. I talked to the teacher, director and owner about it. Sure enough, just about everyday Joe was swearing. Mainly words beginning with F and D. Carter repeated each of the words once, not knowing what they meant and not even knowing they were bad words because he had never heard them before. The F word was repeated early on on the playground. It happened right before I picked Carter up from school. When his teacher told me what he had said I almost fell over. I had no idea where he had heard that word. I was appalled. First of all that my son, my four year old son had said that word and secondly because I was thinking "oh no, this teacher thinks we talk to him like that." Luckily she had heard Joe say the word on the playground and Carter repeated it right afterward. Mystery solved. Carter was disciplined. I explained to him that we never used that word, it is a very bad word, etc. I explained further that he knows a lot of good words and he should use those words to express himself. I also told him that he should never say a word if he doesn't know what it means because it might be a bad word. Problem solved, right? Wrong. For a while he came home telling us that Joe had said bad words that day. Each time I told him that those words were very bad and that when Joe talks like that Carter should tell him he doesn't like it and walk away. One morning at home he had asked Wes for something and Wes said no. Carter started to have a tantrum, which included the use of the D word. Again he was punished and again we explained why we don't talk that way. Also, I marched into school that morning on a mission. I was not going to have Joe bullying my child and I did not want my child going to school (a private preschool that I pay for him to attend) everyday and hearing that kind of language. If I don't talk to him that way at home I certainly don't want him hearing it at school. The situation escalated. When the school had a conference with Joe's parents they seemingly had no idea where he had heard such language. Right. It didn't stop after the conference and as of the beginning of this week Joe was removed from the school, allegedly through mutual agreement between the parents and the school. I don't really care how it happened, I'm just glad that Carter isn't having to deal with it anymore. I also feel bad for Joe. He is also only 4. He is learning that behavior from somewhere and it makes me sad. It really is a shame that some kids grow up in environments where molding them into strong, healthy, happy individuals is not a priority.

- Carter will be moving to the pre-K class at school somewhere around the end of June/beginning of July. We are very excited and think it is going to be really good for him. I can't believe in just over a year he will be off to Kindergarten. My baby is growing up so fast!

Owen:

- What can I say, Owen is Owen. He will be 21 months old at the end of this month. Health-wise he is doing great. We have no specialist appointments until September. He is very active, running around after his brother, climbing everything in sight. He is funny. He loves to make people smile and laugh. His speech has exploded. He has so many words and is saying new ones every day. He will repeat anything on command. He loves to be read to as well as to look at books on his own.

- He is a bit of a picky eater. Well maybe that is too harsh. I remember Carter going through a stage around this age where he was not as willing to try new foods. Owen usually will eat either a really good lunch and then a mediocre dinner or vice versa. He also doesn't have all of his teeth yet, so if his teeth are bothering him he is more likely to be picky. We are working on it. He is gaining weight, so no problem there. The pediatrician is not at all concerned and sees it as a phase.

- Owen is going to be 2 at the end of the summer! How in the world did that happen?!?

Thank you for reading. I am back in the game and am going to be a better blogger, I promise!

Hips Don't Lie

Today Owen had a follow-up appointment with his orthopedist. We haven't been there in 6 months. The purpose of the appointment was to check the growth of his hips as well as measure his bones in order to keep tabs on his leg length discrepancy (LLD). We got to the office and Owen was doing laps around the waiting room. He would run past another waiting patient and stop to say hi. Again, he brought smiles to so many people waiting. He kept going over to the door that leads back to the exam rooms, looking at me and laughing. When it was finally his turn to go back I scooped him up and followed the nurse, knowing that his time for exploring and playing happily had ended. The boy is not a fan of doctors' offices, and really who can blame him. The nurse commented on how much he was running around and was happy to see it.

A radiology tech came in to get us to come take Owen for his x-rays. Wes and I both suited up with lead skirts (for lack of a better word) to protect us from the radiation. The way the x-ray is taken, Owen has to stand up on a step-stool looking thing with his back against the x-ray board. He has to stand with his left leg on about a 3 inch block. Today it was 2 boards and a children's Bible. I stifled a laugh at the irony of him standing on a Bible. He actually did well, much better than last time. He moved right when they took the first x-ray so another had to be taken, but last time we could barely get him to stand there.

