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Chelsea

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now, i have a patient who has Slipped Capital Femoral Epiphysis, a moderate slip, she is 15 and her left slipped when she was 13. I put in 1 single screw and unfotunatly her pain is coming back again. She is very active in sports, not overweight (quite skinny actually), white, and lives in the south (most people with SCFE are obese, male, african american, and live in the northeast). The growth plate in her right hip has closed, but her left hip has made no progress since the previous year. I told her i would take out the screw, and get her an MRI to see what's wrong. I also plan to shave down the bone because of the deformity. i also told her to stay off her legs for awhile, meaning no sports. i told her its probable she will never play competitive sports again, but she can swim and bike. she was DEVASTED by this. however, i am puzzled to why this happened.




any help would be GREATLY appreciated
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So what are you thinking is going on? Do you think the hardware is causing pain? She is unstable? Needs an osteotomy or an epiphysiodesis? I am not seeing the full picture here.
 
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Chelsea said:
now, i have a patient who has Slipped Capital Femoral Epiphysis, a moderate slip, she is 15 and her left slipped when she was 13. I put in 1 single screw and unfotunatly her pain is coming back again. She is very active in sports, not overweight (quite skinny actually), white, and lives in the south (most people with SCFE are obese, male, african american, and live in the northeast). The growth plate in her right hip has closed, but her left hip has made no progress since the previous year. I told her i would take out the screw, and get her an MRI to see what's wrong. I also plan to shave down the bone because of the deformity. i also told her to stay off her legs for awhile, meaning no sports. i told her its probable she will never play competitive sports again, but she can swim and bike. she was DEVASTED by this. however, i am puzzled to why this happened.

any help would be GREATLY appreciated
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Upon second read, this sounds like a parent trying to sound like a doctor.

Why dont you just say that you are a parent and we'll answer all the questions you have? We know you are concerned for your daugher and a bit intimidated by the medical system.

It's ok, we're all strangers here...

DB
 
actually im a 15 yr old kid trying to sound like a doctor because i dont really understand whats going on.
 
Chelsea said:
actually im a 15 yr old kid trying to sound like a doctor because i dont really understand whats going on.
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Damn, pretty sad story now that I get what's going on here.

Guess that's why the Europeans pin the contralateral hip right away . . .
 
Chelsea said:
actually im a 15 yr old kid trying to sound like a doctor because i dont really understand whats going on.
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Sorry, I should have actually answered your question.

In fairness, I am not an Orthopedic Surgeon, I am a medical student starting my internship in the field this June. Most of the folks on here, from what I gather, are either in their Orthopedics Residency, or like me, getting ready for it.

I'm sorry this has happened to you. I can only imagine what an impact this must be on someone who is/was active in sports.

I can't say for sure, but I suspect that most people on this board are going to be reluctant to answer your question about "what's going on". Most physicians feel that they need to physically evaluate a patient and have full access to their history and records before giving an opinion. Probably the most destructive thing anyone here could do, would be to tell you, "I think this is what happened . . . " when actually it was something else. And while you know quite a few details about your diagnosis and surgery, there are many more details any physician would need to know before they could give an informed opinion. These details would be found in your medical records and xrays, which few people have access to or know how to read.

The best person to answer your questions is your Pediatric Orthopedic Surgeon. Given your original post, you sound reasonably intelligent and mature. I would suggest this: Go to your mom/dad, and tell them you want an appointment to talk to your doctor about what is going on. Although surgeons are very busy people, it is likely that yours will agree to your request. Before you go, sit down and make a list of questions that you want answered. Very often, teenagers have a lot of questions and then forget all them the moment they get to their doctor's office. If you have a list of questions, and your doctor doesn't have any appointments in the near future, he/she may even agree to correspond by email.

Again, I'm sorry this happened to you. I wish you the best of luck and a speedy recovery.
 
thankyou so much

i went to my doctor and asked him my questions, and now i better understand what's going on


thanks again!
 
Chelsea said:
thankyou so much

i went to my doctor and asked him my questions, and now i better understand what's going on


thanks again!
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I'm glad. It's always nice to hear stories about surgeons (despite the reputation of being cold, dismissive, etc) that involve taking the time to fully explain things to their patients. I hope, as my training progresses, that I can emulate your doc in the care I take with patients.

I wish you the best with your recovery. Congratuations on having the maturity and intelligence to take the time to get a handle on your health. You have now surpassed >50% of the adult population in terms of brains and resposibility.
 
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