Saturday 22nd November

By Sunday Emma was a different child. She was moving freely on our bed, in fact could get up on her knees. But we noticed that her legs did not seem to be well abducted - maybe the brace had slipped somewhere. So on Monday morning I called the orthopaedic office to see if they wanted to see her earlier then her arranged appointment on Tuesday. We didn't get a call back till late on Monday, so her appointment was left as it was. We had two appointments on Tuesday, the first was with the Surgical Appliance lady, our second appointment was in the afternoon in clinic, where she would also be available.

Itchy rash
Emma had developed a very itchy rash on her back, on Saturday she was crying out because it was very itchy, and for a six-year-old, unbearable. I put a cotton vest on Emma and slithered it under her brace. I wasn't sure if it was a sweat rash, eczema or a reaction to the padding. I had tried aqueous cream, but called a local pharmacy for advice. The pharmacist recommended taking histamine, such a s Piriton (which would make her sleepy too) and to try calamine aqueous cream. This did alleviate the itch a little more, but I had to gently scratch her back to enable her to go to sleep. Emma was not comfortable during the night, and I had to repeat the applications. By Sunday you could see red spots all over her back under the brace. A few came out higher up on her back and under her chin. I called the out of hours doctor's service, Barndoc, to see if someone would come and visit. We didn't want to subject Emma to another car ride and didn't have the wheelchair yet either. They wouldn't come out to see her - only the elderly! But the doctor suggested a cream called Eurax which can come with a mild level of hydro cortisone. This cream did seem to make a difference, she felt less itchy quite soon after the application.

Fitting the brace better
At our first appointment on Tuesday, the surgical appliance lady said the thigh cuffs were too loose and started trimming the padding and plastic to make a better fit. This probably explained why Emma could squirm around. She also felt the abduction had slipped but in the afternoon clinic appointment she'd be available to help make further adjustments. We saw the registrar who could see what I meant about lack of abduction. They decided to take the brace off to adjust it, but Emma was reluctant saying she was 'comfortable'. This made me laugh, the real reason was she had to remove her shorts a knickers. I had bought some large 'shorts' type that could go on the outside of the brace and had no elastic to press on her scar. I said it was OK to take off as I wanted the doc to see her back

The doctor winced when he saw it, it was a very large purplish rash which looked very itchy and uncomfortable. He decided I was probably doing the best for now, introducing the vest, taking Piriton and the Eurax cream - not to try anything stronger. But he admitted it wasn't his area so we mutually agreed a GP visit would be best. As it was outpatients, there was nothing they could give there.

The back of the brace was not covered adequately in the padding, and it had a seam going down the middle which was probably causing the rash too. After half an hour of adjustments they got Emma back in - with one final amend to make it slightly less abducted and causing Emma pain. I was then left to get Emma's shorts on, we could no longer slip the knickers and shorts up over the outside, so with a pair of scissors, tape gauze, I cut the seam and tied the edges together. The bright yellow Airtours shorts had done their job!

Thanks to grandad who held onto Emma while I fetched the car from the top floor of the car park. We've applied for a blue badge, but it will take a while, I'm not convinced we will get one, but I couldn't of got in a normal car parking space and get Emma out into the wheelchair. The car parks are always very busy during the day.

Sore right knee
Emma complained the right thigh cuff was digging into the back of her knee. It was very tender to touch. We decided to move the cuff further up her thigh. Andy eventually found a screwdriver that fitted and we moved it up about 5-6 mm. This helped a great deal. the next day when I was getting Emma up and downstairs for a change, I noticed how her right leg was swollen. Her right calf was more than an inch bigger then her left. I released the strapping a bit and left her for a while, but it was tender to touch on the front. A call the the orthopaedic office got me passed very quickly through to the doctor. I was to get Emma to lay down and raise her foot above her heart level. The pressure on the back of her knee had caused a 'backlog' and should go in an hour or so. It did! We then took our first jaunt out to the school to pick up big sister and see a few friends. This really lifted Emma's spirit.

Emma up and walking
It's Sunday today, the registrar had told me another week of non-weight bearing as they had abducted her legs further. But we decided today, she was in good spirits and no pain. The rash had abated (despite a VERY unhelpful visit to our GP clinic. The doctor we saw just said 'what do you want me to do about it?' - we did come away with some barrier cream Epiderm, but I think the Eurax cream and Piriton had helped the most), to let Emma stand and see if she could walk.

