Hip-baby

Warning: This is a really long post! I mostly put it all in so that I won't forget any of this. Now that you've been warned ... read on.

On Monday we went to Shriner's Hospital for Ellen's checkup. It's been just over a year since we were last there. Her hip looks so good now that she doesn't have to go back for two whole years. She'll be 6! We were very excited. Here is her x-ray from Monday.

This is her right hip, which has always been normal.

This is her left hip. It looks just like the other one doesn't it?

I wish I could show you her first x-ray. I first saw it on our first visit to Shriner's on Feb. 10, 2006. (Naomi was born on Feb 18.) I can't describe how I felt when I first saw it. I'll try to show what it looked like in the picture below: The part at the bottom of the arrow (the head of the femur) was not in Ellen's hip socket like it is in this x-ray. It was clear up where the point of the arrow is. Yikes, huh? It is called hip dysplaysia.

The solution to this problem was for the doctor to pull Ellen's leg down into the socket while she was asleep, of course. Then she would be put in a spica cast for 3 to 4 months to hold the bone in place and help the socket develop. This procedure is called a closed reduction. It had to be done soon though, because as she got older her tendons would get tighter and not allow the bone to be pulled down. At almost 20 months, she was actually quite old to be treated for this. Most cases of hip dysplaysia are caught and treated at birth, and most of them only have hips that slide around, not hips that are completely dislocated. Feb. 10 was a Friday, and Dr. Baird advised doing the closed reduction on Monday the 13th. He was afraid that if we waited till after the baby was born, it would be too long. He also felt that it would be better if I didn't have a brand new baby when Ellen was waking up from the anesthesia and trying to adjust to being stuck in a cast. We scheduled Ellen to be admitted on Monday morning at 6 am, but Dr Baird said to go home and talk to James about it and to really think it over, and if we decided not to do it to just call and let them know. We decided to go ahead. On Sunday night our home teachers came over and helped James give Ellen a blessing. One of them, Brother Stucki, also brought some balloons. This is Ellen playing with the fish balloon Brother Stucki made for her.

Very early the next morning, Ellen and I went back to Spokane. The closed reduction went really well. Waking up in a spica cast was not so good though. I had never seen Ellen so upset. I was trying to stay calm so that I could comfort her, but I could not keep myself from crying. I just kept thinking, "What have I done to my baby?" Ellen did calm down, and actually slept quite a bit that day. They put the cast on her while she was still under the anesthesia, but didn't put the colored layer on till later. She chose pink! This picture was taken three days later.

Every six weeks we had to go back so that Ellen could get a new cast because she was growing. She would have outgrown the original cast. They always put new cast on her while she was under anesthesia. It was also nice to get a new cast because Ellen was wearing them out. She learned to really get around in a spica! She could crawl, roll over, ride a scooter, and eventually even stand up!

James also built her a special table and chair for her to sit in so she could play with toys a little easier.



After 16 weeks, the cast came off on June 12, 2006, just 2 weeks before her 2nd birthday. It was wonderful!!! This is Ellen learning to walk again after she was out of the cast.

Once the cast was gone, she did still have to wear a brace (a rhino brace manufactured by Seattle Seat). At first it was for 20 hours a day, but then after the first 4 months she only had to wear it at night. She wore it for one year. It looked pretty awkward for sleeping, but I guess she was just so used to it that she didn't have any problem sleeping.

The purpose of the brace was to keep Ellen's hip in the best position to help her socket fully develop. Normal hip sockets should be cupped like this:

Because Ellen had gone for so long without anything in her hip socket, it didn't develop quite right and was shaped like this:


For the time being, it wasn't a problem. Her hip was not going to dislocate again, but after a few years it would start slipping around, causing terrible arthritis and most likely hip replacement by the time she was 20. So she had hip surgery on July 26, 2007. A pelvic osteotomy to be more specific. Dr. Baird basically cut her pelvis and moved the bottom part down so that her socket would be shaped properly, then inserted a wedge shaped piece of donated bone into the cut. It is quite common for the bone to be secured with a pin which would later be taken out. But Dr. Baird likes to use bone cement instead. I think it is just powdered calcium that just gets absorbed into the bone. That was a relief to us, especially James as he still has his own screws in his ankle. This x-ray is from 6 weeks after the surgery. The blue line outlines the piece of new bone. If you can picture moving that bottom blue line up, closing that area, you can get an idea of what her socket looked like before the surgery.


After this surgery Ellen had to be in another spica cast, this time it was only 5 and a half weeks though. And her right leg was free from the knee down, so that was really nice. She had wanted a green cast this time, but the hospital was out of green so she chose pink again.

This cast came off on Sept. 4, 2007. And now here we are. As Dr. Baird said pretty early on in this whole thing, "Someday she could be an Olympic runner if she wants to."


Ellen with Dr. Glen Baird on Nov. 17, 2008.

One other thing about Dr. Baird. After one of our many appointments Dr. Baird caught up with us in the hall as we were leaving and said to me, "I noticed your CTR ring and wanted to tell you that I am LDS too." I cried all the way out to the car. I've never had much of a chance to talk to Dr. Baird, except about Ellen's hip. He is a very skilled doctor and surgeon and is usually surrounded by interns and residents and physician assistants. But he has always been excited about our new babies and just so kind and caring. Thank you Dr. Baird!

For more information about hip dysplaysia visit hip-baby.org. I joined the discussion group on that site and got some great ideas, like the special table, using a beanbag chair, and using a hair dryer to dry out her cast when I changed her diaper. I also got a lot of comfort from talking to other mom's whose kids and babies were going through the exact same thing Ellen was. That was a lot of help.