Fused and Fancy Free

I am about to loose any street cred I had regarding knowledge of fibular hemimelia. Seriously. Maybe just stop reading now. Why come here if I don’t know basic information such as…

Nick’s ankle is fused.

I didn’t know that.

My only excuse is that I swear Dr. Standard never used the word fused to describe Nick. Confused yet? I certainly am.

Dr. S basically said Nick’s ankle is very typical for his type of fibular hemimelia. “His type” hmmm… I know it’s type 3 and I know there are subtypes but I have no idea which of those it is. I knew it was the type that needed the super ankle surgery. I knew that there were bone cuts and all kinds of things done in that surgery that I never cared to ask for details on. I have never claimed to understand that stuff. Thank goodness! 

What I do know is that I usually referred to it as on the severe side. That was the type according to me. Severe or maybe I said moderate to severe. Because he’s done so well and we had options. In a way severe sounds like the worst. Nick isn’t the worst it could be. He had bones in his foot to work with.

Anyway the fact that I had to ask Dr. Standard if Nick’s ankle is considered fused felt really dumb. I write about fh here, I support other families through email and the Facebook group. They come to me for information. Like I know what I am talking about, meanwhile I missed this bit of info about my boy. 

We have always focused more on what the result of what was being done would be. The last surgery Dr. Standard put Nick’s foot in a better position and he straightened out his tibia which had a bit of a bend still and lengthened to the point of Nick being even! Thats what that mega fixator did. That’s what I know. But I am thinking I missed something (since I didn’t think Nicks ankle was always considered fused or was that word just not used?).

It also doesn’t matter. Nick has what he has. It is what it is. His fused ankle is working for him. He has a stiff but stable joint. I knew that already. He has no pain. He walks and runs and swims. He talks about trying new things. He does not feel limited by this fused ankle. Fused sounds like a bad word at times in the fh groups… “It might have to be fused”, “Better to amputate than be fused”, and so on but it’s not a failure and not a bad word and just because I am using it to describe Nick now doesn’t actually change anything. 

Except now I can tell parents who fear fusion that it’s just fine! Nick is fused and fancy free. Nicholas will likely tell me tomorrow “I bet fused and fancy free sounded cooler in your head than it did out loud”. And I will tell him it doesn’t matter cause I don’t care about cool and since my street cred is gone already, I’ve got nothing to loose.

 

Fibular Hemimelia Family Potluck

On March 23rd the first Fibular Hemimelia Potluck was held at Hackerman Patz house in Baltimore. On of the moms from our Facebook group planned it and several families came. There was even mom with a new little baby with fh! We also enjoyed the company of some of the families who were staying at the house. Having so many kids with differences together kid of made it so that no one was different at all, if that makes sense. Of course we also had siblings of kids with limb differences and they fit in just fine too!

My favorite moment was when Nicholas and another little girl pulled out their legs to compare. It felt so great for me to see these legs, different from each other but also so similar. Most people are surprised by the sight of Nick’s leg. But not this crowd! 

Sitting around a table chatting with parents who absolutely understand what you have been through is awesome! I think there were 6 fibular hemimelia families altogether. In addition to the newborn there were two little ones, one in an external fixator and one having just had his taken off. Then there were the kids who had had a fixator or a few! 

I loved meeting families in person that I had known on line for a while. Some folks we had met a few times already and it is always a joy to see them and their children too. One family we had met at the RIAO and saw at Sinai when Nick had his last surgery and their son had his fixator put on. Now this sweet little guy was in a cast. Thats another rough adjustment in many ways but seeing him and his parents post fixator was great. It is a long road in so many ways but it’s special to see families on the journey you have been on. To see them at all stages of treatment offering each other encouragement or just the listening ear of someone who has been there was amazing. It is something we will be doing again for sure. 

 

Legs!

Monday was Nick’s post op appointment with Dr. Standard. The op being the 8 plate insertion back in January. It felt like we had not been there in forever, however through web chats, following other families, and having the fh potluck at hp (Hackerman Patz) in March, we didn’t exactly feel out of touch. 

Here’s the pic that really says a thousand words… To me it reads like a song. A very cheerful tune. Maybe an Irish jig.

 

You can see the 8 plate in his knee, you can see that there is a length difference (Just 2 centimeters!!!) and you can see that my boy has really long legs. 

