Femoral Plate Removal

Today was our daughter's much anticipated femoral plate removal.  It is accompanied by a sense of satisfaction, as it feels like this plate removal completes a course of treatment that began 18 months ago.  That timeframe may not sound long for adults, but this accounts for approximately half of our little hippie's life thus far.  She still has ongoing needs and about 15 more years at Scottish Rite... but we are breathing a svelte sigh of relief today.

As we dressed this morning, Daddy sang the Cheers  theme song.  After her assorted surgeries and day surgery procedures, today was Hip Chick's sixth OR visit.  Our routine has morphed into a "knee-jerk" series of motions.  I always wear a pendant with her birthstone, inscribed with her name, to the hospital.  The Admissions Rep who checked us in this morning was the same woman who humored my Twelve Drummers Drumming request from Hip Chick's final cast-off last December- she has admitted us on several occasions.  We never eat before we leave home or before she is wheeled to surgery, out of respect for her NPO orders.  While she is in surgery, we always order the same omelettes from the same cook in Scottish Rite's Crayon Cafe.  Today's day surgery nurse had cared for Hip Chick on previous visits.

We always carry the above buzzer while we wait.  If I were a more enterprising woman, I would concoct a means to hang it around our necks- like a VIP pass.  A thought, perhaps, if we have six more of these in our future.

I asked Daddy: "At which point does routine transform into ritual?"  (Or perhaps ritual with a hint of superstition?)  After a deep swig of coffee, my thoughts tacked on a footnote regarding the benefits of a highly caffeinated parenthood...

Fast forward to Hip Chick's appointment.  Much to everyone's delight, Hip Chick presented us with her best disposition to date.  She relaxed while in pre-op with a new favored doll (at top).  Now that Hip Chick has a weekly dance class, she keeps her ballerina close and her ballerina kept her company during surgery today.  Hip Chick willingly swallowed her dose of "goofy juice" and smiled as they wheeled her away.  Upon return from the OR, she snoozed peacefully in my lap.

Her surgeon provided us with the option to retain her femoral plate.  This had not previously crossed our minds, but we accepted the offer.  Scottish Rite sterilized it and bagged it for us (above).  It is, after all, due a bit of gratitude... it held our daughter's femur together as it healed for the past 10 months.

As for today's results, we were excited to see that Hip Chick did not return to us in a spica cast.  There was a small chance that she would need one if a complication was discovered during the procedure.  I found myself gritting my teeth oh-so-slightly as they provided her a choice of cast colors before surgery... just in case.  Daddy and I much prefer the bandage currently residing on her leg to a sixth cast!

So what does all of this mean?  It means that she continues to heal and recover as planned, which is exciting!  Her load bearing restrictions are "as tolerated" until her checkup, with no high impact activities for four to six weeks.  These are standard restrictions after femoral plate removal.  After her post-op checkup next week, she will resume her quarterly imaging and physical appointments in the fall... her progress still has to be monitored to determine whether she needs another major intervention before her fifth birthday.  This continues to match the course outlined to us by her surgeon last fall.

I neglected to note one detail of our surgery rituals above:  For each major hip dysplasia treatment, we give Hip Chick a fairy figurine from a favorite collection.  Today's figurine is the Flower Fairy.  It appears that the fairy is climbing her flowers- much like Hip Chick climbing Scottish Rite's playground, as pictured in yesterday's post.  Each night, we wish her "sweet dreams of fairies" as they line her chest of drawers to watch over her.  The expansion of her collection has been bittersweet, but we have tangible hopes that this will be the last one for the near future.  

Discharged home, with no complications, no cast... and we have no surgeries scheduled for the first time in 18 months!  Hip Chick received her best possible outcome today... and we parents could not be more proud.  Sweet dreams, indeed.

Quarterly Check Up- July 2014

Happy summer!  We have been busy in the Hip Chick household and hope your summer has been as eventful as ours.  Mommy opted to take a blogging sabbatical for the past three months... but we have a plethora of news to relay and have returned with a midsummer's blog.  This has been a happy time for Hip Chick, as her mobility gains accelerated and some exciting milestones have passed.

