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SpicaCasts.com is here to be a resource and support group for those parents who may be preparing for the process, or are in the process, or have already been through the process of correcting hip dysplasia on a child.

How to Get Prepared for Your Child in a Spica Cast

Sorry, I know this is pretty lengthy. Unfortunately, we felt like when we were writing this that none of these things could be left out because they are all so important. We hope it is very informative, none the less.

What to Bring To the Hospital

I would not worry about bringing too much to the hospital with you. It will just make more for you to carry around. The hospital should have just about everything that you will need such as diapers (large and small sizes) and food. I did however bring a few bottles for our daughter because she is pretty picky about what kind of bottle she will drink out of. If you have a picky child then I would bring your own. You will also need some clothes to bring them home. You will want to use clothing that is several sizes too big normally. For example, Lilie is 6 months wearing 9 month clothing, but I bought onesies that were 24 months. They still fit a little tight, but they work. You do not want clothing that is too heavy because it may make them sweat. This can cause their skin to break out causing sores which are very painful.

I recommend having feminine pads ready to line the cast with, but you are not going to need them at the hospital. There is going to be a lot of swelling around the incision area that will not allow you get them in place correctly. Use these once you get your child home.
I would also make sure that you bring something that is familiar to them. They won’t feel like playing very much, but that will help comfort them. I would just bring something small like a blanket, stuffed toy, or pacifier something like that.

You will most likely be spending most of your time standing next to their bed so make sure that you wear comfortable clothes and shoes. You will also want money for the vending machines because you may be up in the middle of night and need a snack to keep going. Caffeine can be a life saver during really long nights.

One of the problems that we had was people visiting that had been exposed to illnesses prior to coming to the hospital. I would recommend not letting anyone that has been exposed to any form of flu within the last two weeks to visit especially if it is the stomach flu virus. Our first daughter got a stomach virus from someone and became extremely sick in the following days. They are just too weak to fight off any kind of illness. It also made her cast smell from a mile away.

One thing that we learned this last time of surgery was not to be scared to tell the nurses what you need. They are there to make your child as comfortable as possible. If you feel that the pain medication is not working, do not be afraid to ask the nurse to call the doctor for other options.

Things For Home

One of the best things that you can do for the family is to prepare your home. You will want to have everything cleaned and disinfected for when you come home from surgery. I usually spray all surfaces areas with Lysol that day of the surgery that way when we come home everything is already germ-free.

I would also recommend preparing at least one week worth of food. It will be much easier on you if you do not have to worry about food for everyone. If you cannot prepare food in advance buy frozen foods that are easy to prepare. You are not going to have much time to spend on cooking, even if you and your spouse are working together.

You are going to need some place for your child to sit comfortably when you cannot hold them. The cast is always bigger than you think, so try to find something that does not have really high sides. Most of the time, you will not be able to use a swing, bouncy seat, or high chair because there is just not enough room. We have used a bean bag with both our girls and it works really well.

Buying all the things that you are going to need in advance will really help you when you come home. You are going to need two different sizes in diapers. A small diaper will work for the inside (Newborn to s.2) and a larger size for the outside (size 4 to 6). I also recommend buying feminine pads for lining the cast. It has saved the cast from getting soiled so many times. I buy Stayfree ultra thins with no wings. They are easiest to fit inside and relatively inexpensive. I also use medical tape to hold them in place on the outside of the cast. This not going to look great, but it is a necessary precaution to keep the cast as dry as possible.

I hope that this helps you with the preparation.

Posted on November 16th, 2009 under Information, Tips and Tricks | Comments: none

What is Hip Dysplasia?

Hip dysplasia is a condition that involves the hip and the joint. This condition causes the hip to form improperly. In some cases both hips can be affected by Dysplasia. The severity of the case can range widely. The treatment for DDH or Developmental Dysplasia of the Hip depends on how old the child is and how severe the condition.

There are many different causes for dysplasia. A baby that is in the breech position is more likely to develop DDH. A family history is also a common factor. It is important to remember that if you have had one child with DDH, you such have any children that are born after to be checked as well. A female child is also at a higher risk for this condition.

Finding Hip Dysplasia in young infants can be difficult. An ultrasound will be done on the hip joint to see how it is formed and to see if the joint is out of socket. Bones of an infant do not show up on x-rays until they are about 6 months old. Older children will be given x-rays to determine the placement of the hip.

