Post Osteotomies: Week 2 Recap

Today ends our Hip Chick's second week post-surgery.  Wahoo- two down, 10 to go!  It feels as though she has turned the corner.  She has weaned off of pain meds and is eager for activity.  Below are our recent thoughts.

1.  Hip Chick's bed rest restrictions were lifted last Tuesday- how is her mobility now?

She has begun to crawl on the floor again.  The shape of this cast makes crawling more difficult.  The stability bar provides carpet drag and her legs' position makes her "crawl" with straight arms and on flat hands, as opposed to army crawling on her arms and elbows.  She begs to walk, but the cast shape makes this nearly impossible.  With the stability bar, she can balance a bit on her shins.

2.  How are her sleep patterns?  

They are somewhat erratic.  We have begun to keep her up rather late for her age in attempt to avoid a 3:30am wake up.  This is likely due to her drastic reduction in physical activity.  Two years olds love to be active and her cast provides a lot of restriction.  We are hoping a return to daycare will help tire her.

3.  When is she returning to daycare?

We will attemp to reintigrate her into her class tomorrow.  Her surgeon lifted mobility restrictions last Tuesday, she is off pain meds, and her swelling/bruising has receeded.  These were the cues we were looking for to reintroduce her to her childcare environment.

4. Have we continued to take her out of the house and have we used the wheelchair?

Unequivocally yes!  Mommy and Daddy have taken her out for two more meals (see top photo, above) and Mommy took her on a shopping trip with an extra helper.  The shopping trip had three stops and we had no issues (dis)assmebling the wheelchair for each one.  As mentioned in a prior post, the wheelchair was the best decision we made for this phase of her DDH journey.

5.  How is she adjusting to the wheelchair?

She is starting to insist that she push her wheels on her own instead of us pushing her.  She is still rather slow, but she is very independent and proud!  She insists on retaining independent mobility however possible- it just looks a little different now.

6.  What are we using to fill her time at home, now that this spica offers the least mobility thus far?

We recently received a handful of puzzles and a doodle pad as gifts.  These are fantastic tools to enable independent play and stimulate her intellectually.  She continues to be interested in giving "check ups" and talks about being a doctor.  In fact, she seems to have swapped her repetition for tea parties with check ups.  A new "Lambie" doll (from Doc McStuffins) has also driven the medical role play interest.  The ability to take her on outings with the wheelchair is of great assistance.

7.  How are we dressing her?

She is two years old.  If the clothing has a tight fit, such as Old Navy tshirts, she is a size 4 or 5.  If the clothing is loose and breezy, such as flowy dresses or tunics, she can wear a size 2 or 3.  To protect her feet at daycare, she will wear shoes- but we keep her barefoot at home for now.  The climate in which we live still offers highs in the 80's and the cast keeps her rather warm.

8.  What do we find especially helpful at this stage in her plan of care?

Wheelchair aside, we pulled out the oversized, sparkly lapdesk from her traction days.  Mommy is stretching time between hair washes with dry shampoo or leave in conditioner, as needed.  

9.  What do we find especially challenging at this stage?

Her erratic sleep patterns are challenging for the entire household.  She has also been more temperamental in this cast and needed much more cuddle time.  The cast adds additional complexity to the trials of the "terrible twos."

10.  How do we fix her hair?  She appears to be reclining or using a headrest all of the time.

I balance her in my lap.  

11.  Due to her age, will we try to potty train her in the cast?

We will wait until she relearns how to walk again.  

12.  What is her next milestone?

She will have a cast change and arthrogram in late October.

Mommy-Daughter Outing

Today was my first solo outing with Hip Chick and her new wheelchair.  I felt less apprehension over this excursion than the one described in my Cheeseburger in Paradise post.  For that experience, I had to carry her, her portable booster, and my handbag.  Due to the limitations of the booster, I was afraid to leave her side for even a drink refill, lest she tip herself over.  For today's outing, I could push her in the wheelchair instead of carry her, plus she was secured with a sturdy seatbelt.  The wheelchair assembly took a few minutes, but it was worth it!

