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. 

 

This Thursday’s web chat info!

“Thursday, we will discuss congenital deformities (e.g., fibular hemimelia, congenital femoral deficiency). The chat will start at 8:00 PM EST. To receive log in information, e-mail icll@lifebridgehealth.org and provide your name and a summary of what you would like to discuss.”

These web chats are an amazing opportunity to ask the Dr. Standard questions and to connect with other families. I’ll be there! If your new to the world of limb differences it is a wonderful opportunity.

17 centimeters

Adding up the length from each surgery Nicholas has gained 17cm through leg lengthening. I think he still has 7 left but that can all be done internally. This was the biggest surgery and it is over. Dr.Standard removed Nick’s fixator and put a rod in his tibia this morning! Like most of his past surgeries this has gone pretty smoothly. I did not really cry in the operating room when I left him. Usually the walk back to the waiting area is so hard but I asked the fellow who walked me back what his plans were because I knew his fellowship was ending. He told me that his next fellowship would be in trauma. I said “Trauma really? This is traumatic enough for me”. I guess I must have been ok if I was making jokes!

Since at our last appointment we didn’t have a set plan for removal I really didn’t ask many questions about the rod and for whatever reason I did not realize Nick would need to stay overnight. It has actually worked out so well! At least here at Sinai. I hope the kids are doing ok in PA with Grandam and Grandpa. They sounded great when we called them (they sang happy birthday to me) but I hate to be gone longer than we said we would be. I am so grateful that they are with my inlaws, otherwise Nick and I would have been alone and not had an awesome birthday dinner and movie night here in room 3122.

Nicholas has not been in pain at all. I did ask for his pain meds to be given because I didn’t want his blood pressure going up like last time. Still he seems tired but ok. He is so happy to be fixator free. He was even so calm this morning. He didn’t have happy juice or anything before surgery and had an anesthesiologist today that he had not had before but he was a really kind man. There were plenty of other familiar faces throughout the day. It is still surprises me how familiar this place is and how comfortable we are here. It’s nothing you expect in life but hay it is what it is!

When Dr.Standard came out to tell us how everything went he explained why Nicholas would need to stay over night. It’s really just the antibiotics because of the rod. He has a protocol he follows and I would not question his methods. That conversation we have each time when surgery is done but Nick is not really out yet is such relief. Once I see Dr. Standard and he says everything went great I finally exhale! We always talk a little about whats next but this time whats next should be really far away. Nick can have the rod in for years if it does not cause any problems.

Dr. Standard has been Nicholas’s doctor through this whole journey, each surgery has been at Sinai, each time we have family and friends helping along the way and every outcome has been excellent. Every day I am grateful. Without the love and support of so many people this really would not be possible. Nicks right leg may be longer or he’s finally even. That is amazing! If he had had no surgery his right leg would already be almost 8 inches shorter than his left! That seems crazy but thanks to 17 hard earned centimeters Nicholas has a far different reality!

Summers of Surgeries

Some days I really can’t be positive. So I keep quiet. It was a rainy day anyway. No need to venture out into the world which is good because I happen to be pretty annoyed at the world. I am just tired of Nick’s summers being so surgery filled. Last year on June 17th (his baby sisters first birthday) it was the knee. This year on June 22nd (my birthday) it will be fixator removal. I could add previous surgeries to this list but you get the picture.

As much as this is a surgery to be celebrated it is hard because we have no idea how he will feel after it. He might now want to walk for a while. The rod could cause him pain. Who knows! I just want Nick to be able to relax and just be a kid for a while. A really long while!

I also sometimes realize how much it impacts the other kids. We wont be going to amusement parks until Nick can go on rides. Would it be more fair to take the other kids and leave Nick behind? I don’t think so. Is it the end of the world not to go to amusement parks? No but when I think of how few times we really have gone it is kinda sad. There are other things I don’t do because it is hard with 4 kids (and really it’s just hard cause one is in a fixator and one is about to turn 2). The kids also have fifth disease and the rash from it seems to be gone until they are out in the sun and then it is red and itchy for a while after.

