She's Walking on Sunshine...and Don't it Feel Good!

"When you jump for joy, beware no one moves the ground from beneath your feet." - Stanislaw Lec

Today, is a day of celebration. It has been one year since Skiffy...well, became a SCFE. Original saga here. One whole year since the text message I will never forget- "you have to come in i hurt my leg." One year since the scary scene at the skating rink and the heart-wrenching ambulance ride to the hospital. One year since the doc said "we can be cautiously optimistic, but she may lose that hip." It has been one amazing year.

The strength I have seen in my girl this year has truly amazed me. And worried me. And...let's be honest, scared the ever living shit plum out of me. Knowing in my heart and soul that one simple fall could knock the pins loose and destroy her hip forever, I watched as she hopped up on one leg on top of chairs, wrestled with siblings and friends, stomped in anger, and barreled down ramps doing 120 mph in her wheelchair like Evel Knievel. I saw her develop stretch marks on her arms from building muscle so fast because she would not tolerate going to middle school in a wheelchair. I watched her struggle to carve out her identity as she entered middle school in a wheelchair with what she called an old person's injury.

Most of all, I watched her recover and heal. I watched her learn to walk again. I watched as she came to terms with her injury. Best of all, I saw her strength and determination. She is as strong as an oak. You can't break her. Wound her? Well, yes. Hell, she wounds herself. On a regular basis. Should have named her Skiffy Grace. But break her? No. She is tough as nails. Supergirl.

The good doctor has cleared her to do everything but wrestle and play football. Mmm hmm. That will be her first goal. I give it a week. She can't wait to jump out of an airplane. She wants to go climb a rock wall as soon as possible. For now, she will have to be content with spinning her color guard flag with the marching band in high school. And I shall watch her strut with joy. And she will call me creepy. And I can live with that.  

Language Barriers

"We spend the first twelve months of our children's lives teaching them to walk and talk and the next twelve telling them to sit down and shut up." -Phyllis Diller

Today was the day for Skiffy's orthopaedic check-up. I look forward to these appointments with all of the zeal I would approach a root canal with. It is not that I don't enjoy visiting with the doctor; I do. I look forward to hearing about Skiffy's progress and so far, the news has always been good. What I dread is Skiffy herself. Something about these appointments brings out her teenage best. As soon as we arrive she flops down in chair in the waiting room and starts making the face. You know the face- the one that says 'I hate all adults for no apparent reason and I would burn holes in their bodies with my eyes if only I had super powers'-yeah...that face.

You see, there is a small obstacle here; Skiffy and I don't speak the same language. The native language spoken in the home is English. Skiffy speaks Teenagerese. The hospital we visit is no help at all. They have interpretive services for a variety of foreign languages and for visually and hearing impaired individuals, but not one interpeter there speaks Teen- I checked. So, when we leave the hospital, we are never on the same page and we proceed to argue all the way home.

Me: The doctor said you can bear more weight now.
Skiffy: No, he said I could go rock climbing.
M: He said no such thing! He said you have to protect that hip.
S: He said I was all better and I could take on the whole world if I wanted to.
M: He said take it easy!
S: Skydiving is easy.   
 
The last time we visited with the doctor, he said Skiffy would probably walk without crutches by September. I asked about band camp in July and he squirmed and said "we'll see." Today, he looked over her x-rays and declared it was time to start physical therapy and that she may walk in as little as three weeks! Gibberish. He must have been speaking gibberish. I heard "the x-rays look incredible, the bone is fusing, she can start therapy now and if all goes well she may be walking in three weeks." Skiffy heard something different altogether. Her version went "I can start walking TODAY."

Excuse me, interpreter...where is the INTERPRETER....I NEED AN INTERPRETER!!

So, the bone is fusing in the left hip around the screws and for now at least, the femoral head (big round ball on top of the femur) looks healthy as if it is maintaining the blood supply. The growth plate is also fusing in the right hip which means it cannot slip and created problems like the left side did. All good news! She is going to walk months before we thought she would. It looks like this child has been part of a small miracle. Oh, happy day!

