Do Yourself A Favour... Don't Self Diagnose

This morning Emma had her 18-month check-up. All very usual - measured her weight (still way down in the bottom 5th percentile), her head & height (both up there in the 50th percentile). Go figure, Jeff & I having a tall thin kid. Hopefully she won't inherit the Rakowsky fat gene that runs rampant in my family.

She says words, understands direction (though doesn't always follow it), climbs stairs, and makes eye contact. (Speaking of eye contact, it seems I'm being a little too hard on her about the whole colour thing. It's perfectly fine & acceptable that she can't distinguish red from blue or greeen from yellow just yet.)

Then I told the doctor about our concern with her continued leg-crossing.

A: It's, like, ALL THE TIME, those scissor-legs.
D: That's just 'her thing'. Nothing to worry about.
A: Good. Cuz my husband & mother-in-law have both been going on & on about how it's abnormal and how I should get her to a neurologist ASAP. And I told my husband that if I were to come to you saying that I need to send my daughter to a neurologist, you'd likely be sending ME to one.
D: ha ha ha

And then I don't remember how it came up, but the conversation continued...

D: Does she walk on her tip toes?
A: Yes...
D: Most of the time, or just some of the time?
A: I don't really know... a fair bit, I suppose.
D: Let's see her walk...
A: Emma... walk!

And sure enough, back & forth Emma walked completely on her tip toes.

D: Oh.... Ummm... I think we should have Emma come back for a second opinion with Dr. Friedman, the neurological specialist.
A: Wha... wha... what are you thinking??????

Of course she wouldn't tell me anything more than "it's probably nothing..." But quite frankly, she didn't look like she really believed that.

And of course the first thing I did when I got home was to google "Infant walking on tip toes". BIG MISTAKE.

================

If your child is always tiptoeing, it's possible that she has a physical problem such as a short Achilles tendon that actually prevents her from standing flat-footed and limits her range of motion in the ankle. But consistent toe walking is more likely a sign of a motor disorder — most commonly, mild cerebral palsy. The most common form of cerebral palsy is "diplegia," which means it involves the bottom half of the body. This is the form of cerebral palsy most common in children who were born prematurely. If this is the case, your child is toe walking because her Achilles tendons and calf muscles are too tight, which means her heel is pulled up and her toes are pulled down.

If your child's doctor rules out cerebral palsy and other physical problems — if her muscle tone is fine, and she has a good range of motion in the ankle — then she'll likely be diagnosed with what's called idiopathic toe walking. This is a catchall diagnosis that means the cause is unknown. Idiopathic toe walking may be associated with language delays and with certain forms of autism, so it's important to verify that your child's not having other problems with communication or socialization skills. You may want to schedule a development assessment to make sure.

What Your Doctor May Recommend
If your child has a physical problem such as a short Achilles tendon, treatment would probably begin with a program of stretching and an ankle-foot orthosis, which is a lightweight plastic brace that goes up the back of the leg and maintains the foot at a 90-degree angle. Your child wears the brace day and night until the problem is resolved. Of course, you can take it off for baths or to practice muscle activity to strengthen the tendons. A process called serial casting (which involves using a series of casts to stretch and lengthen the tendon and increase the range of ankle movement) is sometimes used, but, says physical therapist Gay Girolami: "It's passive, and when you practice activities in an active rather than passive way, you see more progress." Also, casts can't be removed on the fly like the braces mentioned above. In select cases, surgery may be recommended.

If the problem isn't physical, but rather that your child is delayed in socialization or communication, your child's therapy will treat the underlying problem. A development assessment is the first step in determining what kind of treatment your child needs.

============================

We are scheduled for a neurological consultation for tomorrow morning (on a cancellation).

I likely won't be breathing much until then.