2nd Cast Change: Goodbye, Spica... Hello Petrie Cast!

Today was our daughter's second cast change and third OR appointment overall.  Preparations were a breeze for this appointment.  I hesitate to use the term "routine," but with three of these under our belt, we have certainly built a sense of familiarity by now.  Admittedly, I feel both comforted by and resentment toward that familiarity.  

My husband and I often have restless sleep the night before her procedures.  Anytime general anesthesia is administered, there are risks and a parent cannot always turn off those nagging worries of "what ifs."  As we walked into day surgery today, I could not help but think of my fellow support group members. One member is a 15 year old who has had nine surgeries to correct her hip dysplasia, to include a record for the largest and heaviest spica cast.  Another is a mother whose child just received a bone graft from a cadaver to help reshape her hip socket.  Yet another is a mother who recently banked four pints of blood for her daughter's surgery, as some of the more advanced pelvic procedures carry a 25 percent chance of hemmorhage.  Our worries pale in comparison and perhaps mine are a bit shallow... but today it was our daughter in the OR.

Hip Chick did her best to turn her pre-op area into a jungle gym.  We received a sock monkey which looks to be one of Emily's Monkeys, pictured above.  Emily's Monkeys is how the family of a young girl diagnosed with juvenile dermatomyositis (a rare auto-immune disease affecting three out of one million children) is giving back for their experience with Scottish Rite.  The family makes sock monkeys in bulk and donates them for Scottish Rite to give children just before their OR appointments. We danced with her sock monkey in pre-op until the "goofy juice" took effect and they wheeled her out.

While we usually busy ourselves with breakfast during her procedures, we had a brief detour today.  We agreed to participate in a genetic study and each supplied two vials of blood for research (including two vials drawn from our little hippie in the OR).  Currently, there is no firm medical data to tell us exactly what causes hip dysplasia, but there is a theory that it has a genetic component.  The study we agreed to participate in will help researchers in their quest to (dis)prove the theory.

After a trip to the lab and the cafeteria, we returned to day surgery to receive very good news!  Her femoral head appears to be in socket and her legs and hip are ready for a less conservative position.  So, goodbye, spica cast and hello, petrie cast!   Much to our surprise, instead of a low waist... there is no waist!

The petrie cast will help relieve her hips and legs from the atrophy which has set in during the past three months.  It will enable us to use normal diapers (no more late nights making diapers!!), dress her in shirts and dresses her actual size, and use a regular car seat.  And she will only be in this cast for approximately one month, as opposed to the six or seven weeks we were expecting in a third spica.  Mommy and Daddy are thrilled!  We have not seen those little thighs in four months or her little belly button in three.  I made sure to give her legs a kiss before we discharged home!

Most importantly, the cast can help her to relearn how to walk.  Her surgeon advised that some children are walking by the time the petrie cast is removed.  If the past three months are any indication, we expect that she will, too.  

So... what now?  First, she was discharged with a narcotic pain reliever to help with any nerve, muscle, or joint pain from repositioning her legs and hips.  So, she needs to move past the discomfort.  She will wear this cast for approximately one month and then we will see what her hip can do.  Is she guaranteed to avoid future surgeries?  No.  Does she have a shot at a best case scenario?  You bet.  

At this point, the determining factor will be whether her hip socket remains too shallow to withstand normal mobility.  If that is the case, we will progress to an open reduction- possibly as early as this fall.  But for today, we celebrate the sight before us.  Looks like a little of this weekend's fairy magic found its way to our baby girl after all.