One month gone

Well today officially marks the end of month 1 in the spica cast. I can't say it has gone quickly and I can't say it has gone slowly either. I can say that our whole schedule is dictated these days by Addison and her need to stay cool or have her diaper changed...being more than two feet away from her "changing station" if she has a messy diaper can lead to disaster! Poor thing! She has endured more poking and prodding and blowdrying (yes, I said it, blowdrying!) in the last month than any 4 and a half month old should have to! I, on the other hand, have been peed on more times than I can count as the diapering system is by no means leak proof! Thankfully, she is such a content and happy baby that she seems unaffected by it all and we are convinced that she thinks her cast is just another baby carrier type of thing. She is even able to move in it somewhat, she gets jiggling quite a bit when we have her laying on her back and has even figured out a way to move herself across any surface while on her back. Proof that where there is a will, there is always a way!

In anticipation of some hot summer weather, we ordered a cast cooler early into her cast-dom but have not really had to use it much yet, although August tends to be a particularly hot month so perhaps we will get some usage out of it yet! In just over two weeks Addie goes in for her cast change, and then there will be another 6 weeks of spica-dom. I have to admit I am getting eager to have her out of this cast already because there is so much we would like to do with her! Her dad and I were both bummed this past weekend when the temperatures soared and every other parent in the neighbourhood was down at the local swimming pool or spray park with their little ones and all we could do was spectate from the curb in our air conditioned vehicle! We keep saying...next summer will be different. She will be running around with the other kids and soaking up all the summer fun she can handle. Too bad I will be back at work then and won't be able to give her all my attention!

So far we have averted any major rashes and the cast, while not as pristine as it was when we left the hospital, is not too smelly as long as we wipe it down and keep it as dry as we can. We have found that petaling it with moleskin has helped tremendously but we did notice that the area around her legs is particularly tight and she does have a bit of a rash on her upper thigh that we can't do much about given we are not supposed to be putting any lotions or powders down the cast.

Her new baby bjorn carrier has been a life saver. We go for up to 4 or 5 walks a day in that ingenious invention. For any parent out there with a baby in a spica (or even without the spica) I highly reccommend the baby bjorn! It is single-handedly saving my poor back! I try to get her out early in the morning to avoid the worst of the summer heat for a walk around the neighbourhood, and then we head to one of the local malls later in the day once the temerature starts to climb. Early on she began developing heat rashes on the very top of her little head, but since changing things up to only have her outside in the mornings and keeping her in the basement or in air conditioned places the rest of the day, she seems to be quite comfortable.

First Week Behind Us

We have made it through our first week with Addison in her spica cast and it has been interesting! While she has adjusted as well as could be hoped for, the hot summer days are upon us and it is a challenge trying to keep her entertained but still keep her cool. She loves to be outside, so we are now restricted to taking walks with her in the early morning or later in the evening when it is a bit cooler. A shame, because she also loves water so we were looking forward to some outdoor pool action this summer, but that will have to wait until next year!

We have also had to make a few adjustments around the house. The day after we brought her home we did a quick scan and realized she would no longer fit her high chair or her swing that she loves so much. Before the surgery I had purchased a new baby bjorn carrier that was quite a bit bigger than her current one anticipating that she was going to be like a little brick following surgery...however, it does not fasten the same way was the old one and because of her cast, we were unable to actually get her in it...so off we went to exchange it. We found a much better one made of lightweight mesh with much needed back support and snapped that up, so now she is riding in style. This is the one we originally purchased (the comfort carrier): http://www.babybjorn.com/products/baby-carriers/comfort-carrier/comfort/.  Because of the way it fastened, we exchanged it for this one: http://www.babybjorn.com/products/baby-carriers/baby-carrier-synergy/synergy/. This one also had the added benefit of being mesh, so we thought it might be cooler during hte hot summer months!

Her favourite mode of transport these days!

While we were out we came across another godsend, the handy sitt chair http://www.minuihandysitt.com/ that basically fits on any regular chair and allows you to push her right up to the table, now she feels like a big girl sitting at the table with mum and dad. We also grabbed a jolly jumper, which she loves. She can't actually jump in it herself, but with some help from mom and dad she gets a good bounce in now and then.

Addison sitting at the big people table in her handy sitt

I don't know what we would do without this fabulous chair!