The treatment for Hip dysplasia depends on the age of the child. Infants under the age of six months are normally put into a pavlik harness. The harness is used to place the hip in the correct position. This will reduce the joint and the body will adjust to the proper placement of the hip. Most infants will completely recover using the harness

Older children such as 6 months to 1 year are more likely to need a spica cast. The spica cast will hold the hip in place like the pavlik harness, but it will allow less movement. Surgery is not always required for this procedure. The normal time in a spica cast is six to twelve weeks.

Children close to or over 1 year old are more likely to need surgery to correct the condition. After the surgery to correct the joint, a spica cast will be placed on the child to prevent movement. This will give the joint time to heal in the correct position. The normal amount of time in a spica cast is six to twelve weeks.

Posted on February 10th, 2009 under Information | Comments: none

Hip Dysplasia

There are so many different reasons why a child can develop hip dysplasia. This reason alone can make it difficult for doctors to pin point why it happens. For instance, your newborn baby is a girl, and she seems perfectly healthy and normal in every other area. In this case, your baby being a girl is the only reason for the dysplasia. That is why this particular condition can be hard to diagnose early on.

Hip dysplasia can be very tricky to find. Sometimes symptoms do not show up until your child is several months old. There are some cases where both hips are compromised making the diagnoses even more challenging. This condition is easier to treat the sooner you find it. That is why most infants will endure a surgery to correct the condition.

A reminder of the list of symptoms for Hip Dysplasia:

• A click or popping when the hip is rotated
• There is not full range of motion
• The legs are two different lengths
• The hip joint is not very flexible

If you have any concerns that your child could be having dysplasia, it is important to make an appointment with your child’s doctor, especially if the child is a girl. It is better to be on the safe side then to let the condition go.

Posted on February 3rd, 2009 under Information | Comments: none

Keeping Your Child Dry in a Spica Cast

My wife recently talked about how to keep your child dry with the use of feminine pads. There were some questions about exactly how it was done, so we took some pictures. Below is my wife explaining how we did it. I hope the pictures help!

Wife’s Explanation:

I am going to try to explain each picture the best that I can. This is Natalie’s second cast that the doctor’s office let my mom keep. Natalie’s second cast only covered part of her left leg so it looks a little different then a lot of other spica casts.

Spica Cast Back Spica Cast Top Spica Cast Top #2
(Click on the pictures to enlarge them.)

You can see how the pads are placed through the back of the cast. You will put the cotton side of the pad toward their skin. You do not have to peel the paper off the back. This will actually make it more difficult to get the pad in the right place. Just use the white medical tape to keep it in place.

• Remember do not force anything in your child’s cast. If they do not slide easily into to place, you may have to find a different method.

Spica Cast Back Spica Cast Underneath
(Click on the pictures to enlarge them.)

This area is the inside of the leg from different views. This is where you cut one pad in half. You place one half on the inside of the leg. You will want some of the pad on the inside and some on the outside. This will keep the material on the inner thigh area dry and the material on the outside of the cast dry as well. One pad should be enough for both legs.

I hope that this makes it easier to understand I know that doing all of this makes the cast really ugly, but the cast itself is not much better. It is the price that is paid for the comfort of your child.

Posted on January 16th, 2009 under Information, Tips and Tricks | Comments: 2

Daycare for Children with Physical Disabilities

This is a topic that I do not have a lot of information about. I can image how difficult it would be to find a day care that would even consider taking in a child that is in a spica cast. Since I am lucky enough to be a stay at home mom, we did not have to consider who would take care of Natalie while she was in her cast.

I am not sure how much a regular day care would be able to keep up with the needs of a child who is in a full body cast. Most day cares only staff enough people to take care of children without special needs. For more money, they might allow a child to continue to attend. Even if this is possible would it be the kind of quality care that your child would need?

I think that the best way to go would be to check into a local day care that handles special needs children on a regular basis. This would probably be more expensive, but the people here would most likely be more qualified to take care of a child in a spica cast. It would likely only be for a short period of time so it would be worth checking into.

There is a website that is dedicated to finding child care for any one. It is www.Care.com. It allows you to look at available child care sitters that are listed in your area. They have a page for special needs children where the sitters are educated or experienced with special needs children. You can sign up for a free account or pay for the premium packages. The premium packages offer free background checks. The site also shows if the sitter is full time or part time, and how much the sitter charges per hour. This seems like a great option to try out. It would most likely be expensive since instead of the typical weekly rates, you pay by the hour.