That’s what strikes me. Two long and straight legs. Dr. Standard said that everything looks great. In fact I had a bit of a surprise. Years ago we had talked about Dr. Standard doing a “final correction” to Nick’s ankle. This surgery would involve a diagonal cut through Nick’s tibia which could not be done till the growth plates at the bottom of the tibia were closed. So this was a surgery that would be done at the end to get Nick’s foot into the right position. The right position being directly under his leg. 

Well it turns out Nick’s foot it is in the right position or as right as it needs to be. I guess we’ve had so much going on at the last few visits I hadn’t really talked to Dr. S about the long term stuff. Now the long term stuff is just lengthening (internal lengthening by the way!!!!!). And of course 8 plate removal will have to happen. 

So this means Nick is really done with external fixators. Done. No more. Bye Bye! I was pretty excited discussing it with him in the cafeteria after his appointment and Nick said “You never know Mom. Don’t get your hopes up.” That sounds kind of negative but he really didn’t say it in a negative way. Just sort of ‘hay you never know’.  Of course he’s right and yet… 

It feels like a victory to me. Look at those legs. Nick will be 10 in August. He’s getting closer and closer to my height. We can share t-shirts now and if I were slimmer I bet we could share pants too. He is growing and thriving and running and playing and that’s the dream coming true every day. 

I will post soon about the fibular hemimelia potluck (another one is coming soon), Nick’s foot (because it’s all about a functional foot in the end), and the five fibular hemimelia families we saw at the RIAO on Monday! Yes FIVE in one day. There may have been others for all we know.

Tall and Humble

Thats what Nick called himself recently. We were discussing teasing and bullying and he said kids in school use to go to him for help because they knew he was tall and humble and therefor would help them. It was a really sweet conversation. Nicholas is a seriously compassionate boy. He’s not the tough guy type but he would not stand by while someone else suffered. I am so proud of him. 

On the tall front Nick was worried today. He came to me and said “Mom I don’t think I am growing much anymore”. I asked why and he said because he still does not need a shoe lift he must not be growing. I pointed out that his lengthening surgeries can stimulate natural growth from the bone that normally grows at a significantly slower rate. He was so excited about this. Another good thing to come out of surgery. 

Truth is he will see Dr. Standard next month and for all we know it may be time for a lift again. The fact that he has gone without one since the last fixator came off is awesome no matter how much longer it lasts. 

On a personal note I have connected this week with a few new fh families. Wether they have tiny new babies or kids like Nick I feel such a kinship with them. I am so glad people come here and feel comfortable reaching out to me. Nick is also proud that sharing his story helps others. He still believes he is the most famous kid in the world with fibular hemimelia. He still sees so much positive in the hard hand he’s been dealt. In fact he said he wanted to have a surgery soon so he could go back to Sinai and so he could get a new video game. He’s too much.

Thanks for the awesome pic Aunt Tara! 

Two views of a year in review…

Now that Nick is without restrictions it reminds me of how far he has come to get here. I decided to make a collage and when I was done I decided to make another. The problem with the first is that I felt like it was over fixator focused. Well not just fixator but surgery. There were so many moments in between.

Still even those surgery moments had a lot of joy. Dr. Standard did an amazing job with Nick’s leg. When the bone collapsed he saved the length. When we needed him he was always there. I didn’t take more than the one picture of him with Nick. Strange but I guess we were always preoccupied when he was around.

Nicholas and I had to work hard sometimes to make the most of it (one of our motto’s), but we so did. We laughed 1,000,000 times more than cried. He was up and moving more than not. He was in good spirits more than down. Even when we had to say “this sucks” we laughed about that.

Fibular Hemimelia (and other dramas of course) defined the last year for me. They took over. No denying it. But fibular hemimelia has never defined my boy. As you can see above and below it’s what you make of it. A fixator can be an air guitar, a hospital can be a haven, siblings can be saviors, bubbles can be a beard, a knee can be a monkey, a son can be a star and no fibula can be no problem.

If a picture says a 1,000 words then a collage must say a million!

Be Encouraged

People mostly come here looking for advice. Of course some kind friends and family like to check in on Nicholas but thats not where all the action comes from. It’s those parents of new born babies or expectant parents who heard something they never wished to hear.

I wanted to share the above which I saw on Facebook today because it is solid advice for anyone but when you are facing an unknown challenge, when you know you will have to choose a treatment for your child when none sounds particularly easy, when you are hurting it is easy to loose sight of the big picture.

