Orthopedic Followup

We met with a new orthopedic Dr. today at UC Health. He is Dr. S. and has experience with heterotopic ossification (HO) patients. We didn't learn anything too much from the meeting that we had not heard or read already, but we have a clearer idea of specifically of Daniel's HO in his elbows. We don't think it is in any other joints, but from the questions they are asking we think they were exploring to see if HO had appeared in his wrists, shoulders or elsewhere. We don't think that's the case so we're just focusing on the elbows.

We looked at Daniel's x-rays and you could see very clearly the HO that had developed in both elbows. These x-rays were from April. In both arms you can see the cloudy area under and on the backside of his elbow where the calcified bits have formed. The growth mechanically blocks his elbows from moving. It's not that it would be painful to bend them, it is not even possible to move them. The new calcified areas block the joints from moving and limit the musculature and connective tissue from moving too.

Left elbow

Right elbow

The doctor confirmed that Daniel will need to wait for 12 months from the date of his burn before they will consult and consider surgery. With the amount of HO in both elbows (which is pretty significant) there isn't a way to break free as some patients have self-reported. We suspect they may have less significant HO if they were able to get their range of motion back. We don't think that's possible now that we've reviewed the x-rays with this doctor.

As mentioned in prior posts, HO takes a while to settle down. That's the reason for waiting until his "burnaversary" on January 25th. At that time we would need to get a CT Scan that will give a 3D view of the elbow. Sitting still in a CT scan machine for 15 minutes would probably be a challenge for Daniel so we'll need to think that over, but we have time to think that through. With a CT scan we can begin to discuss surgery options or other things at that time.

Until then we need to follow up with a few new ideas we've considered. One of them is how to keep the muscle, ligaments and tendons in some kind of shape so that he could use them again. Right now I don't have a good answer for that. We already discussed the idea of E-stim (electronic stimulation), but because of the burned and grafted skin that is not an option the burn doctors would support. Other ideas we will explore. Any thoughts anyone? Feel free to comment!
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Coming up in August (next month) - a meeting with plastic surgery doctors to review options for his face grafts. More on that later.