What's New? Update as of 10/18/07...
We had our visit with the ortho on Tuesday, and all went fairly well. He sat there and skimmed over all the hard data, told us what it measured and what it meant and such. Then he sat with the evaluation summary and went over that with us. We pretty much knew most of the issues he has, the leg length discrepancy, severe muscle atrophy of lower left leg (actually, muscles never even developed to atrophy, they're just fibrous bands), tibial torsion, and it wasn't too surprising to hear that almost all the power used for walking is generated by his right leg.
The good news is that the problems that Billy have with his gait due to those issues are adequately compensated for with his current AFO/brace and shoelift. This means that no damage is being done to any of the joints :) As long as he continues to wear his lift and his AFO, we can postpone the leg lengthening/foot flattening/tibial torsion reducing surgery for a few more years yet. The surgeon has said he can address all three issues with one surgery and time in a specially constructed fixator frame.
However, the not so good news is that there is nothing they can fix that will HELP Billy gain a better gait and greater endurance, only protect his joints from degeneration. He is pretty much now at his peak of endurance due to the ability of prepubertal children to generate more energy than adults, so this is as good as it gets.
He can walk fine on even surfaces with limited distances, like in the house or at school...But he has problems in that he cannot keep up with his peers walking outdoors over larger areas, especially on uneven surfaces and in warmer temperatures, unless they are walking super slow - and they don't. He gets left in the dust all the time, and it's sad as a mom to see. But, at least I know now that I have explored any option to "fix" that, and we just have to adjust to this being the way it is. He already uses his electric powered "motorcycle" (a Kawasaki Ninja four wheel toy vehicle) to keep up around the neighborhood when playing with the kids, and as he outgrows that, I guess we'll get him an electric scooter or something...
We had to rent a wheelchair to use at the themeparks in Florida when we went on our trip, and it worked wonderfully. I'm thinking we'll get an inexpensive, lightweight folding transport wheelchair to have on hand for those times when we need to do a lot of walking, or walking over a large amount of time.
I also found out that we most likely won't get to stop using his AFO after his surgeries and growth are done, as the gait analysis noted that it helped considerably in stabilizing his gait pattern (they had videotaped him walking both with and without brace and lift for comparison).
It's funny, I really had thought that I was prepared to hear this from the ortho, my head certainly told me that there was no magic solution for his endurance issues. However, I must have been holding out some hope deep in my heart, cause I was disappointed to hear the results (although happy that no damage was being done!).
Oh well, I'm adjusting to the news, and I'm sure Billy will cope fine and find ways to compensate for his lack of speed and endurance just like he does for everything else :)
We still have our uro ultrasound and routine visit next week, but I'm not expecting any surprises there.
Posted by conni60640-ivil
at 11:51 PM EST