Broken, but not showing it!

Lainee got a second cast put on Thursday. It went a lot smoother than I anticipated. She went back early. They got the iv in her hand on the first try! She got a bath! Annnnd another cast. Dr said the arthrogram went better than he anticipated. Her hip does not want to pop in and out of place, but the socket is still too shallow. But the cartilage around the bone is formed nicely and it's looking promising. Which meant he could cast her differently.

My little zombie baby. It looks like she's dragging her left leg. Or dancing. We'll go with zombie baby. But the cast is bigger in the waist - I can fit to my wrist down the front. And bigger in the feet. Probably because he knows if she has to spend 12 weeks straight in this one I'd knock him out with small feet openings. My baby isn't going to have purple feet this time.

The best part? She fits in her car seat! - the one made for all this. AND her high chair! I was so elated. That means probably no spica table. She goes back in 4 weeks for an x ray and to talk to him.

Pity party, table for 1

My days have been consumed with swimming. We were given a huge above ground pool a couple of years ago and just set it up Sunday. So I'm teaching my 3 year old how to swim while Pip sleeps. Each time I get into the pool I want to pout. I want Lainee to experience it too this summer, and she can't. She loved the bath.

Also, my 3 year old is all boy. He has his sweet moments, where he'll grab my face out of the blue and kiss me. But thus kid doesn't want to cuddle and snuggle anymore. And the baby that's meant to do this is in this purple malformation. I just want to snuggle her again. I want her to roll over and sit up on her own. To try to crawl. I want her to get in the pool with us.

I'm so jealous of my friends who have kids a month or two younger/older than Lainee. One, because they don't have to deal with this cast. And two, because they don't have to deal with a preemie. Their kids are hitting milestones. I'm so ready for this cast to be off and my little girl able to do things other than stay in one spot all damn day.

/end pity party

Piggy paint!

Since I was a little girl I've always wanted a daughter. And now I have her and can do her nails, and hair (when it gets longer). But this product, piggy paint. Love it! It's non toxic and dries in a minute. It's safe for even infant's that stuck their hands in their mouths. And it gives her time in the cast a more interesting one. :)

Two weeks down.

Today makes two weeks since the cast had gone on. Yesterday I took Lainee in to have the bandage looked at. And the cast tech said the cast looked great! I kept mentally patting myself on the back there. Especially since I did not mention the poosplosin. Only 3 weeks and 5 days until her 6 week appointment. Hoping fir a good xray so we can get rid of the cast early and go to a brace.

First trip back to the dr. .

So at 1pm today Lainee will be squeezed in to be seen. I called yesterday about her bandage coming undone. They wanted her in asap to change it. Fun stuff.

Other than that we've been practicing holding our head up while on our tummy. Huge milestone.

Poosplosion.

Lucky. That's what we were today. It took about a half hour but we did it. Just got done cleaning a poosplosion. Had to call in reinforcements, even. It was so far up the back side of her cast we had to use wipes wrapped around the flat end of one of her spoons. I cried. It's only week two of this. In one months time we'll be going to the doctor. I want a clean cast! It's bad enough the incision site bandage is coming up. We think daddy got all of the poop out. The wipes were coming clean and the antibacterial wipe was clean after it's sweep up there. Lucky.

A week.

Not quite a week yet but close enough. Pip is slowly getting back into her usually routine. Just napping more than before. She's only getting up one per night for the past two now, also.

Alek and I take opportunity of her morning nap to get outside for a bit. It's not as hot as our house sits in the shade for a while in the morning and then again in thw afternoon. We'll be setting up the kiddy pool soon too.

I was planning on this post tomorrow, but the hubs will be off and I need to get a chest xray for my last lung appointment on Wednesday. Hoping this partially collapsed lung I left with 4 months ago is finally back to normal.

5 days in feels like fifty.

Tonight is ending day 5 of this Spica Cast.  We've definitely have experienced major hurdles so far. The biggest being food. Today she closed on 20oz and at least 2oz in food. But her temperament is becoming better. Sleep is getting better. I think if we have another day below 20oz I'm calling her pediatrician.

Doing a more normal routine..

