It was only a 24 hours after Natalie received her spica cast that she would endure more difficult moments. The following day we found out that she had a stomach virus. This was a huge problem. She was making a mess of her cast. I had cleaned and cleaned and it was still gross. I did not know what to do because there is no information on what to do if your baby develops a stomach virus while in the cast. The poor baby was stuck in a cast that was full of you know what. That is when I cried for the first time. I was alone with a baby in full body cast who could not even sit up alone and she was stuck with no where to go. My husband had gone back to work, my mother was gone, my sister worked, every one worked. I felt terrible like I had let her down because I could not stop it or make it better for her. I used the blow dryer on cool air for hours to dry her out. That did not work at all and nothing else seemed to work.
I was so tired already and this was just the first week. I thought how in the world am I going to make it for 11 more weeks. I thought to myself she is already covered in poop, the cast stinks, and I can not make the diapers work. I was about to lose my mind until I remembered that the pamphlets suggest that you use a feminine pad inside the diaper for extra absorption. I thought this is what I forgot to do and this will make it all better. Well I was so wrong that I was out of my mind. This not only made her even madder because it was so uncomfortable, and it did not work good at all. I thought what in the world am I going to do to survive 11 more weeks of this. So I decided I was going to try to use the pads in a different way. I noticed that any extra moisture was going up her back and down her legs. I placed the pads in these areas. This was the best thing that I could have done for her and myself. The cast was no longer getting wet or soiled from extra moisture that the diaper did not catch. The second diaper is supposed to catch the extra moisture but guess what, it doesn’t. The only thing the second diaper does is hide the first diaper. I placed the pads with the cotton side to the skin and used medical tape to hold them in place. It was soft like wearing pants to her. This completely changed the whole experience for me.
It took three pads for one diapering session. Every morning I would change out the pads, but if they needed through out the day they were replaced as needed. I only changed the ones that were wet not all of them. I would cut one in half and place them on the inside of the legs. I would place them so that half was taped inside the cast and the other half was taped to the outside the cast. The other two where placed on the inside of the back of the cast. I would feed them through from the top and out the bottom. I would then tape them in place on the outside of the cast. This keeps them in place so that they do not fall off or rub her back causing an irritation. You can also spread butt paste to the ones on the back to keep her skin from getting irritated from sweating. The morning diaper change will take about ten minutes if not more to complete, but it is well worth the time.
I figured this method out about the time that the stomach virus was over. The stomach virus lasted like two whole weeks. I think some of it was linked to the anesthesia. I wished there had been this information available to me because it would have saved so much heartache. Natalie would not have suffered so much discomfort as well. By the third week she had figured out how to crawl, roll over on her own, and she was completely dry by this time. She still had to stay in the stinky cast for another three weeks, but we could survive the smell that slowly faded over time. A little baking soda on the outside of the cast helped a lot.
I hope that writing out our families experience will help you through the times that are about to come. There are going to be trying time, but just remember that you can and will survive if you remember to keep the baby dry. If the baby is dry everyone will most likely be happy.
When we were getting ready to leave the hospital after Natalie’s surgery she decided she wanted to be held for the first time. I did not realize I would have to be taught on how to hold her.
The cast makes it very difficult to hold them close. The nurse had to show me ways that would be comfortable to her and me. A little time passed and we found out how to hold her comfortably. The cast can make it difficult to hold them close to your chest so that they can lay their head on your shoulder. You have to place a pillow at first under their chest to make it even with the cast. That is how the nurses wanted us to hold her. She did not like to lie down like that at all so we had to find other options. After about five minutes of twisting and turning Natalie was able to find something comfortable for her. This was also something that I was not prepared for. It is hard to not be able to hold your baby close to you like you have since they were born. That was one of my difficult moments.
It was a month after seeing the doctor for the first time about Natalie’s hip that she would have her surgery. They had given us pictures of what the spica cast would look like, but that really does not prepare you for seeing your own child frightened and scared. She was so little and this thing was so big. I was in no way prepared for the shock of how little and helpless she looked. I almost fell apart in the hospital, but I couldn’t or that would have frightened her even more.
