Thursday, August 14, 2014

Club Foot Appointment Update

I was so excited to head back to our old Doctor's office here in Utah, but slightly nervous knowing that Dr Klatt was no longer living here and wouldn't be her doctor. I was pleasantly surprised though when I met Siena's new Doctor. She was so helpful and gave me a TON of information, which was what we loved about Dr Klatt. I learned more at this one appt than I did at either of the appts with her Doctor  in Dallas. Anyway, I guess I'll just regurgitate as best I can everything that I learned.

They did X-rays, which I thought were so cute.. getting to see her cute little bones. Ok yes, I find little kid bones cute, I'm officially a mom.:) Siena thought it was pretty cool too. She has a Franklin book (the little turtle character) in which he has to go to the hospital and get X-rays, so she was excited about them as well.

This is just the far away picture that shows that her hips are in place and doing well. It also shows that her Femur bones are bout the same lenght. It is her fibula and tibia that are shorter. If you look at the bottom part of the bone by the foot, you can really see the difference. Here is a close up of those:

We discussed once again the lengthening and the shortening, although we didn't go into much detail on the shortening one because the Doctor thinks there will be a larger difference in height than is allowed to do the shortening. The leg shortening happens if there is a 2-3 inch difference in the leg lengths (or a projected 2-3 inch difference that is). They will take X-rays over the next couple years and keep an eye on it as well as chart it and get a good idea for the length discrepancy and what they think her projected length will be eventually in the future.

Siena's right leg is 1 inch shorter than her left leg right now, and the discrepancy continues to get bigger over time and that is why the Doctor thinks there will be a greater difference than 3 inches.

For the lengthening of the leg she said that they can only do 20% (of the length of the leg i believe) of growth in one go and then they do it a second time later on down the road if needed again. She said this would typically happen around 8 years old ish for the first time and then around 13 years old for the second time.  It would basically be 2 big rings around her shorter leg, one at the top of the bone, one at the bottom, and they cut the bone and then over time you basically crank it and the bone grows in between the gap. She said this process can be as short as 6 months, but she has seen it as long as 2 years.

Doctor Holmes also mentioned a few other things that could possibly happen in the future and would need surgeries if they occured.

Knock Knee- Siena already has this a little bit, so the Doctor made it sound like this is probably going to need some help in the future. Basically the inside of the knee grows faster than the outside and so they would go in and put a "clamp" on the growth plate on inside of her knee for some time until the outside caught up. She said this would probably have to happen multiple times as the leg/knees continue to grow.

Ankle joint, or bone ball and socket- the Doctor said that Siena has some luck on this because she has 4 toes on that foot. Some kids that only have 2-3 have a much higher likelihood of having issues with this. Basically there is a bone that connects from your foot to your leg, and it is usually square-topped, but sometimes with  either fibular hemimelia or a club foot (sorry I can't remember which one usually is the cause.. I think it's the fibular hemimelia though) that bone can be rounded and can cause the foot to turn inwards/ roll inwards. If this happens there is a surgery, and in some cases they amputate.. That kinda freaked me out a bit, but that's just an extreme case and it's not even something that she will for sure have, so no need to fret about that. The Doctor said that her foot was looking really good though, so that's good. One stride at a time!

Also, I have gotten questions from some people about if she needs a lift for her shoe, and the Doctor addressed that today. The Doctor said that sometimes parents choose to get one, but most kids don't and there's no evidence that it messes up the kids backs. She said that if we wanted to we could, but it definitely wasn't necessary. If later on down the road Siena started complaining about pain or something we could do something then and be just fine, but she said that rarely happens.

Anwyay! There is my LONG spiel with all the info! We have some interesting times ahead (poor little siena!:/ ) but she's strong and adapts to everything so well. It's nice to have an idea for the future though so we can plan and such though, so I'm thankful that this Doctor was so helpful!

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