Spica Change Day

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Yesterday was Lucy’s six-week cast change at the hospital. Anyone unfamiliar with spicas might assume this would involve an hour or two at the plaster room and not much in the way of trauma for child or parents. Well, what we went through yesterday was an eight-plus hour affair involving many, many, many tears from our little one. Fortunately this time I managed to hold myself together and could comfort her through it all. It was also a huge help to have Jon there for the day.

One of the biggest challenges for Lucy is that she had to fast before having the general anaesthetic. This was the basic outline of our day:

No solids after 07h00

No breast milk after 11h15

Admission 11h15

No water after 12h15

Procedure at 14h15

The day started off in good cheer, particularly since our new friends were there too for their daughter’s cast change. There is a lot of waiting around between admission and the actual procedure so it was lovely to be able to chat and compare notes and keep the babies distracted from their growing hunger.

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Lucy and Scarlett all dressed in their hospital gowns ready for theatre

To save time in the operating theatre, the doctors like the casts to be split in the plaster room beforehand. By this stage of the day, Lucy was getting pretty darn cranky due to her very empty tummy and no sleep. She didn’t find the ear phones, loud sawing noise and weird vibrations fun at all and expressed her displeasure very loudly and vehemently in the plaster room.

Trying to console Lucy while her cast is getting split with a saw

Trying to console Lucy while her cast is getting split with a saw

Once the cast was split, the plaster lady bandaged it up to hold it in place while we continued our wait for the procedure. We didn’t get a chance to see what her skin was looking like underneath. Jon reckons it’s probably better that way! A few days ago we were very concerned about the skin at the back of her thighs because it was getting raw and weepy and very smelly. We tried to clean the area using a damp cloth and tea tree oil, then blow dried it before placing sanitary liners under the cast to draw moisture away and form a barrier between the skin and the cast. We also applied some Sudocrem to the affected skin. It seems to do the trick and the skin was looking better by the time we got to the hospital. Apparently in some cases they delay putting on the new cast in order to let the skin heal. This was the last thing we wanted so we were very relieved they were able to proceed with the new one.

Lucy with her cast bandaged up, doing some quiet reading in the waiting room

Lucy with her cast bandaged up, doing some quiet reading in the waiting room

Unfortunately the theatre was running late because there was a patient undergoing an operation who also had shingles. To prevent it from infecting other patients, they had to keep the patient in the theatre until he/she had come round from the anaesthetic rather than take them to the recovery room as per usual. Then they had to do a thorough scrub down of the theatre to make sure it was infection-free. So instead of a 14h15 theatre slot, Lucy only went in at 15h30. Jon took her in for the gas anaesthetic which they use to put them to sleep before being taken into theatre and given the stronger anaesthetic administered via a cannula in their hand. When he put her down on the table she got very upset but the gas quickly worked its magic and she was asleep within about twenty seconds.

Grabbing a bite of lunch at the hospital's cafe. Love the hospital staff but the building is a pretty depressing place

Grabbing a bite of lunch at the hospital’s cafe. Love the hospital staff but the building itself is a pretty depressing place

An hour or so later, I was called to the recovery room to sit with Lucy while she came round from the anaesthetic. She was a very miserable baby at this point, crying inconsolably. I tried to breastfeed her to comfort her and get some food into her but she just kept on crying. The nurse gave her some Panadol via IV. Having a cast change can lead to some pain because the legs are accustomed to being in one position and the slightest change in this position can be sore. I also summoned my nappy bag to see if I could get some other food into her. She wolfed down a whole sachet of blueberry, apple and banana puree so she must have been famished. She eventually settled and her pulse calmed to a normal pace. She had, however, developed an intense dislike for anyone wearing a uniform and started crying angrily the moment any nurse came close to measure her temperature or check that her toes were warm and moving or even just to say hi! Any time I put her down on the bed she got worked up because I think she anticipated another unpleasant procedure. We had to wait an hour and a half in the recovery room because the surgeon hadn’t written an operation report and we weren’t allowed to leave until the report was available. The surgeon was busy with his next operation so only when he was done could we go.

After some Panadol and food, Lucy has finally calmed down but does not like nurses much!

After some Panadol and food, Lucy has finally calmed down but does not like nurses much!

But not go home. We then had to go to the next waiting room for observation and also to have the edges of Lucy’s cast taped to make them more waterproof and take care of any sharp bits. Lucy was beside herself at having to endure further treatment and wailed miserably the whole time the kind nurses were taping her up.

Getting the edges taped up - the last straw! (We went for purple legs this time)

Getting the edges taped up – the last straw! (We went for purple legs this time)

Eventually, at 19h15 we were discharged, exhausted and so happy to be able to get home and get our distressed child to bed.

The good news is that we are now half-way through our spica experience. May the next six weeks fly by…

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My Contribution to the Parenting Lexicon

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Becoming a parent means familiarising yourself with a bewildering number of new terms to do with babies. Your first few visits to the midwife or obstetrician may feel like you’re having to learn a new language altogether but by the time you have safely delivered your precious bundle of joy, you bandy these words about like a medical professional while chatting over cups of coffee at mothers’ group. 

