So the results are in ...

And the MRI confirmed the diagnosis of Charcot foot in Alyssa's right foot. The orthopaedic specialist who showed me the MRI pictures decided that it was better to refer her back to the paediatric hospital orthopaedic specialists, so that we could develop a plan for her. And told me just to continue doing what I'd been doing ... ie keeping it immobilised, and her off of it as much as possible. The orthopaedic specialist at the paediatric hospital saw me in a joint consult with the rheumatologist thankfully, and between them (and the podiatrist, whom the rheum had also asked to join us), came up with the plan that we should start letting her weight-bear again. That she could do "normal 4 year old activities" again, (at which I did laugh a bit as she apparently did this damage from either a simple tripping over, or from just trying to go down some stairs) but was pleased that they felt it was improving enough to allow her to start building up some exercise. The ortho had requested more xrays that day and said it there was now pretty clear callous formation present, so she must have actually fractured it initially. Then continued to stomp about on it for almost a month before it was immobilised with the boot. But thankfully, the damage done was not as bad as it could have been! They all advised getting her better trainers to cushion her stepping, and hopefully protect her feet/ankles from future damage. So I went straight out and bought her some new Nike Air Max trainers, in a variety of colours ... as some were also what she was going to be wearing to school, when she starts school in August. And we started trying to build up her exercise again, whilst restricting her immediately again if we felt that her R foot was swelling up again. And the ortho advised having her foot xrayed again in 4-6 weeks locally, to save me yet another trip to there!

In the midst of the "being allowed to walk again" period, I had two other fairly major stressors! The first being the discovery that Alyssa had a NEW TOOTH!!! An ADULT tooth! Already! At 4!!!!! *faints* We'd been told many times that - although there was a VERY SMALL chance of her adult teeth coming in early - she was much more likely to be very delayed getting them, and might actually need help in getting them to come down. But I was perfectly happy with them coming in later (and ready to deal with any complex issues she had, from having no teeth compared to her school friends!), because it meant longer before she could do any damage to her mouth etc again. I couldn't believe that there was something WHITE in her mouth, that had clearly been there for about 3 weeks by the time I found it (and almost passed out!), but was pleased - though terrified - that at least it had been there and she hadn't managed to bite herself with it. And 2 weeks later, the "bleeding" started again! :-/ She had two episodes within a week, though fortunately both were VERY MINOR incidents. She must have grazed her bottom lip with her new very sharp tooth, and had absolutely no idea that there was blood running down her chin! Or again; a few days later, that she had her top lip bleeding! :-/ I was very confused as to how she managed to graze the top lip because the tooth isn't even completely down yet, and I began to panic that - once again - we were going to have to deal with biting damage. But that this time, we'd need to remove her adult teeth! Something I absolutely positively did not want to do!

A panicked call to the dentists ensued, and we were seen really quickly. The dentist was lovely, had clearly put a lot of thought into Alyssa's situation, and was happy to go ahead with my suggestion of just filing Alyssa's sharp, jaggy, new tooth down to a blunt edge, because it wasn't going to do her any harm and would at least be an attempt to save it. He felt it was important that I understand it might not help, because she genuinely didn't know - before or after - if she'd bitten herself with it, but I advised that I didn't feel she was actually going to start "biting" herself like when she was a baby and teething. She is definitely much more aware from that perspective, but that she seemed to be grazing it accidentally and (hopefully) by removing the sharp edge, we'd at least get away with it for longer. He was happy to oblige, and polished it down for us. Alyssa found this very tickly and laughed hysterically every time he touched her with the polisher, which made everyone laugh along with her! :-) He also said he was happy for me to call him whenever we needed him, and save us the extra journeys to the paed hospital. Which we will probably take him up on very quickly, should she have any more issues. I'm very pleased to announce that - so far anyway - there has been no more damage from her teeth! :-D

The "other issue" we've dealt with over the last couple of weeks is the discovery that Alyssa isn't blinking enough. To the point where it's already starting to affect her eyesight adversely. In short, she's not feeling when her eyes are too dry (like we would do automatically, and without thinking about!) so she's not blinking. And they are getting too dry. Fortunately the damage so far is very minimal, and I've now resorted to putting eye drops in her eyes for lubrication, in the hopes that we can save her from any future sight damage. They are purely "artifical tears" so nothing bad is going in her eyes, we're just giving her a helping hand. Let's face it, you only get one pair of eyes! Hopefully when we return for her next eye check-up in 6 months time, they will notice an improvement.

And that brings us to - literally - last night. She was at her dad's house overnight on Monday to yesterday teatime. When she came home, her dad remarked that she'd fallen from the bar stool in his kitchen so to keep an eye on her right arm, though there were no marks/bruises etc. I noted that, then he said that he felt she was also walking funny on her left leg. I asked in what way and he said her leg was "bowing out an awful lot" when she walked, so I asked her to walk ... and just freaked out (internally) at what I saw. Her entire leg was bending - the wrong way - out to the the side, whenever she put weight on her leg! As if she'd dislocated her knee, and it was bending sideways instead of to the front! :-( She'd had periods the day before where she complained her ANKLE was "sore" and when I asked what she meant she meant by sore, she said that it was "really itchy/sore/itchy" but there had been nothing to see. No swelling at her ankle, no puffiness, redness or anything to suggest that she'd injured herself. And she was definitely NOT walking like she was when she returned home. I had yet another panic attack - especially knowing that the hospital wards had JUST (yesterday!!!) transferred over to our new local hospital, and that they were still setting things up and getting to know where everything was in the new childrens ward! And set off for the new A+E department, also just transferred yesterday! It's like someone told her there was a new hospital to try out! :-/

Fortunately; as soon as I explained that she normally has open access to the childrens ward, they phoned the paediatric department and were told just to send her up. And - even more fortunately - it was a consultant paediatrician on-call who I know VERY well! And who knows that I know Alyssa better than anyone! She asked what was wrong, and I explained. She initially thought that Alyssa was "going over on her L foot" and that this was causing her leg to follow and bow outwards ... but once she let Alyssa into the brand new playroom to play with the toys (and informed her that she was the first EVER child to play with the new toys!), Alyssa just wanted to take off round the room ... allowing the consultant to see her walking on it! She just looked horrified at me, and said she understood immediately why I was concerned about Alyssa's knee. That she could xray Alyssa, but it was clearly some sort of internal joint damage (there was nothing to suggest infection etc) and that she would rather just send Alyssa straight to the paediatric hospital ortho for investigation, as he would want his own xrays taken anyway. She was happy for me to continue to restrict Alyssa walking again, and to take her home to her safe padded bed, and said she'd phone them first thing this morning and arrange for her to be seen. They phoned this morning, and I'm currently waiting to take Alyssa up for an appointment with the ortho this afternoon (the same one who's been seeing Alyssa for her Charcot foot), so hopefully I'll find out today what Alyssa's done. We're still not sure if it's her knee, ankle, or both ... but I'm hoping that it's *just* her knee, and that it's something easy to sort! Will update as soon as possible!