She isn't sleeping as well as she used to as I don't think she likes to lay on her back. When she wakes at night it is very difficult getting her back to sleep. We have purchased a crib wedge that elevates her back slightly and have been padding her feet with memory foam and/or rolled up blankets to provide some ankle support at night, but it doesn't seem to please her very much and she cries quite a bit when we try to put her down. Before surgery she loved to sleep on her side snuggled up to me and rarely slept on her back, so in hindsight we should have prepared her better for that prior to surgery!

The other big obstacle is that she is not too crazy about her new carseat, she was never crazy about being in the car before or being in her other carseat, but this new one is the Britax Hippo http://www.adaptivemall.com/hippocarseat.html and it really is a hippo size-wise! The benefit of it is that she fits in it and we can take her places in the car.  The Stollery hospital has loaned us one for the duration of her casting, which is fantastic! She is a little bit too small for it, so we have to pad it with memory foam behind her back in order to fit her correctly. We also purchased a head rest for it to cradle her little bean, hopefully this will help her to nod off in it while we are driving just like she used to do in her old carseat! Needless to say, until she gets used to the Hippo seat, we are doing a lot less driving these days!

All in all, we are so happy that she has retained her cheery attitude. We are still getting plenty of smiles and giggles and coos. Now we just have to work on the sleep!

So far so good!



Addison went in for her surgery on the first day of summer, June 21st...and as luck would have it, it was one of the hottest days we have had here for a while. We had to get her into the hospital for admission by 8:30 a.m. the day of her surgery and she was scheduled to go into the operating room at 10:40 which meant we had to stop feeding her that morning by no later than 6:30 a.m. For a baby who likes to snack all day long, she handled the no eating reasonably well. Once we got her to the Stollery Children's Hospital here in Edmonton, we waited with her for about a half hour before they led her back to the pre-operating area to give her a once over and prep her for her IV.



Getting ready for surgery



She was supposed to have a combined surgery - the orthopedic surgeon to fix her hips with the closed reduction, the other a plastic surgeon who was to remove a little extra bit of skin near her ear that she didn't need. When we got her into the pre-op we asked if that was still the plan as the two surgeons staff were supposed to coordinate it...needless to say there was a "clerical error" so the plastic surgeon would not be available to remove the ear tag. That was a little disappointing and not what two concerned parents wanted to hear right before surgery!

The nurses then gave her a bit of tylenol which upset her as she was getting quite hungry by this point and then they put a little bit of numbing medication on her little hands to numb the area for insertion of the IV. After all that they led us to a little waiting room outside of the OR to wait to chat with the anaesthetist and the surgeon prior to her surgery. The anaesthesiologist informed us that they would be putting her under with gas and that he would take extra special care of her while the orthopedic surgeon, Dr. Dulai, answered any last minute questions that we had. They told us that they thought it would all be done within two hours and asked us to say goodnight to our little girl before they took her into the OR. Both grandmas were there with us, and we passed her around for some final kisses before she was taken into the OR by the nurse. I'm not going to lie, it is very difficult to hand your 4 month old over to strangers for surgery!

Now we just had to wait...and wait. By 1 p.m. we still hadn't heard anything so her dad went to talk to the charge nurse about the status of the operation, after some phone calls were made down to the OR, we were informed that the surgery had been completed and that they were just moving her to the recovery room, after which they would bring her up to the ward. By 2 p.m. we were informed she was on her way up to us so we got ready to greet her. When they wheeled her over to her room, she was so pale and groggy it was a bit scary. Her colour had gone from pink to grey and she was letting out the saddest little whimpers! Her dad and I were prepared for screaming, but I think the whimpering was somehow worse! She was placed in a room with a very sick little boy, Kael, who at two months old had already undergone multiple surgeries to correct issues with his bowels and intestines which were formed outside of his body at birth. Right away we realized how trivial our little procedure had been, and how fortunate we are to have a healthy happy baby with correctable hip issues! That poor little boy was in so much pain and cried constantly for relief.

