Last Saturday my happy little 3 month old, Lockelan, got fussy. In fact, he started to have small screaming fits when I disturbed him. He was nursing a bit more than normal so I assumed he was going through a growth spurt and was extra grumpy when woken up. His cries were somewhat reminiscent of pain cries but neither my husband nor I could find a source.
During his Sunday bath I noticed he couldn't move his left leg at all. Upon closer inspection it was clear that his knee was badly swollen. There was nothing visible as far as redness or bruising. I also checked his temp and it was normal. While he seemed content enough when he was comfortable, moving his leg caused him a great deal of pain. We debated taking him to the emergency room but decided against it since it wasn't truly an emergent situation. We are fortunate enough to live near an orthopedic walk in clinic so we headed over only to discover they are not open on Sundays.
For those of you who know our history you know that Elora's juvenile arthritis started in a similar fashion. She woke with a massively swollen knee. Within 24 hours she was running wildly spiking fevers. Our fears of an infection were quickly replaced with the fear of a chronic, autoimmune disorder (which is nothing like that more traditional osteoarthritis that the elderly develop). We eventually realized those fears and found a variety of treatments and medications that give her a fairly normal life most days.
Despite the similarities, I was hopeful that Lockelan was suffering from an injury, even though I couldn't recall a specific incident. I do my best to shield him from William's 2 year old energy and rough love, but I can't prevent it all. Even though JIA is a autoimmune disorder, it is generally not hereditary. Yes, occasionally siblings will be affected but it's quite uncommon. JIA is far more likely to strike girls and it virtually never appears in an infant. But yes, the thought was in the back of my mind.
We started with a visit to our family doctor on Monday. He was able to perform an ultrasound in the office. He found a great deal of fluid on his knee and up into his thigh. We discussed the possibilities. It looked unusual for an injury. It looked somewhat spot on for arthritis. I was told he would need to have it drained within a week, partly to relieve the pressure and partly to help diagnoses the cause.
The next visit was with the pediatric orthopedic surgeon. I was able to get an appointment with the same doctor who originally treated Elora when she was admitted to the hospital. He found that there was little to no swelling in his knee but there was still significant swelling in his thigh. Lockelan did have x-rays. While those are generally painless I felt sick as they held him down and forced his painful leg as straight as it would go. The x-rays were clear. While that sounds like a good thing, a small buckle in the bone would have ended our journey and healed quickly. The doctor told me he wasn't sure what it was but it was certainly something. He then referred us back to Elora's rhuematology group.
I left with mixed feelings. For the most part, I can't imagine we are dealing with arthritis. Autoimmune arthritis requires a joint to be swollen for at least 6 weeks. Clearly that was not the case. At the very least we were able to avoid draining his knee which would have required sedation. I'm looking forward to hearing back from Elora's rhuematologist. I'm hopeful they'll confirm my suspicions. At this point, I'm not sure if we'll actually go into the office or not. I'm curious if they'll draw blood work as well. You cannot diagnoses arthritis via blood work but there are some markers that indicate it is more likely.
Lockelan's leg has continued to improve over the weekend. The swelling is almost gone entirely. He's close to fully extending it again. Not only has he started rolling all over the floor again, he seems to be pain free. I'm very optimistic that this was an injury and nothing more... not that letting him get injured doesn't bring on a new round of mom guilt. I'll post an update once I hear from rhuematology. For the most part, I'm just glad to have my smiley guy back.
While our week was primarily dominated with appointments and a hurting baby, there were some fun moments as well. The older two decided to dress themselves for one of our outings. By the looks of it, I think this was directed by Elora.
Then it went to this. I decided to let the wear this out of the house. We were all feeling the stress a bit and it helped lighten the mood.
And finally, we started on our first big weekend project. We started with this:
And finished with this:
Ok, so it isn't completely finished but we're close. The only thing missing is the two wood roofs. Everything else is complete and ready to be enjoyed. It wasn't bad for a weekend of work. We should finish the rest next weekend.
Both Elora and William approved.