Bertrand's Bones

Comparison of Bertrand's January 2011 and July 2010 hip x-rays.

Bertrand had his orthopaedic follow-up at Shriners Hospital today. The main point of concern is his right hip. It is subluxated 50%. Fortunately, it hasn't gotten worse since his last appointment even with the break of his right femur in October. "Stable" is the word of the month!

The issue of bone density always comes up at these visits. Every orthopaedic surgeon we've spoken to has said that a dexascan under the age of 5 but especially under the age of 3 is misleading. Fortunately, there is *one* pediatrician in town whose research specializes in bone density issues and treatments who can read such early dexascans--Bertrand's very own pediatrician! As a result, we'll be following-up with Bertrand's pediatrician through Shriners (rather than Primary Children's Medical Center) in February.

The best things for Bertrand's hip and bone density include reducing factors which negatively affect bone density and performing weight bearing exercise. This dovetails nicely into our treatment plan from Cleveland Clinic which eliminates zonegran, the ketogenic diet, & prevacid (all decrease bone density). And, there will be a renewed emphasis on weight bearing in our household in the form of scheduled Tuesday, Thursday, Saturday and Sunday stander time.

If these things don't help Bertrand's hip then surgery may be in his future. However, before that point, it appears that botox would be an option. Botox would be injected into his groin muscle in hopes of relaxing it sufficiently that the femur ball could settle back into the hip socket. The results of this are temporary. We'll be seeing Bertrand's rehabilitation doctor through Shriners in March to discuss both surgery and botox options.

Lastly, Bertrand's spinal curve, possible vest brace and wheelchair were discussed, along with disability certification. Oh, and of course today was the day the Shriners' public relations folks were taking professional photographs of patients for their literature, website, etc. So, now they have pictures of Bertrand and me (hair uncombed, covered in dog hair, dark circles under eyes, etc.) which should evoke plenty of pity and donations for the hospital. :)