Just out of surgery and not too happy

Once inside her new room we asked the nurses how she was doing and they said they had her in recovery longer than usual because she was quite agitated (no kidding!). She wouldn't take a bottle, she wouldn't take a soother and she was just generally unhappy so they gave her a bit of morphine for the pain. The surgeon had to make two incisions on the inside of her groin in order to place her hips correctly, so she was bruised and swollen in that area. Her cast was bright pink and there is an opening from just above her bum to just below her belly button where we are supposed to insert a smaller diaper and then place a larger diaper over the whole cast. Needless to say, diapering is a bit of trial and error! Before the next morning she had already had a major blowout which required three people to clean and disinfect her cast area! Once the morphine wore off she was in quite good spirits.

Later that afternoon, her auntie Wendy popped by and between her and the grandmas cooing at her, we were able to get a few smiles before the night was through. She was doing much better than her mum. It probably doesn't matter what age they are, it is hard to see your child in pain! Her daddy stayed with her all through the night and when I got back to the hospital at 5 a.m. the next morning I found them wandering the hallways of the stollery. Her dad had her in his arms and had tethered her IV pole to his belt and was walking her around the hospital in an effort to soothe her. They both looked incredibly exhausted but he told me that she did really good and despite her best efforts to sleep, the crying baby she was rooming with was just too much for them both to bear.

We walked her back to her room, after which her dad wandered out to the hallway to find a couch to grab some much needed sleep. Addison too only took a few minutes to drift off to sleep once I placed her in her crib and hummed a lullaby to her softly. They both got a few hours sleep before we got the news that the MRI might be a bit of a wait. Turns out that the stollery has 2 MRI machines, one of which was dedicated to emergency care, the other for inpatients. Because one of them had broken down, they just had the one for everybody and the nurses were not sure whether or not they would get us in for her MRI. The purpose of the MRI was for the surgeon to double check that her hips had stayed in place following the casting and we were not to be discharged until that MRI took place and the surgeon had the radiologists report in hand. It looked to us like it was going to be another long day! Her dad and I figured out a way to get her strapped into her stroller so we spent the majority of the day strolling her around the hospital. She was an amazing little baby, she was back to her old self and it was as if she was not even aware of the whole cast situation...despite the fact that the cast runs from her armpits to her ankles!

Good as new the day after

 Mid-afternoon we were visited by the physical therapist who gave us the lowdown on how to take care of the cast, the warning signs to watch for and answered all our lingering questions about caring for a baby in a body cast. The Stollery is a truly amazing place, the care they take of both the patients and the parents is unbelievable and we feel so lucky to have such a great hospital in our own city. Because Addison is frog-legged in her cast, she does not fit her regular car seat and the hospital provided us with one specially made for kids in spica casts, which was a big relief because we were not entirely sure how we were going to transport her! They have loaned us the "Hippo" car seat for the duration of her casting and although it is much bigger and bulkier than her regular car seat, we are so thankful to have it!


One of the amazing nursing staff at the Stollery, Ariane



By 5 p.m. we were strategizing with the unit nurses about arranging for an outpatient pass which would allow us to go home and come back the next day to wait for the MRI, but at 6 p.m. we were told they would take us now, turns out the Mazankowski Heart Institute just down the hall was letting us use their MRI machine...great news! The nurses told us that her surgeon had been harassing the MRI folks all day long trying to get us in so we could all go home. It was a bit nerve wracking as the MRI would be what told us whether the procedure had worked or not. Her dad took her down for her MRI while the nurses asked me to stay back and take care of all the discharge paperwork (assuring us that this would get us out of there faster). About an hour later, her dad brought her back to the room and when I saw she still had her cast on I thought thank goodness, that must mean it worked and we can go home as we were told that if the MRI showed that the hips had slipped out of place, they would be cutting the cast off and scheduling the open reduction, a more invasive surgery, later down the line. Her dad told me that no, we didn't know yet as we had to wait for the report....more waiting...and by the way, the surgeon was now doing rounds and wanted to see us before we left!



During the long wait for the MRI we entertained ourselves by strolling around the hospital



At 8 p.m. we finally got a visit from Dr. Dulai. She said that the surgery went better than she had anticipated so she was a little concerned following casting that this might mean her hips are a little loose and may have slipped out. She told us that she did not have the radiologists report yet, but she had looked at the MRI scan herself and seemed to think that it looked good, but that she could not give us official word until she had the radiologists report in hand. So, we breathed a little easier after that! She said that once she had the report she would call us if there were any concerns, but that if we didn't hear from her by Monday...then that would most likely mean it was A-O-K. So, although we are not quite out of the woods yet, we are so pleased that things are looking good at this point. We packed up our stuff as fast as we could and we sprinted, yes sprinted, out of that hospital...as wonderful as the staff are at the Stollery, we couldn't wait to get home and get some rest.

