We had our 6 week post-hip dysplasia surgery follow up appointment yesterday. That means we’re HALF-WAY finished with the spica cast!!!! We were hoping we’d get an xray to verify the positioning of Sara’s femur (for peace of mind…) and we had been told they would alter the cast a bit. In my research I have read that most kids get a complete cast change at the half-way point, but our surgeon said he prefers not to, if possible, because it requires another round of general anesthesia. Since she hadn’t out- grown the cast, and we’ve been doing a pretty good job at keeping it clean, they just wanted to do a “tune-up.” That was fine with me. I’d rather not have to knock her out again.
Week 6 – Spica Cast Change
Anyhow, to refresh your memory, here’s what her spica cast looked like before:
I’ll get to the after picture in a minute! 🙂
She did have an xray, and the docs said everything looks good. But, they cautioned us. Xrays don’t show everything they need to see. They can see the big picture – hip is in place. Now, it needs to stay there. The cartilage in her hip socket needs to calcify and turn to bone to hold the femoral head in a good position and at a good angle. That takes a long time, even longer than the 12 weeks she’s in the spica cast. They told us the next decision point would probably be when she’s 4 or 5 years old. They like to try again before the kiddos start school, if there are still problems with the hip.
While we were glad they didn’t have to put her under general anesthesia, the cast “tune-up” wasn’t entirely benign. If you’ve ever had a cast taken off, you know they use a pretty loud saw. Sara didn’t like that too much. She did okay with it until they had to flip her around to get at the right angles to cut the cast. It was kind of funny seeing her stuck up in the air with poor left leg sticking out. But her least favorite part was when they opened up the diaper area a bit more. It was such a small hole that I asked if they couldn’t please give me a little more room. And they did!! I felt bad that Sara was so upset by it, but it will help me a lot to have a bit more room to maneuver diapers in and out of that monster cast.
Here the leg has been cut down and the tech is working on the diaper area.
The tech had to re-wrap the leg hole to smooth it out so the plaster and fiberglass wouldn’t hurt.
Sara checking out her new leg:
Then the tech wrapped the cast in a new color of fiberglass – purple! Sara didn’t like that too much either.
We’re happy to have her left leg free! I’m whacking her less often on doors now! 🙂 However, the tech didn’t do as good a job this time wrapping the cast and making it smooth. We’ve had to do a lot of work to get it nice to handle again. I had to wrap the entire diaper area with panty-liners to protect my knuckles from the rough fiberglass. I was getting bloody knuckles changing her diaper. And, we had to fix the leg opening, too, because it was rough and bumpy. A super nice spica-mom sent us a package with a lot of mole skin and tape a while back, and it came in really handy for fixing up the cast.
Here’s what she looks like now. Are you ready?! 🙂
I’m thinking about how to make the final cast-cut-off a little less traumatic. A friend suggested ear phones and a portable DVD player. That might be a good idea. They had bubbles at the hospital and she liked having them blown around her as the tech was working. Next time I’ll take my own and start blowing them before she melts down. And she really likes looking at pictures of cats, so we’ll whip out the iPhone again.
If you have to go through this with your kids I really recommend explaining to them what’s about to happen ahead of time. It may sound weird – but we have had super good luck with Sara by taking things slowly and talking about everything. My husband sat down with Sara and showed her the tools. They watched a couple of people having cast work. She felt the saw. All of these things helped her relax, we think. Dan thinks if they could have sat in the room for 10 more minutes just observing, she probably wouldn’t have cried at all. I don’t know about that. I’d probably cry too if someone stuck a saw near my privates! 🙂 But all in all, she did a really great job, as she has throughout this whole process.
Anyhow, the best part of the visit to the hospital was getting a date for the final cast removal. Sara’s cast will come off on January 30th. 46 days away. But who’s counting?
If you’d like to read the rest of our hip dysplasia story, the posts are here.