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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6 thoughts on “Spica Change Day

  1. Yvonne

    Just wanted to say thank you for taking the time to blog about your experience with DDH. Our baby girl Reina went through a very similar experience, first pavlik, then suspected femoral nerve palsy, another 3 weeks back in pavlik, then closed reduction plus spica, and she’s now just completed her first week in the cast. It has been inspiring reading about your tips on how to keep her busy at home, and I just read about your cast change experience and skin irritations which are both helping me prepare for the worst. I too live in fear of what the next check up will show and I too asked God the same questions. The night Reina came home with her cast she screamed so much she lost her voice, and I was so angry I said aloud “You are not a good God”. Throughout my pregnancy, which ended with Reina arriving via emergency c-section two months early and me on the OT table with failing anesthesia, I questioned Him repeatedly but also trusted Him immensely. My pregnancy, having the baby, and now with her DDH, has brought me closer to God than ever before. We live in Hong Kong but through a miracle and by the grace of God, we were brought to Sydney to seek treatment for baby girl, and yet, I still manage to doubt Him, I sometimes wonder what’s wrong with myself! It’s a struggle every day dealing with the seemingly endless emotional roller coaster ride, but I wanted you to know that your post has made it feel a bit less lonely and more manageable. So thank you!

    • Ah Yvonne, you have just absolutely made my day! Thanks so much for taking the time to tell me about your DDH story and for the positive feedback on my blog. Perhaps once you’ve come through the other end and your baby girl is all fixed up you could write a guest post about your journey? I haven’t shared a guest post in ages and would love to have some more stories on the site. Each one is so unique and can offer so much help to other parents.
      I know exactly what you mean about how quickly doubts and questioning can creep in but I also know how patient and tender God is with us. “For God is greater than our hearts and He knows everything” is one of my favourite, most comforting scriptures (Can’t remember the reference and don’t have my Bible on me)
      So be gentle with yourself and raw with God. He knows everything anyway!!
      All the very best to you for the rest of your baby’s treatment. I pray it goes more smoothly from this point on and she surprises you endlessly with her resilience. Much love and grace to you ♡♡♡

  2. Yvonne

    I would love to write a guest post after all this is over ! I think each family has their own learnings that can be of help to others and the only way I’ve survived this is by talking to others and by reading things online! So I would be very happy to contribute!

    We are counting down three weeks to the scheduled “cast off”! I was wondering if you could share a bit more about your experience with that… I’ve been told that 1) kids find it uncomfortable with the cast off after having it on for so long and may fuss for a while after, 2) the legs stay abducted even without the cast and if you try to bring them together they might be a bit sore (not that it’s recommended that you bring them together anyway, but since we need to get on a plane I was hoping to put her in the bassinet which is quite narrow and she might not fit if her legs are totally abducted; doc said it’s fine to leave the brace off for a few hours); 3) Did Lucy have any problems getting used to the brace (transitioning from cast to brace)? I’ve already stockpiled on leggings and wide aladdin pants so she has something to wear when she’s in the brace… Any additional advice you have would really be much appreciated!! Thanks so much!

    • Wonderful! I would love to have your guest blog up on my site! You must be getting so excited now for getting the cast off. To be very honest I remember very few details of that time (amazing how the brain blocks it out!!). Because we’d had such a horrid time with the cast and Lucy’s skin issues it was just such a relief to have her out of it and in the rhino brace. I seem to remember her adapting to it very easily and soon learnt to crawl in it. Her legs were definitely stiff for the first few days but it didn’t last too long. If I were you I’d just leave the brace off for the flight. Hopefully she won’t be too stiff and will be able to bring her legs together as needed on the plane. Take Panadol along in case she’s really uncomfortable. Sorry I can’t offer much more than that!

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