2 Weeks Down!

We have survived two weeks in the cast.

Things are definitely getting better.  Better because we have an end date in sight.  Better on the sleep front (more about that to come in a later post).  Better with Mackenzie being mobile and playing independently.  Better because we got our amazingly awesome Ivy Rose Spica Chair which I will be posting about later as well.  And better because we seem to be figuring out life in this cast.  And I'll tell you what, it's really not that bad.

The face doesn't show it, but she really does love this chair.

We are heading out camping for the weekend.  Should be interesting.  Our biggest concerns will be keeping Mackenzie cool enough and keeping her clean.  We are bringing along the spica chair!  Our friends have air conditioning in their fifth wheel so she may be hanging out in there if it gets really warm.

After that we are flying to Victoria to spend some time with Mackenzie's Nana and Papa.  We are looking forward to a little bit of a parenting break as well.

9 Months old already!

Cast Check-in Appointment

Today we went back up to the Stollery for Mackenzie to have her follow up appointment.  We were supposed to go back after 3 weeks in the cast, but we are heading out to visiting her Grandma and Grandpa in Victoria so they said to come back a bit early.

We were dreading some news along the lines of her hip being out and the past 11 days being pointless in the cast.  Or that she was going to need to spend 6 months in the cast.  Or that she would still need surgery.  Or something else terrible since it seems like we only get bad news when we go there.

Thankfully the appointment was quite uneventful.  Like all our appointments with the orthopedic surgeon it began with a wait in the jam packed waiting room.  Then we had an x-ray.  Then back to the waiting room to wait some more before finally going back into a room to wait some more for the doctor to come in.  Mackenzie was hamming it up and entertaining the entire waiting room.  I don't know what it is about her, but she just sucks in people's attention and holds it.  Must be her cuteness!

Got a sticker from the x-ray tech.  Which I crinkled and then tried to eat and then cried when mom took it away :)

In the examination room we saw yet another resident doctor.  The third one.  Every time a different resident.  He asked us a few questions.  All things that they should know from Mackenzie's chart like when her reduction was, when she would be getting the cast off, etc.  Then he left to go get the surgeon.   I'm all for teaching and learning, but it gets to be quite frustrating.

The surgeon came in and told us that everything looked good on Mackenzie's x-ray.  Her hip is in place where it is supposed to be.  We then pulled out our extremely long list of questions and corralled him into answering them.  We got a lot of good news.  She will be in the cast for 12 weeks, but only 12 weeks.  After the 12 weeks she will go into a brace and how long she will need to wear it will depend on how well she continues to develop.  He said her case is about middle of the road of what he has seen.  Not the most severe by any stretch, but also worse than some that he sees.  He hesitated to give us the numbers for her acetabular index.  It seemed mostly to be due to the in accuracy of x-ray in infants and also that if she is at a slight angle when the x-ray is taken (and she apparently was this time) that can skew the numbers.  He mentioned the number 33, but I don't know if that was what she is at or he was just throwing it out there as an example.  I also saw the number 42 on one of her earlier x-rays they showed us.

He told us that if this closed reduction and the brace following it doesn't completely fix her hip we will just play the wait and see game until she is about 4 years old and if she needed surgery they would not do it until that point.

We go back in about 4 more weeks and she will get her cast changed.  The doctor said depending on the stability of her hip he may be able to put on a shorter cast that would not go up so high on her chest and may also only come to her knee instead of her ankles.  But they will have to check things when they get her back in the OR.  The nurse practitioner who fills out the paperwork also told us she would ask for a waterproof cast for Mackenzie for the cast change, so that's exciting!

One week down, 11(ish) to go

We have survived the first week of Mackenzie being in the spica cast.  Here are some random thoughts and tidbits from the week:

• Each day seems to take forever, but the week went by *fairly* quickly.

• We don't actually know for sure how long she will have to be in the cast so the count down is a little anti-climactic.  We also have not heard back regarding any of our questions for the surgeon. 

