Mum Life

Toddler in a Hip Spica: Cast Care

Hip spica cast careYou’re pretty much alone, when it comes to cast care. And it’s far more than simply keeping it as dry and clean as you can. With a toddler that’s dragging themselves around the floor, the cast goes through a heck of a lot wear and tear. It’s unavoidable. And it is already patched up here and there with extra padding to try and stop all the edges from rubbing. It looks like a child’s craft project gone horribly wrong.

Day 10

We had to go back to hospital today because the boy broke his cast. It cracked around the hip of his broken leg, and was barely holding on at all. I phoned the plaster room in something of a panic, and they were totally calm, and a little flippant about it. I guess it’s not a big deal. So, off to the fracture clinic to have it patched up.

And that’s all it was; a quick patch up. It took, probably, less than ten minutes. And my son screamed and fought through the whole thing (leaving me with some impressive bite marks on my arm). He just associates hospitals and medical uniforms, and having anything done to his leg, with pain. Understandably.

I said to the plaster technician “I bet this happens with toddlers all the time”. She rolled her eyes and nodded. “I expect we’ll be seeing you again pretty soon,” she replied. Great.

Day 15

Two weeks in, and today I discovered that we’d been doing his nappies wrong all this time.

When his cast was put on, they put his nappies on in surgery, so I didn’t get to see how it was done. Afterwards, the first poo he did, I asked a nurse to help me change him. She whipped off his under-nappy so quickly that I didn’t get to see how it had been done. All we’d been told was to ‘tuck the nappy into the cast’.

So, what we’d been doing, was tucking the nappy in around the legs, and then fastening the top of the nappy around the outside of the cast. What this meant was, everytime he did a poo (and he does pretty epic ones), it was free to shoot straight up underneath the cast front and back. It was impossible to keep clean, and he ended up with painful sores where his skin was rubbing against the wet, dirty padding. We couldn’t understand how we were supposed to prevent it.

So I looked online. I checked the Steps Charity website, and downloaded their information document. For the first time, I saw the advice of ripping the tabs off the nappy. I went on to their YouTube channel, and my suspicions were confirmed. Two weeks of doing it completely wrong. One stinky cast. One sore toddler. The nappy needed to be inserted fully inside the cast, left undone, and tucked up and under at the front and back. Now it made sense. Then a large nappy secured around the outside of the cast to hold everything together. Two weeks of doing it completely wrong. There is just not enough support given in hospital to prepare parents for taking their children home.

Day 16

Less than a week since the last patch-up, he’s done it again. Looks like it’ll be another trip to the hospital today.

Mum Life

Toddler in a Hip Spica: Day 5 – Day 9

Standing up in a hip spica castDay 5

Today, I took my little boy into town for the first time with his broken leg. We strapped him into the buggy (despite his insistence that he wanted to walk), reclined him back, elevated his legs on the footrest and lifted them with a cushion. Because of the angle he had to sit at, his baseball hat didn’t shade his eyes from the sun, so he also wore a pair of his brother’s sunglasses.

I was worried about it rainin. I was worried about people bumping into his leg that extended out past the corner of the buggy. I didn’t want to go anywhere too busy. I was anxious.

About halfway there, it did start to rain again. Only lightly, but I had come prepared. I pulled my thick hooded jumper from under the buggy and laid it over his legs like a blanket. He loved it, and refused to take it off when we arrived in town. I wanted people to be able to see his cast, so that they would take care around him. But no, he had to have his ‘blanket’ on. I shouldn’t have worried so much. Of course, it all went without a hitch. No one bumped him, and he even got to eat some lunch in a cafe perched on Granny’s knee. He did ask to go to the playpark, but we managed to side-step the issue without too much fuss.

By the time we set off for home though, he was exhausted, and crying, and desperate for ‘Mummy hugs’. So I lifted him out and carried him. All the way home. About 20 minutes. It’s not even so much the weight, it’s the awkwardness, his inability to bend, the sharp angle of the top of the cast poking into my ribs, his repeated requests to be allowed to walk. But we did it. First trip into town done.

Day 6

He’s been standing up in his cast again. There’s just no stopping this child!

A buggy ride in a hip spicaDay 7

Went out for a walk with the boys today. We headed off to visit a community farm not far away, but, unfortunately, it was closed. But, a little further along the path, we did find a small conservation area, so we took a walk through the little woodland. So, we didn’t get to see the sheep, goats, and chickens, but we did eat blackberries and meet a wonderfully soft poodle called Saffron.

Day 8

Yesterday, the little one ate some incredibly chocolatey cupcakes. Today they repeated on him. Serious nappy explosion. They had warned me in the hospital that, by the time the cast came off, it was going to stink, that there was no getting away from that. I think it might happen way before that.

This poo had shot right up under the front of his cast, and up the back too. Good job. Took forever to clean and his cast is, of course, covered. The plaster technician gave us some replacement adhesive padding, so I’m going to have a go at changing that. Wish me luck.

Day 9

Not satisfied with standing up in his cast, today, he figured out how to get on and off the sofa, how to get off the bed, he stood up unsupported, and he’s been shuffling around the room holding onto the furniture. Seriously, does he even realise that he has a broken leg?

Mum Life

Toddler in a Hip Spica: Day 2 – Day 4

Home at last in a hip spica castThe morning after surgery, we were discharged from hospital, and allowed to go home. Other than nappy advice, and cast care, we were given very few tips about how to actually deal with this.

Day 2

Luckily, we have a nice big buggy and, with his broken leg stuck out to one side and the back reclined, he fits into it. At least we can take him out and about, even if we won’t be going to the playpark for a while. We wheeled him out of the hospital, bid everyone goodbye, and there we were, on our own with a toddler in plaster from chest to ankle.

