When walked into the Orthopedic’s office today to get Derek’s foot injury looked at, late as usual, I was not nervous, but instead, a little excited. That bump on the top of his foot was driving him crazy, so it needed to be taken care of. I figured the doc would take a look at it, decide that yes, it need to be shaved down, and we would set a date to get that done. The sooner, the better in my mind. The more we can get taken care of, the happier we will be. But that is not what happened.
Jason and Troy were at school, so it was just me, Derek, and Ashley. After we signed in, a very kind volunteer woman came over and read a book to the kids, and had them very entertained. She was great at it! In no time, we were called in. Derek went back and got the X-rays taken, same as every other time. Within minutes, he was back. I don’t even have to go with him anymore. He is an old pro! He walks back, all proud to be able to do it himself. It was really cute. When he came back, we all went to the room to wait for the doctor to come in. The nurse came in first and just asked some basic questions, and then she left. No big deal. Then the doc came in. He took a look at Derek’s foot injury, and got very serious. Usually he is very upbeat, and has an attitude of, “Yeah, this is a bummer, but no big deal, we can fix it and everything will be fine.” Today was different. My radar went up.
He first asked Derek to walk up and down the hallway so he could see how he was walking. It was obvious that he was favoring the outside of his foot. He told me that he could see that, so when we went back into the room, he took Derek’s foot into his hands and started feeling and inspecting it. He showed me how Derek actually had two bumps: one on the top of his foot, which I was aware of, and one on the bottom, which was harder to see. He said that it was this bump on the bottom of his foot that was causing him to favor the outside of his foot. He also noticed that his toe was growing irregularly. He said that all of this irregular growth is likely caused by damage to the growth plates on the bones.
My heart stopped. Growth plates? That is bad, right?
Yes. That is bad. Very bad.
The doc explained that if we didn’t take care of this problem, it could be very bad for Derek. It would seriously affect his ability to walk, put on shoes, go to school, play sports, etc. The problem is that the affected areas are not bone, but cartilage, which does not show up in an X-Ray. He needs a better picture of his foot and toe to see what is actually going on before we can decide our next move, so he ordered an MRI.
This is the part where I need you to bear with me. I have a degree in Biology, but it has been a long time since I have been this engrossed in anatomy, and the doc does not get this technical with me, but I am going to attempt to explain the issue in detail for you because I think it makes more sense that way. It may turn out that I have some of my details incorrect, but if that is the case, I will correct them when I find out. This is how I understand the issue:
There are up to three areas that have irregular growth. The first area is where the bump on the top of his foot is located, and that is at the tarsometatarsal joint. The second area is at the other end of that bone, at the joint between the metatarsal #1 and the phalange of the big toe. The third area is somewhere in the big toe, but I am not exactly sure where. Possibly between the two phalanges. He needs to look at the MRI to see where the irregular growth is occurring, and then see what type of treatment can be done. Because Derek is only 4, and therefore has at least 10 more years of growth left (and most likely more based on his genetics), we can’t wait for him to grow first and then fix it. We are going to have to go in surgically and use screws, wires, and maybe other stuff to change the direction of growth. Right now, the growth is causing angulation and an irregular curve in the arch of his foot. Also, his big toe is growing faster and in a weird direction, compared to the other toes, causing him to fall down and stub his toe constantly. (While writing this post, he came in from outside with a cut on the top of his foot cause by him falling down again…).
So what does all of this mean? That is what I am not terribly sure about. Obviously we will have to endure some surgeries. My hope is that we can stay on top of it and solve the problem entirely, but when I asked the doc if this will definitely cause problems with his ability to walk, play sports, etc., he nodded his head emphatically, and said, “Yes!” My stomach started turning knots. I thought about it later, and I am wondering if he meant that it would definitely be a problem only if we don’t do something about it now, or if he means it will no matter what, but the severity depends on how quickly we can get it treated. Either way, it is obvious my baby boy is no longer going to grow up like every other little boy. Until he is an adult, there will be issues we have to keep an eye out for, correct, and take care of.
The MRI is scheduled for September 4th, and then we go back to see the doc to get answers on September 17th. As fast as time seems to go these days, that still feels like an eternity to wait! I want to know so many things! How many surgeries will there be? Will he need help walking, like with a brace? Will he need it forever, or just a little while? Will we need to have surgeries every year, every few years, or just at this time? How much pain is he in now? How much pain will he be in later? And the questions keep on building. I am so sad and scared for my baby boy. This was not what I expected to hear today. I thought the worst was over, but it seems like maybe it has not even yet begun.
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