• She has started rubbing the hair off the back of her head like a newborn baby because instead of being able to roll over in her sleep she turns her head back and forth, back and forth.  This is exacerbated when she is crying.  I hope she doesn't rub it totally bald because she is already a little lacking in the hair department!

• It's really difficult because she can't tell you what is the matter.  When she cries I never know if she is uncomfortable, the cast is bothering her, or if it is just something "regular".  She seems to be a lot more cranky and irritable than pre-spica.  

• Sleep has been terrible!  She has always been a great sleeper (12 hours through the night since about 3 months old minus a few weeks during teething) and now she is waking up several times in the night.  Often she will be awake for an hour and a half at a time in the middle of the night and nothing seems to help unless one of us just holds her and lets her "play".   When I put her down for naps she literally clings to me and starts crying as soon as she sees the crib.  

• Yesterday I finally went through her closet and dresser and had to pack up so many cute clothes that have never been worn and she will never get to wear.

• Snuggle your babies and don't ever take that for granted.  She is really difficult to hold, let alone cuddle well.  She has never really been one for cuddling, but now its not even an option.  Her cast comes up so high that I can't even rub her back to try to comfort her when she is upset.  

• Her resilience is astounding.  She is pulling herself all over the house.  Brice is trying to "teach" her how to roll over and she did it once on her own on the third day in the cast.

• In a very scientific experiment I weighed myself with and without her and she is about 20 pounds with the cast which is only 2 pounds heavier than pre-cast.  She feels about 10 pounds heavier.

• Thankfully she loves the stroller so when she is especially cranky and refusing to sleep I just throw gentle place her in the stroller and go for a walk.  I'm dreading the hotter summer days where this won't be an option.

• It's tough to work through the feelings (this is Brice writing). The lack of sleep and her crankiness is getting to me. As I was telling coworkers, I understand some kids don't sleep well at  night, I could live with that or I could live with the Spica (at least I tell myself I could), but both is just unruly. I blame the cast for everything. If she's cranky, it's the cast, if she wakes up, it's the cast, if she cries, if we can't go for a walk because it's hot, if I can 't go for a beer after work, if I have a bad day, etc, it's the CAST. One week down. 

Diapering in the Spica Cast

Diapering has not been nearly the ordeal that we thought it was going to be.  We had read a lot of stories about people and their struggles with diapering and keeping the cast clean.

We are fortunate in that I think our "diaper hole" in the cast is much larger than a lot of other ones we have seen.  Mackenzie was wearing a size 3 diaper before the cast and we are able to fit a size three diaper on her pushing it up into the cast in the front and the back.


**I have taken off the pictures showing what Mackenzie's cast looked like due to inappropriate comments being made.  If you have questions or would like to get more info please let a comment with an email address I can contact you. 

We are using either the Pamper's Baby Dry diapers in size three or Pamper's Swaddlers in size 2 inside the cast.  I also had Pamper's Cruisers in size three on hand, but they are bigger than the Baby Dry ones in the same size for some reason and are more difficult to fit inside the cast - as I learned the hard way during a mid-night diaper change.

I cut (or rip) off the tabs of the diaper that goes inside the cast because they are unnecessary and I feel like they are adding bulk and could get scratchy for Mackenzie inside the cast.  I usually start by pushing the top of the diaper up in the front of the cast.

Step 1: Push the top front of the diaper up into the cast

Then I pull it around and sometimes I can get the back tucked in by just turning her slightly on her side and without rolling her over.  Otherwise I roll her over onto her stomach so that her weight shifts off of the back of the cast and then push the back side of the diaper up in to the back of her cast.

Roll over and do any extra wiping that may be required

Step 2: Push up the diaper into the back of the cast.

