Sunday, December 12, 2010

Hip Dysplasia

At Elliot's 3rd well baby visit her pediatrician discovered a click in her left hip.  He said that it could be nothing, but we should get it checked out and he referred us to an orthopedic surgeon at a children's hospital 3 hours away.   We had our first appointment with the orthopedic surgeon at the end of July and sure enough he diagnosed her with left hip dysplasia.  He assured us it was a common thing and can be treated.  The first step in our treatment plan was a Pavlik Harness.       

This is the actual picture shown on the packaging of the harness.  Me and my husband thought "well that baby is happy, it can't be that bad"...wrong!  The nurse put it on her and she screamed her head off the whole way through!  Then they decided that one was too small and took it off and put a bigger one on her.  Oh, it was terrible she was screaming, I was crying.  The doctor and nurse kept telling me that it wasn't hurting her, that it was just different and she won't remember it, all while she is screaming bloody murder in the background.  About 45 minutes later we got her calmed down and were able to get her in her stroller and leave the hospital.  After a few days of screaming fits and me having a few breakdowns, things did get better.  Now, if you are someone who stumbled across this blog because your child is going through the same thing and you are looking for reassurance that things will get better and I am not really helping much, but trust me, they do get better.  Elliot got used to the harness within the first week of having it on.  She slept a lot at first and wouldn't take her bottle that well in the first few days, but a week later she was pretty much back to normal.

We returned back to the orthopedic surgeon's office exactly one week later to check the progress of the harness.  The harness actually has a 90% effectiveness in correcting this problem  when caught this early.  Elliot fell into the 10% and after an ultrasound and showing us that her hip was completely sitting outside of the socket, the harness was removed and the doctor talked to us about the next step.

This was so frustrating! A week of putting my daughter through what seemed like torture was a waste?  I felt like a horrible mother at this point.  I know we had to go through that to figure out what to do next, but it was just awful!

An arthrogram was our next procedure.  She would be put under anesthesia and they would inject a dye in her hip to see if there was anything (tissue) blocking the head of the femur from going into the socket.  If not, they would perform a closed reduction on her hip which would involve them putting her hip into place and then placing her in a cast for 3 months.  If there was tissue in the way we would be sent home and wait until she was 6-9 months and she would have surgery to remove the tissue and set the hip and then be put into a cast for 6 weeks.

So, we came back about a month later for the arthrogram.  She did really well and the procedure was pretty quick, too quick actually.  As soon as they inserted the dye they could tell that she had a large amount of tissue in the way and that is why the harness was unsuccessful.  We were able to take Elliot home cast free, but we knew that the day would come that she would have to come back and have an open reduction and placed in a cast.  But at that time we were able to go home and enjoy our happy baby! And that is exactly what we did!

November 12th was her surgery date.  The surgery took about 2 hours and went really well.  The first 2 days were rough.  You could tell she was in pain and her voice was hoarse from the tube being down her throat from surgery.  I hated giving her drugs that just made her fall back to sleep, but it was better that she just slept until she healed a little.  After 2 days she no longer needed the pain medicine and she was once again her smiling self.  She is in what they call a spica cast  and handles it way better than the harness.  I think it helps that she is older and can understand a little more and not be as confused as when she was only 3 months old and in the harness.  It just amazes me how well she is handling this and it helps me out tons that she is taking it so well.

This is a picture about a week after her surgery.  The left leg as you can see is completely in the cast.  Only her toes stick out. 

Her right leg is only casted to just above the knee.  She can kick that leg freely and she takes huge advantage of that.  She kicks the right leg and wiggles her left toes. (sorry these pictures are so bad, don't know what happened there!)

I know you are thinking, "How do you change her diaper?" .  That is usually the first question we are asked.  As you can kind of see, there is a rather large hole where the diaper goes.  The diaper gets shoved up into her cast and pulled snug from the top.  She has what they call a diaper strap that fastens around her cast and then comes up between her legs and fastens in the front.  We haven't had any major accidents yet!

She cannot sit up in this cast though.  So finding comfortable positions for her can get tough.  We found this lifesaver of an idea online and I don't know what we would have done without it.

It's a beanbag!  Who knew they even made these still! She sleeps on this, eats on this and spends the majority of her time onthe beanbag.  I do try to do a lot of tummy time with her, but she gets frustrated that she can't go anywhere and bangs her head on the ground.  She can twirl herself around with her hands, but she hasn't mastered pulling herself around yet.

The cast itself weighs about 5 pounds and she weighed 17 pounds the day she was placed in it.  It's more awkward then anything and that makes it heavy.  Since she can't wrap her legs around you anymore it is a lot of work to carry her around.  We don't go anywhere!  We did go to Thanksgiving at my Aunt's house, but of course the beanbag came with!  Other than that, she stays home.  Which is fine with me, it's cold and snowy and I am just fine staying at home.

I couldn't ask for a better time of the year to go through all of this.  The holidays always fly by, so the 6 weeks has been going by quick.  It's cold and snowy outside, so I wouldn't want to have her out and about anyway and I dislike the cold as well.

We go back December 30th to see if her hip is staying in place.  They will then decide if she needs to be put back into a cast, move to a brace or not need anything at all.  Of course we are hoping for a cast free baby and it would be even better if she came home with nothing at all!

She is handling things like a champ, but I know she is itching to get moving!


  1. Thank you so much for posting your experience--I just found out my 1 month old will be in a Pavlik for at least 6 weeks and I'm terrified! good luck to you and Elliot!

  2. I'm glad you found it helpful! That is exactly why I posted it. I am always browsing around looking for others' stories about their experience with hip dysplasia. Good luck to you guys too!