She pouted all the way home. She did not like the doctor's lecture about only getting one first chance with this hip and that taking risks could cause her to endure a hip replacement at a young age and how that would be a terrible thing. She did not like that she couldn't walk TODAY. She did not like that we did not go see a physical therapist TODAY. She does not want to wait three more weeks to walk.

Good grief. The biggest joy of the day- we don't have to do this again until May. I hope they hire a new interpreter by then.     

SCFE- The Story of My Little Skiffy

My herd is very special. If something is rare, odd, or just plain wierd, it will affect my herd in some way. So it went with my little Skiffy. Skiffy is 13 years old and fiercely independent. It also seemed that her middle name must be grace. She had an amazing ability to fall. I mean, she didn't just fall, when she fell it was spectacular. She could fall walking across a room, walking down stairs...once she even tripped over her locker. How in the hell does one trip over a locker?

Her falls often left her with a sore knee and a limp that would persist for a few days. The falling thing seemed to last several months and I was convinced that Skiffy was just hopelessly clumsy. While at the doctor's office for a routine check-up, I mentioned it to the Dr. They decided to take an x-ray of her knee the following Monday just to see what was going on.

We never made it to the Monday appointment. On that fateful Saturday that August, I dropped her off at the skating rink to enjoy the day with friends. Skiffy called at 3:00 to be picked up early. When I arrived at the skating rink, she sent a text that I will never forget. "you have to come in mom i hurt my leg"

What happened over the next several minutes is forever seared into my memory. We argued while I tried to wrap my mind around what was becoming clear.
What happened?
I fell.
Fell how?
I did the splits. My leg went up behind me.
Can you walk?
No.
You have to.
I can't.
How did you fall again?
I did the splits. My leg HURTS.
You probably pulled something. Where are your shoes? I'll put them on.
I can't walk.
You have to. We'll go to urgent care.
(I touched her foot to put her shoe on.) OOOOOWWWW!
What hurts?!
My leg!
Where? Tell me again how you fell? Who saw you fall? How did you get to this bench?!
(The tears are starting.) Some people carried me here. They took my skates off.
You have to get up. You've probably pulled something. We'll go to the ER.
I can't.
YOU HAVE TO. The doctors are NOT COMING HERE! You have to stand up!
Call an ambulance.
I can not call an ambulance because your leg hurts. You have to walk on the other one. I'll help.
I can't walk.
Do you think you broke something?
Yes.

Returning with a kid that works at the skating rink, I continued...
Put your hands around our shoulders and we'll walk you to the car.
No.
Exasperated, the employee left and returned with a chair.
Slide onto the chair.
NO.
You have to!
No.

At this point, I was scared. My mind was shifting back and forth between 'she is so stubborn' and 'what if something is really wrong?' I contemplated calling an ambulance but nothing I was looking at said that this was a true emergency. Nothing looked out of place. She had not been crying when I arrived. Somehow, she had gotten to the bench, surely she could get to the car. My mind reeled. I needed to see her try to move.

MOVE TO THE CHAIR!

She moved to the chair, sort of. Her body began to tremble. I knew. The tears started to well up in my eyes now and fear took over. A new conversation began between me and the manager of the skating rink.

Call 9-1-1.
Silence.
Call 9-1-1. I'm not moving her.
Well, either you're going to move her, or they are.
CALL 9-1-1! They can mover her!
Well...you're the mother.
YES! I am the mother. And this child doesn't cry. Something is terribly wrong. Call 9-1-1.
Silence.
Grabbing for my cell phone, YOU KNOW THE ADDRESS, I DON'T!
He left to make the call.

I called my husband and said simply "I'm not moving her, we're calling an ambulance." He replied with one word, "OK."

The firemen arrived first. They asked a few questions and put a blood pressure cuff on Skiffy. Then a terribly odd thing happened. They removed the cuff and took several steps away from Skiffy. The fear gripped me harder. Something was very, very wrong. One fireman took me by the shoulder and turned me away from Skiffy. He said "we're not going to move her. We'll just wait on the paramedics. She has probably dislocated that hip."

