Answers & a plan

    It's been three years since we last saw Dr. Nelson. Amaya was a 5'3 1/2"thirteen year old getting ready to have her eight plate removed. Even though I was taller than her, she seemed so tall and grown up. She's grown so much in these short years. Each time I look up at her I'm reminded of that. 

    At that last visit we made plans to come back for a follow-up once Amaya had finished growing (Dr. Nelson said that would be at about age 14). He projected she would grow to be 5'8." She now stands at 5'8 & a 1/4" I'd say that's pretty close (amazingly close!). He had made additional projections and gave possible treatment options but we were in a "wait and see" point in Amaya's journey. 

    The past three years she's grown but unfortunately her knee pain has also grown. Amaya began to mention she had knee pain a couple years ago. It's hard to remember exactly when because at this point it's become the norm. She's got a high tolerance for pain and don't mention it often. At times we could pin point and explain the cause; a busy day, lots of walking, playing basketball, etc. Over the last year she began to complain of knee pain more often and at times for no obvious reason. Sometimes she would wake up in pain, or if she moved her leg a certain way, or just laying in bed. The last year or so we've have a hard time getting her any pain relief. We tried a customized knee brace, ibuprofen, rest, massages, muscle relaxing creams, chiropractic treatment and created a 504 to give Amaya much needed accommodations at school. All gave minimal and momentary relief. 

    I've been calling to make an appointment to see Dr. Nelson for over a year. The Covid pandemic made that extra challenging. Between quarantine restrictions we were placed on waiting lists and continued to call. In October  I got a call that there was a last minute opening and we could go down the next week if we wanted to. To be honest I immediately panicked. I didn't think I could make the work & travel arrangements in such a short time. Thankfully friends reminded me to go for it and that things would work out, which they did. When I called back Monday we were able to secure the appointment and then we had two days before we left. It was a whirlwind. 

    We left Wednesday morning and began the ten hour drive down to Southern California. The morning of Amaya and I were both nervous, anxious and full of emotions. We were both hopeful there would be an explantaion for the pain and a way to resolve it. The appointment was wonderful! It was so great to see Dr. Nelson and to be have him treat Amaya. I instantly felt calm and was confident that she was in good hands. He reviewed x-rays, watched her walked and then manipulated her knee. He said that overall she's doing great! Her gait is good, her knee is doing well overall as well (especially for a CFP knee). He said it made sense that she was in pain and there were a several things he could correct. 

So here's the plan...
Phase One...Dr. Nelson will release the scar tissue on the outside of her thigh that was left there from her external fixator. He will also perform a femoral osteotomy, to correct the misalignment in her femur. Lastly, he will insert the Precise nail to do a femoral lengthening. She will undergo femoral lengthening to gain 2 cm length to compensate for her discrepancy (this will take about 2 1/2 weeks). Also we need to get an MRI to evaluate the cartilage as well as the TT-TG (to measure the patellar translation). 

Phase Two...a year after the lengthening her Precise nail will be removed and tissue will be placed to help hold her kneecap in place. 

    It was great to get answers and to know something could be done. Amaya was so grateful for that! Dr. Nelson gave her the option to wait until summer to begin phase one or to do it at his first availability (December or January. Without hesitation she said she'd like the soonest appointment. She explained that for her its a matter of how long she wants to stay in pain. She's ready for the pain to be over. And we're ready for that as well. Its heartbreaking as a parent to watch your chid suffer and be powerless to help.  

I'm so grateful we got to see Dr. Nelson, to gert some answers and a plan and to have been able to sneak in visits with family members. 

It's hard to tell in the picture but she's rolling her eyes and said, "ugh, do you have to?" 

The answer was yes, yes I have to. 

Here's a look at Amayas x-ray.

We snuck in a visit to Rhino records where Amaya picked up a Bikini Kill record.