Hip Chick was in a chipper mood, thanks to a well-timed nap.  A portable, dry erase coloring kit provided us with entertainment until our lunch arrived.  Mommy was also wise enough to select a restaurant with wait service, to avoid any need to leave the table.  After eating, she decided to give her new chair a spin.  She has been playing with the wheels at home and this outing was her big break.  She managed to back herself away from the table and wheel herself past Mommy and far enough to gain a closer glimpse at an ice cream cone picture she was eyeing.   A stranger complimented her on how well she turned her wheels.

Afterward, we made a stop at her daycare.  Mommy wanted to chat with her teachers to plan for a return, but it also helped for our little hippie to see everyone before the big day.  By the end of our visit, she was a little fussy- a good visit, but time to return home.

This gives Mommy encouragement regarding future outings.  Carrying a casted toddler everywhere is one thing- pushing her in a wheelchair is an entirely different situation.  I can do this!  So... where to next?

Osteotomies: Post-Op Checkup

Today was our daughter's post-op appointment, from her salter osteotomy and femoral shortening early last week.  Despite a ragged disposition during her xray, she received an A on her progress.  Her surgeon could see early signs of bone healing and all is still in place- the hardware and cast are doing their job.  Her swelling has receeded quicker than expected.  Her bed rest and load-bearing restrictions are lifted, so she can begin test driving the cast!

Speaking of such things, the end of this piece on her right leg, just above the stability rod, had begun to lift.  We ensured this was reinforced prior to leaving.  After the petrie cast wobble of July, we wanted this addressed prior to letting her loose on the floor.

We celebrated with a stroll though our local mall.  She enjoyed a yogurt smoothie as we gave her special chair its first spin in a public space.  She especially loved a famous doll store, filled with babies and "big girl" dolls alike.  We followed with lunch at a nearby restaurant.  We selected the restaurant partially because we knew it would be easy to navigate the wheelchair in it.  Success!  Her first outing in her special chair.

We recently received a generous gift basket, to include a collection of 10 small board books about feelings, box pictured at top.  They are designed for Hip Chick's age group and very smartly written.  The book on anger was particularly interesting to me.  The little turtle above reminded me of how she cried all night after her surgery about "being stuck."  She was a little like this turtle while admitted, on her back and unable to move.  

The birdie above reminds me of her disposition at present.  She has been begging to play in her toy kitchen and host tea parties.  She wants to do things for herself that she cannot quite do.

I hope to help her expand on the "brave" book.  It is apparent that this phase of her hip dysplasia journey will require more emotional maintenance and assistance with verbalization.  The page below may speak a little to each of us in some way, as Daddy, Big Sis, and Mommy each had their own fears about this next round of surgery and casting.

With the hard work of the past eight days behind us, however, we can do anything!

Lastly, we must bid our newfound love for patterned duct tape adieu.  As it turns out, patterned duct tape has latex and it is difficult to fully clean latex out of an OR.  As we are not the only family using patterned duct tape as a means to cheer up a spica, it is causing difficulty for children who have latex allergies.  Our daughter's surgeon advised that we would be welcome to use latex-free duct tape if we could find it (did Mommy hear a challenge?), but otherwise we will use other tape for Hip Chick's final cast.  Now to find craft projects for all of the excess patterned duct tape in the house!

Post Osteotomies: Week 1 Recap

Today ends our daughter's first week after her salter (pelvic) osteotomy, femoral osteotomy, and open reduction.  To recap her journey thus far, she began treatment in February of this year.  Prior to this, her treatment included one month of Bryant's Traction, a closed reduction with groin surgery, two spica casts, one petrie cast, (14 weeks of casting, in total) and a Rhino Brace.  From the onset of traction to the end of her current process, we will have spent 13 months in attempt to correct her dislocated left hip and malformed socket. Below are our recent thoughts.

