We met with Hannah’s new orthopedist today. I had three areas I wanted to touch one.
1] New SMOs (ankle braces)
2] Left wrist misuse
3] Affects of W-sitting
When we first got back to the room (after an hour in the waiting room), they did an x-ray of her hips. She did surprisingly well, as I thought we would have a fight on her hands. But nope, just singing “The Wheels on the Bus” while holding her hands was all it took for that quick x-ray!
Then we met with the orthopedist. I wasn’t sure if he was really paying attention to the intricacies that are Hannah at first. But then Hannah started crawling on the exam table with her left hand upside down (her misuse way), and he made the comment “Wow, is that what you are talking about?” Then the discussion regarding “to brace or not to brace” came up, and I could tell that he was really thinking about the situation. We went into the pros and cons about both. He said that children are much more flexible than we are, and even though it looks like it would hurt, it does not. That if it really was hurting her when she does it, we would know. So the question came down to me – Do I want to try and fix what is not just the norm and hinder her playtime, learning, or activity? Or do we just let it be and just keep trying to redirect her. So we decided “no brace” at this time.
Then the discussion went on to the SMOs (supramalleolar orthoses – ankle braces). He actually said the same thing that Dr. Paul at the NIH said. That wearing the braces are actually more of a hinderance to her than a help because she is not a walker. He would rather see her in a solid hi-top (like we just got). He thinks it is more important for her to let her use her other leg muscles to compensate for her hypotonia and ankle weakness at this time than completely restrict her ankle movement to SMO structure. It would be one thing if she was a walker because then she would constantly be building muscle weakness in her legs, and then it would help in that respect. But right now, she is a crawler learning to get to a stand. Hopefully when we get the stander, she will start really building up some strength.
Lastly, we talked about her W-sit. He says that it isn’t the best thing to do to let her W-sit but, in her case, the alternative is not acceptable. We can’t not let her sit. This is the way Hannah moves. He believes that many therapists are quick to change the W-sit because it is not the norm and it may “in theory” cause problems down the line. Just like the hand brace dilemma, it is more important to let Hannah explore and play than to worry about whether she sits correctly. Her nurses, Daddy, and I still work on trying to get her to sit with her feet in front of her, but it is so obviously not a comfortable position for her. But we will still try.
Overall it was a good appointment. We don’t need to see him back for a year unless something comes back up.
Oh yeah, and her hip x-ray came out normal 🙂
Just so you know…. Olivia still does the W sit to this day. They tried and tried to correct it and guess what? It didn’t work. I like this Orthopedist’s approach!
My kids all still do the W sit even my young teen. In fact Maveric has a sit we call the K squat, he sits on his haunches where his chin rests on his knees and he is 13. All of his OT’s HATED it.
I was a W sitter as a kid…the only thing I can see that it did is that I have a inner rotation in my hips (so was pigeon toed) and don’t have as much hip flexibility…which affects me in yoga…but that is it! no major damage done. although I still sit half W sometimes…right leg still likes to be backwards!
love you guys!!!!