Bryant's Traction- Week 1 Recap

We did it!  We have completed our daughter's first week of Bryant's Traction, and the first week of her approximate 22 week process (in total, for this year) to treat hip dysplasia.  I miss the sight of her walking- the photo above was snapped in the Scottish Rite admissions waiting area moments before her taping.  But we are encouraged in that the first week of her treatments was not as scary as feared.  In fact, our mentor's advice was correct: It has not stolen our daughter's happiness.  

Below are our initial thoughts:

1. Considering that this is an experimental process, would we do this again?
     Absolutely.  Her four week traction assignment is supposed to aid her surgeon in taking the least 
     invasive route possible.  We would do anything to help her medical team achieve this.

2. Do we think Bryant's Traction is working?
     It is too early to tell- especially since we are not clinicians.  We have noticed that her hip is
     "clicking" more frequently now, and we hope this is a sign that her musculature has
     begun to loosen.  At the end of my last post, there are two photos displayed of her "sitting" and
     playing with her feet- she did not do this at the onset of traction.  To be fair, however, we cannot
     say with certainty whether this is due to increased flexibility or simply initiative and boredom.

3. Have we made any adjustments at mealtime?
     Our Hip Chick revoked her high chair a few weeks ago.  She has her eyes set on behaving like a
     "big girl."  Since we do not have the aid of a high chair tray to shield her legs, we have adopted
     what our hippie calls an "ewww towel" or "shoosh towel."  At each meal, we cover her legs with
     a heavy towel to soak up spills and messes.  So far, the only soil on her bandages is from a little
     orange juice dribble.  We have also pulled back the frequency of her eating (she tends to be a
     grazer, which is not compatible to the traction program) and focus on the quality of the
     meal/snack times she does have.  For both her and our household in general, the focus is on
     low-fuss meals. 

4. Do we think our assigned 22hr/day goal is achievable?
     In short- no.  We agree that an aggressive goal motivates us to achieve greatest compliance, but
     the requirement for her to remain upright and out of traction for a half hour after each meal makes
     the 22hr goal impossible.  We do not remove her from traction until her meals are ready to eat,
     and she eats one snack (sometimes none) daily.  Still, she is a toddler and can take up to a half
     hour to eat a meal.  Combined with the half hour reprieve, that equals an hour out of traction for
     each meal. For us to achieve the 22 hour goal, she would eat only two meals per day and
     no snacks. My husband and I agree that 20 to 21 hours is a more reasonable achievement for this
     age range.

5. Has she required special adjustments to clothing?
     Yes.  Her medical team stressed multiple times that she cannot wear cuffed socks, or socks with
     any sort of elastic around the ankle.  We were instructed to either leave her barefoot or to find
     ankle socks without elastic.  I found an adequate solution at Wal-Mart.  Target and our favorite
     clothing stores did not sell socks which fulfilled the requirement.   Her medical team also advised
     that her leg wrappings are warm.  We were instructed not to add leg coverings (we live in Texas
     and are already incurring highs in the 60's and 70's).  She has been perfectly comfortable in
     diapers and long-sleeved shirts or tunics.

6. Has she required special medicines or prescriptions?
     Yes.  We have added a daily dose of Zyrtec to her regimen.  My husband and I are both asthmatics
     and my husband is especially sensitive to environmental allergies.  To help prevent sinus
     infections and/or ear infections, we are using Zyrtec to help minimize the mucus in her system-
     Scottish Rite recommends it more than Benadryl, as it has longer effectiveness and less of a
     sedative effect.  I had also added a liquid multivitamin to her regimen, but she is now refusing it. 
     We are feeding her enriched cereals (Rice Krispies, Quaker Oatmeal Squares) daily and, as she
     will turn two in two months, I will introduce a gummy vitamin early.

7. How are diaper changes managed?
     We change her before each meal and just before reattaching her to the traction device after her 30
     minute reprieves.  For diaper changes in between, we remove her from the unit and change her as
     quickly as possible- I would estimate under five minutes..  Out of curiosity, I once attempted to
     change a wet diaper with her still connected to the traction device.  I quickly decided not to do so
     again. 

8. What/when is the next milestone? 
     She has a check up at Scottish Rite in two days.  It is our understanding that her surgeon will
     attend this appointment.  We should learn whether initial/anticipated results have been achieved. 
     We will learn whether she is approved to remove her good hip from traction.  We will also learn
     whether her surgeon thinks that an open hip surgery (open reduction) could be necessary on her
     surgery date or whether her initial plan of a closed reduction and groin surgery stands firm.  Her
     traction results will be a key determining factor.  If an open reduction is possible, we will be
     educated on the two different types of open reductions and which type her surgeon anticipates
     would be necessary.

9. In hindsight, what would we have done differently for this first week?
     We would have enabled her to utilize her tablet more (photo, below).  We had been so focused on
     family time that her positioning on the floor resulted in a lot of tv glare.  Now, we use our tablet's
     Netflix function to download tv episodes and movies.  Via a lot of trial-and-error, we have also
     found enough games to hold her attention for a while.  The ability to hold the tablet also helps her
     to lay in the most comfortable position possible.

10. How has this affected any pets in our household?
     We have a small dog.  She has attempted to curl up with and/or over our hippie, we believe to
     watch over her.  Our daughter, however, is a bit territorial herself and often shoos our dog away. 
     In turn, our dog curls up on the couch- where she can still overlook our daughter.  Friday, a
     relative stopped by and our dog jumped between him and our daughter, growling and baring
     teeth.  It is obvious our dog understands our daughter is in a vulnerable state and needs extra care.

11. What is her long-term outlook?
     Her medical team has advised that, after her dislocated hip is addressed this year, the next key
     developmental timeframe centers around age four (but could range between ages three and five,
     depending on her growth pattern).  If her hip is not developing appropriately at that time, we will
     discuss another surgery.  In a best case scenario, the 22 week process we are currently in will
     resolve her dysplasia.  In a worst case scenario, she will need additional surgeries every few
     years until full grown.

12. Why didn't we wait until she reached adulthood to treat this?  Why incur repeated surgeries until adulthood?
     It was explained to us that, without early childhood intervention, she could have incurred
     debilitating arthritic conditions by adolescence and could have required a full hip replacement by
     early adulthood.  We are treating now in hopes that she can have a "normal" adulthood and, in a
     best case scenario, a normal childhood.  It was obvious by her gait prior to traction that she would
     have never run had this been left alone.