Previously in A Madison Mom's life...

You know how they start tv shows... so you know what happened before the current episode? I thought I'd start out similarly. That way anyone that is interested will have a little background info. Sound good? So... I'll give you a wee bit of background... Once upon a time, a long long time ago (1995) in a place far far away (North Carolina) I graduated from college. I went to Appalachian State University and majored in Child Development. I recently (Jan. 07) exchanged e-mails with one of my college professors. We hadn't been in touch in quite a while and she asked what I was doing with myself. The last we had talked I was the Parent Service Director (aka Assistant Director) for a hospital child care center (day care for employees' children). I had worked my way to that position by spending a lot of time with infants, toddlers, and preschoolers. I really liked the job I was doing. But... that is not what I was doing when she e-mailed. Here is the e-mail I returned to her...

"Dr. C-

"Because you asked... and you may be interested...this is what I'm doing now....

"I'll tell you my whole long story (as briefly as possible) since it's a child development ordeal!!! You may be interested... and I'll include some pics.

"I had my daughter Zoe in June of 2005. (She's just over 18 months old now.) I had every intention of returning to my job as Parent Service Director at the hospital day care... with Zoe in tow at 6 weeks old. She was all set with a full time space in our infant room. I was so excited to work with her in a room just 10 feet away from me. She would be with a teacher I trained to be teacher when she was my own assistant. It was perfect.

"Zoe had other plans though. She was born with bilateral hip-dysplasia. Do you know about this? I had never heard of it before... even after years of working with infants. (We're told it happens mostly to first borns, girls, breech births, and some with hereditary history. We had all 4... although I never heard about my loose hips, or my mother's metal brace until Zoe was born.) Anyway, she was born with both hips dislocated and not completely developed. We thought she was head down... but it seems she was tush down and feet up by her ears for quite a while. Guess someone thought having a "normal" infant would be too easy for me. It's been a test.

"On her first day of life she was put into a Pavlik Harness. She wore this contraption on and off for about 2 months. On and off because it "fixed" her right hip quickly... but that left hip was stubborn. The Orthopedic doctor didn't want it to stay on and press the bones in the wrong directions since their little bones are so soft while forming. So it was on for a week or so, off for a week or so, try again, no luck, off, on. etc etc etc. Here's a picture of the Pavlik Harness. It was suppose to keep her hips pressed into the sockets to help the soft tissue compress into the socket and to help the socket form.

"Let me just say diapering wasn't fun and you were always worried about keeping her little legs in the right place. (Because of this we extended my leave... I couldn't put this job on anyone else) Zoe wasn't bothered at all by the harness really. She's been just the happiest most easy going baby. I can't even imagine how it would've been with a more difficult temperament. As it is as a new mom you're so hormonal after birth, and this just was so much more added stress and emotion.

"Since the Pavlik Harness wasn't working on her left hip we had to have her put in a Spica Cast. This was a full body cast from nipples to ankles. It was suppose to place her hips in the correct position while they developed. She was almost 2 months old when it went on. She had to have it put on in the OR under anesthesia so she wouldn't move. That was scary. Thank goodness I knew so many hospital moms and dads!!! I had had the anesthesiologist's son in my infant room, so it was easier to have her take my peanut off to "surgery" rather than a stranger. Here are a couple photos of her in the cast. Excuse the tushy shot... it just helps you better imagine the extremely difficult diaper issues. We used waterproof medical tape around the edges of the cast and then wrapped and stuck panty liners around that to help from getting too much pee and poop in the cast and to try to keep it dry. We then tucked a preemie diaper inside and then covered that up with a size 4 diaper. We were nervous wrecks all the time. One big diaper blow out and we were doomed. No changing the cast just because it was yucky or smelly.

"Zoe had the cast on for almost 2 months. You know how much infants grow in 2 months. By the time she was out of it her little tushy was like a balloon bursting out (we called her J-Lo)... and her legs were about an inch further out of the bottom and looked swollen. Like the harness... Zoe wasn't really bothered at all by the cast. She remained as easy going as before. We had to make a lot of adjustments with her things though. We rented a special car seat (wouldn't fit a regular one) she wouldn't fit in the baby bjorn type front carrier because of that bar, same with an exersaucer or jumper, she was too heavy for her bassinet and the swing was shaped wrong, she couldn't fit in her stroller, we bought a beanbag chair (couldn't sit in a bouncy seat) we put her mattress on a 45 degree angle and put her on a bed pillow to cushion her as much as possible, and we held her ALOT. It was all really hard. I have to admit I cried a lot. But, we made it though. (Again, because of this we extended my leave)

"After about 2 months Zoe had her cast off. They actually took it off in the OR and took her for a quick x-ray. They did it in the OR because if the x-ray wasn't good they would put her under anesthesia again and put a new cast back on immediately. So she went into the OR and we didn't know if she'd come out in a new cast... or back in her harness. Thankfully the cast worked it's magic. She did go back into a Pavlik harness to be slowly weaned out. You can see it wasn't a problem for her.

