At our last appointment, Dr. Awesome had recommended that Collin see a pediatric orthopedist since tone as low as his can cause various issues and because we want him to be in as good a position as possible to pursue standing and walking since he seems to have the desire.
Last Friday, we got in with the physician Dr. Awesome referred us to. He was nice enough and asked lots of questions about Collin. He noted that Collin's hamstrings are tight and his joints are hyperflexible, both things one would expect in a child with low tone. Then he took a baseline xray to check his hips. We had had an xray back in 2010 and everything checked out fine, but the doctor felt like this one showed some dysplasia in Collin's right hip. This means that his right femur isn't fitting quite right into his right hip socket. Since it wasn't there in 2010 and seemed to be there on this xray, the doctor felt that this is a developing condition. He wants us to come back in 3 months and that if it gets any worse, we'll need to do surgery right away.
Whoa whoa whoa.
Collin's right leg is the one he does the best job bearing weight on. It's the one he steps with first and the one he kicks with the most. It is totally functional and he shows no signs of pain. That doesn't seem like a situation that would warrant surgery.
I asked what might have caused this and what we could do to help it.
He basically answered nothing and nothing. It's developing just because and the only answer would be surgery (he's an orthopedic surgeon). Being in the stander more has no effect (WHAT?!). His muscles on the outside of his hips could be weak (oh really?!), which would allow the hip to slip outward, but with his low tone, there's probably nothing we could do about that. Says he.
I know not all medical doctors are like this because we have encountered several along the way who are very open minded and critically thinking when it comes to prevention and treatment. But it doesn't take too many appointments like this to make you feel justified in a bit of stereotyping. (Anyone remember Dr. Snarky suggesting a tracheostomy and ventilator because of Collin's sleep apnea?)
He did end up sending us home with a brace for Collin to wear at night that holds his legs in a frog position to direct his femur head into the hip socket. But the doctor didn't seem particularly hopeful that it would really do anything and said that if Collin doesn't tolerate it well to just forget about it. (Luckily, Collin has been sleeping GREAT in it, because I admit that after seeing him in it I cried a little bit over the miserable state of his sleep situation - BiPAP post to follow soon.)
Luckily, we have a wonderful team of therapists I've been able to talk to since then who heartily agree with Kyle and me that there is NO WAY we would consider surgery for possible slight hip dysplasia any time soon and helped us come up with a plan to get him standing more (which many studies show does help to form the hip sockets), strengthen his hip and butt muscles, and stretch some places that could be pulling him out of whack. I also had a super interesting and helpful conversation with Sky Medical Inc. (designers of the TAOS walker), who explained in detail the mechanics behind Collin's hip and had some great, practical suggestions that we can implement everyday.
I don't want to give the impression that I didn't like this doctor. He was a good listener and he seemed to genuinely care about Collin's well being. I just don't agree with his approach. It will be good to have his expertise on Team Collin and we'll definitely consider what he has to say, but I can guarantee we won't be rushing into surgery for this issue.