Saturday, March 19, 2016

Preparing for a Spica Cast

One of the fears that comes with a DDH diagonis is the dreaded spica cast.  Families pray that their Pavlik harness, DDB brace, or Rhino brace treatment plans work so that they can avoid the spica cast.  The open reduction is a simple procedure, but the typical 12 weeks in the cast is difficult to wrap your head around.  
 
We had gotten our DDH diagnosis in September, so I had been reading a lot of other blogs and Facebook posts on anything related to hip displaysia treatments.  As confident our doctor was in our treatment plan, I had an urge to read about the spica cast, even though our plan did not include it.  I think it was God's grace once again interveneing.  There was a purpose in my reading all of those posts about something we didn't think we would need.  

At the beginning of December, our daughter's angles were finally improving, and her hip felt stable in the socket.  We were finally told our weekly "countdown" could begin.  Then 2 weeks later, December 18th, our daughter had had huge regression, the Rhino brace had failed, and we needed to do an open reduction immediately. Our family was given 3 1/2 days to prepare for a closed reduction just days before Christmas. 

I quickly started a list of everything I had learned from all of that online lurking. My daughter was 5 months old, so our list was different than those people who have older children. Her closed reduction failed (read more about that here), so we knew we would be having an opened reduction 6 weeks later.  I kept my list handy. I have added to and tweaked the list, and created this printable check off list.  And as a firm believer in "leave the wood pile higher than you found it", whenever someone would post on one of the Facebook groups asking what they would need, I would post early drafts of the list in the comments.  So many people commented that it was such a great list, I decided to make the printable and blog about it.  

Here is a detailed list with the explanation for each item on the printable:


Ask the Doctors and Nurses about:
Car seat that will work with the spica.  Most hopsitals will arrange a rental for you, but make sure you have this set up before your surgery.
Ask about what to do for muscle spasms
Ask about what to do for constipation
Ask about a cast cooler - depending on the type of cast and lining, it might not work.  
Filling presrciptions at the hospital before you leave.  This saves you one less stop on the way home.  
Extra mole skin for rough edges
Extra water proof tape
Extra inner batting, if cotton
Ask who to contact if you have a problem with the cast.  
Staying in the hospital over night with your little one.
A gel positioning pillow.  If they use one for your little one, ask if you can take it home.  It might be one of those supplies that cannot be sanitized and reused, and is just getting thrown away when you leave anyway. 
Post op follow up appointment. 

For your little one at the hospital
Insurance card, and any referal or insurance approval paperwork.
onesies in 3 different sizes 
socks 
hat
extra blanket
toy or lovey

For you at the hospital
Books
Magazines
Card game
Phone charger
Medicine
Sweater
Snacks
Cash 
Water bottle
Extra clothes for you - in case they throw up from the anesthesia on you.
Breast pump and supplies.  I did not need to pump for the closed reduction.  But for her open reduction I was engorged.  It is such a long time in surgery, and they are sleepy for a few hours after and don't nurse that much. 
If you are staying over night with your child, an overnight bag for you.  

Items at home for diapering
Poise pads for inside diaper
Diapers one size too small for inside the diaper.  
Diapers 2 sizes too big for outside diaper. 
Our daughter had changed diaper sizes between her open and closed reductions.  We already had diapers one size too big, but I waitted to see what size diapers the hospital used.  I had a friend do a costco run for me since I did not have the right sizes at home.  The hopsital will usually let you take extra diapers home with you, so you'll be set for at least few hours. 
Sanitary napkins to petal the cast 
Flashlight for looking in the cast during blow outs.
Scissors for cutting the tabs off of the inner diaper, if you can't easily rip them off. 

Items at home
We already had a bumbo cut for her rhino. 
Bean bag 
Spica Table
Pillows
We didn't get a bean bag chair or spica table for her closed reduction, as she was 5 months, and just over 10 lbs. For her rhino, we'd been using a pillow and blankets under her knees.  With her open reduction, we were gifted a spica table that had been passed around several other families in our state.  It has been great for her. 

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