1.  Hip Chick had difficulty while admitted.  How is her current disposition and what do we attribute it to?
She is still a bit emotionally volatile, but her disposition is much improved.  Despite the cheeriest of environments and the best medical care, a hospital is still a sterile environment.  There is simply no greater comfort than home.

2.  How is her pain management?
It is under control, but she is not yet ready to be weaned off of her pain medicines completely.

3.  Has she attempted any of her infamous antics yet?
No, not yet.  This experience has been harder for her, but we know she will return to her usual self soon.

4.  Has the diapering process changed?
No.  We are still able to use the same diapering process.  In fact, this cast is roomiest of all!  Once her swelling fully recedes, we may have to go up a diaper size for the inside "tuck."

5. A prior post indicated that her crib was disassembled for this surgery.  What is she sleeping in now?
Her nursery had a convertible crib, so Daddy removed the front crib side and converted it to a toddler bed.  Her feet are casted so wide that she would have no longer fit in her crib.  The mattress is so low and she is so immobile in her sleeping position that we see minimal risk in this arrangement.  We would have preferred a cheerier occasion to give her a "big girl" bed, but we are thankful that we already had this option at home.

6.  She was unwilling to ride in her wheelchair at first- any progress?
Mommy has been playing with fabrics and bows.  One look at the latest fabric Mommy was playing with and she begged to sit in the wheelchair and go for a walk, despite the unfinished product.  (See top photo.)  It's all in the presentation!

7.  The last post indicated a craft project of sorts to give the wheelchair more "toddler appeal."  How did this work out?
Young girls like colorful patterns with shapes they enjoy- or, at least, mine do.  They also like fun details such as tassels and sparkle.  After listening to a friend remark about "no sew" blankets, I decided to give a similar attempt to her wheelchair covers.  There are lots of tassels to play with and Hip Chick was toying with them at her first opportunity.

We'll call it... "orthopaedic shabby chic."  Were I more enterprising, I would knot beads or jewels Iinto the tassels.  Who knows?  We have 11 weeks ahead of us- plenty of time for such things.  In the meantime, a very smart person suggested ribbons on the spokes of her wheelchair.

With Love,

Mom

Drive My Car

Wheelchair.  

Say it with me: wheelchair.  

Repeat it five times fast.  Repeat it until you no longer grimace or pull a knot in your stomach as the word trips across your tongue.

Can you?

We brought a wheelchair home for our baby girl when she discharged from the hospital this week.  For some, a wheelchair contains a stark connotation and difficult associations, but I think it was one of the best things we did for Hip Chick's next chapter.  While I take ownership for pushing the issue as early as a month ago, part of me expected a poorly parodied version of The Beatles' A Day in the Life to subconsciously play as I navigated it around corners or lengthy corridors: "I  pushed the wheelchair today, oh boy..."

Our little hippie's first ride in it was a touchy affair.  It brought her little consolation- even when we brought her to view one of her favorite displays in the hospital.  By discharge the next day, however, she was far more attached to the chair than her first ride foreshadowed and we even spied a meager smile.  Her first ride in it at home, however, was a different story.  Baby girl had a meltdown of mammoth proportions.  And thus began my plight to alter the wheelchair from a sterile,  black-and-white hospital fixture into something with more toddler appeal.  First, the basics.

The wheelchair pictured above has been altered.  As our insurance does not cover wheelchair rentals, Scottish Rite was kind enough to loan us one.  This is the smallest pediatric wheelchair they offer.

The photo above features an arial view of the wheelchair seat as it typically looks, footrests elevated.  You may notice something is missing.  Can you identify the missing piece(s)?

The chair's arm rests had to be removed to make way for the oddly shaped addition above.This is an abduction board.  It provides support for the width of Hip Chick's spica cast- or at least for the width of the bar connecting her shins.  

As arm rests also help hold a person in their wheelchair, it is especially important that we secure her snugly with the chair's seatbelt.  Regardless, Daddy and I are grateful and relieved for its presence.  We can't take a wagon into a restaurant or bookstore, but we sure can take a wheelchair!