Last night was rough. It started out as yesterday being rough. Hubby went to a new shift at work, Alek was home from his babchi's house for the hospital stay. Pip barely ate. She ate really well the day before 31oz when she only needs 28oz per her pediatrician. But she also ate from midnight. Anyway, she ate maybe a grand total of 18oz in 24 hours. Which made me worry. Because she'd eat 1-2oz every 2-3 hours and slept in between. She did eat almost the whole container (3.5oz) of apples I gave her and almost all the sweet potatoes. I gave in trying to push formula at around 10 last night. Gave her some loratab and spent an hour trying to put her to sleep.

230 she woke up. After many failed attempts of putting the paci back and rocking the pack n play, I made a bottle. Out of the 4oz she drank one and happily dozed back off. Until 330. Drank another one ounce. After that she got up every 15-30 minutes until 730. Then Alek got up.

She's been at least eating better for me today. And playing. As she gets more used to this cast I'm hoping she'll go back to sleeping 6-8 hours at night.

Needless to say, everything that I thought would be hard about this is rather easy, diapering, pain tolerance, carrying. And the things that I thought wouldn't have changed - feeding, sleeping - are harder right now (sucks to assume right?). Although, the one thing that I thought would've been decent was travel. I thought the dr would've made the cast at least somewhat fitting the car seat that's made for this. It was very hard to hear that the most likely way we were going to go home was to strap my 6 month old to the seat of the car with a belt. I'm really glad they got her to fit in the car seat.

11 weeks 6 days left hopefully..

But who's counting? Today we came home after about two hours of trying to see if Pip would fit into a car seat. She's managing pain pretty well. And since being home I've changed two diapers, one being poopy. It's decent to stuff on her right side, but her left is swollen and I can tell not comfortable for her when I stuff it in.

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Another treatment

☆Closed Reduction

This is the most common treatment for babies between the ages of 6 and 24 months. The doctor physically manipulates the hip joint to get the ball back into the socket while the baby is asleep under general anesthesia.

Occasionally, before the procedure, a few weeks of traction is used to stretch and relax the child’s ligaments before attempting the closed reduction.

After the child is put to sleep with anesthesia, there are generally four steps involved in a closed reduction procedure:

Closed Reduction Procedure OutlineArthrogram

Dye is injected into the hip joint with a needle so the inside of the joint can be seen on x-rays. This allows the doctor to verify the hip reduction and helps identify any potential problems that may prevent the hip from going into place.

Adductor Tenotomy

The doctor makes a very small opening in the groin and surgically releases the adductor tendon. This tendon is normally very tight. Releasing the tendon takes pressure off the soft surfaces of the hip and helps keep the ball in the socket after the hip reduction. The tendon heals very well, growing back like it does in an athlete that has a groin pull.

Hip Reduction

The doctor physically manipulates the ball at the top of the thigh bone (femoral head) back into the hip socket while monitoring progress by x-ray. The doctor uses x-rays to verify that the hip is in the best possible position before casting.

Spica Cast

The child is put into a hip spica cast. This keeps the hip in the newly aligned position while the joint heals, and encourages proper formation of the hip joint as the child grows.

Follow-Ups After Closed Reduction

Usually the spica cast is changed every 6 weeks until the child has been in the cast for 3-6 months. Improvement in the hip may not be realized until the first cast change. At the cast changes, an arthrogram is often performed to check on the progress of the hip joint. The total time in the cast depends of the appearance of the hip on x-ray with the arthrogram.

When the final cast is removed, the child is normally placed into a hip abduction brace for several more weeks. Since the child has been in a stiff cast for so long, he or she has temporarily lost muscle tone and some flexibility. The brace provides extra support, as a transition stage, as the child regains the strength and flexibility. During this time it is important to follow your doctor’s prescription, which will normally be to wear the brace at all times, except for baths, in the beginning. The brace allows for more hip movement than a cast, but the hip still needs time to grow and become more stable before the brace support is taken off.

After a few weeks in the brace, the doctor will begin to allow more time out of the brace for the child to further regain strength and movement. Generally, children seem to tolerate this process very well and they quickly catch up to other children in all of their activities.

After a year, when the hip returns to normal, it should be impossible to tell children who spent time in a cast from children who were never in a cast. This process is not always successful and sometimes problems develop during or after treatment.