Sometimes, despite your greatly expanded post-bub vocabulary, you just can’t seem to find the perfect word to fit your experience and you have to make one up to do the job. There are three that I have coined since having a baby:

You get a thermometer. You get a spedometer. And then you get an

  • f-bombeter

noun

1. a system of measuring and indicating mental health or stress based on the frequency of thought or uttered f-bombs.

Now, I hate the f-word. Hate. Hate. Hate. It never featured in our house growing up. Hearing it makes me cringe. And I have never been able to say it out loud. It is a deplorable word. So when I find myself thinking the word or – gasp – muttering it under my breath (never with any volume or vehemence – just muttered)  then little warning bells go off in my brain. This is a signal that perhaps I need to slow down a bit, get some rest or ask someone for help because if I have stooped to such a level as to use that word, then I can’t be doing too well. 

My second new term is:

  • mockingbird night

idiom

1. a difficult night for a parent during which their child resists going to bed and repeated verses of the lullaby ‘Hush Little Baby’ are sung in an attempt to get the child to sleep.

The beauty of this particular lullaby is that you can just keep making up verses as you go, coming up with all sorts of wild and wonderful items to buy your little cherub (though they totally don’t deserve these gifts at this point!) I have tried a few times to learn the original lyrics but I just can’t seem to get them right. So instead, Lucy has been promised golden larks that turn brown, bales of hay that get burnt, diamond rings that are fake, and other such things that get increasingly silly the tireder I get. The plus side of these silly verses is that they often make me giggle and this makes me feel better despite the fact that my child just WILL NOT SLEEP!

And thirdly:

  • napalysis

noun

1. the moment of paralysing indecision faced by a parent when their child has gone down for a nap and they have to choose how they will spend their free time.

One day I was particularly flummoxed by my many options and actually wrote them down to use as raw material for this post. This was my list – in no particular order:

  1. Unpack the groceries from the car
  2. Finish washing the dishes I’d started hours earlier
  3. Make a new batch of food to freeze for Lucy
  4. Take the washing off the line
  5. Sort the groceries should I choose to fetch them from the car
  6. Have a nap
  7. Have a cup of tea
  8. Unpack the dishwasher
  9. Gather tiling ideas for the bathrooms in our new house
  10. Wrap a present and write in a card for a friend’s birthday
  11. Read the magazine that my husband bought on subscription for me for Christmas and which I never seem to get to
  12. Remove the chipped, month-old nail polish from my toenails
  13. Read my Bible
  14. Catch up on the tv episode I had missed the night before because Lucy took hours to go to bed
  15. Play with my dog
  16. Catch up on months of filing since the dining room table was barely visible under the piles of paperwork
  17. Check the postbox

What makes the decision-making that much harder is that you just don’t know how long you’ve got. It may be that your baby usually sleeps for one hour but there’s no guarantee that’s how long she’ll sleep today. This means that you tend to choose the most urgent options – usually the chores – and plan on doing the more relaxing, nice things second. So that lovely, hot cup of tea that you put off until you’ve unpacked the groceries etc etc usually gets poured the same moment that the baby wakes up and the poor dog simply never gets played with other than her daily walk and the magazines stack up next to your bed, gathering dust. 

So let’s put these new terms into a sentence:

After a few successive mockingbird nights, my f-bombeter was indicating dangerous levels; there was no room for napalysis: I had to sleep. 

I’m quite sure I’m not the only parent making up new words and phrases as I go. Anyone else got some to share?

The Spica: Four Weeks Down

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It’s taken me four weeks of Lucy being in the spica before I could sit down and write this post. For many reasons. An eight-month-old baby forced into immobility is a very needy little thing, demanding my full attention and having mini-melt-downs if she doesn’t have it. I have also just surfaced from my escapism stage. For the first two weeks I spent what little spare time I had watching movies and season five of The Mentalist on weekly hire from the dvd store ($10 for 8). Watching Patrick Jayne crack every murder case with such ease and charisma while he desperately tries to track down serial-killer Red John is one of my favourite ways of zoning out from my own dramas. And then there is our evening bedtime routine which has been turned on its head since Lucy went into the rhino brace two months ago. We have done the same calm, soothing bedtime routine for months and it’s always worked beautifully. But recently Lucy has been resisting going to bed at night and getting her to sleep can take up to three hours – occasionally even more – meaning that I don’t have any evening hours to myself to do adult things like writing blog posts. The purpose of today’s post is really just to report back on how our little girl is going in her spica and what we’re doing practically to make things work. One of the positives to come from this hip dysplasia journey is our new friendship with a couple we met in the hospital ward. Their daughter is Lucy’s age and had her spica put on at the same time. We have been in regular contact and met up a few times since then and it has been such a comfort to have friends going through the same thing as us. They have also come up with some very cool coping strategies which I’ll share here too.

So my first tip for today for any parents facing DDH: make friends with other DDH parents! When you’re at the hospital, engage with other parents and get chatting. You may discover some awesome new friends who will become your closest confidantes over the next few months. There are also support groups on Facebook that can connect you to other parents. I’ve signed up to a Western Australia support group (https://www.facebook.com/groups/Ddhparentswa/) as well as an international hip spica one (https://www.facebook.com/groups/Hiptoddlers/). People are really generous with their advice and encouragement so it’s worth being part of these networks to feel less alone.