Big Sis is with us this weekend and has begged to push Hip Chick in her wheelchair.  I thought both girls could use a dose of fresh air and sunshine this morning, so away we went.  The cover for baby girl's wagon was made with such quality and care that I thought we should make every effort to utilize it with the wheelchair.  Our little hippie instantly took to the chair in its fancy new cover.  After our excurion, however, it was apparent that we needed to save the cover for the cold days ahead and find an alternate solution for the volatile Texas fall.

Enter Mommy's newest craft project.  I shopped for oversized pillowcases and other options today, but brought home two fabrics:  the "flower power" pattern above (what else is more fitting for a hippie chick?) and a Minnie Mouse pattern.  I have yet to fully flush out how to apply these to the chair, but I view it as an unknown to conquer.  Cheer up a wheelchair for a girly, sparkly, vibrant toddler?  Challenge accepted!

Discharged Home

We are home.  Obviously, no one is more relieved than our baby girl, but Mommy is a close second.  This was not our easiest experience and most of our difficulty was attributable to Hip Chick's personality and age.  

At nearly 2 1/2 yrs of age, Hip Chick was old enough to be aware of what was occurring to her, but too young to comprehend it.  This added complication to tasks ranging from dosing medicine to positioning to labs and clinical assessments.  Mommy was especially affected by repetitive, middle-of-the-night cries of "I am stuck" and "I need help."  This resulted in two very sleep-deprived and stressful days and nights, with marginal improvement on the final day.  We were most surprised at her refusal to participate in Scottish Rite's weekly pet therapy yesterday morning.  Two adorable, small dogs were brought to our room to play and she wanted no part of their snuggles- a far cry from her cheers to romp through the dog park last week.

During her surgery, I had spied a collection of fairy figurines.  While these types of occasions don't exactly warrant a "collectible," I thought it a charming idea to provide a treasure from the collection for each of her big procedures- more as a reward than anything else.  She has developed a bit of fandom toward faries and mermaids, so this seemed to be a perfect "first collection" for her.  Thanks to a couple of trips to the gift shop, Hip Chick now has the three above, for her bravery during traction and each of her surgeries thus far.  

Despite the description of her hospitalization above, the transition home was far easier than anticipated.  She relaxed while watching her favorite movie with two new friends.  This was followed by a peaceful three hour nap.  After waking long enough for a fruit smoothie and extra fluids, she settled into her room and slept seven hours overnight.  

Today, it feels like our daughter has started returning to us.  She took her new, grape-flavored pain medicine with a big "AHH" this morning and enjoyed a small breakfast.  She insisted Daddy let her kiss him before he left for work.  We have a lot of work ahead, but hold high hopes now that the surgery and hospitalization are behind us.

Open Reduction, Salter Pelvic Osteotomy, and Femoral Shortening

It finally arrived.  The much-dreaded date of our daughter's "big surgery."  We worked hard to prepare Hip Chick as positively as possible this past week: numerous Hope the Hip Hippo readings, reviews of photos of her smiling in her first three casts, and her pre-op visit made preparing her for the experience much easier than preparing ourselves.  Mommy and Daddy's nerves provided a three to four hour catnap of sorts in place of sleep and, while I cannot speak for Daddy, mine were frought with nightmares.

Despite the early wake up, our little hippie held no shortage of spunk for her 5am admittance.  She was in a particularly chipper mood as she greeted staff members.  After donning her hospital gown, she was excited to walk the halls with Daddy- especially when she spied the carousel horse she loved so much from her first surgery.  When it was Mommy's turn to accompany her on a walk, she asked to sit and read.

When it came time, we cheerily told her that she was taking a special princess ride down the elevator.  She drank her dose of "goofy juice" and gave us high fives.  She and Mommy sung the "Choo Choo Soul" (Disney Jr) theme song as her nurse pushed her bed to the elevator.  We rode down to OR holding and met todays team, some of whom were familiar faces.  When asked her name, she proudly announced both her first and last names for all to hear. As the medicine took effect, her first name grew longer and longer, until she was announcing a first name of nearly a dozen syllables and plenty of giggles.  Neither frown nor tear crossed her face until they pulled her down the hall and around the corner for surgery.  Such a brave girl.

