The day before Thanksgiving, Keagan had an appointment down in Nashville with a pediatric orthopedic surgeon. His pediatrician found a slight curvature in his lumbar spine at his 3 year well-child visit...and it remained 4 months later at a follow-up. So an appointment was made to allow a specialist to follow him on this. I seriously wasn't worried. I hadn't noticed the curve until his Doc had Keagan forward bend, and I felt like a slight curve was nothing. I honestly felt like the doctor down in Nashville would take x-rays, talk to us, then say they will see him back in a few years unless it seems to get worse. Keagan is a typical 3 year old kid...he plays, jumps, runs. I didn't want to go. To me it was just another specialist appointment that we didn't need. Josh was more positive about the trip to Nashville, and actually remarked that it might be fun! I guess he thought maybe we could do some shopping while down there...? (For the record, our all-day trip included lunch at Wendy's and the doctor's appointment. No shopping.)
On the way down to Nashville we told Keagan we were going to the doctor. He kept asking if he'd be getting a shot. We continuously told him No Shots this time. But then he asked the nurse first thing if he'd be getting a shot...she confirmed what we had been saying. Keagan was such a brave boy...no tears or fears throughout!
We headed to the appointment a bit early and they got us back early, nearly immediately took some x-rays, and then we waited a bit. One doctor came in and did a thorough physical exam on Keagan, including watching him walk and run down a hall. He told us that they did note the curvature of his spine on the x-rays, and asked if Keagan ever complained of pain in his back or legs, did he seem to have lots of pottying accidents, did scoliosis run in our families...to which we answered no to all. Then he said that he and the doc we were actually there to see would go study the x-rays some more and would be back to talk to us in a bit. OK. No big deal...so we waited...
Doing anything we can to keep Finn happy. And quiet. We were probably back in this little room an hour and a half...to be honest, this kid was super good. Keagan is easy...just give him Thomas the Train on the phone and he is content!
In these next few pictures I was trying to take a picture of Keagan's back...to show the curvature. But it really isn't that bad so it really isn't that obvious unless you get him in a good forward bend position. So I might not have gotten a good picture of his scoliosis, but I did get a good picture of his sweet hairy back, and his hand reaching to scratch his bum. Just like a man! (And really, this child has the hairiest little back...it is like peach fuzz but it is thick!
Finally the doctor came in and gave us a very thorough explanation of what was going on. And I was, to be honest, blown away. Kinda of sick. Keagan does not have idiopathic scoliosis (the general curve of unknown reason)...he has congenital scoliosis. Meaning his scoliosis is something that happened in the first 6-8 weeks of gestation. Or in his case, didn't happen: some of his lower vertebrae failed to separate like normal into individual vertebrae. I took some pics of the x-rays with my phone to try and show you. It is hard to see but I did my best to differentiate between normal and abnormal portions of the spine. The first picture is from the side. I honestly don't have a good explanation for where the problem lies in this view...I know it is in the lower part of the spine, but it is hard to see. The second and third pictures are the same, just one is drawn on. At the top of the spine you can see the normal portion. Each vertebrate has two little "eyes" called pedicles and a relatively rectangular shape. Then you can see in the abnormal portion, or where the scoliosis actually is, that the vertebrate actually take on a triangular shape with 3 pedicles ("eyes"). These are the ones that failed to separate in utero. And if you can think of what happens when you line up a bunch of rectangles and then throw some triangles in there...well, you get a curve. And in Keagan's case he has a 19.3degree curve.
So what does this all mean? Well, like I said Keagan has a near 20 degree scoliosis. This in and of itself is not much. But what it means is we will watch this curve until he quits growing, and we will watch trends. We learned that congenital scoliosis does not get better with growth, other types of scoliosis actually can even itself out. It will likely worsen. How much it worsens is not something we can really tell from this one appointment. Keagan goes back in May of 2014 for another consult and x-rays. The doctor talked to us about the treatment plan which basically includes visits and x-rays until there is concerning worsening of the curve. Then he will do a CT scan to get a more 3D view of what we are dealing with. And if it continues to worsen, surgery will be the likely treatment of choice to prevent nerve damage and/or spinal cord compromise. The doctor briefly touched on options for surgery but then said that this is impossible to foretell because we don't know what will happen, or if anything will happen.
We are very positive and aren't changing anything we do. There's no point. He isn't broken or hurting. We have a sweet, thriving, normal 3 year old who is excited about life. And so we have kind of made a point to not even mention it to him. We put it on the back burner. Once he's mature enough we will explain it all to him, but for now he has no reason to concern himself with this. And we aren't really either. I mentioned I was sick to my stomach when initially told, but then I looked at him and realized that he is still the same kid. And there was nothing I could have done differently to prevent this. And we both decided it can always be worse.
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In other news: On Friday I have a follow-up CT-angiogram to check the integrity of the torn vertebral artery from April. I am asking you to please pray for complete and 100% healing! And for strength and trust in God. I won't know anything until the end of next week, but I will update you. Thank you!!!
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