6 Month (after) Spica Update

Assimetria dos centros de ossificacao das cabecas femorais, menor a esquerda.
Discreta verticalizacao do teto acetabular esquerdo.
Demais estruturas osseas sem alteracoes significativas apreciaveis ao metodo, para a faixa etaria. 

Using online translator:

Asymmetry of ossification center of the femoral heads, the lower left.
Slight left vertical line in the acetabular roof.
Other bony structures without significant alterations to the appreciable method for the age group.

A couple weeks back I had mentioned we took Dylan to get his follow-up Xray (6 month checkup after the spica cast was removed).  The "plan", as I understood it, was to get the Xray at the hospital and review the results with specialist approximately two weeks later.  However, one thing I have learned here in Brazil, what is planned versus what actually happens are never usually the same.  For instance, about 6 days after the Xray we returned home from work to find an envelope from the hospital -- which contained the hard copy of the Xray and the 3 sentence Portuguese diagnosis shown above.  You could imagine our reaction!  First, online translators are by no means an exact science, you can understand the general meaning but often times the sentences are a bit broken.  Second, even if this was a diagnosis in English I wouldn't be able to understand it! 

The two words we immediately pulled from the document were "asymmetric" and "slight".  After your child has surgery due to asymmetry from a dislocated hip that he was born with, our immediate reaction was this is bad news -- with the hope that the word "slight" might lessen the blow.  Now we were scrambling to get a hold of the doctor here in Brazil to get a better explanation AND trying to call the surgeon who performed the surgery back in MI.  In the mean time we were reading and re-reading the translated diagnosis and reviewing his Xray -- some of the asymmetry was rather obvious.  For the next 3 hours we were envisioning a re-spica scenario and wondering if his hip would ever heal properly.  Finally the doctor from MI called, although he didn't have the Xray, he did say this diagnosis is very typical and what he was expecting... then the specialist from Brazil called and spoke with Cathy, he said based on the Xray that a re-spica was not going to be required and this is quite typical for a child that has this type of surgery.  The reason -- for the first 9 months Dylan's hip was not developing properly... only one side was developing, the left side didn't really start until the spica cast was in place.  Now the left side is playing catch-up with the right, so all things considered, the situation is good with his hip still in place and (now) developing properly.  The biggest concern after this type of surgery is that the hip begins to wander and doesn't want to stay in place, so far this is not the case for Dylan.  The doctor here in Brazil said that we just have to keep monitoring Dylan's hip development, with the next Xray follow-up in 3 months. 

Oh, and more good news to go along with his results -- the brace he's been wearing for the past six months (after the cast was removed) -- no more!  So for the first time in about a year, Dylan is in the clear... recall that this all started with a recommendation for physical therapy early last year (for torticollis), which in turn led to a flat head since he was sleeping in the same position every night, which then led to a 3 month long episode wearing a helmet... and finally during his 9 month wellness visit, the dislocated hip diagnosis -- which, as it turns out, was all related. 

Now our 1Y6M15d old is walking around like a champ and climbing up things with the best of them.  In fact, the little guy is getting rather resourceful now when it comes to a climbing challenge.  If something is too high for him to climb up on he will wander into Madison's room and grab her step stool.  Next thing you know and he's crawling around on top of a table!