We were back in Brighton today to see Dr. Craig. Alison got her cast off. We had gotten some advice from someone with more experience in dealing with cast, so everyone kept commenting that they had never seen a cast like hers before.



The ankle looks just as swollen as it did two weeks ago and I was worried that he was going to put another cast on it, but he thought it looked ok. He was amused at the fact that she had figured out how to run in her cast by the time I picked her up after school the day after she got it. "Wow, that only took her about a day and a half," he said. Because of that, we were having some issues with the cast cutting into her pinky toe. It looks really bad, but they gave us some stuff to put on it and it should heal up all right. Now all we have to do is figure out how to keep a bandage on it.

Alison wouldn't walk normally for us after she got the cast off, so Dr. Craig thought she might need some help until she got her balance back. He had someone find a little walker for her to try out. Fortunately, it was too short for her, because the idea of letting her loose with a walker was not a pleasant one. She was upset that she didn't get to keep it though. He wants her to take it easy until she's stable on her feet again, but otherwise there's no restrictions. He wants to see her again in a month, to make sure everything is looking all right, so we'll be stopping off in Brighton on our way to Mom and Dad's for Thanksgiving. Fortunately, it's right on the way. :)

We were off to Urgent Care today. Alison was complaining about a bad sore throat and her ear hurting. The last time Alison had an ear infection, she only complained here and there about her ear feeling funny and never had a fever, so even though there was no fever today we decided no to take any chances and get it checked out. Her throat was pretty red, but didn't look infected and she had fluid in her ears, but they weren't red. Diagnosis? Sinus infection. So she's on amoxicillan for 10 days and should be feeling better soon.

Well, Alison's sprained ankle wasn't really a sprained ankle. Turns out it was actually a broken leg!

Alison saw Dr. Craig today. He didn't really look to closely at the x-rays that we brought with us because they were three weeks old at this point and he was a little concerned that Alison's ankle was still so swollen. He had us go over and get new x-rays taken to see what was going on. He showed us that there was an area of new bone growth on her fibula, just above her ankle. Great, just great. We've been letting her walk, run and jump around on a broken leg for three weeks!! Luckily, her brace has been helping keep things pretty stable, but Dr. Craig wants to give the ankle a little more support so Alison is now sporting a royal purple walking cast, which will go nicely with the royal purple queen costume she's wearing for Halloween. Fortunately, the cast comes off in two weeks.

Because we have this broken leg/swollen ankle issue to deal with, we didn't really get much of a chance to talk about Dr. Hurvitz's idea of doing a Botox injection in Alison's calf. That will have to wait until a later date.

Alison had a check-up with her pediatrician today. He said that she's doing well. She weighed 50.some pounds and was 47 inches tall. That was good to know, since that's what she weighed and how tall she was at Spina Bifida clinic last week . :) Dr. Mauch also took a look at the films of her ankle and said he thought they looked ok, too. He's a little concerned because her ankle is still rather swollen, but stopped short of having it x-rayed again because we're going to be seeing Dr. Craig next week and he'll make the final call on whether it's ok or not.

In addition to having her x-rays looked at again, I had two more things I wanted to talk about. I wanted to see if we can get Alison tested to get an official peanut allergy diagnosis, so we have a referral to an allergist. The other thing I wanted to talk about was getting a recommendation for a child psychologist, per the recommendation of the neuropsychologist we saw earlier this year. However, the doctor did not seem to feel that was necessary. I can't say that I agree with him and I'm a little annoyed that he brushed off my concerns, but I did not push the issue today because it was getting late and I wanted to get Alison to school as soon as possible so she wouldn't have to miss any more than necessary. So that's where we stand for today.

Alison had Spina Bifida clinic today. Overall, it was a good appointment. Dr. Hurvitz thinks Alison is doing great. He continues to be amazed at her function vs. her lesion level. We talked briefly about spinal cord tethering and how it will be interesting to whether or not it will be an issue for her as she continues to grow. Right now we base things on Dr. Tulipan's statement that all the kids are tethered and just keep an eye out for symptoms that would indicate surgery is necessary. So far, Alison isn't having any.

The main focus of the appointment was what we are going to do about Alison's foot. He is concerned about the fact that Alison has now sprained her ankle twice in the last year and a half. The muscle imbalance (her muscle that controls plantarflexion is hypertonic, her muscle that controls dorsiflexion is hypotonic) is causing her foot to drop and turn in. Dr. Craig had briefly mentioned a tendon transfer when we saw him April, but also said that he was hesitant to do it because he wasn't sure she had the muscle function to rehab the foot and he was concerned about leaving her worse off than she is now. What Dr. Hurvitz is proposing we do, and he will be discussing it with Dr. Craig both before and after our appointment with him in two weeks, is to do a Botox injection into the calf muscle to weaken it and see if there is any improvement in her foot. Even if there is only a 10-15% improvement, it would indicate a higher percentage of improvement is possible if we do the tendon transfer. The Botox treatment is only temporary -- it wears off after about 3 months -- so if it doesn't work, we haven't done anything that will permanently leave her with less function than she already has. It will be another few weeks before we know for sure, but if I were a betting person, I'd say Alison is probably going to have the Botox injection.