First milestone was our family's maiden Disney cruise!  It was decided that, after all she experienced in 2013, no one deserved to meet Mickey and Minnie more than Hip Chick.  Mommy had read other 'hip' moms' experiences regarding their hip kids' (in)ability to manage active days post-surgery/casting and wondered whether Hip Chick would straggle behind... but not our little hippie!

We enjoyed two days at the beach, swam most days, and met every Disney character we spotted on ship!  Any volatility on behalf of Hip Chick was more due to too much fun and too little sleep some nights rather than mobility concerns. 

Our vacation was followed by Hip Chick's third birthday!  This was extra-special for our family, as this was the first birthday that she could walk.  Not only walk... she jumped and bounced her heart out at a local bounce house event center.  It was only befitting that she requested a "Brave" theme, as our spunky little princess certainly acted far more like Merida during all of her surgeries and casting last year than Sleeping Beauty.

After her birthday, Hip Chick enrolled in two activities:  her first cooking class and her first weekly dance class!  We naturally cook at home, as Mommy has a passion for cooking.  As we couldn't enroll her in sports this spring, cooking seemed to be a natural fit.

While casted last year, she would watch her little friends attend dance class and then sadly ask when she would be able to dance, too... so the news that we enrolled her was met with grand excitement.  Her first "dance" was to the Pharrell Williams hit Happy and I cannot think of a more fitting welcome.  She has learned to gallop, is crawling through tunnels, and is jumping!  Her dance instructor advised that Hip Chick's standing locomotor skills are fantastic, given her medical challenges.  Her opportunity lies in some of stretching motions the group begins class with.  Namely, she cannot fully draw her left knee to her chest and sometimes compensates with unusual positions on her left side.  At home, this means she has difficulty putting her left sock and shoe on and pulling them off.  Which leads us to her quarterly imaging and physical in mid-July.

While we have enjoyed a significant reduction in her medical needs this year, her July appointment was met with much anticipation.  Not only was this appointment to check her hip's progress, but to also discuss her upcoming femoral plate removal (day surgery).  When we informed Hip Chick of her upcoming appointment, the first thing she mentioned was Scottish Rite's popcorn machine.  Scottish Rite was certainly wise in integrating that sunny spot into its culture.  Mommy would much prefer that her knee-jerk reaction to Scottish Rite is over popcorn than a series of medical procedures.

As usual, we began our appointment in Radiology.  Hip Chick surprised us all with her best xray to date!  Some of our avid readers may recall tales from prior blog posts of three or four adults working together to restrain her for an xray... but those days are (hopefully) behind us.  Now, she can look at an xray and talk about the bones inside her body.  While 18 months is a relatively brief time for us adults, it makes a big difference in a young child's experience.

After a short wait and vitals, Hip Chick met with a Nurse Practitioner.  She performed a few physical tests to determine her range of motion.  Later, she returned with our daughter's surgeon and his team, which included additional physical tests.  We learned that her femur appears to have healed nicely and her femoral head remains in socket.  It remains a little low... but, as mentioned in her last quarterly update, there is time for this to rise into a mid-socket position.

We asked about her dance instructor's observations.  Her surgeon questioned whether her new hip socket has developed a minor "ridge" or "lip" which is limiting her left leg's range of motion as described above.  As with her femoral head's placement, he suspects this will smooth out over time.  Her mobility gains are still very positive, however.  She would have been unable to run, jump, or gallop without surgery and casting, so Mommy and Daddy remain very encouraged with her news.  (The climb above would have been impossible without medical intervention.  Thank you, Scottish Rite!)

We celebrated with a little playtime on Scottish Rite's newly renovated playground.

And so we have another day surgery to go.  As part of the osteotomies last year, a plate was placed onto her femur to stabilize it for recovery.  Adults may have the option to retain any such hardware placement, but young children need these sorts of things removed to prevent any hindrance to growth.  Her surgeon doubts that a spica cast will be necessary for recovery (Whew!).  He advised that the total healing time is approximately three years, but the immediate risk of refracture is during the first few weeks following removal... it appears that our biggest opportunity for this recovery will be making her rest!  She will remain home from preschool for the first couple of weeks to prevent any irresistible temptation lurking at the playground.  A couple of weeks at home as opposed to last year's 26 weeks of casting?  Challenge gladly accepted!