30 October 2016

44/52 - Hip Dysplasia, the End of Soccer

This past week, we got some disappointing medical news about Oskar. But let me back up a minute first.

In the hospital, newborns get all sorts of screenings shortly after they are born. One of those screenings checks the joints to make sure that they are formed correctly and functional. When we were in the hospital with Oskar for the better part of week, we saw a number of different pediatricians. About half of those thought that they noticed a "click" or "pop" in Oskar's left hip. The doctors didn't seem to be overly concerned about it but did mention that we could followup with an orthopedist to be sure.

Oskar was breech in utero, and breech babies to have a higher incidence of hip problems due to the way they are positioned. For comparison, here are Oskar (breech) and Anders (vertex, aka normal) and the default position of their legs.


...and Anders

We got a recommendation for a pediatric orthopedist and scheduled an appointment. At the first appointment, Oskar wasn't terribly cooperative; he kept his legs tense, so the doctor couldn't get a good feel of his hip movement. The orthopedist also wasn't terribly concerned but recommended that we schedule an ultrasound just to be on the safe side.

By now, I'm sure that you've guessed the outcome of the ultrasound. Oskar's left hip has dysplasia, a condition where the hip joint is not correctly formed. You can see the difference between the normal right (top) and dysplastic left (bottom).

Hip ultrasound

In Oskar's case, the malformation is relatively mild; the hip socket is shallow, but the ball is still in roughly the correct place. There are much more severe cases where the ball is completely dislocated from the socket. Nevertheless, without treatment it would likely result in serious hip problems later or an early hip replacement.

The recommended treatment: Oskar is to wear a harness that keeps his leg at a slightly acute angle (<90°) from his torso. Since all of his bones are still soft and growing, the hope is that keeping the leg in this position will encourage the socket and ball to grow into the correct shape. Apparently this approach has a very high rate of success. If it doesn't work, then the alternative path involves surgery to correct the joint manually. In either case, the result should be a normal hip with no issues in the future.

At the end of the appointment, the orthopedist put the harness on Oskar and showed us how to do it. Oskar will probably wear this for the next 2-3 months, taking it off only for baths. (In worse cases than ours, the harness is kept on at all times, with only sponge baths allowed!)

We weren't mentally prepared for this scenario when we went to the appointment; we were merely dotting the i's and crossing the t's. The doctor warned us that the next several days probably wouldn't be easy. Babies often have a difficult time adjusting to the harness (justifiably!).

Here is a stock photo of the harness, followed by a photo of Oskar just a few hours after having it fitted. See if you can spot the main difference.

Stock photo...

... and reality

After we got over the initial shock of the situation, we had to try to move on with the rest of our day. We had lots of other things planned that day, including having our "new" car repaired. When the dealership sent us to the local Enterprise rental car for a loaner and all they had was trucks, that didn't add to our enjoyment of the day. And when the one-day repair was now stretching out to a second day, that wasn't so good either. But we made it home and tried to adjust.

New parents are taught about purple crying, but we didn't experience it until the harness. Oskar loved to kick his legs, but with the harness he would go into a crying fit everytime he tried to move. Nursing sessions all started with crying. And naps were pretty poor. He was generally pretty irritable; it felt like we had lost a part of his personality. We had read about newly-harnessed babies only sleeping for 15 minutes at a time during the night. Fortunately for all of us, the harness didn't seem to affect Oskar's nighttime sleep. After about a week, things started to get better; he was crying less and smiling more. We put a onesie on under the harness to help prevent irritation from the harness, and we're learning how to change a diaper efficiently through and around the harness. Fun times.

Since he wears the harness all the time, there are lots of clothes that he can't wear. Pants, for example. Or anything with legs, really. Donna made a couple of sleep sacks from some cool fabrics, to fill part of that wardrobe gap.

The first follow-up is in early December, when we'll see how the hip is progressing. Wish us luck!

In other news, Anders' 1st and 2nd grade soccer team had their last game this past week. Last year, Anders played like a ref: always near the ball but never interacting with it. This year he really engaged and loved playing, and the team was actually pretty decent! At this age, there is no keeper (aka goalie), no corner kicks, and they don't keep official score. But of course the kids kept score themselves anyway.

Anders picked up a few tips from watching all of those Olympic soccer games, primarily how to celebrate a goal (victory lap with arms in the air) and how to block the opponent during throw-ins. Sometimes he is paying more attention to blocking the opponent than receiving his own team's throw-ins, but he's learning.

They had a pretty rainy season, but only one game had to be rescheduled entirely. Mostly, they just got wet and had fun. As parents, we enjoyed the required downtime in the beautiful outdoors.

They celebrated the end of the season with a pizza party in the park.

A few days after the "last" game and end of season celebration, the rained-out game was rescheduled. Between the two teams, there were 4 kids from the same preschool class. Reunion!

Anders is already looking forward to next year.

- Mike, Corinne, Anders, and Oskar