After a quick stop for some diapering and sleeping supplies, we got Addie home at 9 p.m. and she was so cute...she was so happy to be home that as we walked her around the house she was cooing and oohing over everthing she saw...clearly as relieved as her mom and dad to be back at home sweet home. Her first night home we had purchased a wedge and a memory foam pillow to help her sleep better. The wedge just elevates her back a little and the  memory foam pillow we slip under her ankles to help support them when she is on her back as her legs are casted a few inches off the mattress when she is on her back and need to be supported in order to ensure a comfy sleep. She slept really well, only waking twice during the night in need of some soothing. She is a little fussier when she wakes in the night, but all in all, not as bad as we had anticipated as I had heard stories of kids not sleeping at all when they are casted. How lucky are we to have such a good baby?

The big day is upon us

Can't believe that the surgery day is here already. Seems like the time has just rushed by us! Addison turned 4 months old over the weekend and she has developed such a little personality. She delights us every day with her giggles and smiles and her quirky little personality. Her dad and I have been snuggling her like crazy in the days leading up to her surgery. She has been getting spoiled this week with a bath in the big people tub with her daddy every night, which she just loves. I think she is definitely going to be a water lover like her dad. Her closed reduction is happening at the Stollery Children's Hospital here in Edmonton tomorrow morning at 10:30 am, they have indicated that the surgery will take us about an hour and a half if all goes well. They will be putting her under, injecting dye into her hip joints and then will be trying to place them back in their respective sockets manually. If her ligaments are tight, the surgeon has indicated that they may need to make a few minor incisions in her groin area to get her hips placed correctly. Following all that she will be put in a spica cast (basically a body cast with a little cut-out area for diapering) for up to three months. The morning following the surgery they will be doing an MRI to see if her hips remained in place, if so, the cast will stay on, if not they will remove it and she will undergo actual surgery once she is 6 months old and have to endure the spica cast at that point. We are really hoping that this procedure works as it will not interfere with her crawling development. Overall, we are just so happy that she is healthy and thriving in every other way. She is just a delight...fingers crossed that tomorrow's surgery will be better than we anticipate!

Spring has Sprung

It's been a busy few weeks but on the upside it looks as though we may finally be in for spring in Alberta. The weather has been double digits all week, the spring rains are threatening to come but it is a nice change to have the snow finally gone! Last week Addie and I visited the plastic surgeon about what we were told was a skin tag on her right ear, only to learn from the surgeon that it is just an extra bit of skin. He informed us that when we are formed in the womb the ear is formed by 6 little bits of skin and Addie just has one extra piece she did not need that will be easily removed. He was very friendly and reassured us that he will try to coordinate that surgery with her hip surgery. He said it should not cause any discomfort and will leave a tiny white scar where he removes the bit of skin. Good news! We also finally received our surgery date, they originally booked it for June 14th, but a few days later rescheduled for June 21st. As that date draws closer I am getting more and more worried about how Addison will deal with the cast. In the past few weeks she has really started trying to move! She is kicking her legs like crazy and has even started rolling to one side. I am afriad that the more mobile she gets, the more difficult it will be for her to put up with the cast! I just keep telling myself that it could be much worse and at least this is something they can fix...and that she really won't remember a thing once all is said and done! Hoping to get her outside more and more in the coming weeks, she took her first stroll in the stroller without crying all the way through it last week...I am going to make her an outdoor babe yet!

Spring in Alberta



View of our street this morning...YUK!



Just when things were looking up...we get MORE snow! Addie and I took a trip down to the farm yesterday for a visit with grandma and grandpa B only to awake this morning to a blizzard. That's right, I said it - a blizzard on April 14th, a time when flowers are blooming in most of the rest of civilization! Grandma and grandpa were quite worried about Addie and I making the trip back to Edmonton this morning, but when you live in Alberta you just have to learn to drive in ridiculous weather conditions. We made it safe and sound, time to put the rubber boots back in the closet and retrieve the uggs for a little more use...<UG!>



Addie loves snuggling with grandpa



Addison had lots of fun with grandma and grandpa, she is really loving being free from that harness, evidenced by how much leg kicking is going on! She is also reallly loving the fact that she can take a daily bath now (her most favourite thing in the world!). She could be in a right fit, but put her in the tub and she quiets right down and starts cooing. She started smiling last week and this week her face just beams when you talk to her, it is very cute.



