#developmentaldysplasiaofthehip

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Brittany Currie Photography came to the hospital the morning after Evie had surgery to correct Developmental Dysplasia of the Hip.  These photos are precious.  What a tender time.  Raw in beauty.  Captivating in the juxtaposition between the harsh/hard hospital and the softness of a little girl and her mother’s love.

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In the clear...

Today, 3 months post-op, 6 weeks after spica cast was removed, the doc took an x-ray and did an exam of our girl and he only had good things to say about her outcome. Of course he warned us that she has a 10-20% chance of needing more intervention before she reaches maturity, but that also means she has 80-90% chance she will be just fine from now forward. He will keep checking on her from now until @ age 16 just to be sure. We are so pleased with how well Evie has managed to thrive during her journey with Developmental Dysplasia of the Hip.

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The limp.  She had always walked with a normal gait.  But this weekend, she had a horrible limp and complained of leg pain.  This is the event that caused us to go see the doctor.  She ordered x-rays.  We got the diagnosis of Moderate Developmental Dysplasia of the left hip.  DDH.  After a week of Motrin, the limp was gone.  But we knew from talking to several orthopedic surgeons, Evie needed surgery to correct her hip.  We were told that this limp was caused by a fever up to 6 months before the limp and the virus settled in her hip and caused the limp.  We were lucky to have a virus tell us about the abnormal hip so we could correct it when she was young.  Otherwise, we might not have discovered the DDH until she was a teen and in great pain and in need of major surgery.  

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Waking up from anesthesia.  Surgery went very well.  The surgeon is pleased and he only needed to operate on her pelvis.  He decided that her femur looked great in the new shape of her hip joint.  Evie woke up angry with an intense itch in her nose.  She drank apple juice and threw that up.  Yuck.  Poor thing.  My hero.

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Ready for Surgery

In two days, Evie will have surgery to correct developmental dysplasia of the hip (DDH). We have known for about 4 months that her left hip did not form properly. This is something she was born with, but she had no obvious symptoms as a baby, nothing that could be seen or felt upon manipulation of her joints. She has only a couple of the common risk factors. She is a first born female and had a vaginal birth. There are no other family members with this condition. Depending upon how you look at it, this is a parent's nightmare or we got lucky. I am trying to focus my attention on the later.

At 3 ½ years old, Evie began to limp. The limp was serious enough that we took her to the doctor and our doctor decided to order an x-ray. That is how we got the diagnosis of moderate DDH. Her limp resolved in a week, caused by some random irritation and inflammation which was soothed with Motrin. That was four months ago. It is hard to understand how our leaping, dancing, swimming, running girl has a serious joint condition that left untreated would result in extreme pain as she grows into young adulthood. We have been told that if she doesn't get surgery now, she will have to have a more extensive surgery when she is a teen or in her early 20's when the pain is so great that it becomes something that cannot be ignored. We don't want her high school years, college years, early professional years or early family life to be complicated with pain, surgery and a cast. While doing this surgery at age 3 ½ sounds awful, doing it at age 18 or 20 sounds even worse. Way worse. So we are lucky. We can do this now.

With her limp gone, no pain at present, we had time to research the internet and wrap our brains around this new reality. We had time to interview surgeons and a get second, third, and fifth opinion. We took our time and talked it over. We selected a surgeon who has a middle approach to intervention with a medium amount of invasive-ness and a moderate amount of recovery time. He has reserved the option to go deeper and more invasive if it is indicated, but he doesn't have that as his game plan. I liked his bedside manner too. This surgeon walked in the exam room and shook my hand and my husband's hand and then he turned to Evie to interview her. He got down to her level and asked her if she knew why she was here and she said “yes, because my leg is going to hurt.” Then he asked, “does your leg hurt now?” and she replied “no.” She wasn't shy with him. He truly wanted to hear from her. That exchange won me over. For my husband, in addition to surgical skill and treatment plan, it was important to consider the billing department's accuracy rate and the administrative team's skill level as well as the ease of making appointments and getting copies of records. All of these details create the patient experience.

We are also supremely lucky to have the internet. I am so grateful to all the other mom's and dad's who have filmed their little one in a Spica cast or blogged about your thoughts and feelings. Your advise has been invaluable. Watching your children adapt and thrive while in a Spica cast has been inspirational. It has helped me envision what our life will be like. My heart and mind have had time to get ready. We have had time to purchase items you all suggested. We have had time to get Evie ready. Thank you Pinterest for directions on how to make a doll cast. We are thankful to the authors of “Hope the Hip Hippo.” We are grateful to the swim coach at Houston Swim Club for helping Evie gain confidence, muscles and comfort in the water. We look forward to the day we will return to the pool for physical therapy. We are as ready as we can be.

To be honest, even though I am ready, I am dreading it and I am trying not to be so down in the mouth. I feel it the most when I am in a store, trying to think of what else I could buy to make this all go away or at least help reduce her suffering. In these last few days before the surgery, I am savoring the feel of her warm skin under my hands, knowing that a cast will cover much of her body in a couple of days. I am relishing the way that her body forms to mine when I pick her up, the way her monkey legs wrap around my hip on the rare occasion she wants to be carried. I am noticing the rise and fall of her breath when she cuddles with me on the couch before bedtime. Her rib cage will be wrapped up in fiberglass in two days. I am soaping her up in the bathtub and wondering how we will survive without this night-time ritual during the cast days. I am aware of the little sound her feet make each morning as she walks into our bedroom to wake up slow with us. With the cast, she will have to wait for us to carry her to our bed for our morning ritual. I am trying not to get stuck too much thinking about the cast. I know we all will be waiting for her chrysalis to transform her her insides so that she may be released again transformed. I am trying to stay positive and think about the greater good, the best outcome, the metamorphosis. We are lucky that this condition was discovered early, that there is a treatment available to correct it and that in six weeks the cast will come off and a new normal will shape our family and be the shape of our Evie Girl. We are as ready as we can be.