Spica Tips

Today I was grocery shopping with Helena and Juno while Tempe was at preschool. Helena was in the car part of the shopping cart and Juno was sitting in the baby seat, both eating cookies and happy as a clam. Grocery shopping can be so easy sometimes! But then I started thinking about grocery shopping when Juno was in her cast and how not fun that was. In case you forgot, this is what her cast looked like:

Yeah. Her cast went up to her armpits and down to her ankles. She couldn't bend at all. Her legs were spread about as wide as they could go and there was a bar at her ankles. I figured things out, but it took a while, so I thought I should share in case anyone out there is looking for tips!

Shopping

I did my "big" fill-up-the-cart grocery shopping when Jason could stay home with Juno, but no matter how well I planned, there were plenty of times that we were out of milk, or dishwasher detergent, or diapers, or something else that just couldn't wait. So when I did have to take Juno to the store, I took our Boppy pillow and put it in the bed of the shopping cart and nestled Juno on it. When she was in her second cast (it was just on her legs, so she could bend at the waist, but there was still a bar holding her legs apart), one of our grocery stores had carts with a baby seat that was wide enough to accommodate her cast, so that was nice.

Feeding

When it was time to eat big girl food, I put Juno in a bouncy seat with a rolled up towel behind her to support her back (remember, she couldn't bend, and bouncy seats are sort of bent in the middle). Unfortunately, she really hated the bouncy seat. It was not comfortable for her, but with that stupid bar, she couldn't sit in any kind of "chair".

Playtime

Again, the Boppy pillow was great. She could either lay propped up on her back or on her belly relatively comfortably to play. And tummytime is a very important component of skincare in the cast, because it lets air circulate into the back of the cast, so you really need to find a way to help your baby be comfortable on their tummy.

Traveling

Our hospital provided us with a medical carseat--a Hippo. She used it with both her casts. It was such a blessing that our hospital had a loaner program. We were able to use the carseat free of charge as long as we needed it, which was great because it is crazy expensive. I've heard, but I'm not sure if this is true, that if your hospital does not have a loaner program, you can contact a car seat advocacy group and they can help you get an affordable one.

I posted about the stroller I used while Juno was in her cast here. She could also sit in an umbrella stroller when she was in her second cast.

Skincare

My biggest concern while Juno was in her cast was her skin. I had nightmares of her cast coming off and finding big sores and flaking skin all over her body. Luckily, her skin was absolutely fine when her cast came off! Not sure if my skincare regimen had anything to do with it, but maybe. I made sure to always keep her diaper area dry. That meant changing her pretty frequently--here is my Spica cast diaper tutorial. A blow drier is your friend!! I also tried cleaning her skin every once in while by using a wipe to reach down inside her cast as far as I could and then using the blow drier to make sure she was dry. Every morning when we got her dressed, Tempe and Helena helped rub lotion all over her feet and ankles and we would make sure the cast wasn't rubbing her anywhere. I found a few rough spots along her ankles and inside the cast and I covered them with extra moleskin.

Well, there you have it, all of my Spica cast tips! Can you believe it has been almost 3 MONTHS since Juno got her cast off? Wow!

pink and purple striped girl

Can you believe 6 weeks has gone by since Juno's open reduction and Spica cast???

I can't!

But the calendar doesn't lie, and today Juno's Spica was removed and a new cast was put on. Her hips looked good enough for her to go into a different kind of cast--a broomstick cast. It's really two casts, one on each leg from thigh to ankle, held apart by a bar (or two, in her case!) Since it's only on her legs, she can wear normal diapers and bend at the waist! Woohoo! It's the little things that make me happy :)

Here's one last picture of her in her Spica cast. Jason convinced me that we should keep it, so I asked the doctor to save it for me. It actually doesn't smell bad at all--she doesn't sweat yet and we didn't have any blowouts during the 6 weeks she was in it. Right now it's in two pieces, but I'm going to tape it back together.

I was going to mark on her ankle at the bottom of her cast so that we could see how much she grew, but I forgot to. But I can tell you that she grew a lot.

And her she is in her broomstick cast! She's wearing a onesie so you can't see that it's only on her legs. It is so strange holding her without her big bulky cast. She's almost seven months old but she has no trunk control at all. It's like trying to hold a 3-week-old upright! I hope she gets stronger quickly and will learn to sit up soon. I think she will be much happier if she can sit and play with toys instead of laying on her back all the time.

So we've got 6 more weeks in this cast and then hopefully, that will be it!

tutorial: diapering a {spica cast baby}

When people see Juno in her Spica cast, the first thing they ask is "What happened to her??"

The second thing they ask is "How do you put her diaper on??"

It's really not as hard as it seems!

We use a size 4 diaper on the outside of the cast to hold everything in place. This diaper doesn't get dirty or wet, so we reuse it for several days until it starts pilling. When Juno is wearing a onesie, I don't bother with an outer diaper. You can also use a cloth diaper cover for extra cuteness (like this one)
At the hospital, they lined the edge of the cast opening with moleskin. As soon as we got home, I covered it with duct tape. Moleskin soaks up moisture, eww!! Duct tape protects the cast and is wipeable.

Pull the inner diaper out of the cast on the front.

After I pull the inner diaper out, I flip Juno over on her tummy and pull it out the back.

Toss the inner diaper and use a blow dryer on a COOL setting to dry off the cute little bum and any cotton batting that might have gotten wet.

Prepare the new inner diaper by tearing the velcro tabs off both ends and opening it up all the way. We use a size 1 for the inner diaper, which is what she would normally wear.

With the baby still on her tummy, start stuffing the new inner diaper into the cast. I start in the middle and push it up as high as I can.

