Wednesday, April 2, 2008

This is where i was the past 3 days!



I know most of you have heard about what happened to poor Christian this last Sunday.. he's been having problems since the end of feb..when he fell in a little dog hole and hurt his leg.. at first i thought it was just because he bruised his leg up and cut it that is why he was limping around then a week went by and he would constantly complain about his leg but i didn't think anything of it cause when i was little i always got really bad leg aches and so I would just rub his leg til he fell asleep and he seemed to be okay until last week when the limping got worse so when my mom was worried i got worried to and called the doctor and last tuesday I took him in.. well first of all .. they had a "Student" Doctor look at him which kinda bothered me at first but figured he would be okay.. so i told the doctor everything i just told you guys and even how long it had been that he was off and on limping and how he's in pain and how it's gotten worse.. well he just looked at his feet and told me he had fallen arches and that it's PROBABLY just a musle he's pulled ..which of course sounds about right to me .. and sent us away doing nothing.. then comes sunday morning after grant's birthday party on saturday (which by the way i still have to blog and i will...) anyways he woke up and went to get out of bed and fell onto his knee and was crying cause he was in major pain...so i figured i would make sure he went to the doctor on Monday morning thinking he just pulled that muscle the "student doctor" told me about ..so all day long i keep thinking i should call my mom but keep putting it off.. so finally around 4pm on sunday i called my mom to tell her how Christian was doing and she told me she had been worried about him and had a bad dream that he couldn't walk and then she told me i should call the doctor and tell them what was going on .. i finally gave into her and called they told me to get him to the Hospital right away.. so we went to an Urgent care that was close by and they did x-rays and didn't have very good news..he was diagnosed with something called SCFE ...and I will copy an article that Roy found while staying in the Hospital.. so if your interested in what Christian went thru the past few days here it is another thing that was comforting during this time of stress and worry our surgeon just happen to Specialize in the SCFE surgery.. which was nice to know.. he also put the pins (screws) in both hips .. even though it was just his right one he said that from looking at Christian's X-rays it was an 80% chance he would be back for another surgery .. so we decided to go ahead with it.. anyways i just wanna thank everyone for their prayers and love we couldn't have done this without everyone ..sorry if you are just finding out.. i had been under alot of stress and didn't have time to call anyone...but i figured i would blog about it in more detail to let everyone know and i will keep you up to date on Christian's progress...



Here's a little more detail on what happend to Christian:



Slipped Capital Femoral Epiphysis

Slipped capital femoral epiphysis (SCFE) is an unusual disorder of the adolescent hip. It is not rare. For reasons that are not well understood, the ball at the upper end of the femur (thigh bone) slips off in a backward direction. This is due to weakness of the growth plate. Most often, it develops during periods of accelerated growth, shortly after the onset of puberty.



The patient's left hip (arrow) shows that a slight shift of the head of the femur occurred through the growth plate.
(Courtesy of John Killian, MD, Birmingham, AL)
The condition is diagnosed based on a careful history, physical examination, observation of the gait/walking pattern, and X-rays of the hip. The X-rays help confirm the diagnosis by demonstrating that the upper end of the thigh bone does not line up with the portion called the femoral neck.

Risk Factors
The cause of SCFE is unknown. It occurs two to three times more often in males than females. A large number of patients are overweight for their height. In most cases, slipping of the epiphysis is a slow and gradual process. However, it may occur suddenly and be associated with a minor fall or trauma. Symptomatic SCFE, treated early and well, allows for good long-term hip function.


Symptoms
The typical patient has a history of several weeks or months of hip or knee pain and an intermittent limp. The appearance of the adolescent is characteristic. He or she walks with a limp. In certain severe cases, the adolescent will be unable to bear any weight on the affected leg. The affected leg is usually turned outward in comparison to the normal leg. The affected leg may also appear to be shorter.


Diagnosis
The physical examination will show that the hip does not have full and normal range of motion. There is often a loss of complete hip flexion and ability to fully rotate the hip inward. Because of inflammation in the hip, there is often pain at the extremes of motion and involuntary muscle guarding and spasm.


