Hi, my name is Stephanie and I just found this board. My son is 14
months and up until 12 months he seemed to be hitting all of his
milestones. I have been concerned about his unability to stand alone
or walk. He also has some speech delay but that is another story. I
decided to call Early Intervention to have an assement done on my son.
The first thing she noticed was that he sits in the "W" position. He
can crawl, pull him self up, and cruise. He can climb up and down
stairs. Hovever, he cannot stand alone or walk. He is very wobley and
falls down. His legs tire easily and go weak/limp. He also side steps
alot instead of walking forward.
I took him to the Dr. yesterday and voiced my concerns. After
examining my son, she said he thinks he has "loose hips". She said we
should start physcial therapy as soon as possible. She told me she did
not know the extent of it, and she did NOT recommend x-rays at this
point.
I think I left there with more questions than answers. It seems odd to
me there were no x-rays done? Should I have a second oponion? Please,
any advice you can give would be a great help.
If ever you don't think you have enough info or your not sure etc, get a second opinion.
If your doctor is one that you see all the time, know/trust etc, I would go back and maybe have a double appt and as them to go through it all in detail, unbtil you are satisfied that your questions have been answered.
Was this a GP or a paediatrician? I would def. get a referral to a paed as well as whichever kind of specialist the doctor has reffered you to.
I say this assuming you were given a specialist referral for the physical therapy? If not ask about that as well.
I would get a second opinion too, maybe if only to have more of your questions answered.. When my daughter was born, the Paed told me she had a clicky hip and that it might require treatment, but that i need to have an ultrasound first to see if the hip is out of place or not. I was told they usually dont start treamnt for it without having an xray or ultrasound first?
I hope you can have your questions answered and that your son is ok.
Ok a lot to cover here but first for you during this trying time. There is nothing worse than having unanswered concern about your little one. My DD (14mths) has a one leg an inch shorter than the other so I have some experience with both child authopods and peadiatric physios. So here goes:
1. Get a second opinion. No physios will treat a child let alone a toddler without an x-ray. You will definately need an x-ray and you will need a doctors referal. Your DS is too old/big now for an ultrasound as the results wont be conclusive. I would also be looking at a referral to a paediatric authopaedic specialist, a lot of doctors wont give this prior to x-rays and a physio assessment but you might luck out. The way I look at it is peace of mind is priceless.
2. You CMHN can give you a referal to a paediatric physio and they can actually do a basic assessment. Waiting lst can be long but considering your sons age it would be more of a priority than my DD was for her referral as she wasn't behind age goals when her problem was discovered. What I can tell you they will say is to stop the 'w' sitting asap as it is harmful to hips, knees and ankles. I am lucky with my DD that her communication skills are good because we are at the point were we say "are you sitting the good way or the silly way" and she will correct it, then of course she gets a clap. To encourage 'correct' sitting you can sit your son in the correct way and then play pass the ball so it is a game. Another tip from my physio was to say when you sit down you need to see your toes, where are your toes?... just make it all a game.
3. Good News: Side walking/couch surfing is actually really good for the muscle development in your son's hips, legs and knees. Don't be disheartened that he is doing this.
4. If you have access to a pool get your son there at least once a week... even just playing in the water stimulates muscle use and it is also a good place to practise step (about waist height in water) as the gravity resistance is less so movement is easier.
5. It is a doctors job to educate their clients, basically some doctors seem to think this is only important for patients undergoing a proceedure where "informed consent" is a legal requirement but the actual law means that any doctor must inform their client so that the client understands what is wrong, what a treatment is for, what a medicine will do and any possible side effects. Doctors are just people who understand and can pronounce big latin words, yes they are educated to a level in a field above most of us but that doesn't make them any less human or any more godlike. I never leave a doctor or specialist unless I am confident I understand what has been said AND I will say "I'm sorry I don't understand what you just said could you please explain it again opr differently".. a good doctor will do just that.
Wishing you all the best, but remember you son may just be a perfectionist and not want to do anything walk wise until he is certain he can do it properly.
Thank you for responding. I am so grateful to have this board for advice and support.
I definatly think I'm going to have a second oponion. My concern is having a correct diagnosis and proper treatment. This is all new to me, and I am a little unfamiliar with some of the termology you guys are using.
Kerry - (hugs) thanks for the long post. What exactly is physios? What is CHMN? Since I found out W sitting was bad, I have been encouraging him to sit the right way. I think that he is a little lazy, and he prefers W sitting so he can get into a crawl position faster. The peditricion seems to have the "wait and see approach" to doctoring. I am getting a little fustrated by this. I just dont thinks its normal to have ordered physcial therapy without x-rays. First thing tomorrow morning, I will be making phone calls.
Karina - That is what I thought also. Especially after some research on the internet.
I am in Fredericksburg, Virginia - close to Washington DC. I dont think we have CMHN here - just regular nurses. Or at least they dont call them that to my knowledge. I saw a peditricion (sp)? Thats all so far.
OK definately be seeing someone else... mobility/muscles etc are not something to 'wait and see with' as far as I am concerned. The sooner things get sorted the better. As I said it may just be something minor like a confidence issue but the fact is on the off chance it isn't the sooner you take action the sooner you can come on here whinging about how tiring it is to be chasing around after your DS (darling son... DD is darling daughter, DH is darling husband etc) .
Even a GP should be able to give you x-ray and physio referrals.
I went to another Dr. today and she basically said the same thing. She said my sons ligaments are very "loose". His hips do not click or pop out of place, but he is very flexiable and has a hard time balancing and walking. Hopefully, physcial therapy will help him gain stregth in his hips and legs. Time will tell how he responds. Hofefully, he will be walking by 18 months.
Step - I am glad you got a second opinion... what you are says sounds like a hypermobility issue. I suffer from severe hypermobility and unluckily for me it wasn't picked up until I was in my 20's. By then the damage that had resulted from repeated soft tissue injuries meant that physio wasn't any good for me. Luckily for your son it has been picked up early and early intervention and exercises will give him the best opertunity to develop more stable joints and therefor less injuries when he is older and less long term problems.
My sister was picked up much younger than me and her joints are in much better shape because of this.
Doing physio exercises with a little one can be very frustrating and tiresome but the benefits are so worthwhile that I wouldn't ever skip my DD's exercises. Personally I have had surgury on both knees and 5 ops on 1 ankle. I also have arthritis in most of my joints. The worst thing for me was that during childbirth I dislocated both hips and have had many sublaxations (partial dislocations) since that have needed medical intervention to correct them. All this aside, if my 'loose' joints had have been picked up and addressed as a child I would not be in this possition now.
If your physio thinks it may be something more they will have more sway with getting the doctors to take any action that is required.
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