when it rains, it pours

So I took Juno to the ortho today. I haven't been worried about it all since we got such good news last month.

But I didn't even need the radiologist to tell me that her ultrasound looked bad. Last month, her hip was very close to being halfway covered by the socket (it should be at about 60% to be normal). This month it was not even close to being halfway covered. Her hip is even a bit worse than it was when we started treating her for DDH back in December.

So the ortho told me our two options at this point are to put her in a Spica cast, which has a 90% chance of success, or try the Pavlik harness again, which is down to a 30% chance of success at this point. He felt strongly that we should give the Pavlik one more shot before doing the much more difficult Spica cast, so Juno is back in the hated Pavlik harness for four weeks.

I mean, I guess there's a chance the Pavlik will work. It just seems like since it didn't work the first time we tried it, it's not going to work this time either, so we might as well skip it and go straight to something that will work. I just want to get it over with.

I hate to think that my happy, smiley, bubbly (literally, she blows bubbles all the time), cooing little baby is going to be miserable and uncomfortable again for who knows how long.

I hate it. I hate it. I hate it.

And what I'm really afraid of is this: I will be stressed and worried all month. Then, next month, the ultrasound will show just enough improvement to make us think that what we are doing is working. So I'll be happy and excited. Then, the next month, the ultrasound will show it getting worse again and I'll have to deal with these emotions all over again. I seriously just want to put her in a cast so I can deal with something real instead of the fear of something.

That's all for now, folks.

Goodbye, Pavlik... hello, Abduction...

Today was Juno's follow up ultrasound and exam at the ortho. I was hoping that there would be enough improvement that we could start weaning her off the Pavlik harness--or at least give us some encouragement.

Unfortunately, there was no improvement. The ortho didn't think another 2-4 weeks in the Pavlik harness would make a difference, so he put her in a hip abduction brace. Unlike the Pavlik harness which is all velcro and canvas, the abduction brace has a hard plastic back. It does the same thing--keeps the legs flexed and spread apart--but it's more rigid so (hopefully) more effective. The ortho said the reason the Pavlik didn't work was probably that Juno was too strong for it and stretched the straps with all her kicking and straining against it!

Our first afternoon in the abduction brace has been ok. With a different brace, we now have to figure out nursing, swaddling, and sleeping all over again. She napped ok and was even happy for quite a while laying on the floor, but she did cry for about 30 minutes and I think she was just uncomfortable.

(Of course, it's always hard to tell if she's uncomfortable because of her reflux, the brace, or a combination of the two--or maybe she's just a fussy girl)

Here's a front view of the new brace. At least she can wear normal clothes again!

And here it is from the back. You can see in this picture how big it is on her. She's between sizes which makes it even more uncomfortable but hopefully won't make it less effective.
As for me... I'm doing ok, although I'm sure there will be some tears later on. I'm disappointed and discouraged and scared. If there is no significant improvement between now and Valentine's Day (our next follow-up), then we'll have to consider a reduction and a Spica cast (surgery and body cast). I don't think I have to say that I want to avoid that. Then again, if this isn't going to work either, I'd rather just cast her and get it over with, instead of wasting time and torturing her with things that don't work.
Juno and I (and the rest of the family, who do still live here even though I haven't blogged about them in weeks) would really appreciate your thoughts and prayers.

Juno is 2 months old!!

Juno turned two months old on Monday, but with Jason being home from work for MLK Day, I didn't get around to taking her two month picture until today. Here she is, the apple of my eye!

Juno's second month was quite a bit harder than her first. Part of it was that she got her Pavlik harness and she had to adjust to eating, sleeping, and playing in it. She was also diagnosed with reflux this month. Her pediatrician put her on some medication for it, but unfortunately it doesn't seem to be helping much. She is still uncomfortable a lot of the time.