All snuggly in her warm towel after her bath



No surgery date has been booked yet, we went for our six week check up yesterday and the doc said she is doing great, growing well and meeting all her milestones save for those bum hips! She has started already at 6 weeks old to try and roll a bit, which scared grandma this morning! The doctor is going to check with the Stollery to see if they can do two surgeries on her at once, she was also born with a bit of a skin tag on her right ear that they want to surgically remove, so if she has to go under for her closed reduction why not see if they can't kill two birds with one stone! Once they have that sorted out, we should get a surgery date and be able to start planning for that. On the bright side, she will be so distracted by the spica cast following surgery she won't even notice her ear, although they have reassured us that the surgery on the skin tag shouldn't hurt her at all. I hope this weather improves so we can spend some time outdoors with Addie before her surgery...let's face it, we are all ready for winter in Alberta to be over!



Some Links of Interest for Those Interested

We have received lots of questions about hip dysplasia (and have had lots of questions ourselves) since learning Addie had DDH. Following are some of the sites that we have found or been pointed to that have some additional information:

http://www.hip-baby.org/
http://www.hipdysplasia.org/default.aspx
http://spicacast.com/

As we have been looking for information for ourselves we have also come across many other parent blogs and have come to understand that many many kids go through this and we do feel lucky it was caught so early and are optimistic that before we know it she will be through it and running around in no time!

A Little background

Addison 6 days old all dressed up to go home from hospital

On February 26, 2011 my husband and I welcomed our first child...a beautiful little girl that we named Addison. She came into the world through a difficult delivery that ended she and her mum in the hospital for a week following her birth due to a blood infection her mum developed during labour. That first week in hospital was very difficult because the doctors were concerned that Addie may have contracted the infection as well, so she was very closely monitored, hooked up to IV antibiotics and poked and prodded a lot (poor little bean)! When we were finally able to take her home we were so thrilled, it was such a great feeling to have her home with us and get this family act on the road!

The following week I took Addie in for her two week check up and my doctor started asking me about whether or not there were any hip issues in our family. My husband's sister had hip dysplasia as an infant which was caught at 6 months and corrected by wearing a brace for three months. My doctor decided to send us for an ultrasound that week to check into little Addie's hips and to also check her kidneys as she was also born with a little skin tag on her right ear. Following the ultrasound we got the good news / bad news. Good news was that her kidneys were gangbusters, no issues there but nothing prepared us for the bad news... both of her hips were dislocated and the orthopeadic surgeon was reccommending we put Addie in what is called a Pavlik harness for three weeks, at which time we will do another ultrasound to see where whether or not the harness was working as it needed to.

Addison in her Pavlik Harness

The day they put the Pavlik harness on my little angel, I cried....a LOT. Her dad was also very emotional. It was so hard to see our perfect little girl confined to that harness. It looked like some kind of medieval torture device, but the doctors reassured me that it didn't bother her at all and was not as bad as it looked. Well Addison didn't get that message, as she had two pretty fussy days. She was inconsolable the first day she had it on but by day three she was getting used to it (and so was her mum and dad). Each week we had to visit the doctor at the children's hospital for a harness "adjustment" and after three weeks we returned for another ultrasound. This ultrasound, unfortunately, did not give us the news we were hoping for. The radiologist informed us that her hips had shown no improvement. So, back to the orthopedic surgeon we went. Yesterday the surgeon removed the pavlik harness (which was great!) but gave us information on the next step which is what is called a closed reduction. The closed reduction is a surgical procedure during which they will put Addison asleep, inject dye into her joints and try to position the hip joints into place manually. Following surgery she will be placed in a spica cast which goes from just below her armpits to her ankles...poor beanie!

Finally out of her Pavlik

While I am so happy to have my little squishy baby back free from her harness, I am very scared about the closed reduction and how she will tolerate the spica. Let's face it, I am concerned about how I am going to tolerate the spica! According to our doctor, they will try to do the surgery around 3 months of age. Addison is now 6 weeks old, so I have promised her that she is going to have daily baths and lots of skin to skin cuddling for the next six weeks!