This video is from a few weeks ago, when Uncle Al was up visiting for Will’s 2.0 birthday:
I love how Will blows out air when he gets to the “huffing and puffing” part. :-)
On a more serious note, we are heading back to Cardinal Glennon tomorrow for yet another followup with Dr. Aki Puryear, the amazing pediatric orthopaedic surgeon who did the surgery on Will 0.2 – almost two years ago. (Start here and keep reading if you really want to revisit the experience. It’s hard for me to read some of those entries.)
They’re going to take another x-ray of Will’s left hip socket to see how the bone is developing and calcifying. Here’s what the x-ray looked like in April:
You’re looking at his hip sockets and the top (ball) of each leg from above, so the ball and socket on the right is actually Will’s left leg/hip, where he had the infection and surgery.
As Will grows, his bones slowly harden from cartilage (nearly invisible on x-rays) into bone (the white stuff you see on x-rays). If you compare the two sockets in the shot above, you can see some raggedness or serration in the bone in Will’s left leg (on the right in the image) that isn’t present on the other leg, right at the top edge where the bone is calcifying.
The fear is that the septic hip Willpower had when he was two months old may have damaged the bone’s development, and so that’s why we have to keep going back every six months for x-rays. Outwardly, he seems to have suffered no effects from the hip surgery – he runs and jumps and walks and kicks like a normal two-year-old – but in the back of our minds is always this concern that there may be something damaged or weakened that we just can’t see yet.
Of course, we try to put the worry out of our minds until our regularly scheduled visits occur, and then the anxiety starts. Hopefully tomorrow goes well, and Dr. Puryear tells us there’s nothing to worry about any more. We’ll post an update tomorrow night after we get done.
Today we journeyed to St. Louis and back for separate follow-up appointments with Will’s pediatric orthopedist and immunologists.
First we saw Dr. Aki Puryear, the lead pediatric orthopedist who performed Will’s hip surgery in November. After looking at x-rays taken today, Dr. Puryear was very pleased – everything with the hip looks great. They want to keep an eye on him as he grows, and as his cartilage turns to bone as he ages. Dr. Puryear wants to see Will again in three months for another checkup.
Then we saw Dr. Bradly Becker, Will’s immunologist. The concern with his immune system stems from the mystery of how Will’s hip became infected. None of the doctors know what happened, but they do know that this type of infection almost never occurs in babies as young as Willpower. Dr. Becker’s concern is that Will may have an immune system deficiency that facilitated his becoming infected, so they’re testing his blood after every round of his normally scheduled immunizations to see if his immune system is reacting properly. So far they’ve only run one test – after his two-month immunizations in mid-December – and he’s still too young for them to know conclusively whether his immune system is normal or deficient. Another round of blood tests are scheduled for two weeks after his four-month immunizations (and so on) and if Dr. Becker sees anything untoward, further testing or treatments may be needed. A baby’s immune system is more developed by six months of age, and they should know more as they keep testing him until then. At this point, all we can do is stay vigilant and have his pediatricians treat every infection aggressively with antibiotics just in case there is a deficiency.
Really, that’s just a long-winded and worrisome way of saying that Will 0.3 is doing very well, but that we still need to keep an eye on him, if only because the infection that he had was so rare for a baby so young, and because his not-yet-developed immune system didn’t appear to react to that infection.
His PICC line will remain until January 10, which is six weeks after he was discharged from Cardinal Glennon. I had thought, for some reason, that January 3 was six weeks, but high-level math has never been my strong suit. On the tenth, barring any complications, we can stop his antibiotics and the home health care nurses can remove the PICC. We are very much looking forward to that day.
(By the way – the doctors really liked his shirt.)