I'm letting this blog take me where it takes me, while making a really admirable attempt at keeping some sort of focus most of the time. That statement says it all. What I didn't know when I put my little piece of the internet out there was the reach that it would have. Early in July I wrote a post about how I was feeling shallow about the possibility that L's teeth might turn grey after a little accident she had. You can see that post here. Part of that post contained photos of L in her pavlik harness when I talked a little bit about hip dysplasia. Just a few weeks ago I had some people in Europe reach out to me because their child had been diagnosed with hip dysplasia and they had questions. And I was like, WHOA. The internet. It is crazy. So I'm putting this out there for anyone else who is going through this diagnosis and looking for someone else's experience.
It's easy to forget how difficult something was when it's in your rear view mirror. This is why women have more children once they have forgotten about the third trimester, child birth, and colic. Hip dysplasia isn't completely in our rear view mirror, but it's hard to remember the time between diagnosis and meeting with the orthopedic surgeon. It was a long, hard time mainly spent online looking for answers. I think one of the most difficult things is having something wrong with your child that you don't fully understand. I will also say I am still not an authority on HD, but this is our story.
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| Cookie cutter mom with weird high school backpack. |
L was a breech baby. Just to clarify a pet peeve of mine, a baby is BREECH. There can be a BREACH of contract or a BREACH in a levee. So there is that. The main thing I thought of when I learned about her position was c-section. Then I didn't really think of anything else. We tried to turn her, she wouldn't move, so we got to pick her birthday and everything turned out perfectly. After she was born and the pediatrician came, I learned about hip dysplasia. I'm kind of embarrassed to say now that I had previously only heard of it in large breed dogs and I still didn't know what exactly it was.
Here is your crash course. HD is a condition affecting the hip socket and the top of the femur (the thighbone). Either the hip socket is too shallow and cannot hold the top of the femur in place, or the femur is in the wrong place. They check all babies for this at the hospital and you might have seen your pediatrician spread your babies hips open during a routine exam. (One in every 1,000 newborns has HD.) This is called checking for a click. When a hip is dislocated it makes a "click" when the dr moves it a certain way. If left untreated HD can lead to lifelong pain, osteoarthritis, difficulty walking (limp) or inability to walk. Untreated HD is also linked to a marked decrease in quality of life.
Landon was a perfect storm for HD, but her hips never clicked. She was a first born female child who presented in frank breech. The reason that breech birth can lead to HD is because the femur might not be in the correct location for the hip to form properly around it. Most babies spend the better part of their 40 weeks sitting indian style, with their femur securely locked inside of their hip socket. When a baby is Frank Breech like L, the femur is extended further out of the hip socket.
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| Frank Breech |
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| Also Frank Breech, Also, not Landon. |
Since L didn't have a hip click at the hospital, we went home and had plenty of other things to worry about. Like breast milk shortages and baby indigestion and projectile spit up. Ahh, fun times. At our two week check we were told we needed to schedule an ultrasound for Landy's hip. It was standard procedure for babies born breech just to take a better look at the hip socket. I still wasn't concerned though. I knew we were going to ace this. I like to shove positive thoughts in when I can't deal with a negative outcome, and also, I still had oxytocin coursing through my veins from breastfeeding. Oxytocin is my new #1 favorite reason to breastfeed that I never knew about. Back on topic...
After the scan we went back to the dr and found out Landon had HD. And I still didn't get it. My dr said "she'll probably be put in a harness for a little while." And I was like "okay" and walked out. Then I got home and started chatting with my bff Internet and I cried. And I cried and cried and cried. I think I cried for a number of reasons, some of which were shallow, others were because I was already trying to figure everything new out every day and here was one more thing I had to try and figure out. I was worried she would hate the harness and cry for weeks. I lost all of my optimism. Thank goodness for S in this situation. Because although he later told me he had no idea what to do, he just told me it was no big deal and everything would be fine. Even though he was mainly acting the part, he ended up being right.
Next we met L's surgeon at Texas Children's Hospital (you see an orthopedic surgeon whether you are having surgery or not) and she was AMAZING. She has twins just a year older than Landon. She brought out the harness and I was prepared and I was tough. She said "you did a great job. Most moms cry when I bring out the harness." And I was like "yeah, it's no big deal." (LIES). We had a treatment regiment in the pavlik harness that lasted from 12 weeks of age until around 30 weeks.
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| The Pavlik Harness |
It was the summer time so mainly she was just in a onesie and the harness on over it. Initially she had to wear it all day except when bathing. It took 6-8 hours to wash and dry, so it stayed dirty. She got poop on it the first day, and spit up on it almost every day. It was nasty. Luckily we got a new one every appointment. Amazingly she really didn't care about the harness after the first day. It was hard to see her stretch and be so happy when we took it off during bath time, but we just tried to stick to a routine so she knew what to expect.
We used to swaddle her before the harness, but we dropped it cold turkey because we couldn't figure out how to swaddle over the harness. I've also always wondered if I swaddled her legs to tight and that might have led to her hip angles being too steep. To read about hip healthy swaddling, click here.
After her regiment with the pavlik harness we went in for another ultrasound and an x-ray. Her hips were still not in the normal range, but she was moving in the right direction and we graduated to a rhino brace. I loved this because we didn't have to worry about the shoulder straps and little sock boots anymore. She wore it for 16 hours a day so we had it timed to when she was sleeping (night and naps) and longer during day time if needed. It was closer to her skin and made of foam (read HOT), so we switched her pjs and added a sleep sack. The brace fit in the sleep sack perfectly.
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| rhino brace |
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| Please ignore the sheep and look at the rhino brace. Nap time. |
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| Rhino brace in sleep sack. |
After another regiment with the rhino brace and another x-ray, we were cleared with hips in the normal range and told to come back in 6 - 8 months for another x-ray. Last week we went back and while L's hips are still in the normal range, one is close to the border. It was a good check up, not a great one, and we'll be back in another eight months for another x-ray and will hopefully be sent on our way for a few years. This experience, for me, is a lucky one. She didn't need surgery, and hopefully won't in the future. She crawled and walked in a normal time range even though we were told the harnesses and braces might set her back. Going to Texas Children's Hospital also helped to keep this hip issue in perspective. Pediatric orthopedics shared a waiting room with pediatric dermatology, surgery, radiology, and oncology. It was a nice reminder from God every time we went to see that HD is small potatoes and we can handle it. We have a happy healthy girl who happened to have shallow hip sockets at one time and hopefully will stay on the road to normal hips. Thankfully we live in a place where there are measures to check for those things.
Tomorrow we'll be back to recipes and real housewives and true blood finales. Today I'm hoping that someone who might have been like me over a year ago, doing a google search for "hip dysplasia", can get something from this post.
For more information on Hip Dysplasia:
And although I usually don't send people to babycenter.com for information, they have a support group for parents who have HD children. It is really helpful and informative, especially in the beginning when you have SO many questions.
Here's to healthy babies!
-RT
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