Our Little Miss Update

We've been talking (semi-regularly) with a doctor at Palo Alto Medical Foundation (PAMF) re: Amelia's index finger nail abnormalities. She invited us to attend a conference of Dermatologists at Standford on Sat. 11/19. So we're taking Amelia to her first conference! The goal and plan is to get a discussion started between attending Dermatologists regarding options for treatment. A lot of dermatologists will examine her and later discuss her diagnosis and treatment options with our doctors at PAMF, who will then follow up with us.

Last week, in preparation of the conference, we went into Stanford for Xrays on Amelia's fingers. This is to help inform the dermatologists prior to meeting Amelia at the conference.

Having done some research ourselves, we thought her nails closely resembled Congenital onychodystrophy of the index fingers (COIF). From the review of the XRays, it looks as though our diagnosis was correct. Below is the direct quote from the review of Amelia's XRays.

"Identical anomaly involving the distal phalanx of the left index finger to the anomaly of the distal phalanx of the right index finger.

There is a slightly larger exostosis arising from the base of the tuft of the terminal phalanx dorsally extending into the subungual region. This exostosis measures slightly less than 2 mm
in height. It is presumably congenital and due to bifid development."

Translated and abridged - this means she has bone spurs on the last bone digit of each of her index fingers. The spurs pushed into the nail matrix/bed, which is the cause of the abnormality.

This is a very rare abnormality, only cosmetic and has no known health issues associated. There are surgical options, where a matrix transplant from the toe could be done to correct the condition. Timing is flexible and waiting until Amelia is older allows for larger structures to operate on. This makes for an easier operation with a more predictable outcome. Waiting until Amelia is in her teens would also allow for more advancements in the field of tissue engineering and in the surgical procedures themselves.

We will also start meeting with pediatric hand surgeons based off recommendations we hope to get from the conference. We'd like to learn as much as we can about various options, rates of success etc.

Included are Amelia's XRays (I annotated).

Now we know how much 'chubb' surrounds baby bones.

Mia giving the finger...twice.

Amelia is a beauty and we're looking forward to her charming the doctors at her first conference.