Let the spica journey begin

It has been two weeks since Squeaky had his open reduction at the Royal London Hospital.
It has been a roller coaster of a ride. 

We arrived at the hospital at 7.30 am with surprisingly chilled baby, even though he had missed breakfast.

We had met all the team. Dr Louis, the anesthetist, was amazing, calming and reassuring as Squeaky had a bit of a sniffle and said the operation could go ahead. Then Ms Biljsma and her team, we established the leg that required operating on and she seemed relaxed and happy. I said I was very keen on avoiding a femoral osteotomy. I know this was something that may have to be done but still wanted to avoid.
We were told we were first surgery and there wouldn't be long to wait. I took squeaky to theatre but we were sent back to the ward as there was no bed for when he came out of surgery.
In the end we didn't go to theatre till 11.30 am. Squeaky was very good and even napped although thirsty and hungry.

Surgery last 2.5 hours. I went to recovery, Squeaky was hooked up to a morphine drip and sporting a purple spica cast. It went down almost to his ankle on the left to just above his knee on the right. He was very upset but a mum cuddle soon sorted that out. He had a sleep in me as we waited for the ward nurse to come and get him.  Dr Louis popped in and said it went well. Then Ms Biljsma came in, she was very pleased, she said the hip went in better than she thought it would and that there was no need for a femoral osteotomy! I think a huge weight lifted at that point.

Sarah, the ward nurse arrived soon after and we were go to head to the ward. We collected Mr Gin on the way an and headed up with Squeaky in a huge bed and a morphine pump.

We got up on the ward and there was a visit from the pain management team and all the observations as well as Squeaky wanting to have cuddles. And with those cuddles as much as napping as possible.

We gave him food as soon as were allowed as he was starving. With food in his tummy he seemed more settled.

We played pass the baby and try to chill till after his dinner. Squeaky was really out of sorts and very much suffering with being doped up.  Mr Gin headed home to feed the cats and get some rest. I prepared for a night on an extendable couch.

Buckaroo on a dopey baby

It started okay, Clark settled and drifted off to sleep up kept waking. This continued with a lot of screaming and only sleeping on me. In the end it was decided to give him more morphine and some diazepam for muscle cramps. The spinal had worn off and he was very uncomfortable. He managed to pull out his morphine cannula which was a bloody mess but showed why they put two cannulas in babies, just in case they do that! It was a tough night being on a ward made it tougher.

The following day was a morning full of visitors, the pain management team, who where going to cut down his morphine with an eye for taking him off it. The OT fitted him into his buggy and gave me lots of information and was impressed with our organisation. A surprise visit from Dr Louis! The surgical team came in and agreed to make the hole around his bits bigger so we didn't have to fight to get the nappy in. The plaster technician was going to come and do this. Then for Squeaky, the best bit, Mr Gin arrived.

More cuddles, reading and playing happened. I went out for lunch and a bit of break while Squeaky slept and had lunch.

We waited for the plaster tech and got the morphine out. We then took Squeaky joy riding in his buggy! It became clear we were not going to see the tech so we had dinner and Mr Gin headed home.

I was a bit more prepared for the lack of sleep. We had some diazepam again but that hyped him up and he played peek a boo with himself for forty minutes! I managed to get him to sleep a little buy propping him up on his tummy. It was broken sleep after that and in the end I dozed on the couch with him wedge in but on me.

Mr Gin arrived early to rescue me and Squeaky played in the play room. We had a visit from the orthopedic team who chased up the plaster tech, Derek. Who some of you may remember for removing his other cast and fitting his palvik harness.

Once that was done it was a sign off from the pain team and the nurses and we could go home. I left the hospital about Lunch time and Mr Gin got Squeaky home for dinner.

A very long few days. More on the adventures with a small boy in a big cast soon.

A tale of two hips.

Hips, our lives recently have been revolving around these joints.

Squeaky had his closed reduction this week. It was long and ultimately disappointing day.
We arrived at the hospital at 7.30 after a very early start with a chilled baby, surprising considering he had missed breakfast. We got shown into the day ward and settled in with the standard visits from the anesthetist, surgeon and nurses with their repetitive but needed questions. We signed forms and Squeaky smiled at every one. We changed him into his huge hospital gown and waited to be called to theatre.

For reference, a closed reduction is when the patient is put to sleep and the hip injected with dye and x-rayed and then manually manipulated into place, and x-rayed to check the placement.  It is done under General so all the muscles are completely relaxed. Once the joint is in place the patient in put in a spica cast, a plaster cast from waist to ankle of the affected leg(s), knee on the other, for 12 weeks.  Sometimes a tendon in the groin is released (cut) to release the tension on the hip to stop it being pulled out of place.

I walked him to the theatre, no bed for him, just the comfort of mum’s arms. He was very interested in everything going on.  I sat in a chair, answered the questions as they made sure they had the correct patient. I held him as they put him to sleep, not a pleasant experience as he struggled against the mask and then went floppy. I had to hold my head back because the smell of the anaesthetic gave me some unpleasant flashes of the times I had smelt the same smell.

Mr Gin and I went and had some down time in the hospital restaurant. We went back and waited for the return of our small boy. The surgeon, Ms Bijlsma came to us in her scrubs and a serious look on her face. She was not happy with the procedure. Squeaky’s hip that felt stable was in fact very unstable and she was not convinced that the hip was in place. It looked good on the x-ray but she wasn’t that happy. She said she will order a CT scan to take slices of the hip from other angles to see if it is in place. If not then we would have to look at more invasive options. Not great news and we crossed our fingers it worked.

I went to get Squeaky from recovery; he was being nursed by a nurse whilst he screamed. I held him and tried to settle him, the poor possum was in a strange place, in a cast and hungry.  We got back to the ward, he was still screaming, I pretty much squashed the suggestion of offering him water. He was hungry and needed comfort. So juggled him around and fed him, the cast made him heavy and awkward. The feed settled him and he went to sleep on me, we changed parents as beds and then got him to sleep in the cot.

I took him to the CT scan in the stroller/buggy and he was starting to be his normal self. Mr Gin had gone to get some fresh air and lunch. Squeaky was chilled in the CT scanner and we returned to the ward to wait.

Ms Bijlsma arrived and the look on her face said it all. It had failed, the back of Squeaky’s hip socket is flatish making it difficult to stay in place. Poor Squeaky, going through all this for it not to work.

The next step is an open reduction, more invasive using surgery to ‘fiddle’ with the joint and tendons and fat to get it to stay in place.  Then into a Spica cast, again.  This cannot be done till he is one. I can remember my final open reduction, I was six. My heart breaks for Squeaky.

We took him off to have the cast removed, another situation that bought back a lot of memories. I am so glad we had not taken the Ear defenders off the buggy.

Finally, we took out little boy with his stitches from his tendon release, home. He was super cuddly and clingy the following day as we managed his pain and generally rallied together.

Before Squeaky’s operation I went and introduced Mr Hutt to Squeaky and we discussed my thigh pain which has not disappeared. I am having a CT scan this week to work out what our next step is and if I want to have surgery to fix the issue.  At this moment it is going on the back burner a bit because Squeaky is the priority.
For now, we are going to do a lot of swimming while he is cast free.

In other news, we are running a fund raiser for the hospital that treated Squeaky on the Isle of Skye, Info here: Fund raising for MacKinnon Hospitial