Car seats: We hired a Safe-n-Sound Sleep-n-Recline seat from Kidsafe. This seat works for both the rhino brace and the spica. I recommend that you wait until your baby is in their brace or cast before buying/hiring a seat to make sure it fits properly. The Occupational Therapist from the hospital checked the seat before we were discharged and she added some foam padding to support Lucy’s lower back.

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Lucy in her Steelcraft Cruiser Stroller, with a cushion and a foam wedge behind her for support.

Prams: We are fortunate in that Lucy still fits into her pram (Steelcraft Cruiser Stroller) and we didn’t have to buy a new one. We place a cushion behind her to boost her forward so her legs clear the sides of the pram. The O.T also added a wedge of foam behind the cushion.

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The modified bumbo, which I usually use for feeding time. The tray doesn’t fit on unfortunately so things can get a bit messy!

High chairs: My biggest saving grace is the Bumbo. I saw this idea online and it is an easy, cost-effective way of seating Lucy for feeding or playtime or when I need my hands free for a few minutes. Jon simply used a kitchen knife to chop out some of the foam at the sides so that Lucy’s legs can fit. See if you can buy one off Gumtree second-hand rather than buy a brand new one for this purpose. We got ours for $20.

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Lucy’s New Best Friend Scarlett in her Avante Hi Lo high chair.

Our friends from the hospital visited a baby shop and tried out different high chairs to see if any would accommodate the spica. They bought an Avante Hi Lo chair. Nappies: A nurse at the hospital showed us how to put nappies on in a way to minimise leakage. It is a lot simpler than I expected. She recommended a large size nappy that can fit over the cast then put an incontinence pad inside the nappy to soak up most of the wee. We’ve been using sanitary towels during the day (cheap homebrand ones from Woolworths or Coles) and incontinence pads at night. We’ve added a third component to the system though. Within a few days of being in the cast Lucy had developed a horrible raw patch on her bum where the cast goes across at the back. To stop that area getting chafed we now put a cloth nappy liner in that area and it seems to have solved the problem. Interestingly, our friends from the hospital were shown a different method of using two nappies, both going over the cast, with no additional pads. To save money, they use a disposable nappy as the first layer then put a cloth nappy on the top.

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Scarlett having her cast cooled with a homemade cooling device.

Cast cooler: There is a company that makes a cast cooler (www.castcooler.com) which is supposed to be excellent for easing itchiness and reducing odour under the cast. One desperate night after many long desperate nights of Lucy battling to sleep I very nearly ordered one but stopped at the last minute as I couldn’t bring myself to pay the expensive international delivery charges. Our friends have come up with their own version of it, involving the top of a Nudie juice bottle that attaches to the pipe of the vacuum cleaner. Their daughter absolutely loves it!

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Lucy about to have a nap lying on her bean bag.

Sleeping: The first few nights were pretty traumatic. At times both Lucy and I would be up in the wee hours of the morning with Lucy crying in frustration that she couldn’t sleep despite being exhausted and me crying in frustration that I couldn’t do anything to alleviate her distress. She had a raw, chafed bum which she had to sleep on for hours and hours without a change in position. She could also be experiencing cramp or itchiness but of course has no way of telling me what the matter was. We’re now a month in and I am happy to report that our nights are much more bearable now. Most nights I give her one dose of either Nurofen or Panadol or Dymadon before bedtime to offer some relief from teething pain and any pain or discomfort from being in the cast. I don’t give it to her in the day and I try to alternate types. (Some people may feel I shouldn’t rely on medication but I am only willing to engage with them on this topic if they themselves have a child in a spica.) I place a cushion under her feet to make her as comfortable as possible. I have also had some success using a bean bag in the cot. It provides nice support as it moulds to her body. Unfortunately it’s just been too hot to continue with it but I may try it again when the cooler weather sets in.

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The splash pool! $15 at KMart.

Play time: This is tricky because it’s hard to keep Lucy adequately stimulated, especially for solo play. I sit her in the bean bag or I lie her down on her mat surrounded by toys. My newest discovery has been a splash pool in which I sit her up with some cushions behind her. She really likes this one! Each option works fine for a few minutes but she very quickly gets frustrated because she can’t reach things easily so I need to be close by to help her out. She is a very social little bub so I try to get out at least once a day to have coffee with friends or go to different places where she can interact with people and get that social stimulation to make up for her lack of physical stimulation. Bath time: Oh man I can’t wait to give her a proper bath at the end of these THREE months!! For now, Jon sits on the edge of the bath with Lucy on his lap while I use a cloth and soapy water to wash her top half. Jon keeps a towel tucked in around her cast to keep it from getting wet. Fortunately Lucy doesn’t have very much hair so this method is working fine for now in terms of keeping her hair clean. In the nappy area I just use baby wipes to keep her clean.

I’ll leave it there for now. If I come up with any more ingenious ideas by the end of her time in the cast I’ll do another post like this. Please contact me if you have any questions or suggestions. Feedback welcomed!