Today was one really long day at Shriner's. In fact, we were gone from the house a total of twelve hours. We are all wiped. I feel like it was a really productive day (with some good and bad in the mix), which hasn't happened in a long time. Is.aac and I also really like the doctor we saw today. She was knowledgeable and actually talked to us about our insights and goals for the appointment.
The good:
Both boys were x-rayed and assessed. We also received two different assistant devices right there on the spot. It is so nice to have that over and done without having to wrestle with insurance/scheduling. I have to say that this kind of ease when performing necessary scans and orthotics supplies is
exactly how the medical world should work.
Ja.son is doing everything he needs to be doing. His AFO's are good. His walker is good. His x-rays looked great. For now, we need to continue his stretching and keep on keeping on. Excellent! He goes back in 6 months for follow-up.
The bad:
Sh.awn was sent on his merry way with both knee immobilizer braces (They do just what you'd think--keep you from bending your knees. Doesn't that sound like fun?) and a
hip pillow for sleep (I can already tell you the pillow this isn't going to fly).
We saw PT and were given some targeted exercises to do with him three to four times a day every day.
He'll also likely need Botox injections to relax a few key muscles in his legs. (That would be done at our local orthopedist as Shriner's doesn't do Botox any more.)
The ugly:
Sh.awn's x-rays did not look as good as we had hoped, and has been diagnosed with bilateral
hip dysplasia. My understanding of it (without me having done any research, so keep that in mind) is that Sh.awn's hip joint is approximately 30% out of normal alignment. (In other words, his joint is only 50% in the socket, when normal would be 80% or more in the socket.) This could be the way he's been for quite some time, which is what I believe because nothing significant has changed in his flexibility/movement, or it could be something that is rapidly changing which would mean we would likely need to surgically intervene.
So what does that mean? Well, if at any time his joint falls to 35% (or below) in the socket, surgery would be necessary soon. If not treated, the hip could become dislocated resulting in pain and arthritis. It is also harder to correct should the hip joint dislocate.
If it stays where it's at, there is still a strong possibility of surgery sometime between 8-10 years old. (There are differing theories on this but the doctor we saw believed it is more beneficial to be proactive and treat before dislocation is eminent.) The part that freaks me the fuck out, though, is that the recovery period is very extensive--it could take up to a YEAR to make it back to baseline in mobility.
A year. Just typing that makes my heart hurt.
We are going to try a couple of different stretches and the
torture devices braces/pillow to see if we can correct (not likely) or stave off surgery for a long time to come (if ever). We go back in three months for Sh.awn to get reassessed and have more x-rays taken for comparison. We'll know more about whether this is a rapid decline or a slower decline then.
~~~
There is also the whole insurance thing to figure out as well. I tried to get authorizations for Shriner's, but my insurance company would only refer us to the Children's Hospital. Shriner's knew that going in to the appointment. I was told they'd still try to bill our insurance, but they'd absorb the cost should our insurance refuse to pay. (We are all assuming they won't because they didn't "authorize" us to go, but they're trying anyway.)
Sh.awn has an appointment for follow-up in November. Ja.son's follow-up is set for January. So the intent to continue with Shriner's is there. But, I'm not yet sure how it will work should we continue to go back to Shriner's as far as insurance goes. That's a discussion for another day, I decided. My brain was fried and the boys were fried; after ten hours, it was time to leave.
Now I'm off to go eat chocolate--Reece's minis to be exact.