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This week, the trailer for Little People, Big World dropped full of teases of the things to come.

There is a lot of excitement in the family’s future, but some of the subjects were serious.

Lilah’s eyesight problems pale beside Jackson’s legs beginning to bow, as it’s called.

Tori and Zach spoke about how their precious little son is going to need surgery.

Photo via TLC

Amy Roloff’s upcoming wedding and financial questions about the farm’s future were overshadowed in the trailer.

Zach and Tori have a lot on their minds as parents.

Lilah and Jackson are both grappling with medical issues.

Photo via TLC

Both children have dwarfism, like their father and their paternal grandparents.

But part of the point of the show is letting viewers see how in many ways, they are like able-bodied children.

At one point in the trailer, we see Lilah vigorously kicking in the water as she learns how to swim.

Photo via TLC

However, Tori shares with viewers that Lilah is at times cross-eyed.

Lilah needs glasses, at the very least.

There is also the distinct possibility of eye surgery in her future.

Photo via TLC

Whatever comes in Lilah’s future, her parents are of course there for her.

Surgery is no joke, especially when the patient in question is a disabled child.

But Tori and Zach will put their children’s best interests first, as they always have.

Photo via TLC

Lilah’s brother, Jackson, is eager to help with his baby sister.

Unfortunately, he has his own medical problems with which to contend.

As Tori notes on the trailer, Jackson’s legs have begun to bow.

Jackson Roloff's Legs Have Begun to Bow

Congenital genu varum is commonly referred to as bowlegs.

This is a condition when one’s legs curve in such a way that the knees are far apart even when ankles are together.

Bowlegs can have various causes, but the bone growth disorder achondroplasia is the culprit in this case.

Photo via TLC

Achondroplasia is the form of dwarfism that Jackson, Lilah, Zach, and Amy Roloff all share.

(Matt has a less common form, diastrophic dysplasia)

It is very likely that Jackson will require surgery to correct his bone abnormality.

In some cases, special shoes or casts or (leg) braces can be used to address the issue.

However, that is because bowlegs can have numerous causes that are not achondroplasia.

It is likely that without medical intervention, Jackson’s legs will continue to grow in this debilitating way.

Tori, Jackson, Lilah

Surgery, the risks involved, and the process of a long and painful recovery from surgery are not fun.

This becomes even worse when the patient is a child.

Though it is true that children generally heal more quickly, they suffer more acutely and recovery feels longer due to their limited life experience.

Photo via TLC

Zach and Tori know that they are going to hear opinions from fans no matter what happens.

Some of those will be expressions of support. Others will parent-shame or condemn them.

But they are resolved to do what is best for their children.

Lilah, Jackson and Zach

Surgery is expensive, so it is a very good thing that the Roloffs are an affluent family with a still-strong reality career.

It can take a lot of money to get disabled children the accommodations and healthcare that they need.

Perhaps one day our society will be just enough to ensure that no child needs to be "born lucky" to get these things.