Monday 30 April 2018

Broken Bones


At the end of the January school holidays Evelyne broke her arm. Not just any break of course! A complete displaced fracture of the upper humerus, almost compact, but thankfully didn’t quite make it through the skin! 

It was an ordinary day at the park with Evelyne doing an ordinary activity for a 9 year old – climbing on monkey bars. 
It ended with her on the ground, an obvious serious injury and a Triple Zero phone call for an ambulance. Leading to transport to another hospital, a 'closed reduction' in theatre under general anaesthetic, 3 days in hospital getting pain under control, 2 weeks in a traction cast and a further 4 weeks in a shoulder immobiliser sling. The positive news was that her spinal rods were not impacted!






It’s one of those difficult questions parents with Beals kids (and others) will face. How much do we protect and wrap in cotton wool, and how much do we let them go and be normal kids? It is a balance I’ve struggled with over the years. Sometimes I think I’ve restricted her too much due to worrying about injury. But the fact is, she is going to be at a higher risk of all sorts of injuries. Joint injury and dislocation, risk to damaging spinal rods, and it appears broken bones as well. At school she is not allowed on the play equipment, is restricted from many sports activities and has an aide to watch her in the playground. This has made it hard for her over the years, as she at times comes home from school upset that she was left out of the action. At home, we are slightly more relaxed, and really just ban trampolines, bouncing castles, and I may add monkey bars to the list.

Whilst I’ve never had definite confirmation, it does appear that Beals Syndrome is associated with lowered bone density. One study I read said 'generalised osteoporosis is well documented'. Many years ago, another Beals mum spoke of bone density testing, so I had Evelyne’s checked. At the time her results came back as normal. Apart from some minor reduction in the spinal column, but that was explained by lack of use as it was in the days of her being in casts and braces. From my reading, bone density can often be lower in individuals with reduced physical activity, reduced strength activity, low body weight and small frames and that physical activity is widely acknowledged as a factor in increasing bone density. So perhaps the lowered bone density in Beals Syndrome is by association with lowered activity and low body weight. Either way, it still brings me back to the same conundrum. 

Evelyne is now 12 weeks post break and her arm has healed beautifully. She is about to start physio to get full range of motion back in the shoulder and is looking forward to starting back at Jazz dancing. In regards to my thoughts on physical activity, I'm happy with most of our decisions with restriction vs allowance. In reality, she is often much happier doing drawing and craft than sports and she enjoys her dancing which she will continue. I do think there is more we could do for joint protection rather than just avoiding certain activities, as her knee has partially dislocated twice. Evelyne is fortunate to have been granted an NDIS package (National Disability Insurance Scheme in Australia). With some of her funds she will start seeing an Exercise Physiologist to help strengthen her joints, increase endurance, as well as some hydrotherapy and swimming. We are both looking forward to seeing the benefits.