I'm concerned for my friend's child....

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I made friend's with this lady the hospital where I had my twins, and this evening I called her to wish her and her family a Happy 4th. She had a 28-weeker, and seemed to always run into each other, so we maintained contact when our kids were discharged from the hospital.

Her daughter has had no issues, other than the fact she was 23 months old before she walked. She is as sharp as a tack.

Well, there was no celebration at their house, she was crying hysterically. They recently moved, and she is visiting a new Pediatrician, and he looked at her daughter on Tuesday for a routine physical.

The Pediatrician said to her, "Did you notice that your daughter has knocked knees?" My friend admitted, that she never had.

Now, this kid, when I have seen her, didn't seem to have issues with her legs other than she wasn't jumping or running, and was a little unsteady, then again this kid has only been walking for a year, not two years like other kids in her peer groups.

My children as well, were late walkers.

She said the Pediatrician is referring her to a pediatric orthopedic physician b/c when the Ped layed her kid down and bent her knees, under the knee, in the fold, one fold was about 1/2 inch higher than the other. I'm not sure if that makes sense or not.

Now she can't stop crying and is worried her kid is going to have surgery, scars, braces, etc...I just didn't know what to do except cry with her, and tell her not to panic because she didn't know anything until she saw the specialist. All she kept saying was that it wasn't normal and there would be no way a specialist would just let it go.

I just didn't know what to do.

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Specializes in orthopaedics.

gosh i am so sorry your friend is hurting. all she can do is take things one appointment at a time. regardless of what comes she will still love her child as much as she does right now.

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It's almost unbearable to see your baby sick. Just being there for her will help a lot.

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Specializes in Nursing Professional Development.

The "popular" answer would be to tell you to sympathize with your friend and understand her distress. But as a long-time NICU nurse, I want to give her a kick in the pants and tell her to be strong. Yes, it is hard to watch your child undergo surgery and perhaps endure some long-term consequences. But as a parent, she needs to understand that falling apart is not what her child needs. That type of reaction is not going to help the child develop into a strong, healthy adult.

In addition, she should be getting down on her knees and thanking whatever God she prays to for her great blessings. In today's world, most 28-weakers survive with a high-quality of life. But that is a recent development in human history. For a 28-weaker to survive with only an orthopedic problem that is probably treatable with surgery and/or braces is a minor miricle -- a relatively minor problem considering the long list of really serious things that could have gone wrong.

A lot of families have to deal with a whole lot worse.

Be supportive -- but don't let her wallow in self-pity (for herself or her child). Self-pity will only make things worse.

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Specializes in ER.

llg said it best.

I want to remind you that a second opinion is always wise. Some docs operate a lot, and some prefer more conservative measures. Look at all the options. Maybe waiting to act turns out to the wisest choice.

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Absolutely get 2nd, 3rd, and 30th opinions. And conservative is usually the best way to go.

Help her be strong after her initial teariness, which, BTW, is perfectly understandable and WNL. A lot of us must mourn and must freak out before we can be strong.

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Absolutely get 2nd, 3rd, and 30th opinions. And conservative is usually the best way to go.

Help her be strong after her initial teariness, which, BTW, is perfectly understandable and WNL. A lot of us must mourn and must freak out before we can be strong.

I did tell her to get a second opinion no matter what, especially if surgery was suggested.

That actually made me go look at my own children's legs (mine walked only about 6 months before hers started), and they were a "little" knock-kneed, but not like her child.

When her child stands, you can't even see it, but I went over and she showed me what she was talking about on the phone. You would think that one leg was shorter than the other, but the child doesn't limp at all.

I'm just wondering, and only because I saw this on the internet last night when I was doing some research on it, if knock-knees for late walkers is normal?

Everything that I read said that babies and toddlers were normally knock-kneed, but by 3 the condition should go away...but by 3, most children are walking for 2 years, not half that time, like is the case with some preemies.