Natalie had a rough time with the anesthesia. She would jerk herself awake every few minutes causing her to cry for about a minute then she would slowly go back to sleep. This happened all night long. I read later that in babies the anesthesia can make them feel like they are falling. This was apparently what had happened to her because she was scared when she would wake up. She was probably in pain as well since she would make her entire body jump awake. She also had an upset stomach and was soon being treated for dehydration. Luckily, she recovered the next morning, and we were able to go home as planned. We packed up all of her stuff, and headed home.
We went to see the orthopedic doctor who was the top in his field. The doctor was able to diagnose her within five minutes of seeing her. He sat down next to us, placed her knee together, and pushed them towards her chest. Here it was obvious that one knee was shorter than the other. Her knees did not match up with one another. The doctor sent her off to have x-rays. They came back with proof that a baby can be born with hip dysplasia. I was completely shocked. I was thinking we would go in see the doctor and he would suggest some kind of brace for her legs because we thought that it was her legs. She was slightly bow legged as well. I was not prepared to sit in the room and listen to three different kinds of surgeries that could be used to correct this problem. I still could not believe it when it was time to go and I had to call my husband and tell him that the only solution to correct it was going to be surgery. I was so very thankful that my dad had drove us to the doctor appointment that day. There was no way I could have made it home in one piece. My world felt out of control and scary all at the same time. I had no idea what to be prepared for because I did not know any one who had a child that had gone through any kind of surgery not to mention one that would leave them in a body cast afterwards.
Our daughter Natalie was born on February 12, 2006. She was the average healthy baby that every parent hopes they will be. The pediatrician checked her from head to toe and found that nothing was out of place. At least that is what every one thought at the time.
It was when Natalie was around four months old that we noticed that her right hip was not as flexible as the other. My husband is not flexible at all and we thought that she had inherited this from him. Little did we know that can be a sign of a dislocated hip. I did not even know that babies could have a dislocated hip or hip dysplasia. We did not really think any more about it for awhile. This was our second child, but because our first was the picture of health we did not even consider that there might be something wrong. Actually no one in our entire family really thought that anything was wrong.
Two months later I was playing with Natalie on the floor and decided to measure and see how much she had grown since her last check-up. This is when I noticed that one of her legs was shorter than the other. Her right leg was actually shorter than her measurement from her last check-up which had been a month prior to this time. Natalie’s legs were ¾ of an inch different. She was about six months old by this time. She has an appointment with her regular doctor two weeks later so I waited to for her appointment thinking that it was all in my head. I thought I was a paranoid mother who constantly finds things wrong with children. You know the kind where their children always have the symptoms of every new disease or sickness. I talked to the doctor anyway and found out that I was right it was shorter and Natalie was scheduled to see an orthopedic doctor the following day. Natalie’s doctor also found that she had torticollis.
Torticollis is where one side of the neck muscles will grow shorter than the other side. This causes the head to lean to one side or the other. Natalie was scheduled to start physical therapy for this condition two days later. We would go through three weeks of physical therapy to see no improvement at all. I even did extra therapy to make sure that I was doing my part to make her better. It did not work, but there was a reason why. A study showed that 5percent of babies who have torticollis also have hip dysplasia. We did not know that at the time either and apparently neither did the physical therapist. The physical therapist had no idea why the therapy was not working. After Natalie’s surgery, her neck was perfectly fine. We decided that she was using her head to balance the rest of her body so she could sit up. She no longer needed physical therapy, she needed surgery to correct her dislocated hip.
This stomach virus was our first trouble or obstacle to tackle. It is recommended that you change your child’s diaper every time they are wet. That means about every hour when they are this age, but with a stomach virus it could be every fifteen minutes. I know that sounds crazy, but I have been there. The hardest part was keeping the cast dry. A stomach virus makes that completely impossible with out the proper precautions. I am going to tell you what no one told me to do and it was what saved me and Natalie a lot of pain.