Emma was very wobbly at first, unsure of how to move. I had to demonstrate how to move her legs, but that was it, she was off...

Tenotomy operation

We finally got a phone call last week from the surgical appliance officer. It seems getting hold of the brace was not as straightforward as the surgeons thought. There was too much red tape involved; being a preferred supplier, navigating through customs, it was all going to take too long. They had found a British importer who had a very similar brace and needed to measure Emma before deciding on the size. Once they had that they could get the brace couriered over and the operation could go ahead the next day.

Later the next day, and having Emma measured, we got a call that we could bring Emma in by 10 the next morning, nothing to eat after 7am. It was no longer to be a day clinic and they wanted Emma to stay in one night. I packed a little suitcase - prepared this time (just a suspicion it might be longer then one night). I added leggings, vests, strong shoes to walk in and not just her favourite Crocs. As you will see later, this showed I was not prepared for what lay ahead!

Emma was quite excited - looking forward to the adventure. I told her she would be a little sore after, but would feel better quickly. We were shown a bed, the same bed as the summer when she was in traction. Saw various people to answer all the pre-op questions. The SHO was lovely with Emma, instead of drawing and arrow on her left leg he drew a cat from her t-shirt. I told him I had brought with me leggings for her to wear as I'd been told the brace was not comfy against the skin. He wasn't sure but to take them to the theatre with me to hand over. The anaesthetist made it fun too. So when it was time, we left to walk over to the theatres, had to wait around a while, Emma got changed, we were asked name and dob about 2 million times! The consultant arrived with the brace, wasn't what I was expecting - it looked very futuristic, all white like Eve from Wall-e. He said it was a very simple operation, would only take about 10 minutes and the clothing I brought wasn't necessary yet.

When it was our turn, Emma was not scared. Unfortunately they had difficulty getting the needle in her hand, then Emma did cry, so they had to use gas. She held her eyes wide open when the anaesthetist said she was asleep and wouldn't remember anything, then her eyes closed and I had to leave and return to the ward.

Of course that was the hard part, she wouldn't be long and 45 mins later I was called back to recovery. Emma looked all bleary eyed, spoke with me a little, then said she couldn't see, then said everything was blurry. The anaesthetist reassured me, it was normal and she'd be OK soon. I was shown the brace, she did look like a robot. The consultant came to say hello, said it all went OK. Then told me something he hadn't mentioned before, Emma was to wear the brace for two weeks solid, only sponge bed-baths and to be non-weight bearing for the first week. So no changing of clothes and the padding wouldn't of made that easy either. The brace was against her naked skin and a bed pad had been folded up and placed as a nappy.

Now I realised my folly in the clothing I brought with me. I thought I'd been well prepared, but what about knickers - should I have been advised to get large nappies? I would have to amend trousers to fit - velcro up the sides?

Emma was comfortable till early evening till the medication started wearing off. We had to wait some painful time before she could have more pain relief. As you can see from the pic, there is lots of padding. Emma did suffer with a lot of pain that first night. She had repeated muscle spasms that came in waves. The combination of paracetamol, ibuprofen and codamol were not enough. They tried codein instead, but she was still in pain. So we both had a difficult night. In the morning we saw the registrar who said he could give something for the spams. And 20 mins later after having Diazapam they subsided.

Now I'm thinking here, surely they know this can happen - why wasn't it written up so she could have it if need be. The physio came to visit - another Emma, she was super with the kids, but had to battle with their fear of moving and the pain that might cause. Emma did not want to use the bed pad to wee in, it was not a nappy in any case. It was just going to be too painful to get her on a bed pan. So the physio was able to eventually find a commode through a lot of phone calls. I did have to leave the room for Andy and the physio to get Emma onto the commode, she hadn't been for over 24 hours! It's been a difficult day as another boy had screamed intolerably as they had the cut his cast after just having a big op on his leg.

I listened to Emma scream from the parent room, not for too long, and a great relief to go to the toilet. If we could have a commode at home we could leave, a wheelchair wouldn't be available till after the weekend. In the end, they said they couldn't deliver till the next day but Andy volunteered to go get it from the warehouse. So a mad dash was made - too much traffic, but they waited. In the meantime Emma became very uncomfortable and decided she preferred to stay another night. Good job she did, as the evening progressed her surgery site became very painful and she started screaming with the pain.

