Second Opinion Update

Most of our friends and family are familiar with Nora's orthopedic issues from birth.  Though temporary in nature, they required many trips to the doctor and physical therapist on a weekly basis.  In a nutshell, the pediatrician who examined her at birth felt that Nora might have hip dysplasia.  It took a couple of weeks to show up on an ultrasound, but Nora was diagnosed with both hip dysplasia and torticollis.  These conditions arose from development in the womb.

Nora at birth.  Her legs appear 'twisted' and she always looked to one side.

I had a blissfully easy pregnancy with no complications.  For whatever reason, my uterus never grew large enough to accommodate her growth and she was "smushed" for the whole pregnancy.  Her hip was dislocated, dysplastic (misformed) and her neck muscles were weak on one side.  The good news was that these conditions are temporary.  The bad news was that the treatment was pretty intensive to correct these issues.  At three weeks old, she was suited up for a Wheaton-Pavlik harness and sent to physical therapy for her neck muscles.

Nora in her harness.  Don't diaper changes look like fun??

Initially, 12 weeks of treatment was prescribed with six weeks of full-time harness wear and six weeks of part-time harness wear.  However, her hip dysplasia was pretty severe warranting full-time harness wear for almost four months.  Once the follow-up ultrasounds began to show improvement, her pediatric ortho downgraded her to part-time wear, finally allowing this Mommy to put that sweet baby in all those adorable outfits!  We were fully expecting the doctor to release Nora from the harness when I took her in for a check-up last week.  Unfortunately, the doctor very casually explained that she wanted Nora to be fitted for a long-term brace that she would wear for 3-4 years at bed time.  I was pretty upset to say the least.  We really like Nora's ortho doctor, but this was completely the opposite of what I had been expecting.  My sister suggested (in a very loving, helpful way, not bossy) that I get a second opinion.  I had thought about getting a second opinion before, but it took us so long to find a pediatric ortho that was in our insurance's network that I knew seeing anyone else would be expensive. After the prescription for a long-term brace, I decided to bite the bullet and get a fresh pair of eyes on Nora.

Nora at our appointment.

The new doctor agreed with the initial diagnosis of Nora at birth - she needed the brace to stabilize that hip and capture any opportunity of normal formation due to the rapid growth of infants.  However, he felt that the hip had stabilized.  The X-rays showed that her right hip still hasn't caught up to the left hip in terms of development, but he felt that the hip socket would form more normally as she began crawling and walking.  In fact, he went in to the controversy in the pediatric orthopedic field about bracing children and treating them for orthopedic issues for which they have no symptoms or complications but might have issues when they are adults.  Nothing we had done for Nora up until this point hampered her development, he just didn't feel that extended brace wear was necessary. He said that a third of pediatric orthos would tell us to brace Nora until she was 5, a third of them would say to brace her until she refused to wear it, and a third of the doctors would tell us to take the brace off.  There just wasn't enough science to justify either approach once the hip stabilized.  So, we made the decision.  No more brace for Nora!  We will miss her sweet pediatric ortho she has seen every week since birth because we will schedule her annual follow-ups with the new doctor, but it had to be done.  Next week, she should be released from physical therapy for her torticollis treatment.  Everything is really coming together for our little girl - she will be crawling before we know it!