She's a Hippie Chick...

Marissa had an appointment with her orthopedist about her hips yesterday. We were actually supposed to see her in July, but due to a very busy Summer, we just now got around to it. If you recall from a post I wrote back in January, Marissa has hip dysplasia and the ortho wants to keep an eye on it. Back then, Marissa was popping her left hip out of place. Since she started back in PT in February, she has not been popping her hip. Yay! Through PT and wearing her AFOs, her muscles, joints, and ligaments have become stronger.

First, I was very impressed with how Rissa handled the x-ray and appointment yesterday. I have explained to her in the past that the x-ray is just a big camera and that we are just taking pictures of her and there will be no owies. She has always screamed and cried through every x-ray ever taken of her, and that is a lot! Yesterday, she finally believed me and even volunteered to get up on the table. She even yelled "cheese!"! No tears! Then, when it was time for the doctor to examine her, she still didn't cry! I am so glad she was able to take this appointment in stride and realize no one was going to hurt her.

The doctor said she is pleased with how Rissa presented clinically. I told her about how she is not popping her hip anymore. She examined her, feeling her hips as Marissa moved her legs in different ways. The doctor said she feels so much stronger. That's great news!

But...

She did say she still has some concerns when looking at the x-rays. She showed me how her right hip is properly formed, with the ball of the leg bone fitting correctly into the cup of the hip, and how the cup is also properly formed, with the ability to keep the ball joint in place. But the left hip cup is more open, allowing the ball joint to slip out. Not good.

She did say that the right hip has "remodeled" itself quite nicely since her last x-rays. She said that kid's bodies, up until the age of four, have the ability to remodel their joints and bones to a certain extent. Very interesting! So she wants to see Rissa again shortly after she turns four, in March or April. If her left hip has not remodeled itself by then, the doctor said we would "have concern that it won't and we'll have to look at other solutions". Which means surgery. Blech.

I just can't think about that right now. Our hopes and dreams for Rissa's next Summer include getting her trach stoma surgically closed in May (yep, it is not going to close on its own. Bummer.) so there will be plenty of time for her to swim, dig in the dirt and sand, and just generally have a "normal" Summer. It definitely does not include her being locked in a cast for quite some time, recovering from hip surgery. Please pray with us that her hip remodels itself in the next six months and we can forget about surgery. Our kiddo deserves to finally get on with the business of just being a kid, don't ya think?

A Good Problem to Have

Marissa is scheduled to start school Monday, November 1.

That is, if she still qualifies.

Last year, when we did Marissa's IEP in December, she was still pretty delayed. She was only 2 1/2 and she was behind her peers enough that she qualified for all services, 4 days a week, 2.75 hours a day. She was not very verbally communicative and did not really understand how to follow directions well. I knew that we would not be enrolling her in school until this Fall because of the hopeful decannulation. Therefore, we would need to reassess her abilities and needs, being as it was so long ago when she was first evaluated.

So, when I called the Child Find representative for our school district this week, I was not surprised when she asked me to update her on how Marissa has been doing in the last year. Through speaking with her about how Marissa can now speak in 3-5 word sentences (she is still unintelligible a good portion of the time but there are several occasions where she speaks very well and is understood by others), and can follow not only simple directions, but complex ones as well (Jeremy asked her to get her milk. She came into the kitchen from the living room, opened the fridge, got her formula out, and handed it to Jeremy.), we figured out that she may not qualify through the Child Find program for school. She can say her ABC's, count to thirty, and knows the different colors and shapes. She sings songs with mostly the correct lyrics, and dances like no one's business.

The representative did tell me that, if she does not qualify through the Child Find program, she will still probably qualify for school through the "at risk" category. This means that she functions high enough to be amongst her peers but is at risk for falling behind. In this case, she would be able to be enrolled in school, but would be put on a waiting list. We would have to wait for a child to age out of the program for her to be able to start. We do not know how long of a wait we would be looking at.

So, we are beyond ecstatic to hear that our girl may be too "in step" with her peers to attend school funded through the government right now, but it sure would be nice if she could start school sooner, rather than later. One of her biggest issues is the fact that she has not been socialized like other kids her age. We have kept her isolated through the Fall/Winter months because of the trach making her more susceptible to illness. She does not necessarily know how to play with other kids her age. She does not know how to share or how to interact with them. So, if she does not qualify for schooling through the Child Find program and we have to wait to enroll her in school for the "at risk" program, I will be seeking out avenues of social interaction for Marissa, whether it is a play date group or a formal preschool, until we can enroll her for good.

We are scheduled for another Child Find evaluation and IEP on Oct. 29th and that will determine what services, if any, she qualifies for. I'll be letting you know the results of that meeting as soon as I know.

It is excellent news that Marissa may not have a cognitive deficit big enough to qualify her for these particular services. That is something we have worried about since we first learned of her brain anomaly at 19 weeks gestation. At this point, it is a good problem to have and we will only work that much harder to find a suitable situation for our girl.

Left You Hangin'

Sorry about that. I know Rissa got her trach out almost two weeks ago and I have not updated

since. We have been pretty busy. I'll catch you up on what we've been up to lately.

Rissa has been doing awesome!!! If it weren't for the fact that we have to change the dressing on her stoma every day, she would not know anything was different. She is just going about her "Rissa Roo Business" as usual. In fact, just tonight, we decided to try letting her sleep without her pulse-ox for the first time in... well... her life! She and I started to catch a cold on Wednesday last week but her symptoms seemed to have dropped off. Hooray for that!

Her stoma is still open. Honestly, it really hasn't gotten any smaller since the morning after decannulation. Although, we do think it may be closing, ever so slowly, from the inside out. But it is still open and we still have to keep it covered, which is a problem in itself. Marissa has such sensitive skin that the tape leaves red, irritated marks on her throat. We have tried gauze, paper tape, Band-Aids, and Tegaderm. If any of you out there have any suggestions, I'd be glad to hear them!

Dr. P says her stoma might take months to fully close, and it might not close at all. She says she doesn't like to consider surgically closing the stoma until a year post-decan. We had a follow-up appointment with her yesterday and I asked her if she would consider surgically closing it next May if it hasn't closed on it's own by that point yet. It is very important to us that Marissa be allowed to experience a normal Summer, complete with playing in the sand and dirt, and swimming in the water, without us protecting her neck all the time. Dr. P said it is definitely doable and she will consider it if the time comes.

Speaking of yesterday's appointment, Dr. P said Rissa is doing so well that she doesn't need to see her for the next six months!! Isn't that awesome? So incredible!

I have been taking care of my friend's son and it is going really well. Both Rissa and I enjoy having him to play with during the day. Rissa has really handled it all very well, showing very little jealousy. She loves helping me with him and I really think this was a good move for her.

We are hoping to enroll her in school by the end of the month. We are so excited to move on to this next step. Rissa is so ready to meet new friends. We think she will do so well!

I thought I would end this post by showing you a few fun pictures of Rissa in her old infant car seat, then and now.

Then...

And now!

Hear no evil...

See no evil...

Speak no evil!

Big girl!