The doctor came into the exam room and told us that his hips look great. That is one of the most important things with Owen regarding his LLD. First of all, he had hip dysplasia, so making sure his hips are developing and forming well is critical. Also, without the structure of a strong, well developed hip, a leg cannot be lengthened. Since that is what will correct his LLD, we need his hips to be in top notch condition. They look great, and hips don't lie! Great news.

We expected the discrepancy between Owen's legs to have increased. It did not. His left leg is still about 3 cm shorter than his right. It is GREAT that the discrepancy did not increase. The doctor (I don't know if I've mentioned but I love her) insists that it will eventually increase, but I choose to hold out hope that it will not. She watched him walk (and run and climb) and said that no way did he need a shoe lift at this point. I was thrilled to hear that. I feel that we should wait to open that can of worms until it is absolutely necessary medically. He gets around amazingly, and really doesn't even notice the difference. Even MORE good news, we don't have to go back for another follow-up for a year. A year. This is the first specialist that has allowed that long between visits.

We discussed the lengthening procedure. She believes that she will have to perform two lengthening surgeries. A bone can only be lengthened by 20% at a time. I don't like the thought of it, but the good news is that she feels she will only need to lengthen his femur and not his tibia. She thinks the discrepancy in the tibia will be so minor that the length can be made up in the femur. This is promising because only one bone will need to be broken. One thing that was quite shocking was when she shared with us that at the last deformity class that she attended, there was discussion about beginning the lengthening process at the age of 4. Previously we had been told age 8 at the earliest. I just didn't feel great about the idea of a leg lengthening surgery at the age of 4. She agrees, saying that she is not sure how comfortable she is with the idea. I am not sure how she is thinking about it as a surgeon, but as a mom who has a 4 year old I am aghast at the idea of keeping him non-weight bearing, about turning screws in an external fixation device to grow his bone when he can't truly understand what that means. After the lengthening is complete a child can walk, but it is very important not to bear weight during the actually process of growing bone. The screws can only be turned 1mm per day, so it isn't an extremely expedient process. The good news is that we still have 2 1/2 years of medical advancement and time for the medical to community to decide what is best. It is not a decision that needs to be now.

I think one of the most satisfying aspects of today's appointment for me is that according to what the doctor said when she first began seeing Owen, this would have been when he started to walk. Instead he has been walking for 8 months and is now running, climbing and getting around like he has no idea that he has LLD. Again, he amazes me, I am so proud of him. The doctor was too, it was clear.

Walking and Talking

Little Man has really come a long way with both walking and talking lately.

First the talking. He has probably 5 words: Mama, Dada, Carter, this, doggie, Grandma, Nana. Ok that is 7. Today he was holding my cell phone, which is something he isn't usually allowed to do but he was really trying my patience, when someone called on the home phone. He had the cell phone up to his ear and said "hello". Of course a stranger on the street wouldn't have recognized what he said at hello, but he definitely said it. He also knows several signs including Daddy, eat, more. I can't for the life of me get him to sign Mama. Little stinker. It is wonderful to see his language develop.

Ok, walking. Little Man has certainly earned his new nickname, "Spider-baby". He has been cruising for quite some time, and in the past few weeks has realized that he does not need furniture to cruise. He can literally cruise around the entire house using walls, molding, anything he can get his little hands on. And the boy is fast! He took his first steps 4 days after his 10 month birthday, but quickly became apprehensive, deciding to stick with the cruising and crawling for the most part. O is now a full blown walker. He still dabbles in cruising and crawling, but he will walk across a room, taking great care with his balance and keeping his eye on his destination.

In addition he has become quite the climber. Who am I kidding? He is a monkey. Our stairs sort of fan out at the bottom, making a normal baby-gate impossible. The result- he is constantly making a break for the stairs with the intention of booking it to the top.*

Here he is trying to climb up the sides of the stairs.

Our temporary solution was to put one of our ugly hand-me-down benches from our dining room set in front of the stairs. This was the result:



Not wanting to spend my entire day retrieving Little Man from the bench, I quickly searched for something to keep him from climbing around the bench (see below). He hasn't figured out how to traverse this particular set-up yet, but I am certain that it is only a matter of time. We really need a permanent solution. I did find a large gate with multiple pieces that we could finagle for the space, but it is rather pricey. Suggestions welcome!



*Disclaimer: I was within arms reach for these photos to prevent Little Man from taking a spill, but of course had to document the climbing.