Namine was experiencing pain in her wrist again, so we took her in to see her bone specialist.

Namine’s bone specialist, Dr. Black of Sports Medicine and Orthopedic Center , is primarily her foot surgeon, but he also advises on her scoliosis and other bone-related issues. The past few times Namine has broken a bone or even had a sprain — and they’re not all in her legs — he’s been the point guy each time.

By the time we got in to see Dr. Black, the pain had spread from Namine’s wrist to just below her elbow. We didn’t know if this was another break or sprain, so we weren’t about to take any chances.

Namine had been bowling the other night, which was our first thought as to the reason for her elbow hurting. Except that she bowled with her left arm, while it was her right arm that hurt.

After taking X-rays, Dr. Black informed us that Namine did not have any broken bones. She essentially had tennis elbow, but there was also more to it than that. Before I get into it, I have to back up to explain about Namine’s arms.

Namine has never been able to fully rotate her arms. A normal (as much as I hate that word, “physio-typical” is unfortunately just too unwieldy) person can straighten their arm out in front of them with palm face-down, rotating their arm so that their palm is facing up. Namine cannot do that. Her left arm can rotate more than her right, but neither will rotate as much as Jessica or I can.

We have always attributed this lack of rotation to her shoulders. Namine’s entire arms have never before been X-rayed — there had been no reason to — but we knew that the PICC line she had in her early days in the hospital had left scar tissue. All manner of medical staff agreed with this assessment.

After Dr. Black was done examining Namine, he gave us some shocking news: Namine’s elbows are the cause of her inability to fully rotate her arms, not her shoulders. Furthermore, her elbows are not properly lined up the way they ought to be. There is a misalignment and the overlap of bone at the joint prevents correct rotation.

If this had been caught early, it might have been possible for Namine to have undergone a corrective procedure to ensure proper rotation. As it stands now, Namine is too old. The procedure now would be too invasive, likely quite painful, and the risk would not be worth what it would gain, if it was successful at all. (Dr. Black was doubtful.)

As for what this means for the long term, we’re still not quite sure. Being in a wheelchair, Namine depends upon her arms for everything. At the very least, Dr. Black has encouraged her to try taking it easy on her right arm as much as possible — although for a fully independent disabled child, I’m not sure how much “taking it easy” is there to be had.