I guess we’re home bound and a little stir crazy. I took them to Target yesterday and the best part was that I could get them all in one cart. People found the sight of us quite amusing. Big kids, little kid, baby and stuff all in one cart. I counted pushing it around as a workout for me.

I think the moving factor is changing this summer too. We’re in a kind of limbo and I am tired of it. So really I am just complaining which is a waste of time and energy considering the kids are asleep and I could be asleep. Plus I realize I have much to be grateful for. I just wish this summer was easier for my boy and I guess the rest of us too.

The home stretch… I hope!

So this should be the home stretch. Nick had an appointment with Dr.Standard Thursday and the smile on Dr.Standards face while looking at Nick’s leg really says it all! His right leg seems to be about 1cm longer than his left! This was unplanned and unexpected. It also made the news that Nick’s bone is not consolidating as well as we would like much easier to take. There’s really nothing wrong. It’s not really been that long but we still hoped for more.

The fixator could come off next month as planned but Nick would need a rod put in his bone to protect it. I’ve heard this is often painless and no big deal but sometimes it can lead to painful setbacks. As in the past I am inclined to let Nicholas decide what to do. His options being 1) take off the exfix and have rod inserted or 2) leave the exfix on another month or so and then hope he won’t need rod at removal or 3) just wait till the bone completely consolidates.

So far my boy has chosen option one. He’s seemed a little down lately and I think loosing this hunk of metal would help! He also still has pain in his foot when he walks, which the weight of the fixator could be contributing to. His new shoe insert helped with the pain in the bottom of his foot but now his heal hurts because it makes his shoe a little too small! I’d really like this insert to work out! Nick needs to walk pain free! And considering it was over $400 and not covered by insurance it would be a pretty penny to have spent!

On the home front the specifics of our move are still not settled and Steven is obviously still traveling and I’ve been unraveling just a little bit. I think I jinxed myself with my mental health post. I’ve gone back to therapy and even just one session was helpful. I needed to hear that all my stress and feeling’s about surgery/moving were ok. Why do I need professional to tell me this I do not know. Maybe it is too darn hard to admit to those I’m closest to that I am struggling (well some of you know and now anyone who bothers to read this knows). I often think I should be able to handle this or I just don’t want to ask for help. I hate asking for help. Maybe that’s reason alone to go to therapy.

So right now I am doing my best to simplify and say no to anything that will add stress or items to my to do list that are not necessary. The definition of necessary at the moment is “what my family needs” and of course friends if they are in crisis. Otherwise I am not available.

I’ve even taken a Facebook hiatus. I have Steven checking in on Fibula Hemimelia and Limb Lengthening Awareness. I feel a sense of responsibility for the group I created and I want to make sure folks are getting what they need. The group has over 540 members! Its awesome and seems to really be helping families connect and face the future.

My tenure as board president of our church is ending just in time and I’ve not been called in to the nursing home, where I am a companion for dying folks, in a while. I’ll hate to say no to that if they call but the times I go are usually at night and I need to sleep more! Plus there are others in the program they can call on. I am so grateful for the time I’ve spent as a companion. I hope to find similar volunteer opportunities in Delaware.

So while much of our future is unknown I am comforted by many things, including the cute little boy next to me who needs me to help him play Mario vs. Donkey Kong on his Nintendo DS. Time to get to what’s necessary!

Back to School?

Yesterday I asked Nicholas if he felt ready to go back to school. His response didn’t surprise me much “Yeah Mom I’ve only been waiting for you to ask me”. I’ve made an appointment for him to get fitted for his shoe insert on Thursday and I think Friday he’ll go back.

Nick is ready. I am not. I am so happy having him at home. Aside from it being hard to get out and about. I suppose I will be able to get more done during the day. Still I will worry! To be honest Nicks at home instruction experience has been one of the reasons I have decided to homeschool, or at least to try it for a year. It sounded a little crazy to me at first. Even felt crazy to be considering it but the more I research the more I want to do it. I don’t think public school is evil or anything. I do think it’s an awfully long day considering Nick could learn everything he needed in an hour or less. It’s just not the only way to learn. Once you start thinking outside the box it’s hard to get back in!