Treatment
The goal of treatment, which requires surgery, is to prevent any additional slipping of the femoral head until the growth plate closes. If the head is allowed to slip farther, hip motion could be limited. Premature osteoarthritis could develop. Treatment should be immediate. In most cases, treatment begins within 24 to 48 hours.

Early diagnosis of SCFE provides the best chance to achieve the treatment goal of stabilizing the hip.



A screw is inserted to prevent any further slip of the femoral head through the growth plate.
(Courtesy of John Killian, MD, Birmingham, AL)
Fixing the femoral head with pins or screws has been the treatment of choice for decades.
Depending on the severity of he child's condition, the surgeon will recommend one of three surgical options.

Placing a single screw into the thighbone and femoral epiphysis.
Reducing the displacement and placing one or two screws into the femoral head.
Removing the abnormal growth plate and inserting screws to aid in preventing any further displacement.

Complications
There are several potential complications associated with a slipped capital femoral epiphysis. The most common are avascular necrosis (AVN) of the femoral head and chondrolysis.

Avascular necrosis means that the blood supply to the femoral head has been permanently altered by the femoral head slipping. There is no way to identify children at risk for avascular necrosis or to prevent this complication. Evidence of avascular necrosis may not be seen on X-rays for as long as 6 to 24 months following surgery.
Chondrolysis, or loss of articular cartilage of the hip joint, is a major complication of SCFE. It may cause the hip to stiffen with a permanent loss of motion, flexion contracture, and pain. The loss of motion may be a result of an inflammation in the hip joint. This is still not fully understood by surgeons. Aggressive physical therapy and anti-inflammatory medications may be prescribed for this rare complication. There may be some return of motion.

Care After Surgery
Most likely, the child will be admitted to the hospital by a pediatric orthopaedist. Surgery is usually performed within 24 to 48 hours. After surgery, the child will be on crutches for weeks to months. A physical therapist will demonstrate how to use crutches. The doctor will give you specific instruction about your child's weight-bearing status and activity restrictions. Follow the instructions closely.

It is important that your child be followed closely for 18 to 24 months after surgery. After the immediate postoperative period, X-rays every 3 to 4 months are needed to ensure that the abnormal growth plate has fused.

Your child may be restricted from certain sports and activities during this time of recuperation. This helps to minimize the chance of further complications. The fusion must be mature enough to prevent further slippage. Then, vigorous physical activities can begin.

8 comments:

salena said...

I'm so glad he is okay! We were REALLY worried about him, as I'm SURE so were yOU guys! I wish I couldve done more to help. LOve you Christian..hope you feel well soon and your recovery is fast!

Marie said...

Glad everything went well. It is always so stressful when your kids are in pain. It makes you realize how much they depend on mom to make things better. We will keep him in our prayers.

Anonymous said...

OMG Ana....I am SO sorry! I am feeling like a failure of a friend that I knew nothing about it, I would have loved to help you guys out in some way! I totally understand the stress you have been under...It is a scary thing....I know!

I hope he is doing okay...if you need ANYTHING...Im here for you! I would LOVE to help!

I have never heard of that before. Poor guy...It is often hard to know ( us as parents ) when something is serious...by the complaints of things hurting them. Any time my kids complain about stomach pain...I automaticly think appendisitis. (sp) I freak out...cause of my ordeal. So Im glad you took him when you did, and that he is now "fixed."

I hope his recovery is a fast one! And...remember...I am here to HELP!

salena said...

Is Christian still into Harry POtter?

Anonymous said...

Im not sure if you will see this first...but I left you a message...Dane is wanting Philipe and Sione's phone number to talk to them. I know you are super busy, so just go ahead and email them to me when you get a chance.

I am going to stop by tomorrow...probably later in the afternoon. I will bring you guys a treat.

Tuihalalalala said...

Wow, I read th whole post carefully and I feel like A proffessional doctor and specialist in the SCFE area of expertise ...after all that reading and the other readings that mom gave me to read . All I know is that we witnessed a miracle from the blessings of it not being the worst case scenario. Love ya

the Hansen's said...

Ana, I hope he gets better fast! I'm sorry! Your s great mom. Your boys are so handsome in their Easter clothes below. You done good! What cuties! I wish Christian a speedy recovery.

Anonymous said...

thats SAD
SoRRy

jaycie



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