Another doctor appointment for Kara

She saw the orthopedic doctor today, he said she had...well with Kara having Down syndrome what do you think he said??? HYPOTONIA, and laxity in her joints. She pronates excessively
her medial (inside) ankle bones touch the ground when she bears weight, making walking really difficult (duh Kris, of course it does), so she will be getting an orthotic. In addition to that, her peroneal tendons (alongside and behind the outer ankle bones) move over her bones instead of staying behind them. Yes tendons are supposed to slide over bones during muscle contractions, but Kara's just stay on top of the bone and do not return after eversion (turning the foot outward).

Picture above shows torn tendon from an injury, Kara's slides over her ankle bone because her tendons and ligaments are lax or loose. I noticed this in passing when I dressed her on her gotcha day. The picture below shows both tendons where they belong, notice they are behind (posterior to) the ankle bone. This is normal positioning.


The doctor says there is not much to do about it, that walking will strengthen her ankles and feet in time. Orthotics will help give her more support and place her foot bones in proper position.

Image from:

http://www.physsportsmed.com/issues/1998/10Oct/mckeag.htm

This laxity deforms her ankle bones and makes wearing shoes difficult. She will not get full AFO's, which is what Meghan had, but something that will allow her to flex her ankles. The ortho doc said she would get maximum control DFO's.

http://www.oandp.org/jpo/library/1990_01_040.asp is a great website that talks about the foot issues.

I do have to say that I like the doctor, he was kind and caring with the girls, and all of you moms who have kids with Ds know, not all doctors are, but he said one thing that sets my teeth on edge; "All children with Down syndrome have issues like this". Argh, they are NOT all the same, some, believe it or not, do not have marked hypotonia. Nothing makes me grind my teeth more than docs who say this to me. As if all kids with Ds are exactly the same, come on docs, enough already.

We also got a script for PT, they said they found one we could take both Amanda and Kara to, but no way can we manage it, is is 15 miles away through town, it would take 3 hours a day to do this. Surely there is someone on our side of town. I am going to ask for an in home PT, this should please her support coordinator, who already thinks I ask for too much, too bad, my girls deserve everything I ask for and more. So there!