Mabel's Milestones....

Sundays are always our family day. Typically we stay home and relax - Mabel hates to nap on Sunday since both Mama and Papa are home, she doesn't want to miss a second! This Sunday I was able to take an amazing morning nap, Mabel had been up for several hours in the early morning leaving me so tired that Zack told me to take a nap while he and Mabel played after breakfast. Mabel then fell asleep on Papa for about an hour and a half (as I slept more!). Since Mabel and I were so well rested we decided to check out the Irish Ceili that the Irish American Club puts on once a month. We wanted to go the last few months, but it just wasn't in the cards. Mabel loved it! She danced on my lap and got such a kick out of watching the people dance and seeing the band play music. Check out the video, all that bopping is her!

When we were there we saw a few other babies. There was a little girl about Mabel's age just walking around and a little boy younger than Mabel walking and standing. I forget that Mabel "should" be doing those things if she didn't have hip dysplasia and the 12 weeks in the cast followed by the few weeks of the brace, and the reality is that she would have done those things long ago. She will learn to stand and walk, I guess it is something to look forward too and on the bright side now that she is older when she starts walking she is older and listens better, that's a plus. It does make me a bit sad though thinking about her being physically behind right now, I know she'll catch up, but it is still hard to think about, but at the same time when Mabel saw the babies she kept pointing and saying, "Baby!" I didn't see any of the other babies talking! Also she was the only baby that seemed excited about the music and dancing. She also was excited about looking out the big windows and seeing the ocean with the birds and boats, she's always been very aware of her surroundings, maybe she has too many other things to focus on to worry about walking right now.

Making some progress...

Mabel is making great progress with her physical therapy. The doctor was quite impressed with how much our homework of having Mabel sit on her stool has helped limber up her left leg. We are now working on getting her to stand with both feet on the ground and I have a toe massage exercise to do with her - to Mabel it is "This Little Piggy" to her foot it is magic. I'm so glad to know that she is progressing and the physical result of seeing her now able to sit unassisted and have both feet on the ground and even pull herself up to standing is so rewarding and amazing. It is impossible for me to even picture her standing or walking, I mean seeing her all tall and straight is still amazing since for so long she has been in that strange position of the cast/brace.

We have another appointment with the physical therapist next week, she is teaching Mabel the things she never got to naturally learn like getting up from belly to knees to sit and back down from sitting and all that stuff. Mabel doesn't necessarily like being shown how she should be moving her leg, but she deals very well with it and as the doctor said she is a quick healer and natural learner so we have that on our side.

We also see our orthopedic next week so he can monitor her progress and probably will x-ray. I'm still so terrified that her hip will come dislocated again and we'll have to start all over. I'm trying to not think about that, but I can't keep it out of my mind. I can still see on her left leg that she has that roll that tipped us off that something was wrong back in September, but I constantly line up her feet and her legs look even so hopefully all will continue to be good. I guess it will take some time for that roll to go away.

I have to say I was so upset that we needed to start physical therapy, but in reality it has been a great addition to Mabel's healing so I'm glad it worked out this way and would recommend it to anyone else in a similar situation - I image that getting the right physical therapist is the trick, ours is wonderful. She doesn't force Mabel and everything is about playing and exploring all the fun new toys at her center, Mabel has no clue she's even at a doctor's office!

Practice, Practice, Practice...

We have been very committed and serious about doing what the physical therapist told us to do for our home assignment this week, we bought a stool just like the physical therapist had at her office and we have been practicing all week. Mabel can sit like a pro - and she loves doing it. She sits there on her little stool, both feet flat on the ground and she can reach to each side now without falling over. She can reach all the way to the ground even on her left side. When we started this she would fall over if she had to lean too far or to the left and we needed to support her, but now she is so steady and strong that she can do it herself. She also has taken to pulling herself up to standing by holding on to us from sitting on her stool, now when she first stands up she does have both feet on the floor, but she still lifts up her left foot. It is a vast improvement from the flamingo stand she use to do!

So she goes again this Thursday and we'll see what the doctor wants to do this time. I have to say again that I'm amazed every time I see Mabel sitting on her her little seat. She never got to do that before the cast, she was only learning to sit up unassisted before the cast so I never even thought of trying this before the doctor plopped her on the little stool at her office. It is hard to remember that Mabel should be doing these things and just didn't have a chance to try and do it, I guess I underestimated her! Honestly I don't even think about what she would be doing, I try not to read about what 14 month olds are doing because it does upset me that she isn't walking, standing or cruising, but that's ok, she talking up a storm, "reading" books, and is very bright and amazingly focused and good with her little fingers - she can turn on our ipod and unlock it! She can also unlock Zack's cellphone and turn that off! I'm not worried, she'll catch up!

A step in the right direction...

Mabel's Physical Therapy session was yesterday morning. I was full of nerves and questions about this whole process since it seems impossible to find information online regarding 14 month old babies needing physical therapy after a spica case, brace, closed reduction or anything like that.

Our morning didn't start so well. Do you ever feel that things only happen to you? Well, we got to our physical therapy office and our doctor's clinic is inside a larger facility. The larger clinic is usually open at 8am to allow her patents to come in, but no one else was there. We rang the bell and she came out to let us in, only for us all to get locked out in the hall. I felt really bad for her, obviously she didn't mean for that to happen and she had never faced this before because there is usually several other staff members for the clinic there. So we had to wait in the hall for someone to arrive, it only took about 15 minutes, but still not too much fun. Zack tried to pick the locks, he looked like he knew what he was doing, but that's about it. Mabel cried for a minute as she realized that this is not what should be happening. I just laughed, I mean you have to right! It was the perfect storm of "so-and-so was on vacation" and "the other guy was out of town" and the "first appointment wasn't until 8:30 so I figured I'd sneak in late" that is how we ended up waiting in the hallway for the first person with a key to arrive...