Push the sides of the diaper in as far as you can go, spreading the "wings" of the diaper out. During the first few days, I made the mistake of not spreading the wings out and we had some leakage issues. But ever since I started spreading the diaper out more, we haven't had problems.

Tuck the diaper under the edge of the cast, all the way around.

Flip the baby over and tuck the front sides of the diaper under the cast, reaching as far as you can to each side. If your baby has incisions on either side, be very gentle for the first week until it has started healing.

Once the inner diaper is tucked in all the way around, close the outer diaper like you normally would.

We haven't had any problems with leaks and she usually wears the same inner diaper for 10-12 hours at night. We also have her crib mattress tilted up at one side so that the urine runs down into her diaper and not up her back.

Now, as far as dirty diapers go... so far, so good. But I have read that a wipe wrapped around a rubber spatula is GREAT for cleaning down the back of the cast!

{pretty in pink}

Our first week (almost) in the Spica cast has gone so well!

Juno was discharged from the hospital Wednesday afternoon. She's been so mellow and happy all week--of course, that could be because she's been taking Lortab every 6 hours. I'd be happy, too!

She has a special Hippo car seat that the hospital loaned us. It's basically like a normal convertible car seat, but about twice as big and she sits on a huge wedge shaped pillow to accomodate her bar.

I was happy to see that almost all her clothes still fit, including onesies! I attempted to make a cloth diaper cover today so you can't see her giant diaper all the time, but it was a fail. I think I'll just buy one.

So far no diaper disasters. I do have to blow dry her bum in the mornings, but she seems to like it!

Tempe and Helena were so happy to come visit their sister at the hospital! They were also excited to play in the hospital playroom. Yes, my children think the hospital is fun.

It's only been 5 days and her cast is already pretty much covered with flowers, butterflies, names, and scribbles.

Tempe loves her portable art project!

my little pink block of cement

Here she is....

... in her hot pink Spica cast!
I wanted a white cast because I bought an 8-pack of bright colored Sharpies and I thought it would be fun to literally cover her cast with flowers, butterflies, and bugs (since we call her Junebug or Buggy)
But apparently I am the only person in the world who doesn't want a colored cast, because they don't even offer white anymore!! So we had to settle for pink.
Right now her diaper is a mess. For some reason, they only have size 3 diapers and they are WAY too big to stuff in the little opening. I have lots of plans for diapering her once we get home and I don't think it will be that bad!
Juno has been awake, alert, and smiling this morning. Her swelling has gone way down and her pain is better controlled than it was yesterday. She hasn't been crying when I move her and she's pulling her blanket and wires into her mouth to chew on them, so I think she must be feeling back to normal (or pretty close at least)
Now I just want to get out of here!!

open reduction

Today was a new experience for our family. It was the first time (and hopefully last, although that is a lot to ask for) one of our children has had surgery!

We checked in at Primary Children's Medical Center at 6 am and Juno was in surgery around 8. It took just under 2 hours. The doctor injected dye into the joint and was able to see that there was fatty tissue obstructing the socket and a short, thick tendon pulling the femoral head out of the socket. He fixed those two problems and then put a neon pink Spica cast on her. It goes from just above her belly button to her ankles with a thick bar holding her legs about as far apart as they can go.

Juno took a few hours to wake up (seriously, like 2) and is still really groggy and out of it. She's been asleep pretty much all day, except for eating. She only seems to be in pain when we move her, and I think that could be my fault because I am not very good at positioning her without pulling on her IV and all the wires stuck to her skin. But she hasn't been crying inconsolably like I thought she would after surgery! In fact, she even smiled, blew bubbles, and tried grabbing all the wires stuck to her chest.

The cast is big and bulky and awkward, but I think I will figure it out. It should be much easier when she's not connected to stuff. I haven't gotten a picture of it yet because she has been cold and so she's covered up with a bunch of blankets. I'll get one of her tomorrow and her very fancy carseat we get to borrow from the hospital!

Here is Juno's last bath for 6 weeks! I am going to miss those chunky thighs!
Our cute girl in her hospital pajamas.

Cuddling with Dad before the doctors took her back to surgery.

And here she is in the recovery room. She was pretty out of it.

Thanks to everyone who has been thinking of us and praying for us and offering to help! We appreciate it so much. Our friends, family, and neighbors are so wonderful! We feel truly blessed!

Spica dolls

Today I took Tempe and Helena (and Juno) to PCH for a surgery prep class so that we could all see exactly what was going to happen next week. It was so helpful and the girls really enjoyed it! My dear neighbor Joy is a Child Life Specialist at PCH and I told her we were coming today, so she put Spica "casts" (they're actually just bandages) on the hospital dolls that are given out in the class so that Tempe and Helena could see what Juno will be wearing next week.

Here are Tempe and Helena in their surgical gear with their hospital dolls.
And here's my sweet little baby with her Spica doll!
For me, it was so nice to get a walk-through of exactly what is going to happen next week and see where we will be spending the day and night. I still feel like I'm going to have a panic attack every time I think about it, but I feel a little better...

spica cast, here we come!

Today was Juno's Big Appointment with her orthopedist.

If you don't remember, last month we found out that Juno's hip had regressed and we put her back in the Pavlik harness in a last ditch effort to avoid the Spica.

Well, it was a valiant effort, but it failed.

I am really not surprised.

Juno will most likely have an open reduction and then go into a Spica cast in two weeks. She'll be in two Spicas--which go from just below her ribcage to her ankles--over the course of 12 weeks. There's a chance she'll only need a closed reduction, but she'll be in a Spica for 12 weeks either way.

Right now, I am just worried. About diapering her, keeping her comfortable, nursing her, helping her sleep, and interacting with her--so basically all the same concerns I had when she first went into the Pavlik harness. And most of those turned out to be unfounded. Somehow I have the feeling that won't happen again...