Monthly Archives: May 2014

The Long & Short of It

If you just want the short version, scroll down.

The Long:
I’ve told the story a hundred times but it never gets old to me. Does it for any mother? The hours I pushed. How he seemed to be stuck. And then POP! (I actually felt a pop, unlike anything I’ve ever felt before or since). And then he tumbled into this world, and it was there but no one saw it. You can see it clearly when you look at the pictures. It’s funny how pictures capture things you never noticed in the moment. They cleaned him up and there were some whispers. The nurses noticed quickly and paged the on-call pediatric nurse practitioner. She swooped in, swaddled him, and brought him over to me. She held him near me, talked of abnormalities and what they knew and what they didn’t know. He is healthy, she said, but there’s this one thing. And she danced around the one thing for what seemed like ages. It may or may not be related to any other issues. We don’t know. It’s nothing I’ve personally ever seen before, she said. And, y’all, my honest thought was that he had an extra head growing out of his neck. It seems ridiculous now, but that’s what I thought. I’ve always had an (over)active imagination. She finally got around to telling me about this “abnormality” and I laughed. I laughed! And then she looked at me like I had an extra head growing out of my neck! She’s prepped it as some big, awful thing and I was just so grateful he didn’t have a neck-head that I laughed. So he was born with 10 tiny fingers and 8 tiny toes. Even then, I never worried. And I can usually compete in the national championship of worrying, but with this it just was. The pediatrician came in the next day and said that sometimes some syndromes can be connected with limb deformities but my heart-gut knew that he was syndrome-free. My very first baby, I (of course) thought he was perfect. I was (and am) proud of his special foot and I love that he embraces it as what makes him unique.

We saw a few specialists after he was born (thankfully we were living near an academic medical center that has great doctors and many resources) and it was decided that we would do nothing for now. Nothing can be done to add extra toes (and there’s no need, really). But eventually, when he was around 10, something would need to be done about the discrepancy between his leg lengths. When he started walking, they said, he may need a shoe lift. But he walked well without it and the difference in length wasn’t enough to harm his hips and so we just let it go. We’ve always had to buy two pairs of shoes to create one “Carter pair” but that’s manageable. Last year it was decided that the difference was enough to warrant a shoe lift – a pretty significant one at about 3/4in. And so we bought four pairs of shoes (to make two pairs) and took them to the orthopedic shoe place where they sent them off and had them custom-made. It wasn’t difficult, but it wasn’t cheap either. But you do what you have to do and move on with it, I suppose.

A few weeks ago I noticed that his gait had returned to a limp-step, much like he’d had right before we started with the lifts. So I called his orthopedic’s office and asked what I needed to do to get a new lift prescription. They told me I needed to bring him in and be measured again. So yesterday a friend (thank goodness she was able to go!) piled into the car with me and the kids and we drove to his office, which is about 2 hours away. I assumed we’d be in and out like normal. It didn’t happen quite like that. I won’t go into all the details of the visit because although it’s an adorable story, it’s not my story to tell. Maybe one day Carter will share with you but it’ll be up to him whether or not he shares that part. I will say this much. When the doctor first suggested that it was time to do the procedure, Carter wasn’t very thrilled with the idea. The doctor, resident, and I talked over the options and I made the choice on how and when to proceed. In retrospect, I should have included him then, but I didn’t. I’ll just blame that on the fact that I was a little surprised that we were here already. Last year we’d been told his bone age wasn’t anywhere close to where it needed to be for surgery. I knew he’d grown significantly in the past year, but I didn’t realize it was that much. So I called Marshall and was going over things with him when I noticed that Carter was sitting there, stunned. I  quickly hung up the phone and sent my friend out to the waiting room with the other children so that he and I can talk. It was then that I realized that I hadn’t included him in the conversation at all. I try to be cognizant about keeping my kids in the know about things that will affect them and I felt really awful that I’d just breezed through this without ever talking to him. I asked him what questions he had and he had some really great questions. Questions that I, honestly, probably should have asked before consenting to such a big procedure. So I asked if the doctor could come back in and answer some questions. The resident came in and was so very wonderful with him as he asked a handful of really thoughtful and specific questions. I told him later that I was proud of how logical he was about it all and how professional he sounded when he asked his questions. He didn’t shy away. He knew what he wanted to know and he asked.

The Short:
So here we are. After a lifetime of knowing that this was coming, it kinda slapped me in the face when it got here. I was expecting another prescription for a new shoe lift; I left with a surgery scheduled for a little more than two weeks away. The procedure is called an epiphysiodesis. The epiphysis is the big, rounded end of your leg bone. Between that big, rounded end and the long, straight part of the bone is an area called the epiphyseal plate, or (as most of us would call it) the growth plate. They will use an eight-plate, which is (as you may have guessed) a plate that’s shaped like an 8. And they’ll use this plate to essentially hold the big, round end of the bone and the long, straight part of the bone together so that the growth plate can’t grow. This will allow the shorter leg to catch up to the longer leg. It will mean that he’ll be shorter than he would have been otherwise, but that’s much better than having wonky hips and a lifetime of hip problems.

He’ll go in early on June 12 and they will do it as an outpatient procedure. After that we’ll come home with him on crutches for a few days, maybe a week. And he’ll have to take it easy for a little while. I’ve explained to him that it will hurt some but that the benefits far outweigh the risks and long-term effects of not doing the surgery. He is a little nervous (as is normal) but pretty excited about having unlimited electronics time. I, oddly, have been pretty calm about it all so far. We have been seeing the same doctor for almost his entire life and have developed a bit of a rapport with him. He is an excellent surgeon and I have complete confidence in him. I was a little taken aback initially that we were at this point already, but I’ve yet to be nervous. It’s one of those times when I hear Marley singing in my head, “every little thing…is gonna be alright.” And it is. It’s all gonna be alright.