TC

In my last post I talked about orthotics and concerns about Nick's foot turning in. SB mommies know what I'm talking about, but for everyone else, it may see like a bit of an over reaction.

The answer is TC, or tethered cord

I talked with his neurosurgeon who agrees that we should get it checked out.
Not as an emergency or anything, but a MRI in early spring.
Good, that means we are still getting it checked out, and I'm not handing my child over for major surgery because of a foot turning in... yet

I'm trying very hard not to freak out. To think of how all of the kids I know did after their TC surgery. And how their parents survived it. Even if they did worry a lot before hand
And we aren't even there yet! Maybe it is just the excitement and busyness of the day at school.

But let me back up a bit.

Here is a video by the show The Doctors that helps to explain it a bit

The spinal cord normally hands loose in the spinal column

As children grow older, the spinal cord raises up in the bony spinal column, but when it is tethered, it doesn't raise, and is pulled tight. And there is nerve damage.
A picture is available here

The symptoms are not obvious, but are gradual changes. And that's what we are supposed to be watching out for, subtle symptoms. So here I am, unsure if there are any subtle symptoms.

My understanding is that any damage that is done from the nerve damage, is permanent. So you don't want to wait for huge changes, because surgery doesn't fix it. It just prevents further damage (and hopefully doesn't cause further damage - with the spine surgery and everything)

Surgery can free the scar tissue, but creates more scar tissue.
So I'm always watching out for symptoms, while hoping that I won't see them.

So I have a couple of months to think and wonder and watch.

Orthotics and ...

It is that time of year again.
Orthotics time.
And you can tell that Nick is starting to outgrow his orthotics. He is growing taller and so they aren't fitting as well.

The plan had been for his KAFO to only be temporary. That was the plan, and we all know how that works.
A quick little chat with physio, turned into a couple of 30 minute phone calls.

And the decision to keep the KAFO on the left leg

We have a new PT, she is the school age physiotherapist, so she has only met Nick in September, and she sees him during school hours, without me there.

I've been talking with her about orthotics, wanting to figure out what we are doing and when we will be getting fitted.

I talked about my concerns about keeping the KAFO, are we giving him too much support that will prevent him from gaining that support himself? Or does he need the extra support, and if he needs it then I don't want to say no because of ....
Because of what?
My idea and wishes for what I want for him? That I want him to have less support, that I want him to need less support. And just because I want him to need less support, doesn't mean that he doesn't need that support.
Or that having a KAFO is really pain in the butt, with pants and skin breakdown and heat.
Or that I really don't want to do something that could prevent him gaining strength.

So I am deferring to the professional, the physiotherapist. She thinks that the KAFO is needed, so that is what we will get.

Except that wasn't it all.
This past week when I was talking with her she mentioned that his right leg has been turning in. Turning almost all the way around by the end of the day.

His right leg has always been the good one.
And now it is turning in.

Turning in, that simple little phrase, that subtle sign that I'm supposed to watch out for.
Or is he just tired and its normal?

While PT talked about maybe considering a KAFO for the right leg, all I could think about was tethered cord. It's not supposed to do that. It is not supposed to go backwards. Function in the right leg is good and strong.
If all of a sudden he starts to need 2 KAFOs is there something else going on? I did ask the dreaded TC questions, she doesn't think it is tethered cord, but she is not a neurosurgeon. And my worse-case-scenario brain jumps there.
Or is it just simply activity. School is busy, he does a lot of walking in his walker, is it just simply that he is tired and doesn't pay as much attention to his leg. Or even that his AFO is too small to maximize what he needs.

I am not sure.

I'm going to ask his neurosurgeon. The specialist who will be able to tell me if I should be worried or not. Because I am trying really hard not to be worried, not to think about surgery, and handing my child over to a surgeon, all for a little twisted foot.

So I started talking about orthotics. We are going to go with the AFO-KFO combination, and see if there is something we can add to an AFO to give it more support at the end of the day. Kind of a mix

All of this and I still don't have a design yet!