The big picture is that life is too short to dwell in the details. I had planned on a post recapping the last year in terms of fibular hemimelia treatment but that serves no earthly purpose. If you want a recap you can look back and read old posts.

What I can say is that this was our hardest year. 2012 will not be missed. I wish I had spent more time looking past the hard moments to the finish line. It felt too far sometimes. There is nothing worse that seeing your child in pain and not being able to do something or having that something not work or just waiting for something to work. In those moments I would try to still myself and hold Nick and be at peace. Sounds crazy yes but hugging him full of tension would not have helped. Thankfully there were not too many moments like that but it is easy to get lost there.

Right now Nick is doing great. Great enough to be playing football outside with a friend and to run to another friends house to play (by himself!!!). These are the details I could stay in for a while but truth is even these are not the place to be. Nick will have another surgery this month to put a small plate in his knee and take the big plate out of his tibia (hopefully). I can’t hang my hat on my kid playing football but I can focus on the fact that through it all he is still my loving and happy boy. Through it all he has grown (oh my goodness has he grown) into an amazing boy.

The big picture for me includes a little picture I’ve had in my mind since we chose the lengthening road. Nick getting out of bed in the morning with his own two feet hitting the floor. Nothing more.

I know he would be ok without his leg. I love reading about all the kids who are doing amazing whatever treatment they have but for me that little picture is important. It’s his leg and he worked really hard in 2012 to keep it that way. His legs are still nearly even!

So please be encouraged. Even if you go back and read about how hard 2012 was in some ways it may turn out to have been a great year looking back. It’s too soon to tell. We’re still too close to it. I think Nick and I both learned that we are even tougher than we thought. Though he will be the first to say he’s actually soft on the inside. Of course I am too (we are so much alike) but maybe that softness is actually where the strength comes from.

Leg lengthening number three is over!

Nick’s leg is healed. His arm is healed too. In the words of Dr.Standards PA Allison, Nicholas is “super healed”.

Super healed!

No more braces or boots!

Super healed!

His right foot even grew too big for his summer shoes. I can’t remember his right foot ever outgrowing a shoe before his left. It’s pretty amazing.

It was a happy RIAO visit… my boy didn’t want to leave. He was enjoying the cable tv and he made another friend with a broken arm. I guess it’s not such a coincidence at an orthopedic clinic but it’s funny to me. Nick was a little sad not to get to see Dr.S (he was in surgery) but he said “I really like Allison. I mean I like her like a friend”. I think he thought I thought he meant romantically. LOL

I have waited for this day since January when the mega fixator was put on. I have dreamed of hearing that the bone was finally healed and it’s here. Nicholas is so happy. He was running down the hall at the the RIAO.

Without the boot on his gait is off but it still feels funny to him to walk barefoot. We’ll give him time to adjust and get physical therapy down the road if needed.

I am listening to the kids playing and need to put them to bed but at the moment, in addition to feeling elated I am exhausted! The emotions of the day, the drive, it all wears me out. What a great reason to be super tired.

Super Healed!

If I had the energy I would write a love note to the RIAO! I am already thinking of doing something special for the all the folks who saw Nick through this. It takes a village (and one wizard of a doctor of course). I can’t name you all but so many people helped us get through this (almost a full year of ups and downs).

Thank you!

50% weight bearing… ??% stressed…100% GRATEFUL

The Bat-mobile at Sinai

Batman arrives at the RIAO. This is after we had the chance to see him in the lobby where he whispered in Nick’s ear “Get better ok”.

Super Hero and Doctor Hero Hugging!

With the summer of the “normal kid break” and the 7 screw plate coming to an end I am realizing just how stressful this has been and continues to be. Nicholas had a great visit with Dr. Standard yesterday. His arm looked well enough to leave the cast off and just get a splint. His leg was healed enough to go to 50% weight bearing. It’s a big step considering he has been hopping for what feels like the whole summer.

We’ve got to pick him up an additional splint to use while swimming! Swimming is going to feel so great. He can 100% weight bear in the pool. I can’t wait to see my boy moving freely and joyfully. Really can’t wait!

Comparing the Nick of this summer to the Nick of last summer I see a completely different kid. He has grown so much in so many ways. Physically he is like 20lbs heavier and so much taller. He’s almost up to my eyeballs! At nine years old that’s pretty tall. Emotionally he has matured as well. Maybe this is all normal. Since he’s my oldest this is all I know of mothering a nine year old.

