So what happens next?
Well, on Tues, we'll go in for another ultrasound to see if the harness that Diya has been wearing has helped at all. Our orthopedist told us that if it's going to work, it will push the hip back into place pretty quickly. If it doesn't (and she basically told us not to expect that it would), then we'll proceed with surgery.
I do, though, use the term surgery rather loosely. It's not that invasive of a procedure. Ideally, they'll be able to do what's known as a closed reduction. She'll have to go under, but our doc will basically push the hip socket back into place. Sometimes, a tendon may have to be cut or something like that, so if that's the case, she may have a small but deep cut. And while she's out, they'll place her in a hard cast called a spica cast. It'll start from her abdomen and go down to about her thighs, with an opening for diaper changes. I've heard that diapering is lots of fun with the cast on. The cast will hold her hips out, so she won't be able to fit into most of her clothes or gear (there's a special car seat she'll need, her high chair won't be wide enough, etc). So a HUGE pain for parents, but I keep reading that most kids adapt quickly because they don't know any better. I've heard that babies sometimes learn to crawl or walk (sumo wrestler style) with the cast on. But it'll be harder to keep her entertained without the numerous hand-free gear we've started using with her during the day. It'll probably be harder for her to sleep initially. And the cast care sounds like a bitch.
Sometimes, the surgeon won't be able to do a closed reduction and will have to actually go in and have the hip repositioned. This happens in cases where there is too much tissue in the way, so basically, the doc will have to go in and clean it out, so to speak. To me, this would be the least satisfactory of our options (because everything else you know, sounds SO pleasant). It can still be successful, but I think this is where most kids run into problems down the road, with the need for future procedures. What also sucks is that we won't know how it's going to turn out until the day of. The doc said she'll make every effort to do the closed reduction, and if she can't, she'll go for the open reduction while Diya is still out. Either way, Diya will come out of the procedure in a spica cast, so those good times are here to stay.
So I guess at this point, all we can do is wait. Our procedure is scheduled for March 17th (exactly what I wanted to be doing on St. Paddy's day). In the meantime, we have a follow up on Tues and can hope that Diya beat the odds with the harness alone. She does seem to be adjusting to her harness already, although our nights have still been pretty terrible. The cold isn't helping. But during the day, I've caught her trying to roll over with the harness on. And she's been more and more like her old cheerful stuff. I'm sure that she'll start to love it just when we're ready to change things up again and restrict her movement further with the spica cast.
And then she'll stay in the cast for 6 weeks, go in for a cast change, and be in that cast for yet another 6 weeks (approximately). After that, she'll probably get a brace that she'll need to wear (at first I think 24-7. and then at night only for some time after that). I'm crossing my fingers and hoping that by her first birthday, she'll be down to (or at least close to) just a night brace. All this assumes that everything progresses well along the way and that her hip begins to develop normally. I don't know yet how long that process really takes or what to realistically hope for in terms for future x-rays and ultrasounds.
As for the VUR, not much to do but wait there also. It's assessed on a scale of 1-5, with 5 being the most severe. Diya's a Grade 3, right smack in the middle. Not serious enough to warrant surgery, but we may have to wait awhile before it fixes itself. It could be 2-3 years, or it could be 5. But the urologist was pretty confident that it would get better on its own. In the meantime, she'll have follow-ups every 6 months or so to see if there is slow improvement. If there isn't, then we'll have to re-assess. And in the meantime, we just have to hope that she doesn't get any more infections. She's on a daily dose of antibiotics, so . . .
And there you have it, more doctor drama at our house. I'm starting to think we may be able to build a medical drama based on our experiences alone. What do you think?
Well, on Tues, we'll go in for another ultrasound to see if the harness that Diya has been wearing has helped at all. Our orthopedist told us that if it's going to work, it will push the hip back into place pretty quickly. If it doesn't (and she basically told us not to expect that it would), then we'll proceed with surgery.
I do, though, use the term surgery rather loosely. It's not that invasive of a procedure. Ideally, they'll be able to do what's known as a closed reduction. She'll have to go under, but our doc will basically push the hip socket back into place. Sometimes, a tendon may have to be cut or something like that, so if that's the case, she may have a small but deep cut. And while she's out, they'll place her in a hard cast called a spica cast. It'll start from her abdomen and go down to about her thighs, with an opening for diaper changes. I've heard that diapering is lots of fun with the cast on. The cast will hold her hips out, so she won't be able to fit into most of her clothes or gear (there's a special car seat she'll need, her high chair won't be wide enough, etc). So a HUGE pain for parents, but I keep reading that most kids adapt quickly because they don't know any better. I've heard that babies sometimes learn to crawl or walk (sumo wrestler style) with the cast on. But it'll be harder to keep her entertained without the numerous hand-free gear we've started using with her during the day. It'll probably be harder for her to sleep initially. And the cast care sounds like a bitch.
Sometimes, the surgeon won't be able to do a closed reduction and will have to actually go in and have the hip repositioned. This happens in cases where there is too much tissue in the way, so basically, the doc will have to go in and clean it out, so to speak. To me, this would be the least satisfactory of our options (because everything else you know, sounds SO pleasant). It can still be successful, but I think this is where most kids run into problems down the road, with the need for future procedures. What also sucks is that we won't know how it's going to turn out until the day of. The doc said she'll make every effort to do the closed reduction, and if she can't, she'll go for the open reduction while Diya is still out. Either way, Diya will come out of the procedure in a spica cast, so those good times are here to stay.
So I guess at this point, all we can do is wait. Our procedure is scheduled for March 17th (exactly what I wanted to be doing on St. Paddy's day). In the meantime, we have a follow up on Tues and can hope that Diya beat the odds with the harness alone. She does seem to be adjusting to her harness already, although our nights have still been pretty terrible. The cold isn't helping. But during the day, I've caught her trying to roll over with the harness on. And she's been more and more like her old cheerful stuff. I'm sure that she'll start to love it just when we're ready to change things up again and restrict her movement further with the spica cast.
And then she'll stay in the cast for 6 weeks, go in for a cast change, and be in that cast for yet another 6 weeks (approximately). After that, she'll probably get a brace that she'll need to wear (at first I think 24-7. and then at night only for some time after that). I'm crossing my fingers and hoping that by her first birthday, she'll be down to (or at least close to) just a night brace. All this assumes that everything progresses well along the way and that her hip begins to develop normally. I don't know yet how long that process really takes or what to realistically hope for in terms for future x-rays and ultrasounds.
As for the VUR, not much to do but wait there also. It's assessed on a scale of 1-5, with 5 being the most severe. Diya's a Grade 3, right smack in the middle. Not serious enough to warrant surgery, but we may have to wait awhile before it fixes itself. It could be 2-3 years, or it could be 5. But the urologist was pretty confident that it would get better on its own. In the meantime, she'll have follow-ups every 6 months or so to see if there is slow improvement. If there isn't, then we'll have to re-assess. And in the meantime, we just have to hope that she doesn't get any more infections. She's on a daily dose of antibiotics, so . . .
And there you have it, more doctor drama at our house. I'm starting to think we may be able to build a medical drama based on our experiences alone. What do you think?
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