Well...there it was. The confirmation. My child was seriously hurt. I answered some questions for the fireman and waited on the paramedics to arrive. Next thing I know several firemen and two paramedics are stepping in to move my little Skiffy onto a backboard. Although I have never experienced this before, something in my mind knew what was about to occur and I naturally cringed away from it. I knew that I had no place in the situation. I couldn't help. I couldn't get close enough to console her, so I just turned away, as if turning my back would close my ears to the screams that followed. As we rolled toward the ambulance I called my husband-"we're going to M." "Ok."

The ambulance ride was horrific. We moved cautiously at 40 miles an hour, but Skiffy screamed out with every bump we hit and I cried with every scream and the paramedic who was driving lovingly patted my leg and tried to keep me talking and laughing. Soon the morphine kicked in and we all started to relax a bit. Funny how the morphine in her I.V. helped all of us.

The arrival at the hospital was a whirlwind. I was hearing lots of terms vollied about by the nurses and EMTs, things I didn't understand, but on occasion I would hear something I could interpret. BP160. Femoral shortening. Rotation. I knew that something between her hip and her knee was not where it should be. It was plain to see with her lying down- one leg was shorter than the other one and clearly not in a natural position. I watched them cut her new red skinny jeans from her body.

Later, in the x-ray room, I first heard the term that would change our little Skiffy's life. The technician entered the room after checking the x-ray and said to the nurse "it's a skiffy." The nurse walked me out of the room and said "it is broke, you won't be going home tonight, she is probably going to surgery."

I tried to dry my tears so Skiffy wouldn't see my fear. With the nurses and technicians I joked about her shredded jeans and now panties that I was carrying in a bag. I went out to call my mother to share the news.
When I returned to the room the ortho surgeon was there. It was all a blur. Broke hip. Slipped something-or-other. Surgery. Pins. Couple of screws. Right now.

I worked with the nurses to remove her black fingernail polish and jewelery. We met with the anesthesiologists and then as she drifted off to sleep the surgeon explained the situation. Worst case we see. Severe break. Severe unstable slipped capital femoral epyphisis-SCFE. Cautiously optimistic. Outlook is not good. Possiblity we could save the bone. Won't know for months. May need a hip replacement. Not good outcome when we replace hips this young. Hip replacements don't last long in patients of this age. She will always have an arthritic hip. She won't walk on this for many months. We'll take good care of her.

And then it happened. The surgeon asked "has she been walking with a limp?"

I felt like I had been hit with a sledgehammer. My baby was hurt in a horrible way and worse, I should have seen it coming. She had been walking with a limp. Yes, she had knee pain, as a matter-of-fact we were going to get it x-rayed on Monday. I lost control of my mind and mouth. "HOW IN THE HELL DOES A 13 YEAR OLD BREAK HER HIP ROLLER SKATING? HOW IN THE HELL?" The tears flowed freely. My husband held me tight. The doctor just looked at me with concern in his sweet eyes and said "we see this a lot, this is how SCFE kids present."

So began our journey with SCFE. A SCFE is when the ball slips off of the femoral neck like the ice cream slipping off of a cone. Doctors don't know why it happens but it occurs in 1 out of every 100,000 kids. When the ball starts to slip, the pain is often felt in the knee and kids begin to limp. Somehow the fall at the skating rink hurried the process and removed the ball entirely. It has been reattached with screws. The bone may heal. Or it may die. All we can do is wait and see. If it dies, Skiffy will get a new hip. She has a 40-60% chance of a slip occurring in the opposite hip within 18 months. The signs of a 'pre-slip' are already present. In one day, in a brief moment, everything changed for Skiffy. She started school a week late and in a wheelchair. No basketball. No gym. No activity for at least a year. She uses a shower chair now and is quite adept at using scooters when we go shopping. She has really cool black fingerless gloves so she can act like Evel Knievel in her wheelchair. We see the ortho every 6 weeks. We are being cautiously optimistic. We stay far away from roller skates.