Child care can be a difficult decision to make especially when it comes to a child who definitely needs a lot of care. I hope that this will help any one who has concern about how and who will help take care of their precious little bundle during a difficult time. Also, if anyone else has any ideas or solution feel free to add to this information by posting a comment. It would be greatly appreciated.

Posted on January 13th, 2009 under Information | Comments: none

A New Addition

We recently found out that we are going to be adding a little girl to our family. This will be the third little girl. I feel slightly sorry for their dad being the only guy, but my dad survived three girls so I figure he can too. At least I think he will be able too. Anyways, this has brought about some concerns on my part.

Little girls are more likely to have DDH according to statistics. It is also common if you have had one child with DDH the next one following is likely to have the same condition. I have not really found out why this happens, maybe someone who has experienced this may have more answers. I am trying to prepare myself for what might come in about four and half months. I am not trying to be pessimistic. I am simply telling myself that I can do this again, if I have to.

I asked the ultrasound technician if there was any way they can tell in advance if a baby has DDH. He said as far as he knows there is no early test. It can be difficult enough to diagnose after they are born through ultrasound. So we will have to wait and see what our little bundle brings us.

Posted on December 26th, 2008 under Information, News | Comments: none

Being Prepared

This is kind of a false title because I do not know if you can be fully prepared to hear the news that your child may never walk correctly or with out pain. That is one of the first things that I heard the doctor tell me about Natalie. That is until he said “with out surgery of course.”

The word surgery slapped me across the face that day in the doctor’s office. I was so stunned I know I did not hear all of the conversation going on around me. Here I was bringing my daughter to an appointment where I thought the doctor would say something like “She will grow out of this, we only worry when the bones are curved as well” or “I think that if she wore a brace for a little while it will help.” I thought well she is only slightly bow-legged surely it will correct itself with out much help.

I was completely unprepared for the rest of the appointment. He brought in the x-rays and you could see without assistance that her little leg was not in the proper place. Her left hip looked perfectly normal, in the right spot, growing normally. Her right leg was nowhere near where it should be. It was like an inch higher than the other side. I was shocked. All I could do was sit there. I could not even form a rational thought. I just sat holding her in my arms thinking this is not happening.

I wish that I had known what I was walking into that day. I had asked my dad to drive us to the city because I did not know where I was going. I was so glad because he asked several questions for me. He made sure that surgery was necessary. He asked things like how long till she would recover. How long would she be in the cast? You know important questions that I could not even begin to put together. I was so very thankful that he was there with me and that I did not go alone. My original thoughts were that I would be going alone, thank goodness I wasn’t. I do not think that I could have handled it.

Many of you already know before you see the surgeon what you are dealing with. I wish now I would have asked her regular doctor to check her more thoroughly on that particular visit. Maybe I would have been prepared with some really good questions to ask when I saw the surgeon. Things like will she ever be able to play sports, or even run normally? If she falls down hard, will it hurt her badly? Will she grow up without pain everyday? Will she have severe arthritis when she grows up?

I could go on and on about questions I still have. I always forget to ask when we go because I am so happy that she continues to make such great progress. The best advice I could give to some one who just found out is to be prepared for the worst. Most of the time with this condition surgery will be required. There are some that are lucky and it can be fixed with a harness or brace. Write out your questions so that you do not forget to ask them. Ask questions about the procedure that is necessary for the correction.

Posted on December 19th, 2008 under Information, Tips and Tricks | Comments: 3

She is a Typical 2 Year Old After Her Surgery

I thought that life would be different for Natalie. I thought she would probably not be as active as other children her age. I was even prepared for her to be happy watching other children run by and she would be content to watch. I had a lot of thoughts about what having surgery and hip dysplasia would do to a small baby who was even tempered and quiet. Boy, I had another thing coming. I only have one word that truly describes our two year old and that is crazy.

She is not only active; she is more active than other kids her age. The girl is every where at one time. I thought well she might not ever run very fast, but that’s okay she will be able to walk with out hurting. The girl can run, and she can run faster than most kids her age. She has endurance, determination, and a temper to push her through what ever obstacle is in her way, which most of the time is her big sister who is six years older.

She is constantly on the move. She always has some where to go. She always has a plan, if not she will just wing it and destroy what ever is closest to her at the time.

Most people look at me funny when I say she is crazy, but the people that spend time with her all laugh. All of our family and church friends laugh because they know her so well. They know that she can be gone in the blink of an eye. This is not a child that you can let walk next to you while you are out and about because the first time she sees an opportunity she is gone. We have talked about getting her one of those backpacks that look like an animal, but they are really a leash so your kids do not get lost. We need one of those if not two that way we both have a hold on her.