This went on all through the night, with small breaks when she'd conk out, then resume again when she woke a few minutes later. It was terrible for Emma, me and the other poor kids in our ward. The nursing staff came when they could to give her more meds, but nothing quite broke through. By daylight it had eased a bit, but she was so pail and unhappy. The registrar arrived, surprised to see us. I told him what our night had been like. He decided to issue oral morphine, if more unbearable pain happened.

This we hadn't really been prepared for. Having been told it was a simple little op, would take 4 days to get use to moving in the brace I had just assumed, she'd be up a walking in days - actually walking out the hospital, and she'd be a bit sore. It may be a very simple operation, but for some children, it is very painful.

We did return home later that day, after a dose of morphine for the journey. Although our med bag did not contain any strong pain relief as I was told she'd have, in the end she did have a good night. By the end of Saturday, she started moving herself around and by Sunday Emma was a new child. No apparent pain and throwing herself around our bed! How these kids feel so better so quickly after being in so much pain - it is a real wonder.

Waiting for re-schedule of operation

Emma was due to have her tenotomy operation last week, but the brace hadn't arrived in time. So for now it has been postponed. The brace is coming from America - perhaps it got delayed in the elections going on.

Last weekend we thought we'd take the girls for some fun time, as we thought Emma wouldn't feel like going out much after the operation. We had a nice meal out, then on the sunday we took them to a small local wildlife park where we got to feed the animals, watch the funny otters, pet a snake, skunk, bearded dragon. Emma did make use of the buggy we have on loan from the Perthes Association.

Emma enjoyed feeding the zebra.

The otters were lots of fun; mum, dad and six babies.

We are noticing more and more how short Emma's left leg is, She is walking with a straight leg again, not bending her knee properly. This cannot be doing her muscles much good. I think she needs to see a physio to teach her how to walk better. Emma has experienced pain in her right leg, especially the knee. The last few days at school she has asked for the buggy to take her to school - OK this is downhill, but at hometime too - not so good uphill ;-). I'm not sure if she is being lazy on some days, or it is becoming an effort.

Emma's class had made her a lovely card. It was huge with lots of little letters and pictures inside wishing her well. I then had to tell them the operation got cancelled. But it was a lovely thought.

The girls had some fun at halloween, I had two pirate ghosts!

October 21st appointment

Well we had our hospital visit this afternoon and unfortunately the doc has decided she now needs to go to the next step with helping the contracture and irritable hip. This means a tenotomy, there are two muscles that come from the groin area, one goes over the top of the thigh and the other along the inside of the thigh (I may have got this a bit wrong - but you get the picture). When he flexes Emma's legs at the knees - frog leg, these tendons and muscles pop out - you can see them like a thick cord under the skin. This is where he says they are too tight.




I noticed the other night while preparing for traction that Emma's left leg was a fair bit shorter then her right, maybe even by 2cm. I also saw that her knees are no longer level. When she is standing she has her right leg bent slightly, she is limping all the time. We also had a little scare coming out of school a few weeks back. Emma suddenly complained of pain in her groin and unable to stand. Then I realised it was her right leg! She remained in pain for the rest of day but we haven't had a repeat episode, so putting it down to overcompensating for her left hip.

We went for the usual x-ray and saw the house doctor first, he asked how she had been and I mentioned the shortening of the leg seemed much greater now, and how she had been running too much. He examined her range of movement and the shortening of her leg then went to view the x-ray. He was a while so I knew he was speaking with the consultant and then they both appeared in the cubicle. The consultant examined Emma then asked the questions, have you been keeping with traction, taking the Nurofen regularly, yes I said and the 5ml each night after dinner. I could see him thinking whether he had advised the right thing on that. He said it was very hard to decide, we needed to go to the next level, we'd tried the other methods and they were not working. He asked if I had any questions, I asked to know what stage and category she was at - they often don't like answering that in case they get it wrong!

He explained the four stages:1. Femoral head becomes more dense with possible fracture of supporting bone; 2. Fragmentation and reabsorption of bone; 3. Reossification when new bone has regrown; and 4. Healing, when new bone reshapes. Emma is still at stage two so her head is very soft and at risk. He didn't answer to what category. He then came to a decision, repeated how hard it is to decide to intervene, but the tenotomy was a simple little operation where they release the tight tendons and muscle. In other parts of the country he said they go for the broomstick plasters after the operation, but he favours the brace which gives a child more movement and can be taken off for washing and swimming. They have to wait for the brace to arrive, about a week, then perform the little op, in about two weeks. She'll have to wear the brace for 23 hours a day poor little love, for two months which is a lot better then 2-3 years I've read about that some still do in the States and elsewhere.

