Friday, May 22, 2015
Yesterday Mason visited his developmental ophthalmologist for his yearly checkup and new glasses. Last year Mason got glasses to help correct the over focusing of his left eye that causes it to turn inward. These glasses have worked well for Mason, though within a minute or two of removing the glasses his eye will turn inward again. It does it when he is focusing closer in, not when looking far away.
The appointment was long. First you have a basic exam with the nurse and the doctor. Then they dilate your eyes, sending you out to the waiting room to let the eye drops take effect. Then you go back in for a second eye exam. Diagnosis happens. Then you take your new prescription next door to order glasses. All of which took two and a half hours. Thankfully I knew what to expect and we had packed things to do and a full lunch.
In true Mason fashion nothing stays quite the same. His eye prescription is a little bit stronger this time around. He also will be getting one bifocal lens! The doctor feels that the left eye could use the extra support of the bifocal when looking at things close up because his eye is beginning to turn in a bit even with the glasses when doing activities like drawing or looking at things up close.
Mason knew he would be getting new glasses today and we had been talking about color choices. For several weeks he had said he was picking black frames. In the end that is exactly what he chose! All those color chips above were his options for the Miraflex frames. He tried on quite a few colors, a few different frame shapes too. Mason actually still fits his orange frames so we have decided to get new lenses put into them as well. He'll have two pair of glasses available just in case something happens to the first pair.
Friday, May 15, 2015
Developmental Pediatrics - According to this doctor Mason is doing great in overall development (outside of those pesky physical milestones like walking that he'll never accomplish). He's speaking, figuring, sitting, playing, and progressing. Yay!
Physical Medicine, Physical Therapy, Orthotist, Wheelchair Fitting, and Orthopedic Surgeon - I'll cover these three together because they are interrelated in some ways. We came to clinic with all Mason's equipment (wheelchair, AFOs, stander, HKAFOs) and some questions.
- How can we help Mason learn a safe way to climb down to the floor from his wheelchair? Currently, if he climbs down by scooting forward onto his footplate and then to the floor he scrapes his back (right across the large scar where his back was open at birth). This is bad. So between the specialists the current plan is two-fold. First, we'll work on teaching Mason to turn around in his seat and climb down backward like he does climbing down the stairs. The difficulty is maneuvering the lower half of his body into the right path (because he can't feel anything) and not hurting his knees when they come down onto that hard footplate. We'll work on it at home and then if we can't get a good climbing pattern figured out we can access physical therapy for some help. The second part of the plan is that our wheelchair company is creating a padded footplate for Mason's wheelchair so it won't be so hard on his knees or back when climbing down. We have to be careful that it doesn't interfere with his ability to climb UP though.
- Do we need to add a heel/wedge to Mason's HKAFOs or one shoe? His legs are not even when in a standing position, partially due to the small contracture of his left knee from the large callus that femur made when he broke the leg last fall. Partially it is due to his hips, which are a bit unevenly seated in their sockets as well. What this means is when Mason uses the HKAFOs in his stander he still gets a red pressure mark on that thigh that no matter how many times we've adjusted the HKAFOs we can't get rid of. This limits his time standing. The standing is part of our treatment of his osteoporosis, helps his bowels function better, etc. We really need the standing and would like to be able to do it for 2+ hours per day. Right now we've only been able to do about 30 minutes at a time before the pressure happens. The current plan is to try adding the insoles back to one shoe to see if it helps. We can call the orthotist to get a heel added to things if this isn't effective.
Urology - Today Mason had ultrasound done to check his bladder and kidneys. The scans showed that they are stable - which means what we're doing is working. We continue with his current medication and catheterization schedule. We also discussed enema options with urology. What we are doing is working well (cone enema). That is great. However in the future we know we want to transition to a different enema setup that is more independent for Mason to do himself. They referred us to the Colorectal specialists to begin that evaluation and process. (For those in the know, we're looking at the Peristeen system. Many people around the country travel to Cincinnati Children's Hospital for their week long program but we're blessed that one of the main doctors from that program is now heading things up at our hospital. )
Mason busy making friends.
