January 25, 2015

Yearly check-ups

     Today was our annual orthopedic check up for Amaya. I can't believe it's been a year since we were last there. This year has flown by. We've enjoyed a year free of surgery, appointments, physical therapy and recovery. This past year Amaya grew both in size and strength, played soccer for the first time (she had a great time!), and participated in her third triathlon with Lidie right beside her. She continues to meet and exceed our expectations. Her left leg is strong, and she's got two feet firmly planted on the ground. A fact that I never take for granted. She has enjoyed being able to wear whatever shoes she wants, and own more than one pair at a time (as she hasn't needed a shoe lift in three years now). It makes me smile each time I have to remind her to put her shoes away.  
     The day of the appointment I awoke with a familiar feeling...nervousness. This past year has been so great to watch Amaya live a "normal" year: without surgeries or therapies or pain. Going in for a follow-up is a reminder of our reality. Amaya has PFFD and still has at least two more surgeries ahead of her.  As her mother these appointments remind me of past nerves, surgeries and pain, both Amaya's and ours.  But as her mother I have to put on a brave face and remind her of all that she's accomplished and that everything will be okay. Sometimes I have to remind myself of that too.
     On the drive to the appointment Amaya had some nerves. Actually quite a few. In fact her stomach was so upset we had to make a stop at a restroom. My poor sweet girl. I comforted her and reminded her that we were headed to see an old friend and just getting a check up. Having such a good rapport with Dr.Nelson helps so much, especially in moments like this. She admitted that she was nervous about today's appointment and about starting snowboarding later that night "it's too much in one day" she said. It was a coincidence that both things happened to land on the same day. I reminded her that she's had tougher days and did great then and she would do the same today. 
     In the lobby we saw a pamphlet on orthopaedic care that said, "Because of my orthopaedic care I can....!" I showed it to Amaya and without hesitation she began to list off all things that she can now do with ease. "Run, walk, swim, bike ride, play soccer, snowboard." I can't tell you how amazing this truly is! I still remember my sweet little toddler who would fall when her unstable knee would give out as she tried to walk or run. Thanks to Dr.Nelson, she's come so far! 
     The appointment went relatively quickly, we were in and out in less than two and a half hours. When Dr.Nelson looked at Amaya's x-rays he gave us the following information. Her hip is doing great. Thanks to the hip osteotomy she had three years ago there is no sign of hip dysplasia at all. Currently there is a 2 mm discrepancy between her left and right leg. Last year her legs were almost perfectly even so in one year her right leg has grown 2 mm more than her left leg. Her projected discrepancy is 12 cm. We lengthened 8 cm during her first lengthening and she'll lengthen 4 cm more during her next lengthening. Dr.Nelson reminded us of how much easier the lengthening is with the Precise nail compared to the Orthofix. Not only in procedure but in therapy and recovery. He said he'll correct the knockedness of her left knee during the lengthening as well. He corrected part of it when he did her first lengthening, but you can see in her x-ray that her knee still turns in. Dr.Nelson said we can wait until she finishes growing (around age fourteen) to do her next lengthening or if it bothers her before then we could do it before she's done growing as well. He said if her knee starts to bother her we could do the 8 plate surgery before the lengthening (inserting a metal plate on the inside of her knee to help straighten it). He's hoping to do the two procedures at the same time. So depending on her growth and pain or discomfort she will have the 8 plate put in at the same time as she has the Precise lengthening or do one before the other. We'll start surgeries either at age fourteen or before, depending on her growth and discomfort. For now we'll continue with yearly check-ups. Dr.Nelson also said during the lengthening he could release the scar tissue just above her knee that's pulled in (she has a dent in her leg). He told her that he knows she's proud of her scars so if she doesn't want to she doesn't have to do it. She is proud of her scars, but later we discussed how much discomfort those scars sometimes cause her, so if that can help eliminate the discomfort she decided she'll let him do it.
     Before we left I verified that it's okay to do sports and all her activity. He said yes and that the only thing that would affect her is her left knee but added that kids compensate so well and she'll be fine. I mentioned my fears of her hurting her left leg and how precious it is (after all we've done so much to get it to where it is now). He said that when you look at the x-rays you can hardly tell a difference between her two legs because her left leg is so strong and healed so well. I mentioned she was going to be starting snowboarding lessons that night and he was happy and had no reservations. 
     Thank you all for your prayers, well wishes, care and concern for Amaya. She's doing great!
Sweet Amaya waiting for Dr.Nelson. I love this picture. With her cheerful smiling face at the foreground and her x-ray in the background. It speaks to her life. Her PFFD is a part of her life, but it takes a back-seat to her joy and doesn't limit her. 
Here's a close up of her hip and femurs. In case you're wondering what all those round things are, its the buttons on her shorts. Doesn't her femur look great? Its so solid and white.  
Here's her x-ray showing her from hip to toes. You can see how her knee is knocked and just above the knee you can see the indent from her scars.