It is here! Our daughter is in her last five days of her second spica cast. This is her 13th week of casting to date and 17th week of immobility. Her next procedure is on Monday morning.
Monday's agenda is similar to her first cast change, with a slight caveat. As before, she will be placed under general anesthesia. Her cast will be removed and an arthrogram completed. If the imaging is favorable, they will recast her and send her home for a final six to seven weeks of casting. If her imaging is unfavorable, she will remain uncasted and an open reduction (open hip surgery) will be scheduled.
The difference is that there are two possibilities for her casting position. If her surgeon opts for the most conservative position, she will be casted the same as her first two casts. If her surgeon determines that her hip is ready for a less conservative approach, she may not be in a spica, per se. The height of the alternate cast would drop to a more natural waistline and her legs would be casted nearer together, in a more natural "sitting" position, with a firm bar connecting them.
Below are additional thoughts:
1. Several posts seemed to center on cast condition- how has it held up?
The duct tape at her ankles and torso opening made all the difference in protecting her skin and cast alike. The inner, front torso lining ripped again just under the duct tape line. This time, I left it alone. By the time it ripped again, she had only one week left in the cast.
2. There was one diaper leak in the first cast and none at the mid-cast update for this second cast... what's the score now?
Unfortunately, there have been two more leaks. We have determined the problem: Daddy's fingers are too big to tuck the diaper flat enough to dam the urine overnight. When she lays on her stomach, the cast positions her hips up, at an angle. If the diaper is not flattened against her skin at the bikini line, the urine streams down her torso and leaks out at the chest opening.
The leaks have occurred on the nights my husband offered to take the graveyard shift diaper change so I could get a full night's sleep. Usually, I handle the diaper changes both immediately before our daughter's bedtime and in the middle of the night. Now that we know the issue, it's an easy fix. I may have nearly two more straight months of late night diaper changes and interrupted sleep... but Daddy can round it out with the early morning shift.
3. Does Hip Chick have difficulty with spacial awareness or has she attempted to push her limits too far?
Her teachers once relayed a story of her interest in a specific, toddler-sized car. The first time she requested to play in the car (in her cast), her teacher relayed skepticism, telling our hippie that she could not fit. Hip Chick protested, so her teacher relented... sure enough, it was an exact fit. Despite her young age, she seems to have a good perception of her capabilities- perhaps better than we adults do at times. But she still needs oversight, as she will occasionally take big risks.
4. Prior posts have read as though we are ready for the third cast- any particular reason as to why?
Time seemed to pass quickly with the first cast, due to our steep learning curve and the adjustments we had to make in our daily routines. Our daughter was still home bound for nearly the first half of the first cast, so her return to daycare helped break up the casting period. This second casting period felt stagnant. There were no big milestones, medically speaking, so this seven weeks was more about the reality of everyday life with a (temporarily) crippled child. Should her arthrogram yield favorable results, this third cast will propel us to prepare for life without a cast and answers to very big questions for our little one.
5. Looking back, is there anything we would have changed to date?
My husband and I have still been on only one date night in four months. We had shied away from the idea of using anyone outside the family to babysit due to Hip Chick's special needs. But our usual babysitters are either physically unable to do so or feel uncomfortable doing so for the time being. Some very good friends and neighbors of ours have offered and so it is time we stop fretting about burdening non-relatives. In the meantime, I pulled out all the stops for a DIY upscale dinner a couple of weeks ago just for us two parents... complete with our china!
6. Earlier posts referred to an online support group. Is this still a resource I am drawing from?
Absolutely. At first, I felt a bit deflated by the reality of what the other mothers in this support group were facing with their children. I experienced another, brief grief cycle when I saw the grittier details of what awaits if Hip Chick's current, six month plan fails. But there are some truly remarkable women in this group and it is a great resource to find mentors to aid you through your child's treatment plan. While I admire many of them, I hope and pray I never need to draw from their personal experiences.
7. In summary, what has been accomplished in this second cast?
By Friday, the accomplishments will include: 33 days of daycare, a first haircut, one (short) out of state road trip, an overnight stay at Bubbie's house, an aquarium visit, an attempted dance recital, an attempted first movie, approximately one dozen restaurant excursions, a grocery shopping trip with just Mommy, one birthday party in a park, and two family gatherings for Father's Day. Excursions feel a little less challenging than when we first began taking her out and we believe it is important we continue to offer her socialization.
8. How is her overall disposition?
In general, she continues to be a happy child. But if she feels the need to assert herself... watch out! Those advanced verbal skills have pushed into negotiating and lecturing.
9. How has Big Sister continued to manage her experience with the situation?
She has done exceptionally well. Since Hip Chick has such developed verbal skills, it helps their ability to interact. Big Sis is also embarking on some additional "big girl" milestones of her own these days, which seems to help- as well as daddy-daughter dates. I think it is also helpful to her that she has another home to find solace in, where she doesn't have to experience her little sister's disability (and the lows that can accompany it) on a daily basis.
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