Brendan Update

We had our follow up appointment at duPont today about the Perthes Disease. I almost don't know where to start.
We saw the resident doc first (he treated us in the ER originally) then saw Dr. D who we saw a few times during our stay at the hospital last time and finally we saw Dr. B, who is the Perthes "expert" (if you will). As far as I can tell, all three will be keeping a close eye on us for about the next year.
From what I learned today from Dr. B, Perthes is basically caused by a blood clot that cuts off blood supply to the hip joint, thus causing the bone to die, collapse, fracture and cause pain. (All of which we have experienced....and are still technically experiencing). After this stage runs its course the blood flow will return to the joint and will start trying to "heal" the area. Basically it will start eating up all the dead bone. Dr. B said that the next x-rays will probably look worse than the first as the dead bone starts to go away. After that the hope is that the bone will start re-growing. This is probable considering Brendan's age. In the meantime we will just be focusing on "containment", meaning that we want to keep Brendan's range of motion good and try to prevent any more damage to the "ball" of the joint itself. Part of what can happen is that the head of the femur (the ball) can actually get pushed outside the hip socket and then we have problems and need some serious surgeries. So we have physical therapy exercises to do at home (because every day is better than a couple times a week with a PT) to keep the muscle on the inside of his leg really flexible. It is already very tight and spasms when he does a "butterfly" type stretch. He also is prohibited from doing anything that would cause impact to that joint. For example, JUMPING is not allowed! Oh Lord, we are going to need help on that one. Seriously, how do you keep a five year old boys' feet on the ground??? No jumping, hard running, and "absolutely no trampolines". :( This limited activity is prescribed through all of winter and spring...and possibly longer. The doctor thinks that because of his age he may come through this quicker than a year, but it could be a year at the longest. He also said he has an 87% chance of making it through this no problem. That's good! He also said he has a 17% chance of getting this in the other leg. Oh, I hope that doesn't happen. We had blood work done today to check certain anti-clotting levels that he should have (it is unknown why he would have gotten a blood clot, as children naturally have anti-clotting "stuff" in their blood).
I think that's about it in a nutshell. Some of the issues include his right leg being slightly shorter already (not major right now) and the possibility of permanent damage to the growth plate in that hip which could cause growth problems in the future and the possibility of major surgeries and problems if that ball flattens more or protrudes the socket. There's some pretty major "if this then this" kinds of things if more damage is done as we navigate through the end of this first stage, but the prognosis is good and the doctors are positive. Being 5 is the best thing about this right now. If he was 9 or 10 this would look a lot different.
So, I'm off to read some articles (my homework from Dr. B) and learn as much as I can. He also wants Rand present at the next appointment (in 4 weeks) so that he can learn and be a part of the treatment, too. Dr. B has seen 900 cases of Perthes and is in the process of writing a book about it right now. I'm overwhelmed by how God takes care of us and knows our needs before we do. He has proven this to me over and over again, especially in the last 2 years. It feels like we are in the perfect place at the perfect time.

Here's Brendan with evidence of another "poke". He tried very hard to be brave today (much better than the hysteria that happened last week with the pediatrician) but he sure was scared. I was holding him during the blood draw and I could feel his heart just about to burst out of his chest. Poor kiddo!