In two months, Juno has gained 3 1/2 pounds. She's up to 9 lb, 7.7 oz. Wahoo! She sleeps pretty well at night--usually at least one 5-6 hour stretch and 4-hour stretches the rest of the night. I put her to bed at 7, wake her up to nurse at 10 before I go to bed, and then usually only have to get up with her once before morning. Pretty good for a 2 month old! We are still working on naps during the day. I bought a box fan that I turn on the highest setting during her naps and the white noise seems to help, but she's still a bit of a catnapper.

Juno is getting stronger every day and likes sitting in her Bumbo seat while I make lunch for her big sisters. She's not strong enough to sit in it for long, but she always wants to be upright. She likes being a part of things! Like all babies, she has fussy periods, but she rarely cries inconsolably. She loves to be held and cuddled!

Tomorrow we are going to the ortho to see how much progress has been made in her hip. Cross your fingers for good news!

sleep like a baby

Whoever coined that phrase obviously never had kids.

Because newborns are anything but peaceful when they sleep. They snort, grunt, cry, wiggle, thrash their little bodies around, and whimper. Sometimes it feels like I spent 75% of my day trying to get Juno to sleep, and the remaining 25% trying to keep her asleep.

Wearing her Pavlik harness only complicates the issue, of course!

I am a big swaddler. I swaddle my babies from day one. They lose control of their little arms and legs so easily and swaddling them keeps them happy, even during playtime. So after an entire month of swaddling almost 24/7, figuring out how to swaddle around the Pavlik was a big shock to both me and Juno. Luckily, I figured out a way to work around it well enough that she feels secure enough to sleep peacefully.

1) Unlike a traditional swaddle, fold the blanket into a full triangle shape instead of just folding a corner in.
2) Pull the pointed end of the triangle up between the baby's legs. Pull it up as high as you can so that it will stay secure.

3) Wrap one end over the baby, tucking securely under the baby's opposite side.

4) Wrap the other end over the baby, tucking securely under the baby's other side. Just like a traditional swaddle, this only works if you do it TIGHT TIGHT TIGHT!

Because the harness pulls Juno's legs up in the air when she is flat on her back, we put a small throw pillow under her legs to give them support and keep the circulation from being cut off.

As for pajamas, most footie pajamas are out for now. She has a few pairs that are extra big on her (3-6 months) and sometimes I put them on over the harness and just leave the crotch snaps open. As long as the position of her legs doesn't change, this is just fine. However, it looks really uncomfortable and tight to me, so I normally dress her in an infant gown--the kind that is long and open at the bottom with elastic around the opening. The one I have looks like it belongs in a rest home, so I've been meaning to make one of these out of an old Taking Back Sunday shirt. I just haven't gotten around to it yet. Imagine that, having time to sew again!!

keeping it real

This sounds so shallow, but one of my biggest concerns about dealing with the Pavlik harness was how to dress Juno. It's not that I just want to get use out of the cute clothes she was given or that I am concerned with her being "cute"; I want her to look like a normal baby. I don't want people to look at her and see the harness and not my sweet little girl. I don't want her to be a ball of velcro.

I took this picture of Juno in my favorite outfit the day before her first ortho appointment. She had almost outgrown it anyway.

If you've been wondering how the harness looks on a real baby and not an illustration, here it is! The ortho gave us permission to take it off for diaper changes and to change her clothes. She can have it off for a total of an hour every day. However, I found that she was getting frustrated when I took it off often throughout the day--it was a tease. So now I only take it off every few days for a bath and to change her onesie.

Under her harness, she wears a short sleeved, tight onesie. I've tried a couple different things on her legs. She really needs to have something on them to cut down on chafing from the canvas straps on her fat little thighs. First she wore regular tights, which just made it too hard to change her diaper without taking her legs out of the harness. Then I tried babylegs, but they were too thick to wear comfortably under the straps. Finally I cut the legs off a pair of 18-24 month tights and she wears those. They work best, although I have to constantly tug them back up to her thighs.

