06 August 2012

Let's close this hip chapter, shall we?

Yeah, I know I've been banging on about hips lately, the last post about MissyMoo2 (3) thankfully being good news.

Last week, it was MissyMoo3's (10 months) turn. Those of you who have followed my blog for a little while will know that she was in a pavlik harness as a newborn. (If you want to recap, this is how it looked (a bit), or you can click on "harness" in my Topics section on the right hand side of the blog to see other posts on the subject.) This most recent appointment was a follow-up check to make sure things were still fine.

Thankfully they were :-)

The x-ray looked fine and her physical examination was also positive. That was that then, or so I thought. The specialist then said he would see MissyMoo3 again in a year. I was confused. "How long do you follow them up?", I asked. It turns out the protocol has changed and now they want to keep seeing her until she's two. I accepted his response, took the x-ray form for next time, made an appointment for this time next year and left.

Then I thought about it.

Protocol is a funny thing. Protocol for MissyMoo1 (5) was no follow-up at all. She was out of her pavlik harness after 5 weeks, at the age of 6 1/2 weeks, and from that point on was no longer the specialist's patient. An amended protocol failed MissyMoo2 (3). If their protocol had been at all practical, she would have had an appointment as a baby, been put in a pavlik harness and not had the threat of surgery haunting us all for most of her young life. And now a further amended protocol dictates that MissyMoo3, whose pavlik harness came off at the age of 17 weeks, needs to keep going back until she's 2 years old?

MissyMoo3 is fine, the specialist himself said so. Her x-ray looks just about perfect. I'm no orthopaedic surgeon, but I've seen a few of these things now. I know what looks good and what doesn't. The key question in my mind is: who gets what from us going back in a year? Doctor's gain: research. Our gain: zilch.

We have learned many lessons in what we have experienced with MissyMoo2 over the past couple of years, one of which is to question, question, question and not take things at face value. MissyMoo3's hips are not going to go from perfect now, to so bad that they will need a surgical fix in twelve months' time. And at this mobile baby/toddler age, with the particular issue that has been fixed in MissyMoo3's case, surgery is the only intervention available (as we have been told numerous times with MissyMoo2's consultations). So why would I go back, put MissyMoo3 through another x-ray, drag MissyMoo2 along, wait at a hospital for an hour past the appointment time and pay for the privilege of parking while waiting around all day?

I haven't cancelled the appointment at this stage, but I doubt we'll be going.

As far as we're concerned, this hip chapter is closed. Happy ever after :-)

4 comments:

  1. That's good news on the hip front.

    I totally agree on your issue with specialists follow ups. Gracie's sees a dermatologist for her ecsma (hmm too late for spelling) and there appears to be no significant change or worsening, the specialist offers no significant insight other than, continue with current treatment but we need to continue going every 3 monthts for follow up.
    Apparently this specialist is the best, but his appointments run at least 2 hours late and that is on a good day!
    I am considering the same as you and cancelling our next appointment for October, unless there is some major change between now and then.

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    Replies
    1. It's hard, because they are the experts, but as parents I think we more readily see the bigger picture, not just a hip problem, or a skin problem, but the consequences as a whole, on the child and on the family.

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  2. You sound like you have done your homework and having two bigger girls who have been through the system I can see your frustrations with the seemingly pointless return visits. It is great news that it looks like you will be "Hip, Hip, Horray'ing" goodbye to the doctors for now!

    ReplyDelete

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