He also said she would need a dye and contrast scan, it's called an arthrogram. They inject some iodine into the joint space and the iodine covers the surfaces inside (I looked this up by the way) then they scan with a low density x-ray and they can see how much of the head is involved. Not sure when they'll do this, but with children it is done under anaesthetic.

He concluded that if this didn't work, she may need to have one of the repositioning operations- at this point I didn't ask anymore.

I have to give Emma three 5ml spoonfuls of nurofen each night - seems a lot doesn't it! I did put Emma in traction again I'm thinking if we are more resilient in making her do it, there maybe a miracle and her tendons release before the D-day.

Emma leopard, school fair

12th September appointment

This was our third vist to the hospital since Emma's diagnosis. We were told at the last appointment two weeks ago they would repeat x-rays. In fact there was just the one taken. We had to wait a while as the doctors hadn't signed the x-ray forms! We saw a registrar first who showed us the new x-ray. Her left femeral head showed further flattening, it looked roughly a little under half the height of her good hip and was just beginning to peak out from the socket.

There are no further fractures, however, so that was good. It was the first time my husband had seen them. Obviously he was surprised by what he saw.

The doctor said how her hip was still vulnerable and beginning to fall outside the socket. It was not in the best position and he thought maybe a brace or crutches would be needed and he’d speak with the consultant. The consultant examined Emma’s ROM and was still concerned about the contracture. He decided she no longer needed the three doses of Nurofen (Ibuprofen) but to give one dose after the evening meal. He felt the Ibuprofen may possibly be masking any problems.

He is still against broomstick plasters and other forms of bracing and how awful they are for a child. He explained his experience comes from studying in the US, Europe and UK and would not offer Emma much benefit as the important things were a good diet, keeping mobile, exercising – swimming, not running or jumping basically allowing the body to remould. He also explained the need to keep the synovial fluid in good health, as this was important to keep the cartilage healthy. However, if she should suddenly be in a lot of pain to rush her back in – I’m guessing here he means if her hip displaces!

The next x-rays will be six weeks. He also mentioned home traction – we realised he hadn’t remembered anything about Emma and that she had been in traction. He decided if Emma could put up with it, to put her in traction every night. Emma is not happy about that! We decided we will give her some time off now and again.

We are still unsure to what stage she is at or to what category she is in. The registrar suggested 50% involvment and grade 2 but we are not sure if he was referring to a particular grading system or the stage she was at. Unfortunately the NHS doesn't give you much time. We still have a long road ahead of us, so it maybe too early to tell in any case.

Extra swimming lessons

As swimming is one activity that Emma can still do and is encouraged to do, we enrolled her into another swimming club for some extra lessons.

Emma went to her first lesson on Monday, she was moved up to the next class as there was more room with just one child. The coach said she wanted to give her more room so that she wouldn't be accidently kicked by other children and she is able to cope with the deep water.

At the end of the lesson, the teacher gave Emma a slip of paper. She'd been awarded Grade 2 Water Skills! Not bad for her first lesson at the new club LOL!

26th August

We met with the registrar today. Emma made him laugh, as soon as he closed the curtains she said 'look at this' and before anyone could say anything she stetched her legs quite far apart. 'That's very good Emma!' he smiled.

He examined her in more detail, holding her hips still, it was very good! he asked if I could remember what the consultant had said about continuing traction or not! But decided she was doing well and to come back in two weeks where they'll probably do more x-rays to see how things are going.

Such good news! but of course has the slight down side, Emma is now is feeling so good she keeps forgetting she is still on restricted activities. She keeps playing games and running! I've sat her down twice now to say she still can't run or jump even though she is has no pain, the limp is there still a little, some days more then others.



I guess we wait in anticipation for the next appoinment!


It's hard at this time to think what may lay ahead. I read about other children with Perthes and wonder what lies ahead for Emma and us. We've been told this can be a long path and we don't know what route it will take, but I think for now we can be happy that Emma is very cheerful and in no great pain;-)

Is the traction working?

We've been applying the traction for 9 days now and Emma has done her stretching exercies fairly regularly. She has shown great improvement, I'm sure she is past that magic 30 degrees now!

Our next appointment is on 26th august, no x-rays just to see how she is getting along with the home traction.

Andy's boss gave us some cakes, Emma tucked in!

Home traction kit August 15th 2008

So off we trotted to the children's ward accompanied by the sister who proceeded to lecture us on how we should leave it to the professionals to look after our daughter, how it was not such a good idea to do this at home. We were a bit stunned, it wasn't our idea we explained but the consultant's.

