

Just a few days before Yule ’10 Sephoni got hurt during Taekwondo practice. They were working on doing dive rolls. In a fashion similar to the one shown in this video, the idea was to jump over a barricade (made up of stacked body shields) and transition the landing from hands to shoulder and “rolling” to a standing position. In the vernacular of my girls Sephoni’s attempt on the night of 12/16 was an epic fail.
After a running start, and a dive over the waist high barricade, she landed on the juncture of the back of her skull and top of her neck. The rest of her followed, folding her in half, the weight of her body on top of her. It knocked the breath out of her, scared her half to death, and resulted in her being taken by ambulance to our local hospital on a back board, fully immobilized and thankfully cleared of any serious spinal injury.
We left with a “working diagnosis” of a severe back and neck strain. A follow-up appointment with her pediatrician a couple of days later led us to a local orthopedist. Who, after having her in his care for 6 weeks and seeing her pain get gradually worse ad opposed to better (and having no explanation for us) used the finding of a Chiari 1 malformation on her MRI to wash his hands of her until we could see a neurologist.
With the realization that the first appointment we could get with a pediatric neurologist was months away, our child was suffering, and with our (former) orthopedist’s last words echoing in our memory we decided to get a second opinion.
Our next stop was to a pediatric sports medicine office. At first we were hopeful. The Doctors seemed nice. They took lots of time with us. However, they quickly decided that part of her issue was a “missed diagnosis” of a concussion and started treating her accordingly. Their first recommendation was a week home from school with a focus on quiet and rest. When that did nothing to alleviate her symptoms, and our return visit found them still focusing solely on their belief that she had a post concussion syndrome issue (writing her out of school for a second week, and adding an off-label use medication to her regimen to treat “brain fog”) instead of, also, helping us find a way to diagnose and treat her pain we decided that it was time to head back to CHoP (who took such good care of Reya last summer).
Today we saw a pediatric orthopedic surgeon. He listened to her history. Did a quick exam. Reviewed our films briefly.
The good news:
He doesn’t feel that anything has been missed on her films.
The bad news:
His best guess is that we are dealing with a case of RSD, also known as CRPS. In other words, a type of chronic pain. A diagnosis category that I am all too familiar with after almost 9 years of living that nightmare with Accolan. His advice is that our next step is a pediatric pain management doctor.
The I’m not sure news:
We still don’t have a cut & dry answer. No one is ordering more tests. Even though my own research indicates at this point we should be looking into things like blood-work (for signs of infection or juvenile arthritis markers) or a bone scan (for fractures or other bone-related issues that other tests (yes even MRIs) can miss.
The bottom-line:
After some fruitless calls trying to find a “local” pain management doctor who sees pediatric patients and takes our insurance, we have a call in to the Pain Management department at CHoP. They take our insurance (yay!) but they are about a 3 hour (or longer if traffic is bad) round trip away. I have no idea when her first appointment will be.
Until then, the best tool we have to manage her pain are a TENS unit, which helps, but only during the day and can stop working without warning. We have nothing that helps her at night and so she sleeps in short bursts – usually no more than a couple of hours at a clip.
She is still on a written medical excuse from school. But, according to that she goes back on Tuesday (out of gym (and Taekwondo) until late March). She’s going in 2 weeks behind, because the sports medicine doctor advised that we not have work sent home. I have no idea how she is going to handle returning to school. Her grades were already slipping as a result of the pain and lack of sleep interfering with her ability to concentrate and focus.
Because we’re technically in between doctors right now, we may have to go to her pediatrician to get the necessary paperwork to force the school to make necessary accommodations for her (and that’s only if they are willing to help us). Because I have no way of knowing what the next months hold I don’t know if its advisable to sign her up for summer camp (a local day camp program) and I only have less than 6 weeks to decide (in order to get the lowest price for the 7 week program). Life is, in short, on hold.
What I’m after:
A doctor who will listen to my concerns.
A doctor who will not stop until they figure out why my child hurts.
A doctor who will appropriately treat my child’s pain so that it no longer interferes with school, play, and sleep.
And if I don’t get the things I am after … I am going to scream.
Image thanks to JenniferLynn123