Do not get me wrong, I would not change a thing about her. She has her very sweet moments as well, such as early in the morning. You know when she is jumping on the bed to wake us up on Saturdays. Why do we need to sleep past seven after she kept us up until one o’clock in the morning? She is a night owl like her dad and a morning person like my mom. The two really do not mix well for me since I am neither.

The surgery definitely changed my quiet little baby into a crazy little two year old, but to see her run, walk, play, and be happy was worth every moment in that hospital, spica cast, and brace. I am very thankful for her even though there are times I wonder what were we thinking have more than one kid. Especially, since we will be adding a third one in May. I can only say that she has worn off on us and we are a little crazy too.

Posted on November 28th, 2008 under Information, News | Comments: 2

Oklahoma Orthopedic Recommendations

There have been many question asked about how we choose the surgeon for our daughters surgery and why we choose this particular surgeon.

The truth is we didn’t really have time to search for a surgeon. She had seen her regular doctor one day and then two days later we were seeing the surgeon. The day leading up to this appointment was actually spent in physical therapy for her neck condition called torticullis. This were your child’s head may lean to one side or the other causing their neck muscles to not form properly.

I just showed up with my dad at the appointment not really aware of how serious her condition really was. Her regular doctor was only slightly concerned, so I thought, “how bad could it be?” That assumption was totally off. I wish I had been more prepared. If I had known what the next couple of months would hold, I would have tried to do more research. I probably would have come up empty handed as most of you know there is not a lot of information available on this particular topic.

We were lucky that our appointment was with a very experienced surgeon who has treated this condition for over twenty years with several success stories. Natalie’s surgeon was Dr. Sullivan from OU Children’s Center. When I looked him up this morning I found that he has actually been in practice for 39 years.

I know not every one can see the same surgeon, but I found a web site www.revolutionhealth.com that will help you search for a specific doctor or specialty. They will even give you some information on the doctor of choice. This may or may not help in your search for a good specialist. It was one of only a few that I could find and it was the easiest to navigate.

If you have any questions or concerns that you do not want to post on the site feel free to email us at contact@spicacasts.com.

Posted on November 21st, 2008 under Information | Comments: none

How Common is DDH?

This is the question that I asked when I first found out about Natalie. I had no idea that this even existed in infants. That was until I thought back over the previous years and realized that my sister-in-law had said something about the doctor was going to check her son for a problem with his hips. She simply stated that they were going to try to force his hip out of place. The point was to see if it would come out of place easily. Her son’s doctor really didn’t explain to them what exactly they were looking for. I believe they were looking for DDH because they were concerned with how loose his hip was in the socket. This procedure was suppose be very uncomfortable possibly even painful for my nephew. This is a common practice that a lot of doctors do to determine if it is possible for DDH to be present.

Natalie’s doctor did the normal hip rotation test and never seemed to notice any thing until I brought up the fact that her leg was shorter than the other. I watched her do the same hip rotation that she did in the very beginning and she still did not mention DDH. I believe that is why it was such a shock when the orthopedist diagnosed her with DDH in the first five minutes of the visit. We were given pamphlets on DDH, but nothing that was in depth to really tell you about the condition. It really only stated that she had DDH and the surgery is commonly used to correct the condition. It showed an x-ray of a dislocated hip and a baby in a Spica Cast following the surgery. It did not say what could have caused it, how often does it happen, or risk factors involved. We went into the surgery with very little information available to us. The internet at the time did not really answer very many of our question because we really did not know what to look for.

One year after the surgery we have gotten more information. DDH is more common than most people realize. The numbers are somewhere around 1:1000 infants a year will be diagnosed with DDH. Depending on the age of the child will decide if surgery or a brace is required. Early detection is the key to save your child from the possibility of surgery.

Here are some of the most common causes of DDH:
• Female child
• First pregnancy
• Breech baby (feet at shoulders)
• Caucasian
• Previous child with DDH (possible that it can run in the family)

Children born after previous child diagnosed should automatically be screened with in the first three months of birth.

A few states require that a breech female baby be scanned for DDH before they leave the hospital or with in the first month of life. This condition can alter the life of your child if it is not diagnosed early. In many cases children developed osteoarthritis due a late diagnoses of DDH. I suggest if you have any concerns, you should schedule an appointment with your pediatrician as soon as possible. Do not delay if you suspect that some thing might be wrong.

Posted on May 16th, 2008 under Information | Comments: none