I would also love for my kids to have some choice in what they learn. I would love to have more time with them. Being gone seven hours a day five days a week changes things. I am often sad that Charlotte is in school while the rest of us are at home together. I know it suits many people just fine but it’s never sat well with me. I never look forward to the end of summer. I don’t think it’s as easy as people say it is to have your kids in school. I know I have taught them many things, I fell confident we can learn together. I know I will have to work hard and be disciplined. I believe it’s worth it.

This is not to say that I don’t love and respect teachers. I know what they do is takes it’s own skill and education. It’s just not the only way to learn. I don’t compare myself to teachers at all. My kids have had amazing teachers. Really! I have loved them. Nicholas’s current teacher has literally been perfect. She was the turning point when Nick came home from surgery and wasn’t himself. She makes schoolwork fun. She is a beautiful, smart and kind person. All you could ever ask for.

Sadly she and many other teachers in our district are either loosing their jobs or being shifted around. Like many areas, central PA schools are suffering financially. My children have a wonderful school. I respect the principal and pretty much all the staff I have encountered. They have all been kind and helpful in handling Nicholas’s surgeries and anything that has come up. But with these cuts I know the school will suffer. They will be loosing some amazing educators. How could the school not suffer?

Many experts say our education system is broken. I’m not going to worry about quoting anyone here. You can google yourself. When my husband and I tell people we’ll be homeschooling the only real argument against it we get is “what about socialization?”. If socialization is the best thing a kid can get from public school there’s more wrong than I thought.

All I know is it feels right to us. We’re moving to an area of Delaware with so many amazing homeschooler activities and groups. There’s a coop, there are weekly playground dates, monthly roller skating, and many other group classes and activities. We’ve received invites to a beach day, canoeing classes, a family farm day and more. We won’t be sitting at home reading textbooks. We’ll be living and learning together and in community with others. There’s even a yoga and meditation class this month for 6-9 year olds! In addition to a class at the Apple store on Garage Band. I wish we were there already to take these! Really there are so many different things. I am sure we won’t be able to do everything because of time and/or money but there are options.

So hopefully Friday Nick will go back to school. At least for a few weeks. School here ends in the beginning of June. He’ll likely have his fixator till after the end of school which could work out since removal would have been more missed school!

I am so nervous but if he feels ready I have to be ready to. When we told Charlotte she hugged him so hard she could have knocked him over! Still as happy as she is going to be is comparable to how sad Christopher will be when his big bro is gone all day. He and I can comfort each other!

Two More Months

Thursday Nicholas had an afternoon appointment with Dr. Standard. His x-rays looked great. His leg looks so very long and straight! The bone is not filling in or consolidating as fast as I planned for it to so while I thought Nicholas had about a month left in the fixator its’s actually two. As has happened in the past my plans and reality just don’t match up!

In the long run this could work out better for a couple of reasons. One ofcourse being the longer his leg is in this pricey hunk of metal the less likely he is to break it when it comes off. Dr.Standard knows what’s best in this area. The last thing we want is for Nick to have a fracture after all this is done! So that’s that. Plus if we wait long enough Nick may be able to go from fixator to removable cast! That would be wonderful in comparison to giant cast which is not removable. I imagine Nick sleeping and bathing and swimming with his leg free and it makes another month of the fixator feel even more worth while. As if the bonus of not breaking his leg wasn’t enough!

Thursday’s visit was even better because our cousin Kent, Auntie Liz and Uncle Jim were there too! Kent sees Dr.Standard for Perthes. I’ve probably written about that before but the fact that Dr.Standard is the best person in the world for Perthes and Fibular Hemimelia is pretty awesome. Kent is doing great and had his own wonderful appointment. He is Nicholas’s idol. They were finishing each others sentences. I love seeing them together almost as much as I love being with my Aunt and Uncle! A hug from someone who loves you and knows you so completely is a little piece of heaven to me. Nicholas has been big into hugs these days, which is fine with me! I’ve got him saying “A hug and a squeeze if you please”, a phrase from my childhood that can feel so bittersweet with so much of my family gone. Hopefully resurrecting it in our house can make it more sweet than bitter.