It was at this point that I cried like a baby.  Daddy gets the "strong backbone" award of the day.

And so began our routine.  While this was Hip Chick's second surgery, it was her fourth trip to the OR since this process began last February.  Cast changes are such an involved procedure that they require general anesthesia.  The buzzer above is becoming a rather familiar companion and, in a best case scenario, we will see it two or three more times after today.  We scooped up the buzzer and hopped downstairs for breakfast, then returned to her room to read and wait out the surgery.

We received a buzz roughly a half hour after she went to the OR.  They confirmed that all began well and we would receive an update in two hours.  Our second update indicated the first half of her procedures were complete, she was doing well, and had incurred minimal blood loss.  Five hours after she was taken into the OR, we receives the update we were waiting for:  she did great!  Everything occurred according to plan.  

So what did her surgery entail?  They performed a femoral shortening, meaning they cut her femur completely through and removed a centimeter of length.  Her femur is now held together with a plate.  They performed an open reduction, meaning they placed the femur into socket with the hip surgically opened.  They performed a pelvic osteotomy,  specifically a salter (there are various types of pelvic osteotomies).  For this, they cut through the pelvic bone on the left side and rotated it down to help round out her malformed socket.  This is also held together with hardware.  Lastly, she is back in a spica cast... and a different form than anticipated. 

Her recovery room nurse (who has previously cared for her in day surgery recovery) remarked on how well she did waking from anesthesia.  Our little hippie was able to converse far better than expected for her age.  She never ceases to impress.

And now to begin the recovery process.  When I explained to her on Saturday that she would have a new cast, I took a tip from her book and advised that her legs and hips needed to rest, so they can grow strong.  Strong she is and strong she will be.

Turn the Page

This is my 100th blog post.  I wish this could be a celebratory post, but it is ill timing for much fanfare.  The timing is significant, however, in the sense that we are on the cusp of a new chapter in Hip Chick's journey- and it so happens to coincide with one of the most meaningful holidays of the year for our family.

We spent this past week nailing down lagging details, which gave space for us to observe a religious holiday at week's end. In this instance, holiday observance meant fasting.  Admittedly, I have been rather upset with G-d this year and may have attempted a bargain or two.  I found it an injustice that an innocent child should have to experience such hardship due to issues out of her control.  I wished (okay- maybe I begged a little) that somehow I could swap her hip for my own, so she may be as active as she desires.  I protested to G-d that, at age two, she belongs in dance class and on playground slides... not in spica casts!  With that said, I cannot verbalize exactly what my fast was about this year... but it was not entirely about myself.

We attended our annual family dinner after fasting.  Of course, Hip Chick is too young for such things and was in a much spunkier mood than we adults before mealtime.  We arrived early and took a stroll down a nearby pond to feed ducks, which is one of her favorite activities.  I wanted her to enjoy as long of a walk as she could handle coupled with this favored activity while she still could.  Later, she was treated to her great-great grandmother's cheese blintz recipe with blueberry sauce.  A sweet start to her new year, indeed- if only it could remain that sweet for her.  Perhaps it is better wished that her year will end as sweetly.

This morning, Daddy and I drove Hip Chick and her trusty dog to their favorite dog park.  The heat is finally breaking and the park was full of tail-wagging friends to enjoy.  After a little exercise, we dropped off our furry companion and enjoyed brunch with our hippie at our favorite diner.  Baby girl squealed when her pancakes arrived, which prompted Daddy to remark that we would miss mornings such as this in the coming months. After pancakes, we surprised her with one last bit of fun.