We arrived in the ward to be greeted with 'what home traction kit - it doesn't exist!'

So before we knew it Emma was choosing a bed and I was filling in a form with the nurse who then asked 'so who will be staying tonight?' Then the penny dropped Emma was being admitted, there was nothing for us to take home - yet, and it was best we observed how to look after her in traction.

Unfortunately we hadn't been prepared for this and neither had Emma, 'am I staying?' She asked.

The traction kit ended up being two rubber straps to which a cord was attached, some brackets to add to the end of the bed, pulleys, weights and bandages - not quite the slightly higher tech image we had in mind.

We ended up staying two nights. Emma was in pain the first night but managed to drift off to sleep.

In the meantime Andy got busy! He'd measured up the hospital bed and with the help of B&Q and some welding help from a local business, Andy made our own frame to fit onto the end of Emma's bed at home.

We wanted Emma to be home, the consultant said we could do the traction at home, but the staff in the children's ward seemed less convinced. Andy brought the frame into the hospital to show the doctor and nurses and home support staff. They were impressed! It took some persuation still to convince the doctor we will do this properly, we wanted Emma to stretch her leg we were not going to cut corners. The doctor wanted Emma to stay another week, but after discussing the issues with the consultant the doctor let us home to try home-traction for just over a week.

The home visit staff arrived to check everythink was OK and to set up the traction. We had to jack-up the end of the bed to counter-balance Emma's weight against the weight of the weights.

One problem with this kind of traction is the bandages slipping down the legs and the weights reaching the floor during the night. So I came up with a cunning plan!

Traction alarm

I made use of my elder daughter's electronics kit. With some thin wire I adapted a switch circuit that played the loudspeaker when the circuit was closed. I attached the wires to the circuit board and laid this outside our door, then run the wires under the carpet into the girls bedroom and under the bed. I attached the other end of the wires to the simple switch and taped this to the carpet, aligning it under the weight. If the weight should reach the ground the weight itself would then close the switch and activate the loudspeaker.

That second night with my alarm in place we were woken to 'happy birthday' about 8 times!!! Poor Andy had to get up and pull Emma up the bed each time.

The next day he raised the end of Emma's bed a little higher!

Second consultant appointment August 15th 2008

What do we need to ask? What stage was Emma's Perthes at? What level of Perthes was it? What measurements would be done? Another x-ray? I gathered the questions in my head. We purchased a diary in the airport to keep track of dates, appointments, events and when she had her medicine. I wrote a few keywords to remind me.

We arrived early as the letter said there maybe a need for an x-ray, so Andy was on his way from work. We were called in early and saw the Registrar first, I was hoping we would see the consultant and Andy hadn't arrived yet! The registrar read the notes and then examined Emma's range of movement (ROM). I told him how well she was doing from the swimming and exercises we had done. He did some simple movements like how far she could move her straight leg out laterally. Not very far! He said he thought it was still very tight and to wait for the consulant to take a look.

Andy arrived in time and the consulant examined Emma's ROM. 'Still too tight, let's try skin traction for 4 weeks, just at nightime and a few hours during the day while she watches TV.'

4 weeks! That was longer then we expected but we were sent to the children's ward to get a home traction kit. The consultant explained it was too soon for another x-ray but the most important thing to do was to solve the irritable hip and eliminate the contrated tendon as it was pulling the head into a bad position. So I did not manage to ask my questions save one on physio therapy, he did not think that was a good idea at this stage as a pull could be made in the wrong direction.

Holiday in Turkey 2008

Our consultant said it was OK to go on holiday and to continue her Nurofen doses 3 times per day. Lots of swimming and the heat would do us all good but especially for Emma. We were hoping that spending so much time in the pool and the warmth would ease her tight tendon and muscle.

We had a couple of mishaps, falling onto her bottom the first day because she was running on the pool side. It is so hard to constantly tell her 'No' but she did slow down. Emma made friends with another little girl, Emma was so happy to have someone to play with, but soon she was running a little and jumping a few times into the paddling pool. We discussed just how much to tell her and what can she understand, again we sat her down and tried to tell her how she must be careful.