Orthopedic Surgeon - Yes, this is the second time I'm mentioning this doctor. Why? Because we have a separate issue that we will be watching with just them. Today they sent Mason for spinal x-rays to check the curvature on his spine. Developing scoliosis is something that in not uncommon with Spina Bifida, especially with Mason's level of paralysis (incomplete T12). Today we saw that he does have a curvature beginning but it is below 10 degrees so it is called Mild Spinal Asymmetry. If it increases to more than 10 degrees it will be scoliosis. For now we will track this every 6 months. If the time comes that his curve increases we have a variety of treatments depending on how severe the curve becomes (from bracing to spinal surgeries like a fusion or having rods placed).
Well, those are the major things from today! Next week he has his vision checkup with his developmental ophthalmologist. He's hoping to choose new glasses - I'm wondering if he'll try a different color. Overall Mason is a happy, growing little boy who is busy enjoying life.
Wednesday, April 29, 2015
Blogging here seems so sporadic but that is usually a GOOD thing, it means Mason's health is going along on a nice, smooth path with nothing unexpected. We've had fun as a family and just this week was Mason's first family bowling trip. Here are some general health updates:
- We're struggling to get his braces adjusted right. The HKAFOs (standing braces) are not quite working out. Because one of his knees won't straighten all the way due to the broken femur and extra thick callus the healing bone laid down the braces put pressure on his thigh. That means right now he can't wear the braces for more than 30 minutes at a time, when we would like to see him getting 2-3 hours a day in them. (Remember, standing promotes bone growth and density, helping his osteoporosis. That is why we keep adjusting the brace and trying.)
- Mason is scheduled for his third IV infusion for his osteoporosis next month. We're almost through the first year! One more dose after that and it will be time to check his bones to see how they have responded.
- We've taken the arm rests off Mason's wheelchair. This may be temporary, it may not. The idea was for Mason to try it and see if he likes it. (It makes the chair lighter for him to push, means less is in his way when climbing in or wheeling around, etc.) It does, however, mean he's had to develop a new climbing pattern and some more upper body strength. He figured it all out while we were waiting for our physical therapy evaluation next month at Myelo clinic.
- Bathroom business - Mason's nightly cone enemas are going pretty smoothly. We've gotten a decent handle on the amount of dietary work we do (lower amounts of dairy, added almond milk and the needed miralax, encouraging drinking water often and juice once per day) so we have been able to avoid major constipation backups for a while. This is a huge deal!
Coming up in May Mason has several appointments. He'll kick off the month with his third IV infusion for his osteoporosis, then spend a full day at Myelo Clinic seeing about 8 or 9 of his specialists, having ultrasounds, etc, and he also has an appointment with his developmental opthomologist for an eye checkup and to see if his glasses prescription needs updated. It's going to be busy but hopefully uneventful! That's the way we like it.
As always, if you have any questions about Mason, Spina Bifida, Hydrocephalus, etc. please leave a comment and I'll do my best to answer!
Tuesday, March 10, 2015
In a week or two we will go back and the orthotist will make any further adjustments we think Mason needs. That could be adding padding, straps, or cutting and trimming things.
Saturday, January 10, 2015
I also wanted to share a quick video from today.
It shows the progress he has made since losing a lot of strength last fall spending two months in casts. He can now climb into his wheelchair completely independently.
Thursday, January 1, 2015
Friday, December 5, 2014
Yesterday Mason finally got his bracing! He now has his very first pair of AFOs (Ankle Foot Orthotics) as well as refitted HKAFOs (Hip Knee Ankle Foot Orthotics). The AFOs are green with dinosaurs on them. Their purpose is to help maintain Mason's heel tendons stretch, keeping them in a proper position so they hopefully do not tighten and need surgery again. Right now he wears them for an hour a day, with the goal being to work up to most or all of his waking hours.
The HKAFOs have a different purpose. These Mason had a long time ago but became unable to use when his tethered spinal cord caused contractures to his hips and feet. The surgery road to fix all of that took over a year and a half because of unexpected complications. Now that things have stabilized we're working to get these fitting properly again. Why?
The down side to the HKAFOs is that Mason has no balance because of his level of paralysis. He literally needs someone holding on to him to keep him from tipping over at all times.
All these explanations are great but if you're like me you want to SEE Mason using the stander, right? This is from today:
Mason does not remember using a stander before, so I wasn't sure what he would think of it. He loves it and asks to do it all day long. It is really hard to tell him that he can't yet, because we're still working to get the perfect fit on his HKAFOs! I also thought some of you would enjoy this video because you get to hear a good bit of Mason talking. He's such a chatter box! I love my little man!