As we were considering what else to do for her before surgery, the question had come to mind: "What activity would no parent in their right mind do with a child in a spica cast?"  One answer stood out above all others: 

Chuck E. Cheese

We arrived early enough that Hip Chick could enjoy all of the seizure-inducing lights and sounds without much competition.  She rode a swing around a giant clock.  She bounced balls into jugs for tickets.  She threw down levers to launch pigs into space.  She danced with a "real life" Chuck E. Cheese and other kids during the floor show.  Her favorite activity of all, however, was riding in the car above.  We let her do so as many times in a row as her heart desired... which neared 20.  Daddy earned enough tickets to win her a bracelet and stickers from the prize counter.  So much fun... she fell asleep during the drive home.

And now for a hefty dose of reality.  We have bags to pack and a crib to disassemble.  We have a too-long, extra splashy bath with twice-scrubbed hair to host... which reminds Mommy: time to pull out the dry shampoo.  What is most unusual about today's preparation is a thorough scrub with the cloth pictured above.  It is one of the nagging reminders that this surgery is of greater significance than Hip Chick's experiences to date.

It is with a big sigh I also write that there are diapers to assemble.  Years from now, when this is far behind us, one of the hallmarks of her spica cast phases will be the nights of cutting off diaper tabs and halving menstrual pads for her spica cast diapering.  The most unexpected, odd things characterize life's chapters, don't they?  We aren't entirely certain what this next chapter holds for our young daughter... but it's time to turn the page.

Pre-Op

Today was Hip Chick's pre-op appointment and what a day it was!  This was a far more extensive pre-op experience than for her closed reduction (rightfully so) and resulted in a five hour affair.  First, however, a bit of play was in order.

Scottish Rite provides an inviting, colorful playground and Hip Chick has begged to romp in it all year.  Mostly due to her traction, surgery, and casting, the answer has always been no, so today seemed to be her best opportunity.  Mommy also suspected a little play would help soften her for the long day ahead, so we arrived a half hour early. 

She drove a choo-choo train and played "peek-a-boo though playhouse windows.  She slid and climbed.  She soaked up a little extra morning sun.  Best decision to start her day with a little joy.

We popped downstairs into the newly renovated admissions area.  We hardly had enough time to appreciate the installation of their animated mobile before we were whisked away to our series of appointments.  

After completing standard paperwork (consents, privacy notices), we progressed to Radiology.  Hip Chick was in a chipper mood and insisted we march to our destination.  After a brief wait, she impressed all with her best behavior during xrays to date!  Neither tear nor tantrum was shed (Mommy suspects it may have been the Curious George cartoon playing in the room).  Her imaging showed little change in her hip's condition since July- all parties were unsurprised.

Phlebotomy was a different story.  I often joke that the one piece missing from those "What to Expect" pregnancy and parenting books is the not-so-tiny detail that being a parent means you have to help restrain your child for the scary medical procedures.  For Hip Chick, this usually means two to three people using all of their strength to hold her for xrays.  Today, this meant me holding her in my lap and restraining her free hand and torso during blood draws.  She earned a half dozen sheets of stickers for that stop.  Three vials were drawn, for a complete blood count, blood typing, and blood bank.  As she is too young to bank her own blood and it is unsafe to bank an adult's blood for someone her age, the hospital will have a small amount reserved for her from their bank.

Our next stop was a consult with her surgeon.  We revisited the surgical plan, discussed expectations, and explored risks.  We were thrilled to learn that she may not require the straight-leg spica... she may be casted in a different type of "bent leg" position.  Of course, nothing is certain until her surgery, but we would be relieved if she was able to sit up by any means!  

Her two biggest risks are:

1) The need for more surgery

2) Avascular Necrosis, or AVN

AVN is the disturbance of blood flow to the femoral head.  Her surgeon explained that over 50 percent of children who have these surgeries experience AVN to some degree, but that younger children tend to experience better outcomes with this.  A worst case scenario

includes the need for surgery to address damage to the femoral head from AVN.

After our clinic visit, we stopped by Pharmacy.  We discussed any recurring medications and pre-ordered what we want them to dose while admitted, to include any over-the-counter medications.  This was followed by a conference in Anesthesiology.  We discussed her medications, medical history, and the anesthesia plan.