We then layer a larger diaper (size 5 is what they gave us in the hospital and that seems to be working well) over the tucked diaper and do it up on top of the cast.  I make sure the "ruffles" of the diaper are next to her skin and not resting on the cast for extra leak catching protection.  We reuse the large diaper for as long as it holds up and doesn't get spoiled, usually one whole day.

As you can see in the pictures we have a folded up towel on top of her change pad to help support her head and neck when she is on her back on it.  Very high tech!

Dad practicing his "spica tricks",  but a good view of the larger diaper

We are only about a week in but so far we have had no leaks into the cast and no accidents at all.  Again, I think we are probably lucky in that Mackenzie's bowl movements tend to be quite solid.  Pre-cast we never had the dreaded "poo-spolosions" that a lot of parents talk about.  Our hope is that we don't start now!   Mackenzie is also not a heavy wetter.  We have never had any issues with leaking though a diaper at night and that continues to be true.  When she does wake up in the night I will occasionally change her diaper if it needs it, but quite often she goes 12 hours overnight in the same diaper with no problems.

Spica Cast - Day 5

Yesterday was our first day on our own as Brice had to go back to work.  Lucky for us he is a teacher (so am I, but I am still on maternity leave) so we will both be home for all of July and August.   We just have to get through this week.

Mackenzie decided that napping wasn't for her and was quite fussy.  She always wanted to be held or directly played with.  She would also start crying as soon as I went in her room and got even close to putting her down in her crib.  I found myself constantly wondering if it was just "regular baby stuff" or if it had something to do with the cast.

We tried to play outside on the deck for a little while but shortly after getting out there I felt a few sprinkles of rain and that's no good for a baby in a cast!

She seems to be quite happy in the stroller so we went for a walk in the morning and again in the afternoon we walked down to pick up Daddy from work.  The day had been overcast all day and then shortly after we headed out the sun started shining.  It got hot fast.  By the time we got home Mackenzie had fallen asleep, but was drenched in sweat.  I felt so terrible.  We are really going to have to be diligent about not letting her get too sweaty in the cast.   Sorry friends, I'm going to be wishing for cool weather this summer.

Our Regular Stroller - Bumbleride Indie - works great

Just a pillow behind the back and we are good to go!

In the afternoon I did manage to get some smiles and giggles out of her.  It's amazing how that giggle and those teeth can just brighten up my day.

 I think we must have lucked out on the second night where she slept straight through.  Since then she has been waking up a few times a night.  Last night she was awake from about 4 until 5:30.  Again, not really sure what is going on.  We let her fuss for a bit, when she started crying harder I nursed her, but same thing that she would start crying so hard when we would put her back in her crib.  Finally Brice went down and just sat beside her crib for about a half an hour until she fell asleep.

Today I'm thinking about venturing out of the house - maybe make a Superstore run to pick up a few things.  I'm just not sure if I'm ready for all the stares yet......

Trying to Escape

Maybe I can chew my way out of this thing

Spica Cast - Day 3 - Some Emotions

We flip flop back and forth between being so relieved that Mackenzie is doing so well with the cast and being worried and scared about what the future might hold.  We have read a lot of stories where children need further treatment, often times for year and years, after the cast comes off.  However, there are also lots of stories where the problem is fixed and the child has no hip concerns at all afterwards.  I think a lot of our "worry" stems from the fact that we have never really been told or had it explained to us what the severity of Mackenzie's dysplasia is and how it compares to other cases.

Today I went out to find some onesie's for her in a larger size.  We had been just putting a t-shirt on and pulling it down over the cast but she picks at her diaper so we'd like to cover that up.  I had a bit of a moment in the store when I was looking through all the really cute summer clothes, swimsuits, etc that she won't get to wear this summer.  Then while standing in line there was a "normal" baby about her age with his mom who was waving at everyone and happy as could be.  It made me sad.  I wish my emotions would stop flip-flopping all over the place, but it is nice that I can feel happy, hopeful and optimistic with just one look at my smiling content baby.