Three Tiny Poozils: Orthopedist

Wednesday, April 14, 2010

Orthopedist

I took Adel to the orthopedist a couple of weeks before Pesach. We wanted to check out her leg length discrepancy. It seems to be changing depending on the day. Sometimes it's only a couple of millimeters. Other times it's a clearly visible centimeter. And there are times when it's barely visible altogether.
When she stands, she keeps one knee bent and one or both feet rotated out.

I didn't have a very good experience there, but since Adi's geneticist now has access to this blog and is friends with the orthopedist, I will keep this post as civil as possible.

I doubt he will read this, but still. I had already written this post up and am now going to edit it to remove my opinions, feelings and inflections and just leave the facts.

I came into the office. After somewhat of a wait, I got called into the exam room. The doctor is elderly, and didn't seem to have too much patience for me or Adel.
He asked me questions about her development and therapies, and would cut me off mid-answer with another question. When he touched Adi and she started screaming, he had a look on his face of, "What's wrong with this child?" I don't know... did he never treat kids who cry when a doctor touches them?

He didn't look at her thigh folds. They are uneven, but he didn't even look. He compared the length and sent her for an x-ray. It was in the same building, but there was a whole runaround and lots of waiting.
Finally I went back to the exam room. The nurse opened the x-ray image on the computer, and I was able to see it before the doctor came in. There was a clearly visible difference in leg length.

The doctor came in and measured. He dragged a line on the screen from the hip bone to the ankle and announced, "Tell your therapist that her legs are identical within a millimeter."
"Uhhh, but why is there a visible discrepancy in the length?" I asked.
"It might be that her hips are rotated. But it also may be just the way she is lying in the x-ray."
"So can you find out which it is?"
"In order to do that I will have to give her more x-rays and I don't want to now. Come back in six months."
"The tech took two x-rays. Can you check that one?"
He checked and told me that it didn't come out.

Oh, so for incompetence, it's okay to expose her to extra radiation. But to find out whether her hips are rotated or not, we have to wait six months?

"I'm sure that the hips are rotated in real life. The difference leg length presents itself consistently," I continued.
"I compared her legs twice, and once I saw a difference and once they were even," was the doctor's reply.
I began to get frustrated, "So what do I do now? What if she has rotated hips? Doesn't it need to be fixed?"
The orthopedist's reply nearly made my eyes pop out.
"Children with special needs are often asymmetrical. That's the way it is. I'm not going to do anything about it. Come back in six months and we'll check her again."

Is he for real??
That's the reason I came here in the first place. Because Adel has special needs and is asymmetrical.

Whatever. The only reason I went to him is because he is the only orthopedist dealing with limb length that takes my insurance. Now that I am able to see an orthopedist dealing with hip issues, I have more of a choice on whom to see.
If the problem is really in the hips, that is. I can't know for sure. He measured the legs from the hip to the ankle instead of from hip to knee, and from knee to ankle. Both bones in one fell swoop. But what if Adel's left femur is different from the right one? Or her tibia? What if she was bending one leg slightly and you pulled a line from the hip to the ankle? It would be different than if she held it straight.
What if she was bending her longer leg? Then the measurement would be the same in both legs.

I left the appointment exhausted and disappointed.

But to make you all feel better, and to reward you for sticking with me through this long, long post, here are some happy pictures.