The most important thing for your child is stay dry while in the cast. If the cast becomes wet, it can cause it to break or a rash can develop. Breaking the cast means it will need to be replaced and the risk of the hip coming out of place. Moisture in the cast will also cause the skin to become irritated. This can lead to a severe rash which we unfortunately found out. Dressing your child too warm will cause them to sweat making the skin wet and more likely to break out. Natalie had a severe rash due to her Halloween costume that caused her to sweat too much. She had small little blisters from the cast on her back. This could have been prevented if I had better information on how to keep her dry.
I used Stayfree Ultra Thin feminine pads to soak up any extra moisture inside the cast. I lined the insides of the legs and the back side of the cast with these pads. I cut one pad in half to fit on the inside of the legs where you change their diaper. I placed two whole pads on the inside of the back so that the soft side was against her skin. I used medical tape to keep it in place. I also placed butt paste on the pads if I thought that any of her skin was irritated. I changed them once a day in the morning or before bed if needed. I used this method to prevent any leaking from the diaper to stay on her skin. Most of the pamphlets recommend that you use a pad on the inside of the diapers, but this was uncomfortable and really did not work as well. It took a while to figure out the best placement, but Natalie’s second cast was completely clean when they removed it. The first cast was not clean at all. It smelled very badly because I did not have good information. I hope that this will help any one else who is about to take the journey with a child in a Spica Cast.
On October 18th 2006 Natalie was scheduled for a procedure called medial open reduction. This surgery would require the doctors to remove the muscles attached to the top of her femur. They would then place the leg in the proper position with her hip. See, infants do not have the ball at the top of the femur to hold the leg or hip in place. This part of the joint develops later around 18 moths old. The muscles are then reattached to the leg in the proper position. The Spica Cast is then placed on the child to hold the hip in the best position for the growth and strength of the newly attached muscles.
The surgery itself was not the difficult part to handle. Though there was a lot of swelling and bruising around the incision. It was simply the fact that she could no longer move the entire lower half of her body. She had just learned to crawl, pull up, and walk along the furniture two weeks prior to the surgery. It broke my heart for her to have that taken away, but I was extremely grateful that this surgery would give her a chance for a more normal life. If she had not had the surgery she would not have been able to walk with out having pain for the rest of her life.
The doctors told us that she would learn to adapt to being in the cast, but that it would be us, the parents, who would be mad at the world for the next three months. They were so very right. It only took Natalie about 10 days to figure out how to pull herself around in the very heavy cast. I think that she would have figured it out sooner had she not been sick with a stomach virus for the first two weeks. Something that is very important to remember: do not let anyone who has had a stomach virus around your child after being placed in a Spica Cast. This will make it very difficult to care for them because of trying to keep the cast dry and clean. It is pretty much impossible if they develop a stomach virus.
The purpose of this post is not to scare anyone. It is just to tell you what I saw and how I felt at the initial phase of Natalie getting her spica cast put on. I went into the whole thing pretty calmly as I think most men do. I am naturally an optimistic kind of person so I felt that dealing with the whole situation would be rather easy for me.
Unfortunately, it was far from one of the easier things to see. They took Natalie and when they got done with the surgery we were able to see her for the first time. She did not appear to be in as much pain as she was just scared with the nurses and mama and daddy no where to be seen. As soon as my wife held her she seemed to calm down a bit.
However, it was hard for me to see my daughter in a spica cast. The thing seemed so big in comparison to her it was really kind of scary. I got a little teary eyed when I saw her for the first time with it on. It certainly is true that it is probably harder on the parents than it is on the child at that age.
The night was not so great either but I think it primarily had to do with the anesthesia wearing off. I guess it affects people differently but for Natalie she kept jerking and waking herself up. So basically every couple of minutes she would jerk as if something had startled her and would cry for another 30 seconds until she was able to go back to sleep. This was rough on my wife as she spent pretty much all night next to the bed.
Things quickly got better for Natalie as she began to get used to the idea of not being able to move her legs. I know it was hard on my wife who did the majority of the diaper changing which seems to be an all too regular occurrence when trying to keep the cast dry. In the end though, Natalie coped very well and with a little bit of a learning curve, we learned to cope with it as well.
Welcome Parents! We hope you find a lot of resources and information about Spica Casts and how to care for children who may have hip dysplasia.