The mini disco showed how good she actually can be at looking after herself. The first time we just watched, it was the third time we had visited this resort so the staff already knew Emma so she did know most of the songs and dances. The next time she joined in and when the movement was too fast or invloved jumping she came and sat out. I tried to encourage her to just bend her knees to the music when the jumping was involved, that worked on a few occasions.
No jumping, how far do you take it? How much damage can be caused? A little boy pushed Emma off the stage, a drop of about 2 feet. I shouted out not realising she had been pushed, 'It wasn't my fault mummy'. How can other children be wary when your child looks so normal?

We began some simple exercises, front leg raises and sitting in a frog-leg position, letting gravity help stretch the muscle. By the end of the holiday Emma could almost sit cross-legged we thought she had improved greatly. Our next visit to the consultant would determine just how well she had done - would she still need traction? Or would she need the tenotomy?

Emma's Perthes Diary

12th May 2008 It started with a limp
It all started about 12th May 2008 Emma would be screaming in pain when she got up in the morning and not being able to put any weight on her left leg. I assumed she had just pulled a muscle or strained herself. She was so active, runs everywhere, jumps around like a loon, did trampolining, Ballet, tap and modern dance, swimming and general tearing around and often falling over, bruising a leg etc. so I didn't put much thought into it. I gently massaged her leg and moved it slowly till she could stand again. Then sent her off to school! She moaned all the way that her groin hurt and she couldn't walk too fast. This went on for about 10 days, then she started getting a bit better - at least no more of the bad pains in the morning. But we were worried how she was compensating for the pain in her groin, turning her leg inwards, rolling her hips side to side. She soon developed her own way of moving fast a kind of skipping hop where she would not use the left leg so much. Soon she was tearing down the hill again.

It happens that one mum at school has scoliosis, and my husband's sister has it too. She said to me after about 3 weeks of Emma limping that her own scoliosis started in her hips and I should get it checked out. So we went to our GP clinic - you never see the same doctor twice - the young doctor gave me such a surprised look when I said she'd had the limp and pain in her groin for 3 weeks. I thought what's the fuss it's most likely growing pains or a strain that's taking time to heal. We got referred to the childrens assessment unit where I answered a million questions - mostly about if she had had a cold - they went through possible reasons and had mentioned Perthes as the last possibility. They took blood tests and an x-ray and said everything looked fine and go take some neurophen if she was in pain. They let me look at the x-ray I couldn't help notice the larger joint gap in her left hip and pointed this out. I was told the x-ray team would review it but they thought it was normal.

I spent the next week or so trawling the net for sample x-rays of a joint gap, trying different searches not quite sure what terms to use. I found one set of x-rays where gaps were mentioned and pointed to Perthes. The Perthes sites detailed how early onset may not show in the x-ray, an MRI or bone scan was needed. At the next outpatient appointment Emma was bright not in much pain, jumped a bit but still had some weakness in her left leg and lack of full movement. The doc decided it was most likely a strain and to have a physio assessment. I then said how we were still concerned about Perthes, we wanted to be sure she didn't have it and I queried about the gap I saw in the x-ray. I also reitterated that something wasn't right - this was not my normal active daughter. He said he'd speak with the team who reviewed the x-rays.

Of course a week later he called back, the radiologist had suspected Perthes and to come in have a frog-leg x-ray done. We did this, and the childrens assessment unit said it told them very little and she'd need an MRI. They examined her, and by then she was back to a little bit of running although not to running at full tilt, she was in good health in general. They made me feel I was wasting their time really, she seemed perfectly normal to them but Idecided that we should wait for an ortho to examine her. The orthopaedic surgeon gave her a much more thorough examination, held her hips still why'll he tested her range of movement. He didn't want to worry me but...

So 2 days after the MRI we get the confirmation from the consulant. I was shoked but also not surprised either. The few days before I had convinced myself everything was OK. He showed me her x-rays again and pointed out the flattening and the crack. I couldn't help saying why had everyone missed it! He said you have to know what you're looking for! It was only my motherly concern that had brought us back.

So stopping an energetic six year old running and jumping and making her walk... I met with the school during the strike here in england, many schools were shut so it was peaceful. They were very good and ours is an inclusive school. I made her some lables to take to school last friday it was mostly to remind her what she cannot do now and also to remind the teachers and her friends. The label said 'I must not run or jump so please wait for me'. They're not for ever just the last few days of school and maybe the first week of the new year. I guess some of you will think I have 'labelled her' - but this is not the reason, she forgets so easily, she'll be off in a shot running with her friends or onto the climbing frame. Listening and remembering is not one of her strong points! As hubby says she has the attention span of a nat! I've told her for now it is until christmas. she asked me yesterday if christmas was next week ;-)