So all in all Nicholas is doing well. He’s walking much more than he was. We do have go get him a shoe orthotic/insert though because he is still having foot pain when he walks, even for a little while. If the insert works I will try not to worry. Dr.Standard says he just may not be a barefoot person. But Nick really likes being barefoot now so needing an insert long term could be upsetting to him. Sometime next week we’ll have to go back to Maryland to get it since we were not happy with Geisinger’s work with the last insert. It didn’t help at all and from what Steven told me the second appointment to get it did not go well. The first had been great.

In addition to going to MD for the insert we’ve got to go to Delaware to check out houses. Steven’s working three days a week there now and it looks like come June, it will be five. I try really hard to be positive and not think myself into misery but right now having him gone so much feels like a lot. With Nicholas not totally mobile we don’t leave the house more than we have to (when Steven’s not here). I can’t push Nicholas in a wheelchair and Bess in the stroller at the same time (there’s also Charlotte and Christopher to keep track of). I do my best not to be grouchy the kids (or in the least apologize when I am) because of the daily frustrations. It is hard enough for them when Steven is gone!

Nicholas and Charlotte are not happy about moving. Steven and I are just going with it. Trying to see the positives. There really rare positives. But to move forward we’ve got home projects to finish so we can get this house rented or sold. Most of this is stuff only Steven can do, so even when he is at home he has regular work (since two days he works from home) to do and house projects and there’s regular day to day stuff! I still feel incredibly fortunate that Steven has a good job in Wilmington but the whole moving to Wilmington thing while Nicks still in the fixator with Steven gone so much already has added another stress dimension to our lives.

Managing the stress is the best we can do. Even when I am up till midnight with one crying or sleepless kid, or two, I still feel such gratitude. Ok maybe not every second but I am grateful for the moments of clarity when I see that if this is what a hard moment is for me, I am pretty lucky. If I am annoyed because I didn’t get the dish washer loaded I am lucky. If I am tired because I spent the day caring for my children I am lucky. How many parents face so much more and how many people aren’t here to feel annoyed and tired at the day to day things! I sometimes say “if you’re lucky enough to be breathing, you’re lucky enough” (I am sure it’s someone else’s phrase). I like Nicholas’s version even better “if you’re lucky enough to be hugged, you’re lucky enough”. Indeed!

Fibular Hemimelia Before and After

I’ve been asked to provide some before and after photos of Nicholas. That’s kind of hard to do since at the moment he is in a kind of before situation. Being that he’s currently undergoing treatment. It was even hard to find great photos from between previous surgeries. It really reminds me of the fact that between surgeries we don’t pay a whole lot of attention to his leg.

I guess that is truer at some times than others. The fall was hard with Nick having random pain for the first time. Between surgeries one thing that always reminds us of fibular hemimelia is shoe shopping! That seems like it will never be easy. And getting shoe lifts, which either seems super easy or a real pain. Once we find someone who does a quality lift at an affordable price we pray they will stay in business.

Apparently though Nick does not need a lift right now! He’s walking with the walker but still reluctant to put weight on his right foot. I worry he is going hurt his left foot with all the work it’s doing! Still he’s not terribly active right now and now that the infection is under control we’ve got to encourage him more (I guess the swollen red infection pictures are a kind of before. I should take some nice afters to go with them). Steven is away and told Nick that if he takes a few steps each day he’ll take him to McD’s when he comes back.

This time when this fixator comes off I will be sure to take lots of awesome after photos. I hope it will be a few years before Nick will need another surgery. Though the way my boy grows it is hard to imagine going too long without another lengthening! Hopefully I will get to posting some more before and after pics on this blog later today! For now check out the new header collage I created this morning between toddler temper tantrums, preschooler melt downs and eight year old whining (that’s what Nick has been doing whenever we have to go some place without his dad-evator (as in Dad as elevator)! Considering how little attention I had to give it I think the header is fabulous!

Cellulitis or Dermatitis? Either way it’s getting better!

Last night things got scary. Nicholas suddenly had a fever of 101.3 and it was clear the redness covered the whole front of his calf, was spreading to the back, with major swelling near his bottom three pins. In particular next to two of his old half pins with a lot of drainage. He wasn’t feeling good either. We gave him a dose of roxicet and by the time I talked to Dr.Standard his fever was down to 99.5. The fact that Nicholas’s leg really didn’t hurt and was kind of itchy was complicating things. Dr. Standard thought it could be a delayed dermatitis possibly from something they used in the surgery. We gave Nick a large dose of an antihistamine and watched for a while.

