Thursday 10 November 2011

Hip

We were not just being hypochondriac's.


The right hip demonstrates dysplasia. There is reduced femoral head coverage at 40% and the alpha angle is reduced at 45y. Ossification centre however is identified within the femoreal head.


The degree of change on the right hip would warrant active treatment with a Pavlic harness.


The baby is now in her harness.

The ultrasound went well - she stayed still and happy for 95% of it. She didn't poop on the table. She engaged the scanner and the doctor with her raspberry skills.

I couldn't tell anything while they were scanning, I was trying to keep her entertained and happy. Once she had finished, the scanner stood up and said she was just going to check it with the doctor. When I told her that I'd put the nappy on her, she said that I could just cover her with the towel as they like to kick around and the doctor wouldn't be a minute.

As soon as she left the room, I knew.

The Dr told us the baby would need to be harnessed for at least 4-6 weeks. Her hip socket is meant to be like an egg in an eggcup, but her right eggcup isn't quite right. He called my GP and he said she would explain more.

We saw the GP yesterday and she called through to the pediatrician. She explained that it really doesn't bother the babies - it tends to upset the mothers more. I told her I was glad to be getting it sorted now, in the hopes that it would all be done and dusted before Christmas.

We saw the pediatrician this morning. He explained that it was lucky that we caught it. Normally, they don't bother about checking just for skin folds. When he re-examined her he noticed that one leg looks slightly shorter than the other. Had this been the 6 month check, he probably wouldn't have bothered getting it scanned. He indicated that there is a higher occurence in girls, though he didn't say what might have caused it as such. She will be in the harness for at least 3 months, with a checkup ultrasound just before Christmas (halfway through) to ensure it's getting better rather than worse. If it's not getting better then we'll need to look at 'other options'. I don't know what they are. He mentioned that there are 1-2% of children that have a hip problem that evolves - it isn't there when they are born but gradually gets worse. I don't know if this is her. He called the physio to check that they had a large harness as she was 'a bit chubby'. He later explained that this is because most babies are put in to the harnesses at 6 weeks of age (she showed no signs at 6 weeks). He also commented that I was doing really well with feeding her - she 'looks like a formula fed baby'.

We saw the physio at lunchtime today. I sat in the car and gave the baby a bottle feed while we waited and then took a last 'harness free' photo. We had already made sure she had a few 'last' baths - by the time she's allowed out, she'll be too big for the baby bath.

The physio was lovely and understanding. She told me that she hasn't had a session where the baby gets the harness put on and the mother doesn't cry. Quite often, the baby will cry. I didn't cry. Baby didn't cry. She told me that the 40% is not so bad. She also told me that if it hadn't been picked up, she'd be needing a hip replacement in her 20's.

It's not really so bad. We can't take it off her. If she gets it dirty, we have to clean her in it. We have to facewasher wash her. We will have to put cornflour in her folds and makes sure the harness doesn't get wet or her skin can get (something that I can't remember, but red and shiny and then heaven knows what). It straps across her chest and over her arms. Her legs are up at a 90 degree angle, falling flat. We have to hold her like a koala or we can sit her on the edge of a table. We can't pull her legs together. We can't use her feet to change her nappy. We can't put her on her sides. We have to encourage her on her belly with her funny leg position and she doesn't like it. She can't straighten her legs, but she can kick them out. She should be able to wear pants, but they have to be a size larger and loose so they don't pull her legs together.

She saved her tantrum for when she was home. Her cry was a really angry cry. She is so frustrated.

That's the hardest part.

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