Next, we progressed to the actual room she will stay in during her admittance.  We thought it a smart practice on behalf of Scottish Rite to allow her time for exploration.  She pushed all of the buttons she wanted to, climbed on and off her hospital bed as many times as she wanted, and roamed freely.  She exclaimed to us about the tall buildings outside her window.  It was ideal timing, as Hip Chick was growing ancy and needed to burn energy.  

We paused long enough for lunch in their Crayon Cafe.  Daddy and I have eaten breakfast on site several times, but only one lunch.  They offered an array of wraps, paninis, pastas, stir frys, salads, soups, pizzas, burgers, and desserts.  Dietary also reminded us that patients can order breakfast all day.  How could anyone go hungry there?

We returned to her room and met with her nurse, Dietary, Child Life (Play Therapy/Psych), and Occupational Therapy.  As she may be admitted for up to three days, their playroom will be open to us twice daily.  They also have animal therapy once weekly and will bring a dog to play with her on her third day, if still admitted.  Lastly, they requested a short list of her favorite toys to have them ready for her- she will be able to listen to music and have tea parties to her heart's desire!

Occupational Therapy measured her for a wheelchair.  We are undecided between the wagon or wheelchair, so they will let us decide after surgery- but at least we know a wheelchair will be on reserve.  

After this extended carousel of introductions, conferences, and arrangements, we capped off the day with another visit to their playground.  Mommy and Daddy were so proud of her today!  She was rather relaxed during nearly all of the poking she received today (save Phlebotomy) and was asking for personnel to listen to her heartbeat by the day's end.  Such a brave girl.  Soon, she will be tasked to be brave again... it may be hard at first, but she will do great.

Post-Casting: Two Month Recap

I am nearly a week late on recapping Hip Chick's second month post-casting, partially because it is bumping up against her second surgery.  We do our best to celebrate all of her achievements, although it has been rather bittersweet these past few weeks.  Below are our recent thoughts:

1. Prior posts indicate that Hip Chick regained mobility quicker than anticipated- what does her mobility look like now?

She has been out of her cast for nearly 10 weeks and can crawl, walk, spin, and climb.  She tries her best to run and jump, but cannot- much as before.  

2. How is her disposition?

She is a happy, silly, boistrous, passionate, opinionated, smart, musical girl.  We can safely say that she overcame the past seven months with joy.

3.  Is she aware that another surgery and cast lie ahead?

We have not explained to her directly what is around the corner, but she has been present when the topic has been discussed.  So far, she shows either no awareness or no concern.  Due to her age, we will not fully explain it to her until a day or two prior.

4.  How do we anticipate she will react?

It is reasonable to expect that she will be unhappy.  To help reintroduce the idea, I read our Hope the Hip Hippo book to her tonight.  Afterward, I asked her whether she thought Hope was happy or sad in her cast.  Then I asked whether Hip Chick was happy or sad in her casts.  She responded "happy" to both.  Perhaps these responses are an encouraging foreshadowing of what is to come.

5.  Has she shown any signs of discomfort, despite the regained mobility?

Twice this weekend, she had a small tumble and cried "it hurts," pointing to her left hip.  This was highly unusual and perhaps Mommy is hyper-sensitive to such things.  Otherwise, she has no discernable issue aside from her pronounced limp.

6.  What do we expect will be different about this next recovery and cast?

Plenty.  First, the past surgery was minimally invasive.  This second surgery will be anything but... and so we expect pain management and her discomfort level will be different than before.  Second, we will have to adjust our diapering process, as her positioning will be different.  Third, she will have fewer options for positioning than before- we may discharge with a reclining wheelchair to help maneuver her through the house and/or provide her with a seating option for mealtimes.  Because of the positioning restrictions, we will be unable to take her to restaurants or on outings as we did in prior casts.

7. Will the upcoming surgery fix her hip?

We certainly hope and pray so... but there are no guarantees.

These Are the Days

Today was our family's last day out as a foursome until mid-November.  Hip Chick's surgery date is drawing near and anxious thoughts have begun to seep in.  We took advantage of a free morning to roam our favorite museum.  

