After a long stretch of no medical appointments, M is in the middle of a pretty intense stretch of doctor's visits. Most have been routine check ups without much significance (beyond reinforcing his old fear of medical personnel and strangers generally--we had just been overcoming that, but a few visits in a row with bloodwork, shots, etc., and he is once again pretty skeptical). But last week we saw a neuromuscular specialist, which was a bit different.
Last summer M had an EMG done with one of the doctors in this clinic, and the report was that the nerve function in his feet was less than expected, but not a cause for concern at that time (apparently people with clubfoot typically have diminished nerve function when compared to those with typically developing feet, but it usually doesn't pose a problem). We were there because there was concern that the treatment for his hip had damaged his femoral nerve, but it seemed to be OK. Now, a year later, the concern has changed--his left leg still lags behind the right in development, and he rarely ever moves his left foot on his own.
We saw a different doctor this time. They thankfully did not do a full EMG (which involves inserting needles into the muscles), but they did test some nerve function with electrodes. They pulled up the old results and it showed some slight improvement, but still very little nerve activity in his left foot. This combined with the lack of movement on that side is now more concerning, so we have been referred for further tests.
The most common explanation for this would be what's called "tethered cord"--a condition in which the spinal cord is attached abnormally at some point along the spinal canal. The good news is that this is easily treatable with surgery, and outcomes of treatment are typically excellent. It should be clear on an MRI if this is the case, and we are booked for the test in less than two weeks, so we will know soon.
If it is not a tethered cord, the answers are more murky, and we will have to see what other kind of testing can be done. It is also possible that it is just his left leg continuing to lag behind because of the hip problems on that side, and it may catch up on its own--if that's the case, only time will tell for sure.
In the meantime, he is gaining new skills constantly, and overall his body has gotten quite strong. He can climb a full flight of stairs, and he can get into standing on his own on occasion. It's clearly not comfortable for him to be standing yet, though, so we have a long way to go. But it's amazing to see what he can overcome and what he can learn to do. I suspect he will continue to amaze and astonish us for a long time!
Last summer M had an EMG done with one of the doctors in this clinic, and the report was that the nerve function in his feet was less than expected, but not a cause for concern at that time (apparently people with clubfoot typically have diminished nerve function when compared to those with typically developing feet, but it usually doesn't pose a problem). We were there because there was concern that the treatment for his hip had damaged his femoral nerve, but it seemed to be OK. Now, a year later, the concern has changed--his left leg still lags behind the right in development, and he rarely ever moves his left foot on his own.
We saw a different doctor this time. They thankfully did not do a full EMG (which involves inserting needles into the muscles), but they did test some nerve function with electrodes. They pulled up the old results and it showed some slight improvement, but still very little nerve activity in his left foot. This combined with the lack of movement on that side is now more concerning, so we have been referred for further tests.
The most common explanation for this would be what's called "tethered cord"--a condition in which the spinal cord is attached abnormally at some point along the spinal canal. The good news is that this is easily treatable with surgery, and outcomes of treatment are typically excellent. It should be clear on an MRI if this is the case, and we are booked for the test in less than two weeks, so we will know soon.
If it is not a tethered cord, the answers are more murky, and we will have to see what other kind of testing can be done. It is also possible that it is just his left leg continuing to lag behind because of the hip problems on that side, and it may catch up on its own--if that's the case, only time will tell for sure.
In the meantime, he is gaining new skills constantly, and overall his body has gotten quite strong. He can climb a full flight of stairs, and he can get into standing on his own on occasion. It's clearly not comfortable for him to be standing yet, though, so we have a long way to go. But it's amazing to see what he can overcome and what he can learn to do. I suspect he will continue to amaze and astonish us for a long time!
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