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Sunday, July 12, 2015

Spica Cast Day 1

After being diagnosed with hip dysplasia, my 10 month old daughter was scheduled to have a closed reduction to put her femur bone into proper position in relation to her under developed hip socket, an arthrogram(an injection of dye into her hip and series of x-rays), the placement of her spica cast and an MRI to make sure there was no remaining tissue in the way that may keep the femur bone out of place. All this would be done under general anesthesia.

Her surgery time was scheduled for 12:30 pm. This set us up for a bit of a miserable day. The baby wasn't allowed to have anything other than clear liquids after 4:30am, and for a girl who loves to nurse through the night, she was definitely not pleased. We spent the morning trying to keep her occupied. It took lots of bath time(she loves bath time) and lots of baby wearing to get her to nap(since she also likes to nurse to sleep.

Our hospital arrival time was 10:30 am. We got to the hospital and got checked in. We went through all of the paper work, while trying to keep a now very pissed off baby happy. We spoke with our orthopedic surgeon and the anesthesiologist and picked her cast color(naturally). The OR was running a bit ahead of schedule, so they were going to be able to take her in early. She was given a dose of Versed to calm her down. This worked very well.
Once this kicked in, a nurse came to take her from us. While I was nervous and rather snappy at this point, I held up ok. We were taken to the waiting room. Since I'm a nursing mother and had to pump while she was in surgery, we were given a private waiting room(thank goodness, because the main waiting room was packed!). The waiting began. The surgery itself was scheduled to take around an hour, then her MRI another hour or so. We headed down to the cafeteria for lunch, and took it back up to our private waiting room. Bonus, this was our first kid free meal, just the two of us, since before the baby was born. Score one for a lunch date?
We waited and waited some more. Finally, around 2:30, the orthopedic surgeon came in to speak with us. The reduction went well and her leg went back into place very well. He didn't expect any issues with the MRI. We went back to waiting for the MRI to finish. This seemed to take forever, or just over an hour in waiting mother terms. Finally they came to get us to take us to her recovery room. The MRI was clean. She was still asleep when we got to her.
She slept for another 30 minutes and then started to wake up. Thankfully she woke up very easily(one of my other children tends to not wake up so happy when put under). She was confused at first so I picked her up to let her nurse immediately. Luckily she took right to it so she stayed calm, for then. The cast went up to her chest and went down both legs. I was a bit disappointed, as the doctor had said he would only fully cast one leg, the affected leg. He later explained that he didn't want to chance the other leg being free to move the bad leg out of place.

We were given the choice of being discharged that day or staying over night. I chose to have her stay over night. I was lost. I had no clue how to handle her or change her diaper. I felt better being in the hospital. When they moved her to her room from recovery, things went south.
She was not happy. She was attached to things and she wanted to move, but didn't understand why she couldn't. It's a very helpless feeling. She kept trying to roll over but only her upper body would twist a bit. She seemed like she was in a bit of pain, so once we got checked in, they ordered her Lortab. While we waited for that, we attempted our first diaper change. With the help of two nurses, I was able to manage this in under 20 minutes. She got two diapers now, the first, a smaller one, gets stuffed up the front and back of the cast, in the large hole in the middle. This involves wiping her clean, flipping her to her stomach to shove the diaper up, flipping her back over to shove the diaper up the front, and then putting a larger sized diaper on the outside to hold everything in. While complicated at first, it got much easier with practice.

They were able to detach her from all of her wires, I was able to find Doc McStuffins on the hospital tv(don't judge, you put your baby in such a large cast and then try to keep her happy and occupied in a hospital bed), and she settled down. My husband left to get our three older kids, and we were on our own for the night.
With the help of the Lortab, she was able to sleep. I settled in the best I could on the hospital couch. She slept for a few hours and then was up crying. I had little choice but to squeeze myself into the hospital crib to nurse her laying down, to get her back to sleep. She repeated this several times through the night, until I changed her diaper around 4 am and another dose of Lortab was required. When morning rolled around, she was in a much better mood, once again with the help of Disney Jr.
We tried our hand at some tummy time, which she seemed comfy in.
I sought out coffee, precious coffee. Luckily for me, the family room right next to our room had a Keurig machine and was well stocked with coffee. Discharge papers were prepared. My husband arrived with our other kids around 10am. He brought in her car seat, which she unfortunately did not fit in due to the width of her legs and the angle of her back. Once again, luckily the hospital had us covered. They were able to score us a free Britax Hippo car seat, specifically made for kids in spica casts. Thanks to government grants, they are able to give them to parents who need them(otherwise it would have cost us about $500). So thanks Obama! We were given all of our paperwork, and sent on our way with our much heavier and bulkier baby.
And thus begins life in a spica cast.