Thursday, August 11, 2011

The Orthopaedist

Today we saw an orthopaedist. We were told that we had to see one in order for the state to address any issues that come up with Sadie's CP. And it's good. We need to see someone probably on a regular basis. We did see someone a year ago and he x-rayed Sadie's hips. At that time we were going to keep an eye on the left one because it was slightly sublaxated. We expected more X-rays today, but we also expected to see that Sadie's hip had gotten better. We were's gotten worse.

So, what this means is that her hips is slowly coming out of its socket. When babies are born, their hips aren't totally formed yet. Their joints rely on movement and pressure to fully put that ball in its socket. Part of this is sitting, part is being able to put their feet in their mouth, and part is being able to spread their legs...this is what Sadie can't do. She used to be so tight it hurt to wrap her legs around me when I held her on my lap. But, she can do that now, and she's much looser in her hips, which is why we thought it'd be better. What is happening is that since she's not reinforcing that ball to stay in its socket by spreading her knees apart, the socket is becoming shallow and eventually the ball will dislocate.

The doctor wants to be really aggressive about this and went straight to surgery where he would cut her adductor tendons to release those hips and give her more mobility through her legs. But he also said it wasn't guaranteed to fix the problem. And he said he'd be okay with waiting 6 months and looking at it again.

We asked a lot of questions. We don't want to inhibit even the SMALLEST chance of her ever walking, or even crawling. He told us based on his assessment of her basic reflexes, she has a VERY slim chance of being "independently mobile." I looked him straight in the face and told him we were told the same thing about her breathing and sustaining life. He understood and said he was in the business of providing hope, but he also wants us to set realistic goals for her.
We asked if there is any way this would correct itself. He told us that we needed to start stretching those adductors and working on getting her legs apart. He said she is tight, but it's weird that her hips and legs are loose. Thank you Michelle and your Movement Lessons for that! We will see her again in October and hopefully she can work on those adductors. We will also start stretching them at home and in her other therapies. I have a feeling that if she could comfortably spread her legs apart, she might be able to sit better...or at all.

So, we came to the conclusion that we'll see him again in 6 mos. We're going to work on those adductors in these next 6 mos and do everything we can to avoid surgery, but she's growing, and as her bones get longer, if her muscles can't keep up, who knows where we'll be. Surgery may eventually be inevitable. But the doctor did promise that he would not recommend any surgery that might prevent her from ever walking someday. I appreciated that because I refuse to lose hope on that.

But we also don't want that hip to dislocate because that could be really painful. So, keep praying for Sadie. She has some unique challenges because of her inability to move and use her body like you and I do. And it seems like this is a pretty common CP side effect, and we're in good hands at PCH, so I'm not worried. I just don't ever want my baby to be in pain.

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