I wonder if there is a connection?

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Specializes in Nephrology, Cardiology, ER, ICU.

Second opinion definitely warranted. Mom has to be child's advocate in the medical maze. Good luck.

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Specializes in home health, peds, case management.

your friend is lucky to have you as a friend...and rest assured that you did the right thing for her by allowing her to express her fears...

i wonder if some of her teariness is guilt for not noticing the problem sooner...i noticed that you wroted that her md inquired if she had ever noticed this issue before rather than inquiring if any of her previous mds had informed her of this issue...i wonder if she is feeling that she is a "bad parent" for failing to notice. you may want to reassure her that this is not the case.

as others have said, a specialty referral followed by a second opinion are essential. your friend may find it useful to really think about her specific questions and concerns she has and develop a written list of questions she would like to ask each physician, and take that list with her to the appointment. of course she should also discuss the possibility of "watchful waiting."

no matter what the prognosis is for this child, you can continue to support her by just being there. as the parent of a 28 weeker, she is undoubtedly experienced in advocating for the best interests of her child.

while this may seem a minor orthopedic issue, to us experienced clinicians, this is her baby, and any deviation from normal (no matter how slight) can be devastating. i agree that she is very lucky to have a 28 weeker with no other complications of prematurity. however, i do not think it appropriate to take the mindset that she should get over it because things could have been much worse. this is still horrible news for her and her family, and she has every right to be upset, or any other way that she wants to feel.

continue to be the supportive friend that you have been, and assist her in any way that you are able. please keep us posted as to how things turn out for this family. my thoughts and prayers are with them.

@

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Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

My baby was post mature and didn't walk until 15 months, he had not teeth until 20 months and didn't talk until 22 months. When he sat hesquatted down with his lower legs to the sides and his feet behind him kind of like a Capital "M". I went through all the tears in the world. Maybe hes developmentally slow (disabled) he will need total hips by age 18, he may be borderline hard of hearing.........yadda.

FF 37 years, he is 6'2, runs half marathons, has lovely straight legs, and is a radio announcer/dj/ "personality." He didn't talk because his sister did all his talking for him and he just went along with it. He is stubborn not hoh. Encourage your dear friend to take one day at a time. All babies are different and hers may just be catching up to what a newborn has at day one.

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Specializes in Case Mgmt; Mat/Child, Critical Care.

I have to agree, as a NICU nurse myself....2 things to remember here...her baby was a premie, (a world away from taking a term baby home), there is no guarantee what issues may develop in the first couple years after discharge. She is, like, llg said, incredibly lucky that she is where she is, that her baby actually survived and is having a good outcome. 23 mos is late to start walking, but we know our NICU babes are "developmentally" going to have to "catch up"....she should be thankful that her new Pediatrician caught this now, so if intervention is needed, and it may be no more than PT, it can get started ASAP.... If it were my baby, I would be on top of figuring out, what, if anything was going on, and how I could help my child to overcome and thrive. Support your friend, encourage her to be hopeful...they have come so far, this is just one more step in the process.

The "popular" answer would be to tell you to sympathize with your friend and understand her distress. But as a long-time NICU nurse, I want to give her a kick in the pants and tell her to be strong. Yes, it is hard to watch your child undergo surgery and perhaps endure some long-term consequences. But as a parent, she needs to understand that falling apart is not what her child needs. That type of reaction is not going to help the child develop into a strong, healthy adult.

In addition, she should be getting down on her knees and thanking whatever God she prays to for her great blessings. In today's world, most 28-weakers survive with a high-quality of life. But that is a recent development in human history. For a 28-weaker to survive with only an orthopedic problem that is probably treatable with surgery and/or braces is a minor miricle -- a relatively minor problem considering the long list of really serious things that could have gone wrong.

A lot of families have to deal with a whole lot worse.

Be supportive -- but don't let her wallow in self-pity (for herself or her child). Self-pity will only make things worse.

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