HIppie Girl

Early September...
Back up to UVA we went to check on her hip development. and well, what can he say??? it is developing. just S L O W L Y

it was interesting to put the x-rays from pre-cast to now beside each other. there was a very noticeable difference. but it isn't quite there yet. especially when you look at right compared to left you can see that the right is very well shaped and formed, the left still has some rounding out to go. So he gave us a brace for nighttime. it is a little foam support that fits around her hips and upper thighs and holds sabine in the same position she was in in the cast while she sleeps. the first night we put it on her she fussed a little bit but since then we haven't had any problem with it. and she can roll herself in it no problem. i actually think she finds it a little comforting after all the time in the cast. and if not comforting, at least familiar.

photo evidence that we were actually at UVA that day (that's the rotunda if you don't know)



so she'll be in that for at least 2-3 months and then we'll go back to check again. i don't like all the x-rays ONE BIT. but it must be done. on the upside, we took KaJo's advice and went to Bodo's Bagels in c'ville. UM. YUM! being married to a yankee has included a major education in the finer tastes of bagels. these bagels do VERY well. so now we plan all of our appointments around Bodo's for breakfast or Christian's Pizza (and splendora gelato) for lunch. i guess if we timed things just right we could hit both. yum.

Hip Update

We went back to see Dr R at UVA a few weeks ago for a follow-up x-ray. Sabine did great in the car and for much of the appointment. she does NOT like to have x-rays taken and i don't like that she has to have so many, but what can you do. the only part she REALLY freaked out about was having her length and weight measured. absolute DRAMA over those. it was fun to finally have a length 25.75 in and weight 16lbs after all the time of guessing. max and i both thought she weighed more though.
anyway the x-ray looked good but not awesome. the way he put it 'the hip is still underdeveloped' but the bones are still in the right spot, it's very stable, we're just waiting for the bones to harden up a bit more. he asked us to get her to practice standing and she is more than happy to do that. the standing puts the head of the thigh bone into the socket even deeper and the pressure helps bone formation. (like ladies lifting weights to help prevent osteoporosis) otherwise we're just waiting to see. to see what happens and if anything needs to be done. it's a pain that we can't just say 'SWEET' we're all fixed but at least he didn't want to put on a brace or anything like that.

That's Right!

We drove up to UVA this morning and had an x-ray. then before they even looked at it the nurse came and was really excited to be taking the cast off. we were a little worried that it wasn't coming off but apparently they had planned to take it of today already. so good
to get it off they had to use the saw thingy. it's pretty cool because it is portable, like a large vacuum, and the blade vibrates to cut rather than spinning. so if the blade hit skin it would stop automatically. of course, sabine didn't know that so the sound combined with the vibration made for a very unhappy baby... kind of like when we wash her hair. A LOT of upset for something that ultimately is a good thing. after the cast came off the nurse tried to wash her off some, but she wasn't having it. so i held her instead. she felt SO light after having that cast, and very loose, like a noodle.
her skin looks really good and had only a spot or two where it was almost cracked. in one of the creases of her thighs she had a little yeast going (Ugh!) where i couldn't reach to clean it but we wiped it off and the skin underneath looked fine. so we'll keep it clean and dry and she should be good as new fast.
so then the dr asked for another x-ray so we took her back upstairs. and after that one his exact words were : 'she looks too good' uh! YAY! so as of now we're not doing anything else. we go back in 3-4 weeks once her muscles relax and she has some time out of the cast and then they'll do another x-ray and tell us where to go from there. but it was good to see the beginnings of the femur head on the x-ray and he said her measurements in the hip were within the normal range on both sides, only slightly more open on the left than the right. all good things.
now we get to enjoy her noodle legs and i'm going next to order her a bathing suit. swimming pool, here we come!

Casting Take One

So here it is on sunday and i'm just getting a moment to write how it all went. it is by the grace of max that i have a few minutes at the computer and i think this may be how it will be for the next three months. blog posts may be few and far between as i opt for eating, sleeping, and showering instead.