Risks of Closed Reduction

Sometimes this procedure is delayed until visible bone in the ball of the hip (head of the femur) is seen on x-rays. There is some concern that the hip is too soft before this bone appears and the closed reduction may cause damage to the growth of the hip. On the other hand, waiting until the child is older may cause more stiffness and more abnormality of the hip joint, reducing the effects of treatment.

There is currently no scientific agreement that waiting for this bone to appear helps protect the hip from damage during reduction. Damage to the blood supply of the hip or damage to the growth plate can occur even during gentle attempts at closed reduction. Further, there is no way to know if this has happened for at least 6 months after the closed reduction. Fortunately, damage is not common but requires additional treatment later if it occurs.

The hip may not stay in the joint after the anesthesia wears off even though the child is in a spica cast. In some cases the doctor will recommend an MRI or CT scan in addition to x-rays of the hip after the child is awake to make sure the hip stays in the joint.

While surgery for your child may seem scary, treatment (surgical or non-surgical) gives the child the best chance for a normal hip and most problems that arrise can be treated if things don’t turn out as expected.

- See more at: http://hipdysplasia.org/developmental-dysplasia-of-the-hip/child-treatment-methods/closed-reduction/#sthash.6CGRUzKD.dpuf

No clue.

The first thing I noticed this morning in Pip's pre-op room.

The alarm went off at 5am. I was up with Lainee every hour before that because of her paci. We went and got me some coffee, then made our way to the hospital. Checked in and waited to be called back to pre-op. I was doing fine until the anesthesiologist came in. I started crying then stopped. By 750 they were ready to wheel her back. We gave her kisses and walked solemnly to the waiting room. Which was smack dab in the middle of where I was 4 months ago. On one side was my sicu room where I had given birth to Lainee , and on the other side was where I woke up a month later and then spent my recovery time before rehab. I even saw 3 of my nurses.

At a little after 9 they finally called to let us know they started. Late. They had issues finding a spot for her iv and ended up putting it in her head. Then started the waiting game for surgery. 3 hours later they called to say we could come to recovery.

My eyes got teary when I walked in her lil room to her mewling pitifully. We waited with her until it was time for her ct scan, then walked down with her. After that we went to a room.

She'll jerk every so often and whine but seems to be adjusting so far.

Before surgery. Her hands forming a heart.

In her room. Today starts our (hopefully) 3 month journey with this.. thing.

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Another treatment. This is what happened prior to her spica cast today. Medial Approach.

•Open Reduction

This surgery means the hip joint is opened up to clear out any tissue(s) that is keeping the head of the femur (the ball) from going back into the acetabulum (the socket). There are two general approaches to this procedure:

Medial Approach

[+] Enlarge
Medial Approach incision represented by black dotted line.

This approach is normally successful for children less than one year of age. This procedure starts through a small incision in the groin (medial to the hip). This is a limited surgical approach that allows the joint to be cleared so the hip can be aligned into the socket.

This method is typically used when a closed reduction is unsuccessful and the arthrogram shows something in the joint that’s keeping the hip out of the socket.

This method cannot correct any underlying problems in bone structure

A spica cast is normally needed for a few months to keep the hip aligned, while it is growing and becoming more stable.

Anterior Approach

[+] Enlarge
Anterior Approach incision represented by black dotted line

The anterior approach to the hip joint is used when the ligaments around the hip need to be repaired and tightened after the hip is cleaned out and aligned. This is used after the age of 12 months when surgery is needed, or for more severe hip dislocations.

Reshaping the hip socket can also be done through this approach.

- See more at: http://hipdysplasia.org/developmental-dysplasia-of-the-hip/child-treatment-methods/open-reduction/#sthash.NS8yRUS8.dpuf

Milestones, shmilestones.

Milestones. What are milestones? Well if you have a kid, or have worked with kids you'd know milestones are the little (and big) things that kids do in a certain timeframe. Smiling, babbling, sitting up etc. But if you're a mom to a preemie, EVERYTHING feels as if it is behind. Depending on how early your lil one was, is how behind they might be. Or they might not be behind at all. Every baby is different.

