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Friday, June 5, 2015

The Wide World of Hip Dysplasia

I know I use this blog primarily to record my fitness journey. Sporadically, but yeah. And would you know, I'm actually back in the game? I've started a half training plan, because I'm registered for 4 half marathons this fall. This is all to prepare me for my first FULL marathon in January. Big deals. But at this point, this isn't what consumes my life.

We've entered the land of hip dysplasia. And it's kind of a big deal apparently. First, what is hip dysplasia?
"The hip is a "ball-and-socket" joint. In a normal hip, the ball at the upper end of the thighbone (femur) fits firmly into the socket, which is part of the large pelvis bone. In babies and children with developmental dysplasia (dislocation) of the hip (DDH), the hip joint has not formed normally. The ball is loose in the socket and may be easy to dislocate."

Every 1-2 months, we went to our well baby check with the littlest squishy, with no troubles. I'd watched our doctor perform the hip rotation exam on each of my children as they grew. I honestly paid no attention and had no clue what she was checking for, I just knew it was done and nothing was mentioned. That was until baby girl's 9 month appointment. I watched her rotate her hip, and noticed her leg pop. She repeated this several times, and she noticed the pop each time. Red flags went up. She mentioned dislocation, and I was confused. BG hasn't had any falls or trauma. She has met all of her milestones right on time, with no issues crawling, pulling to stand and now cruising furniture. She showed no signs of being in pain. The popping had never been noticed before either. Our doctor referred us to a pediatric orthopedic doctor. I blew it off. Clearly this had to be nothing.

I did remember my mom talking about me being in a brace for hip issues as an infant. I checked with her, and I had DDH, it was caught very early and I was in a harness for 6 weeks. I looked into it, and while it said this is thought to be genetic and affects more girls than boys, I still didn't worry about it. Surely BG would show some kind of sign of something being wrong aside from one hip popping at 9 months old.

We finally had our orthopedic consultation on her 10 month birthday. They checked her hips, and noticed the popping. They took her for X-Rays. We waited for the doctor to come in, with the X-Ray on the screen. I could see it. Having never seen a hip X-Ray, I could clearly see that the top of her left leg was not next to the hip socket like the other leg was. In fact, there wasn't even that much of a hip socket, like the other side had. I knew it was coming. I sat as they told me she had DDH, or hip dysplasia. They explained that if left untreated, she may walk abnormally and would eventually grow to wear out the bones, requiring hip replacements through adulthood. Ok, we can deal with this. They said that as young infants, they can use a special harness to correct this issue. But after 6 months of age, it's harder to treat and they have to be more aggressive. She would require a special spica cast. Ok, this is getting harder to deal with.
The cast itself is huge. She won't be able to move around in it. BG is a highly independent and mobile baby. She may adjust enough to crawl somewhat at some point. By the time the began to explain the procedure, I had started to cry.

This is basically an operation. They have to put her under general anesthesia. They will inject a dye into her hip and do an MRI. They will then do what's called a reduction. Best case, it's called a closed reduction, and can nestle her leg into the hip socket by moving her leg from the outside. If it doesn't cooperate, they will have to do an open reduction, meaning an incision to guide the bones into place. Once this is done, they will put a cast on her, like the one you see above. This keeps her in a frog position to encourage the hip to develop properly and for the bone to secure itself into place.

She will keep this cast on for 6 weeks. Then they have to repeat the process. Put her under, take the cast off, check her development, move things as needed, and put a new cast back on. That cast stays on for another 6 weeks. Then they check her again, she may need a 3rd cast for another 6 weeks, she may need even longer than that, she may only need those 12 weeks. After that they put on a different kind of brace to wean her off of that positioning. It's a long process. It's a complicated process. It's a pain in the ass.

I'm a planner by nature. I am also able to roll with the punches pretty well. Last year, we went through 2 broken bones with 2 kids 6 weeks apart. The second break, courtesy of my 6 year old, was a complicated break. It happened 3 days before Christmas and required surgery and pins. I dealt with this just fine. This time, I am not dealing as well. It's just not as simple.

All the cute summer outfits I bought BG? They won't fit around her cast. There is a chance she will not fit into her car seat either. We know she won't fit into her high chair. I now know she won't be able to sleep flat on her back. Diapering her will become a feat of strength, agility and patience. She is going to be one pissed off baby. I feel like I'm very lost in terms of her aftercare. I need to plan for it to feel some kind of control over the situation, and not having that leaves me feeling rather sick.

I've scoured the internet and found a few things that deal with this issue in babies, but none of it is laid out simply. So here I am. To keep track of our progress and our lives. Maybe someday someone will come across this and find it helpful. At the very least, maybe it will help me keep my sanity. If not, well, I will have to turn to running and booze.