Answers about Jack's leg conditions

A version of the email I sent Daniel about Jack.

The blessing is we have more answers and tools to help our little Jack than we started with. And if treated at a young age, the problem usually doesn't come back. Jack will always be followed carefully throughout his growth and development. He will also be susceptible to early onset of arthritis (between his teen years and age 30).

The specialist wants to diagnose Jack with Infantile Blount's Disease. It is a form of bow-legs that affects only the tibia or shin. There is no femur involvement. But there isn't any certainty of the disease until he is at least 6 months.

He said that in most cases with infants (9 months-15) and/or toddlers there is no effect on their ability to walk. The doctor said that there probably won't be any need for aggressive treatments (surgery) until he is between 15-18 months.

1. So the first thing we need to do is have his vitamin D levels checked regularly to determine if he is having a hard time metabolizing it. (Apparently it is a cause.) (I had to have his blood drawn this morning before going to the appointment and the specialist said this is why--to screen his Vitimin D levels. So that will happen monthly and can be done Guthrie.

2. No baby shoes and we have to keep him off his feet. The specialist said we don't want to add any additional stresses to his ankles and feet.

3. We will continue with the bi-weekly measuring of the space between his knees and the curvature of his shins. There is a possibility that the curvature will remain until his muscles of his lower back and legs are strong enough to support standing. So that leads us to number four.

4. Continue with the muscle strengthening exercises and the massaging exercise for loosening his tendons. It will help with the charley horses too.

5. Jack has vitamin supplements as well as a special diet for myself since I am nursing him. (Poor diet is a cause too.)

6. Monthly checks with the specialist to document any progess in addition to his well-baby appointments.

7. At four months- we can supplement what we do at home with monthly physical therapy appointments.

8. At six months they will do a series of x-rays to give him the complete diagnosis of either Infantile Blount's Disease or just bow-legs.

9. There are additional treatments if there is progressive worsening of the curvature of his shins. There is a trial bracing period (check out www.eorthopod.com and look up blount's disease in children to check out the braces). The braces have to be worn for 23 hours a day and as the bone straightens out, the orthotic is changed every 2 months.

10. Surgery involves cutting the shin bone to realign it. There is also a procedure where they can surgerically restrict the shin bone to allow natural growth to reverse the bowing process. This procedure usually leads to a leg length discrepancy.