Now my son, Alek, did lots "early". He held his head up without support at 2 months, walked at 11 months. But he wasn't "talking" before two. He was saying like maybe 6-10 words. Me, comparing him like a horrible mom to the kids at the daycare I work at, was upset. But that day, the day he turned two, he walked up to my brother in law's dog. He pointed at and named nearly every body part on the front of that dog while the hubby and I stood there speechless. From that day on, he hasn't shut up. And he is the typical 3 year old now.

Lainee. Lainee has had great head control from when she was born. My husband told me when he had to do kangaroo care with her when she was 2 lbs 12 oz. He was so freaked out because she kept lifting her tiny little head off of him and holding it there for a while. She was supposed to still be in the womb. Now, when she was 4 months old (1 month adjusted) she started to smile socially. Then the next month she started babbling and giggling when she wanted to. She's 6 months right now and had been chewing on her hands finally. She is attempting to roll over but my heart doesn't want to be fully happy when/if she does in 10 days. She pulls herself into a sitting position from a reclined position in my lap. But, on her tummy, she just lays there. She doesn't really attempt to hold her head up or push up on her arms.

When I see friends with babies born (full term) around when she was doing all this stuff she should be doing for a "normal" 6 month old I get jealous. I get sad. I especially get mad at myself for getting sick and having to have her so early. And now, I wonder just how far "behind" my early girl will get from being immobile for three months.

Another sign of hip dysplasia:

☆Hip Click 

Hip clicks or pops can sometimes suggest hip dysplasia but a snapping sound can occur in normal hips from developing ligaments in and around the hip joint. 

- See more at: http://hipdysplasia.org/developmental-dysplasia-of-the-hip/infant-signs-and-symptoms#sthash.6YfGnSmS.dpuf

The countdown begins.

Today makes the 1st of June. Not counting today, we have 11 days left until she won't be able to kick and wiggle for 3 months. Last night I had her in the baby bathtub and she was just wild. Giggling and splashing wild. I loved it. But it also made me sad.

I think I'm going to try to post something a day on hip dysplasia - a sign, a fix. Since it is hip dysplasia awareness month.

Signs of hip dysplasia:
☆ Asymmetry

Asymmetrical buttock creases can suggest hip dysplasia in infants but, like a hip click, an ultrasound or x-ray study will need to be done to determine whether the hips are normal or not.

- See more at: http://hipdysplasia.org/developmental-dysplasia-of-the-hip/infant-signs-and-symptoms/#sthash.OFifuFm1.dpuf

About Pip.

Pip, or Lainee, arrived 11 weeks early into this world. She was due February 5th, 2014 but had to come November 22nd, 2013. I had h1n1 and pneumonia, resulting in coding on November 22nd while trying to clean out my lungs and attempting to take me to the OR. So, Lainee was born in my sicu room at 5:06pm, 3.3lbs and not at all a concern. I remained in a coma until December 23rd. But I finally got to see her in January. I got released January 16th and she got released one day before her due date.

I finally decided to go back to work at the start of June. That is until our Dr appointment for her hip changed my plans.

On May 23rd, one day after she turned 6 months, Lainee had a hip xray. I was optimistic that it would be nothing. Or maybe just needing a brace. But when the Dr came in and started talking, my hope flew out the door. Lainee had a dislocated hip. Her left, to be more exact. And surgery is the only option. He kept asking me, like every other Dr I've taken her to, if she was breech when she was born. They stare at me when I tell them I don't know.

So I explain the story for the millionth time, get the "wow you've been through a lot" and sympathetic smile. He tells me, while Lainee is screaming in my arms, about surgery. And a cast. A cast that will have to be from her armpits to her ankles for 3 months. No baths, no rolling over, no trying to move.

I felt the room spin. But we had an answer. And we caught it earlier than most. Not early enough for just a brace, but early enough. I left the Dr with some questions unanswered, but understanding enough.

This past Wednesday, she had an ultrasound on her hips. The tech got her hip to pop in place for a minute! That, gave me hope again. She said the socket is at 58% which is supposedly really close to normal. Again, makes me hopeful that this little girl will only need one surgery. The only thing stopping her hip from staying in the socket is her muscles that have grown to how her hip is dislocated.

So on June 12th she'll go in being able to wiggle, then come out immobile for 3 months. This blog will help serve as my outlet, and maybe help for other moms who have to go through this.