And here she is, fully dressed for Christmas Eve.
Over the harness, she wears a long-sleeved onesie that's about a size bigger than she would normally wear and a pair of babylegs. I make all the babylegs by cutting the foot off of girl's knee high socks. The knit doesn't fray, so I don't have to do any sewing. I pull the babylegs all the way up to her thighs, over the straps on her legs, and tuck the ends in to her onesie.
You can't even tell she's got something on under her clothes, can you? I think she's pretty darn cute, even though she does look grumpy!
{She's always grumpy in pictures that I post on here; I promise she looks much more pleasant in real life! She's even learning to smile!}
For church I just put a dress over the harness instead of a onesie, or if it's a jumper, I put the dress over the long-sleeved onesie.
Juno could wear pants if they were big enough to not pull her legs together (probably size 9-12 months or so), but I prefer her to wear clothes as close to her size as possible, so for now we're sticking with the babylegs. I think it's less noticeable that she's got the harness on that way. If she's still in the Pavlik harness when it's warm, she'll wear lots and lots and lots of loose, casual dresses, and we'll forego the babylegs--but hopefully it won't come to that!!

Christmas recovery

Helena, Juno, and Tempe on Christmas morning with the Black Apple dolls I made for them this year and their traditional Christmas Eve pajamas.

Tempe spent about an hour on Christmas Eve making this "astronaut" out of junk she found in my sewing desk. She was very proud of it and wanted to take it to Great-Grandma's!

Christmas was fun, but crazy. I'm glad it only comes once a year.

Sugar + a million new toys + visiting lots of family = lots of tantrums from all three kiddos.

Jason's favorite gift is Inception, which we hadn't seen yet (loved it)

My favorite gift is a gorgeous necklace from The Vintage Pearl that I have been wanting for months.

Tempe's favorite gift is her giant stuffed My Little Pony.

Helena's favorite gift is her Woody doll.

Juno's favorite gift is her own copy of Goodnight, Moon, because her sisters destroyed our old copy.

Juno is one month old!

Happy one month birthday, grumpy Santa baby!

I can't believe it's been a whole month since little Juno made her arrival.

We've had a wonderful month getting to know our little Junebug, and even though I have some bad moments (and bad days), I think that I've done pretty well as a mom to three little girls!

Juno weighs about 8 pounds--2 pounds more than her birth weight! She's just about outgrown all of her cute newborn clothes. She has always been a good eater, and now she's so efficient that during the day it only takes her about 3-4 minutes per side to nurse! She sleeps 4-5 hour stretches at night, but wakes up at 2 and 6 for a feeding no matter how hard I try to change her feeding schedule.

Juno loves being held upright so she can see what is going on. She's usually a happy baby, but she has her fussy periods throughout the day, too. She loves being sung too and that is how I usually get her to sleep--singing and dancing around the room. Her big sisters still adore her and I have to protect her from their many exuberant hugs and kisses. She is a very patient girl!

To celebrate (not) Juno's one month birthday, I took her to Primary Children's to have an ultrasound on her hip. Her hip "clicked" during her newborn checkup when she was born, so the doctors wanted us to investigate. Unfortunately, the radiologist was able to determine that Juno does have hip dysplasia in her left hip.

What is hip dysplasia? I asked too.

The hip is a ball and socket joint, and in Juno's left hip, her socket is too shallow (more like a saucer than a bowl), making it hard for her hip to stay in place. Right now her hip is not dislocated, but it is loose and it can cause problems if not treated--rheumatoid arthritis as a teenager and even the possibility of a hip replacement as early as her 20s.

So early next week we get to go see a pediatric orthopedist and have Juno fitted for a Pavlik harness:

It looks like a torture device, doesn't it?

I'm not sure how long Juno will have to wear it, but a minimum of 23 hours a day for 6 weeks. It will very likely be much longer than that.

I've gone through a whole range of emotions today (which I won't get in to here) but right now I am focusing on the fact that we caught this early, it will be fixed in a matter of months with nothing more invasive than velcro and elastic, and if this is the worst medical problem we have to deal with, than we are very, very lucky.