He doesn’t really fit in his car seat, but we only live five minutes’ drive from the hospital, so we did what we could. Perched at an awkward angle, the straps straining to reach the clip at their full extension, and a rolled blanket pushed in behind his back, we managed to get him secure, at least. A careful drive home, and here we were; about to embark on a long summer of who-knows-what.

He can’t sit upright, so there’s no meals at the table, just a messy affair on the sofa, with a chest covered in crumbs. It also means finger food is best. We’ve laid a big cushion on the floor, and he loves lying on his tummy, with all his toys around him. He happily drags himself around by his arms (I guess I won’t be the only one getting muscles over the summer), and is enjoying demanding this, that, and the other, and having me jump to it every time.

He also likes to crawl around my bed upstairs (which is now bolstered all around the edge with pillows and blankets tucked under the fitted sheet) where he can watch back to back Peppa Pig and Mr Tumble on the bedroom TV. He’s taking it all as a fun game, it’s Mummy and Daddy who are stressed out (cue one meltdown from Daddy, and one exhausted Mummy from carrying a twice-as-heavy-as-he-used-to-be son up and down the stairs all day).

But every time I start to doubt myself, doubt that we can survive this, I just look at that tiny, skinny, two year old boy. If he can do this, and with a big smile on his face, then so can I.

Day 3

Through all of this, it’s important to remember that I have another son. He’s five, and currently staying with Granny and Grandad on the other side of town. Today, I left littl’un at home with Granny, and took the big one into town with me. Of course, I came home from hospital to a house devoid of fresh food, so I needed to go shopping. I also took my son to the library to sign him up to the summer reading challenge.

It’s his summer holidays too, and we cannot forget that. He needs to have a fun few weeks, especially as our plans to spend four weeks with my parents, back in Paignton, Devon, in walking distance of no less than four beaches, have been completely scuppered. My Mum also informs me that they’ve added a Komodo dragon to the collection at Paignton Zoo.

Day 4

So, he’s already stood up in his cast, supporting himself on the edge of my chair. Way too ambitious yet, little buddy. I found a video online of a young boy actually running around in his hip spica. I have no doubt that we’ll see that too. Just not yet, little one, please.

Mum Life

Toddler in a Hip Spica: Day 1

Leg in traction splintMy two year old son fell over in a tent and broke his femur. It sounds impossible, and he has a spiral fracture, caused by a twist and pull motion. He was stepping out of the bedroom compartment of the tent, and managed to get his foot wrapped around the loose fabric of the unzipped door before falling. Twist. Pull.

Since then, having done some research, I find that it is surprisingly easy for toddlers to break their femurs, the biggest bone in their body: jumping on the bed and landing awkwardly, slipping on a wet kitchen floor. I was told in hospital that the most common cause is slipping on a toy car.

I took him to A&E expecting, at worst, that he may have dislocated his knee. It hadn’t even entered my head that he might have broken a bone, let alone his femur. Even when I held him still for a x-ray, it didn’t click. But I’ll never forget what the radiographer said to me before I left. “He has broken it, and it’s bad, so be careful with him.” I cried all the way back to the cubicle where I had to be laid on the bed because I was about to pass out from the shock.

But, this isn’t a story about how he broke his leg. This is a story about how he recovered.

Like all little boys, my son is as active as you can be. Boundless energy, limitless enthusiasm, and unstoppable curiosity. He doesn’t walk, he runs. And he climbs everywhere. His ambition often outstripping his ability. Suddenly, he found himself in a full leg splint, tied to his hospital bed.

Keeping busy in hospitalThe wonderful play leaders at the hospital kept him busy, laying a large cardboard sheet across his mattress so that he could have a train set to play with. They brought a bottle of bubbles to his bed, offered to wheel his bed up to the playroom, or into the garden. They were not going to let him get bored.

After a good night’s sleep (we had both arrived at A&E on about two hours sleep), my little boy was finally back: chatty, smiling, and ambitious. He’s always been one to sleep on his stomach, and he wasn’t going to let the splint stop him from doing that. He crawled around the bed, propping himself up on his elbows to play. All of the nurses were amazed; they wouldn’t normally expect so much action until a week or even two after the injury. The play leader told me she’d worked in the hospital for 12 years, and seen a lot of broken femurs, but had never seen such a lively patient on day two. Yep, my boy is very special. This was going to be a long summer.

We were preparing for the possibility of him being in hospital, attached to his bed, for the entire time. We had been told, that it would be at least 10 days before they made a decision to either put him in a cast, so that we could take him home, or if he would spend the whole summer attached to a hospital bed. But after just two days in hospital, they decided to cast him.

And so, the hip spica cast. It’s pretty full on; running all the way from his chest to the ankle of his broken leg, and to just above the knee of his good leg. Legs slightly apart, with a gap in the middle to fit his nappy. It had to be done in surgery, under general anaesthetic (cue more tears from Mummy). When we turned up at recovery afterwards, we could hear him wailing before even getting in there. But, quite frankly, if I woke up in a pair of concrete trousers, I’d have been wailing too. I was allowed to pick him up and cuddle him, and he quickly calmed down. I swear the cast is as heavy as he is. By the end of the summer, I’m going to have some very muscular arms!

Of course, straight after sleeping off the anaesthetic, there he was, crawling round the bed, enjoying his extra mobility. He got the hang of flipping himself over, and made it clear that he wasn’t going to let this slow him down at all. Us adults can learn a lot from children; they’re adaptable and resilient in a way that we can only dream of being.