"She actually had quite a bit of movement available to her legs. She was totally done with the harness in January 2006. The doctor said he'd "hit a home run". The x-rays showed "perfect hips". (At this point I could have gone back to work with no worries... but it was too late. I was loving being a stay home mom. Something I never planned on. Oh well.... life happens. I was on my way to director of a large day care that I loved... and now here I am, as happy as could be.)

"After this I had her evaluated by Children's Special Services. She was about 8 months old at her home evaluation. Her evaluation showed she registered average or above in every category (social, emotional, fine motor, etc.) but for gross motor she registered at about 4 months. Because of her delay (which I totally expected) she qualified for physical therapy. Among other things she wasn't rolling or pushing herself to sitting, and when laying on her tummy (which caused screaming fits) she wouldn't lift her head. Her arms and legs had very weak muscle tone. With physical therapy she progressed quickly though. It started in April (10 months old) and by September she was completely caught up. She was actually walking at 15 months when her Ortho. said not to expect her to walk until at least 18 months. We were thrilled.

"During those learning months she could do some crazy things with her legs. I have never seen any other infants get into some of her positions. One example... to get out of her tummy time she would put her legs in a straddle and just push herself straight up through the middle to sit. She hated tummy time since she hadn't really had much for the first 6 months. She would also sit up with perfect posture (like in her cast) but with her legs spread out wide. She was soooo flexible.

"In the middle of all of her physical therapy progress we did have a slight setback. We went for a follow up shortly after her first birthday and the x-ray wasn't great. Again... her left hip. Part of her hip socket was slightly misshaped. So her Ortho had her wear what he called a Fixed Hip Orthosis whenever she slept. Thank goodness just when she slept. It was suppose to press the hip into the socket at a certain spot and hopefully help to press and reshape the socket. Again, she tolerated this contraption really well. We were afraid it would effect her sleep, and it did. Not how expected though. She slept fabulously. Better than ever. We called it her magic sleep brace. We think maybe she just missed the confined feeling that she'd had from before birth to harness to cast. Those legs weren't used to being free... and the brace gave her comfort, we guess. Here's her brace.

"You can see it didn't even stop her from crawling and she learned how to stand up in her crib with it on too. Wonders never cease. The Ortho. thought she would need the brace for at least 6 months to a year. If it didn't work she'd possibly need another surgery and another body cast. I had nightmares of a 2 year old in a body cast for a whole summer. But... we were lucky. After 3 months she was able to stop wearing it. Another "perfect" x-ray. (I can't count the number of hip ultrasounds, x-rays, and ct-scans this child has had!!!) So, she's been contraption free since Halloween 2006.

"We go back February 5th for another follow up x-ray. My fingers are crossed that we're still "perfect". But, you never can tell. I won't even guess what would happen if something went wrong and I don't want to think about it unless I have to. In the mean time I have a completely normally developing toddler. She's not just walking... she's running. She's jumping (a couple cm off the ground). She's climbing. She's talking nonstop (I think with her physical delay her language took off quickly). She's exhausting me. This one child tires me out in ways that a room full of infants never did.

"So... you asked what I've been doing. You probably never expected a novel in return. Especially an illustrated one! Hope it's alright and that you could see all of the pictures. It was quite an ordeal. I cannot say how thankful I am that I had the Child Development background that I did. I can only imagine how a "normal" first time mom would have made it through... although I know many have. There is very little information (even online) but after finding a few moms to chat with (

http://www.hip-baby.org/

) I realized how lucky I was, both for my knowledge... and in how Zoe has grown. A lot of children don't respond as well to the harnesses, cast, and braces and need all kinds of surgery. We are blessed."Time has flown by. I actually graduated over 10 years ago!!! I make sure to read the appdate e-mail and check out the website once in a while. We want to get down for a visit... but it's been hard to travel too much. Zoe is definitely an outside kinda girl... so I have a feeling some hiking is in our future!"

Gotta go... Colleen"

It has been a couple of months since I wrote this e-mail to Dr. C. Zoe is now almost 21 months old. Since this letter we did go for our February follow up. Zoe's hips are still "perfect"!!! I cannot say how happy that made me. We will still have more follow up x-rays as Zoe grows. Our next one will be in August of this year. Until then I'm just trying to enjoy every minute I have with my little ball of non-stop energy.So there you have it. A partial history of my life as a mom. I completely realize (and hope you do, too) that Zoe's hips have not been our whole life for the last 21 months. Zoe's hip issues seem like a lifetime ago, but... her hips are why life is the way it is now.

Now I'm just hoping I will survive Zoe's new found love of temper tantrums!