The sisters revisited the best exhibits.  Big Sis learned how to hip-hop in the dance lab...

Little Sis played on the keyboard in their sound lab.

Everyone enjoyed learning about metals, minerals, and gems... Mommy was especially taken with this ammolite fossil.

We spent the most time amidst the dinosaur skeletons.  Hip Chick was so thrilled that she would stop, spin in circles, and exclaim, "I'm excited!"

The sisters bid the museum farewell with a song on the outdoor xylophone.

We capped off the outing with a trip to one of the city's best custard shops.  Hip Chick enjoyed her blueberry custard, but may have preferred Mommy's pistachio custard more... Big Sis and Daddy were very satisfied with their cookies & cream custard and "Captain America" shake.

Big Sis admitted to us last night that she is worried about her little sister's upcoming surgery.  We learned that she told her classmates about it on her first day of school and wrote about it in her journal this week.  She also told us that she was glad we visited the museum as a family today, since we will be unable to do such things for so long.  

I wish I could rip away that worry for her, for us- but the best gift we have are the memories we made over the past two months.  Those are the days to remember and, drawing from Natalie Merchant's hit song, we felt in many special moments that we are "blessed and lucky."  As for the handful of days fast approaching?  I hope they speed by and blind our senses.  At least until our baby girl is home again after surgery.  I am confident that we can make the best of our situation after that.

Lessons Learned

With a culinary project brewing (see prior post), I channeled those energies into treating my hubby and kiddos to a special breakfast yesterday morning.  For those who share our religion, this is a special time of year and I snagged a spiral form of our favorite bread from a local bakery.  I seldom make French toast and pan fry in butter on even rarer occasion, but thought it would be a fun start to our week.  Our skillet sizzled and popped with buttery, egg-crisp, vanilla and cinnamon goodness while the girls circled my kitchen like great white sharks, ready to leap at a moments' notice for a yummy morsel.  

As this is also a contemplative time, I thought it appropriate to share some of my strongest lessons from the first eight months of our family's journey with Hip Chick's hip dysplasia. This is an ode to her, as the most surprising of persons have relayed to her father and/or me that she is of significant inspiration to them.  It blows me away at times to hear how her story and disposition remind them of just how good their life is- that their troubles don't seem so serious when a young child with her obstacles can be so happy-go-lucky.  

Sometimes we can be too close to a situation to appreciate the full scope of its impact.

And so, Mommy's lessons:

1.  Life absolutely does change in a single, unexpected, ill-prepared-for moment.  

2.  One cannot fathom all we take for granted until it's temporarily lost or gone... but children are too young to fully grasp this.  They truly are more resilient than adults.

3.  You can find or create cheer in difficult or dark situations if you so choose.

4.  Children adopt no sunnier of a disposition than you model for them.  It is very achievable to have a happy (your word here: casted... hung... disabled... etc.) child if you are willing to work for it.

5.  A parent's love is blinding.  It enables you to see the good in a situation and care for a situation that makes others instinctively recoil.

6.  Generally speaking, people and predicaments will shock you.  Expect to be shocked from now on... it builds character, anyway.

7.  The most unexpected persons will extend themselves and the most unexpected persons will shy away.  Ultimately, you cannot expect anything of anyone and must be grateful for the smallest kindness.

8.  The people who matter most are those who don't think twice about reaching out or checking in.  This is your support system- cherish them and be understanding of everyone else.

9.  People don't know how to react to hardship or disability and may do so in outrageous ways.  This applies equally to your hairdresser as it does your coworker, family member, or a stranger in public.  Your reaction will make more of an impact than theirs.

10.  No, it isn't fair- and you will just have to move past that.

11. It can always be worse and it may grow worse... so be grateful that your situation is as good as it is at present.

12.  Make effort to create beautiful moments.  NOW.  One of the best memories of this year was with Hip Chick in traction, her feet strung up in our living room, and our family banging on musical instruments, having its own concert with the help of our favorite albums.  You have to embrace those moments before they flutter off.