We didn’t notice a change in his leg and Nick said he felt a little nauseous but he said it was maybe just the hungry kind of nauseous so I gave him some mike and bread with butter. That helped his belly so we gave him his fourth antibiotic dose and put him to bed.

Before I went to sleep I checked his leg and it was not better but it was not worse. By five am when we gave him his next antibiotic dose his leg looked less swollen, a little less red and certainly not spreading! What a relief! Nick woke up about 7:50 which is pretty late for him and was willing to stay in bed with his DS and a little breakfast. Thank goodness his Aunt Tara was able to pick up Charlotte and take her to school. I hated the idea of making him come with me to drop her off and then I realized Steven went to Wilmington with Nick’s wheel chair and walker in the trunk of the car!

I had thought we’d be heading to the RIAO this morning. I can’t explain how it felt to be so excited about his long beautiful leg and then watch it swell and redden! Nicholas has worked so hard. He’s really had enough of this fixator so complications right now are beyond unwelcome. Now that the antibiotic seems to be working. Assuming it wasn’t the antihistamine which I guess we can’t know for sure till we talk to Dr.S or Allison… I never asked when we should give Nick more but if the swelling comes back again since I haven’t given it to him then I guess we’ll know.

Right now I am just so grateful my boy’s leg is looking better, he’s feeling ok and we’re home for the day. This fixator business is like a roller coaster ride sometimes but the light at the end of the tunnel is still shining bright. I still take a moment here and there to imagine Nicholas as a seriously handsome and tall young man with two seriously long legs! I imagine him looking down at me and smiling. He may be more than a foot taller than me!

Last night when Nick was feeling down I reminded him of what it’s all about, having his legs equal and strong and I told him that he is the strongest and bravest person I know! I reminded him that every day I look at him and think OH MY GOD that kids is awesome! His response was “And I won’t be shortened. I’m keeping my length”. Even in the hard moments Nick still has his eye on the prize and is willing to work for it! That’s my boy!

“It’s not fair that I have to have a fixator

Today’s title and quote care of Nicholas of course. It does sound sad. It really feels unfair to Nick that he has a fixator but this morning it wasn’t the fixator that started this drama. It was the fact that Nick did not want to take his sister to school. He’s become a little resistant to leaving the house. I could worry that it’s some sort of psychological issue brewing but I honestly think he’s getting kind of lazy.

Having a lazy kid is a refreshingly normal problem. Life is settling into a new “normal” routine. We had settled into a “fixator life normal” and then Steven got a job. He is traveling at least two days a week. I don’t like to whine but it’s hard. I’d like to take this opportunity to tell parents who think the can’t handle this fixator life to look at me and reconsider. If I can do this on my own with four kids, I am fairly certain you can handle it too.

Thankfully I’ve had some help with school pick up and drop off but the rest is up to me. Evenings are the hardest when I have to cook dinner, do homework with Charlotte, leg wash with Nick, showers or baths all while supervising whatever’s going on while I do these things. Eyes in the back of my head would be oh so handy these days! Sometimes I’ll do leg wash in the afternoon while Bess naps. Sadly she rarely naps long enough anymore. Often I’ll wait till she’s in bed but it makes it a late night. Evenings were sometimes pretty hectic with Steven here. Doing it all alone feels miraculous when it’s done and slightly perilous while it’s happening.

Feeling like it’s not fair sounds a little familiar… Maybe I’m no different from most moms just trying to get it all done… Maybe it’s normal. I know I have to change the way I think about it. I am so glad Steven has a good job! I know it’s not easy for him to be away. Especially when he knows I’m struggling. The unfortunate answer to the travel thing is moving which is what we’ll likely be doing this summer.

Just a few hours ago Nick was feeling the unfairness of the fixator. Just now he climbed over one of the baby gates and said “Sometimes it’s like nothing having a fixator”. How’s that for a change of attitude. I think I’ll try to follow his example.