anyway. on thursday morning we got up bright and early to drive up to UVA. the drive went better than expected because sabine slept the whole way even though she was officially fasting by that time. when we got there we dropped off aunt eva in the waiting room and were shown to the children's surgical unit. there we changed sabine into her cute hospital gown and socks that wouldn't stay on and her diaper. and still she held it together really well considering how hungry she must have been. she was pretty content to play with us and look at everyone. her only complaints happened when the room started to get full.
while we were on the surgical unit we met everyone on the team. anesthesiologist and resident, dr romness (his resident wasn't there but she was in on the procedure) nurses to be in the procedure and nurses to take vitals etc. plenty of people. and of course the one i remember is andy, the anesthesiology resident. probably because he was younger than me or maybe my age and he looked us in the eye and he told us she'd have a breathing tube during the procedure (UGH!) the other anesthesiologist was the head of pediatrics anesth. and he scared us. he said "well kids take a while to adjust to the SPICA cast... i'm not talking days" CRAP! but he followed that with "i'm talking hours" and on he went on his discussion....
so then it came time for them to take her away. this was the worst part of course because i had to just hand over my baby into andy's arms (who didn't really look like he knew how to hold a baby) and let her go on alone. there was a brief moment when the nurse asked me if i wanted to come back with sabine, but the dr. said i shouldn't. that babies don't remember and it's really hard on the parents. so i didn't. thinking back though i should have said i'd go because she would definitely know i was there and maybe that would make a difference, who cares if it's hard for me. i'm her mom i'm supposed to help her. anyways, i can only imagine what happened while she was away from us and maybe it's better that way. (i get sad just typing it though)
we were sent back downstairs to the waiting area for an hour. during that time the gist of what happened was that dr romness injected dye into her hip to see the bones properly, then because she was asleep all of her ligaments and tendons and muscles were soft so he just slid the bone into proper place. then they wrapped the cast to hold her in place. so the procedure part doesn't take very long it's just the casting. and he had been considering a prick in one of her tendons to create more space, but with her asleep he found he didn't need to do that, so it was ok.
after about an hour dr romness called to say all was well. she was waking up and we'd be called up soon. unfortunately they weren't able to get her to the CT while she was asleep because the CT was backed up or the appointment wasn't right or something. arg! so instead she had to wait.
a few minutes later we were shown upstairs to the wake-up from anesthesia area. there we found a VERY unhappy baby. she was crying her MAD cry and one of the nurses was holding her. so i took her right away and asked if i could nurse and they ALMOST let me but i couldn't because they were waiting on the CT. if anything was wrong in the CT they'd have to put her back under to fix it... so no nursing. instead, i held her and gave her the pacifier that she likes and the nurses brought the sugar water to dip her pacifier in and it didn't take too long with me holding her for her to come around. she just closed her eyes and sucked and rested back with my hand on her chest.
finally we went to CT and that took a few times because she was wiggly, but they eventually got it. then back upstairs to recovery and as soon as dr. romness OKd the CT i got to nurse her. as i was nursing her i got the nurse to take out the line for the IV and take off the heartrate monitor. the nurse really didn't want to do it just then but i convinced her because i knew it would bug sabine less to have those taken care of while she was nursing.
the OT department brought up the carseat for us to use and the nurse went over instructions. dr romness checked back in and went over instructions and we were sent on our way. we drove away from the hospital by 1030 am. she slept all the way back and really hasn't missed a beat in adjusting to being in a cast. i'm pretty amazed.
when we got home, sabine had a note on the door and when we read it we found out we had a big lunch waiting for us on the back porch, delivered by katie and shannon. it was absolutely the best thing at the best moment. we were all exhausted and not thinking well enough to feed ourselves and there was food provided. (and it was yummy healthy food too, but i wouldn't have complained about a chocolate sundae)
and now we're into adjusting. i'll write more about what the cast is like and diapering and our new life in the cast trimester. but at the moment my time is up. more later.

Casting Pics

So, here she is... these are all taken on max's iPhone. we'll get some better ones soon.
first in her hospital gown on the bed waiting to go in for the procedure. she was a great sport even though she was hungry!


hanging on the couch at home


with mommy back at home.

The Hippy Hippy Shake

Now that my parents are finally back from their fabulous Italian Holiday (sigh) and are in the loop i can finally share with the rest of the blogosphere what's really going on with our family these days.

apparently sabine's left thigh bone has taken off for outer space. and without a thigh bone in place the hip socket won't develop properly and without hip socket development it will really suck to walk and run (limping & pain) and she'd have to have a hip replacement pretty young and probably would have early arthritis. all not good things. (if you want to look it up, it's uni-lateral hip dysplasia)

so we're having that fixed up for her. in april we're taking her to the nice dr at UVA who we met with for our 2nd opinion. he'll give her anesthesia, slide the head of the femur into the hip socket and then put her in what's called a SPICA cast to hold it there. the cast will stay on at least 5 weeks, then be checked and probably changed to stay on maybe as long as 12 weeks. in that time her hip will do some major magic and grow beautifully around her thigh bone to keep it in place and to shape the perfect ball and socket that all of us really want for ease in walking, running, dancing, yoga...etc. at UVA it is an outpatient procedure (thank goodness)

of course, we weren't happy to get this news, especially with it being very poorly delivered by our 1st opinion dr. at the end of the week of my rant against the healthcare industry in general. but we knew it was a possibility, they've followed her since she was 2 months, and max remembers me telling him just after she was born that something was going on on that side. moms always know everything, especially movement therapist moms.

but after feeling our emotions for a few days, now we're just trying to gear up for what i'm calling her "cast trimester." which will mean a lot of care and worry with a frustrated infant who can't really understand what is happening. as one friend put it "that's a bummer" and really, it is and it will be hard on us and hard work for us. the SPICA cast will immobilize her from mid-chest to her ankles just when she'd be learning to sit, roll, crawl. and apparently diaper changes in these things become a real challenge (no more cloth diapers!) but even with the work we remind ourselves, she isn't in pain and it isn't life threatening so we'll support her and do this for her and in a few months it will be a distant memory. and i just keep thinking she was born to the right mom for this... i mean, working with the body is what i DO. she will be very well cared for.