This summer has stressed us all. Last night Nick started having pain in his arm which he said he felt where the break was. I was helping out on a web chat with Dr. Standard so I was able to let him know right then. Basically he told me to give him ibuprofen round the clock for a few days but if the pain persisted to call him tomorrow (meaning today).It was a hard night. Pain would have been ok I am sure but pain right where the bone broke frightened me. Nick and I were both up past midnight.

Today it seems that the pain only happens when he bends his arm and it is not only where the break was. His elbow was hurting today and we are thinking some of the pain is in his wrist. That would be normal. He’s not moved his wrist or elbow in like 6 weeks! But nothing about a broken arm feels normal to any of us. Nick is keyed up because one something goes wrong it is easy to imagine wrong stuff will continue!

At least Nick’s leg looked great on the films and it has not caused any pain. My one worry on that front is that when Nick started to put weight on it while using the walker he seems to turn his foot totally out to the side! UGH Not what we want to see. Yesterday it seemed like Dr. Standard had some concerns about Nicks knee but we wont know anything till we can do a standing x-ray at his next appointment in a month. Lengthening is a big strain on the his knee (his super knee surgery was in June ’11) and I imagine all the rest has been a strain as well. I am hoping he wont need another 8 plate or any other kind of intervention for a while but really hoping is silly. It is what it is already. It will be what it will be.

The fact is we planned this last lengthening when we did for 3 reasons. 1. Nick’s foot began to hurt. 2. Steven was loosing his job and we only had insurance for a few more months. 3. We wanted Nick to be done by summer time or at least by midsummer.

Reason number 3 was not so realistic. We did our best to make it happen and then life happened. Nick said to me “Mom you promised this wouldn’t be a bummer summer and it was”. Nothing SUCKS more than hearing that. At least I pointed out that it is not over yet and as home-schoolers our summer can continue!

We’re hoping to move to less stressed and by next month to more weight bearing. As hard as it has all been everything is ok. This all could have been much worse. We still have the best doctor and team looking after Nicks bones! Here we thought it was just the leg!

Yesterday was a great day at the RIAO. Batman was there. Truthfully my kids are not so much into Batman but it created a really fun vibe. Personally it made me happy to see all the happy kids and the hard working RIAO folks watching the happy kids. Nick was glad to get into the cast room for removal but when it came time to do it he was scared. Melinda the tech was so patient with him. She always is and we’ve spent a lot of our RIAO time with her this summer but this was unusual for Nick to be so upset yet she was easy going and got it done.

Then Nick was scared to get off the bed to go to xray and the tech said (I wish I could remember his name he is the least chatty guy but great all the same) “That’s ok I’ll just wheel him over”. Another instance of patience and kindness making all the difference. I was just not feeling calm myself and it was nice to not have to be the one to figure it all out and make it all ok.

So now we make sure Nick is not more than 50% weight bearing. We hope the arm pain goes away. We try to keep the arm safe. Maybe most importantly we try to have fun and find some cool water and swim. And of course focus on how darn lucky we are in so many ways. All this bone business might have made a bummer summer but we tried our best to make the most of it, and it was all fixable, and Nick still grew 6cm of new bone in his right leg. Even when it kind of fell apart he didn’t loose any of the length he worked so hard for.

The truth is Dr. Standard preserved the length. I don’t think that was a guarantee. At least from what I have read of others experiences with other doctors. Perspective is so valuable. I am trying to teach it to Nick in the kindest way possible. Not just to be happy because it could have been worse or because he’s better off than others but to look at how far he’s come. From my perspective it never ceases to amaze and my gratitude is always present (at least to some extent) even during our first and hopefully last bummer summer!

Permission to Post Poetry Received

I wrote the poem below for Nick and read it to him this morning in honor of his 9th birthday! He even gave me permission to blog it, despite the fact that the Dora part embarrasses him. He did love Dora’s Pirate Adventure so much. In the PICU after his first surgery it made him smile when nothing else could!

For that Dora will always have my love and gratitude. She has traveled with me through my journey as a Mom. From hospitals to cars and home again, state to state, child to child. Dora’s a girl you can count on! In two languages no less!

If you’ve never written your child a poem I suggest you consider it. Nick got something in his eye that made him tear a bit while I was reading.

God I love my boy!