Hip update

I figured that since we are going to be asked a bunch of questions about it I will do a post about Elli’s hips and the plan for the future. When Elli was born the pediatrician at the hospital while doing a routine hip check said that her hips felt a little bit “clicky” meaning there was a possibility that they were undeveloped so she referred us to primary children's for an ultrasound. Primary’s doesn't do the ultrasounds until they are a month old so we just waited to see what would happen then. Our pediatrician said that they were feeling better with each appointment so we were hopeful. When she was a month old we went to an ultrasound and found out that both of her hips were underdeveloped. Her left worse than the right but both were still in socket and felt stable.

At first upon hearing the news at the ultrasound I was devastated. We had to wait a few days before we could get into see the orthopedic specialist at primarys so I spent those few days terrified of what was going to happen. I found out about the harness they said she would probably have to be in, found out she wouldn't be able to wear any of her cute clothes, that breastfeeding would have to be relearn because she'd need to be in a different position (this was particularly devastating to me because I really wanted to breastfeed and I had just barely started to enjoy it so having it be difficult again just seemed impossible.) And of course a million other things. I seriously just cried for several days.

When we went The orthopedic specialist said that she thought that since they were stable they should correct themselves overall. She recommended not doing anything and that it should correct itself in the next few months so we just set up a repeat ultrasound for a few months away, Colton and our home teacher gave Elli a blessing and we lived life. We had our next ultrasound when Elli was four months old. Her right hip was now perfect. Her left however had not gotten any better and was now actually completely dislocated. So into a harness we went. It is called a pavlik and is designed to help hold the hip in the correct position to stimulate the socket to deepen. This is what she looked like in it.

We were to try the harness for a month, and then reevaluate at that time. Elli hated every second of the 23 hours a day she had to wear it, slept terrible was was constantly needy and slept terrible. It's hard not to wonder if we had gone into the harness at a month what would have happened, if we had started it when her hip was in socket if it would have helped but honestly, I feel very blessed that we didn't. The second ultrasound when she needed to have it I felt very calm and at peace about the whole thing. I think I was just in a much better place emotionally to handle it and I feel very blessed that we had those early months without the harness. At her for week follow-up absolutely no improvement was seen in her left hip, which means the harness was a failure and we needed to move on to something else. (Wearing the harness for an extended time with the hip dislocated can actually cause a lot of problems.) So as a last resort before moving to surgery our doctor tried a different brace called a rhino, seen here. The back is hard plastic that holds her hips out at the correct angle. She was also in it for 23 hours a day but it had to be taken off for diaper changes unlike the harness.

Elli liked the rhino way better and slept better and was much happier. We tried this new brace for three weeks. We just had our next follow-up from that and it unfortunately turns out that there is still no improvement whatsoever. So now we are brace free for a few weeks until the next step of her treatment. I'm not sure when it will be, I would be getting a call next week to schedule it.

The next step is surgery. The doctor will put her under anastesthia and then do an arthogram. They inject die into her hip then do a mri to see if there is anything blocking her femur from going into the socket, if there is not they will manually put her hip into socket then cast her. It's called a closed reduction. If there is something blocking the socket, like a ligament or cartilage, they will do a small incision on her inner thigh, move the things out of the way, then put the hip into socket and cast her. Called an open reduction. Our doctor is pretty sure she's going to need an open reduction since she failed both braces which means a one night stay in the hospital. She will be in this kind of spica cast for six weeks. They will do an xray one week after the cast is put on to make sure the hip is still in socket.

With this kind of cast you tuck a smaller diaper inside the cast and then put a bigger diaper around the outside. Yes, there is a chance it will get dirty but you just do the best you can to keep it clean and clean up any mess that occurs. After that first six weeks she will be in a broomstick cast that looks like these for another six weeks. The first cast here was done by the same doctor as Elli has so I imagine hers will look very similar. This cast ends just under the onesie.

At the end of these two casts and twelve weeks she will be back in her rhino at nighttime for another six weeks. Then she will have an xray at 18 months, two years, then yearly until she is fourteen. If get hips are still looking good by five she will most likely never have a problem with it again.

We are of course very sad that it has to come down to surgery, but I feel a lot of peace with everything. I know that we have been very blessed and Heavenly Father is looking out for us with this process. In three months Elli will be fine and we won't have to worry about anymore casts or anything else with her hips and we will go swimming so much to make up for it that we might turn into fishes. If you have any more questions about her just let me know and I will do my best to answer them.