When we got inside things were much better than I thought they would be. The doctor observed Mabel as she played, it takes Mabel some time to warm up to new people so at first it was hard to get her to do much. She use to doctors talking around her not to her so I guess she was a bit confused. She then started to move around and played with the toys and the doctor gave us her input. She said that Mabel's range of movement is more than Mabel is aware of. She is turning her right foot in trying to compensate for not using the left leg at all and that needs to be corrected or she may continue to do that for awhile. She also twists her pelvis up to the left, probably because that is how she was in the cast, so that throws off her back alignment and makes it hard for her to sit up without falling when she turns her head to look at something. Obviously her muscle tone is very low, so that will come with time. The major problem is the main tendon and muscle group that connects the hip to the leg is very very tight. It is what is causing her leg to not straighten, and her ankle is also very tight. The doctor explained that in adults who have this injury they work out that muscle group manually which is very painful and hard on the patient, obviously we wouldn't do that to a 14 month old so she is coming up with play and games that Mabel likes to encourage the right stretches and movements to help her out. I like the doctors approach, she said that she learned long ago you can't force a baby to do things, you have to find away for you to help them do it while making it enjoyable. If it isn't fun she won't do it.

I asked the doctor about everything the doctors have told me before Mabel's surgery and all that I've read saying that babies and young children don't need physical therapy after a spica. She said that the basic school of though it kids will figure it out on their old, and they do, but she does see a fair of amount of kids that figured out how to walk after a spica or bracing and they developed a limp or strange stride to compensate for a weak leg that doesn't go away and needs intervention later. She said that caught early it is much easier to deal with. She also pointed out that the time frame that Mabel was casted was her formative self realization months that she realizes what she can do and as far as she's concerned her left leg doesn't do anything and she doesn't know that is should touch the ground like her right. She said we just need to help her learn that both legs feel the same again and can do the same thing. It seems very basic and logical.

Our first task is to have Mabel sit on a little foot stool with both feet on the floor and have her bend over to pick up a toy off the floor. I'm there to make sure she doesn't fall forward, supporting her as little as possible. She has done amazing with that task, a bit unsteady and scared to lean forward, but still she tries it. Honestly I never thought she could sit unassisted on a little stool like that, we have only been cast and brace free for a couple of weeks and never tried, don't forget she was only first learning to sit before the cast and for four months couldn't sit at all, I think I underestimate what she can do, she does too.

So I feel much better about this. The reality is finding out how much insurance covers of the physical therapy. Right now we have eight sessions, but the doctor said we may not need it all. So we are going to have our Thursday morning sessions for a few weeks and we'll see how things go.

The picture above is Mabel with our boppy. When I'm at work I guess she drags it out from where I keep it under the chair and she says "mama" and cuddles with it. How cute is that? My mother took a picture of it to show me, I love it!

Mommy & Mabel Monday....

Mabel and I always have fun on our Mondays together. This Monday was no exception, although it had a rocky start - like when I went to take my shower in the morning only to find we didn't have water! A water main in our neigborhood had burst during the night and the whole block was out. Then after my doctor's appointment at 8am in the morning, when I finally got Mabel setteled and we were playing on the floor I was thinking it was cold only to realize we had run out of oil so I had to call the oil company to come fill us up and restart the furnace...automatic delivery my butt! And then since our washer had failed on Friday, I had to wait for the appliance repair guy...busy day...but that was only one side of it.

The otherside of it was that Mabel and I had so much fun. She wasn't happy that I left in the morning for my doctors appointment. I guess she gave her Papa a run for his money. When I got home she was asleep in his arms...he assured me "it had just happened ten minutes ago". Mabel and I played on the floor working on our crawling skills, but she mostly wanted me to hold her, that is typical of Mondays, I think she knows the next day I go to work. We had lots of laughing and fun playing on the floor, she was so giggly. I've noticed she has really been in a great mood since she's been freed from the brace. She has been sleeping so much better too (dare I say out loud!). We then went into the kitchen and made some baby food together - today we made a Mango and Cherry blend - yum! We played some more then had lunch at noon. That is the origin of this picture and video below. She was having so much fun, and how much does she love being able to use her highchair again! I don't know what was going on with her hair, she woke up with it like that and with our lack of water (remember the broken water main I talked about) I couldn't make it stay down so she has major bed head, but she's still so cute! The footie pajamas are are result of no heat, it was getting pretty cold so we had to stay warm! Later she took an amazing nap and even slept through the washer repair guy using a shop vac! She got up from her nap refreshed and giggly again and then Papa came home. A great day.

I was able to get her new carseat into my car so now I can return the rental carseat to the hospital. I'm so happy to have that gone. It was just a symbol of this whole ordeal. Now that I have her new carseat in my back seat when I look in my car I feel really good having a visual reminder of how far we've come.

So far so good with no brace. Mabel had a great day expect she didn't want to go to sleep, she was having too much fun I guess! I'm very anxious about her physical therapy on Thursday, but I really can't wait to hear what they say at the same time. I've been reassured on my online forums by parents that PT isn't unusual - but at the same time a physical therapist said she never treated a hip kid after a spica like Mabel, but she did go on to say she can see the advantage of doing it. We'll see how it goes!

I've got good news and...

some not so exciting news. Mabel had her check-up this past Friday and the doctor took a look at the left hip and was concerned with her lack of movement and mobility. He said she is quite stiff and although the hip is in a good position in the socket, he didn't like that she wasn't moving it. I knew something wasn't quite right about the way she was keeping that leg so bent in.

At first he suggested we have her brace free for all waking hours, but after reviewing her x-rays again and examining her he consulted with another doctor in the practice and they both agreed that the risk of her hip becoming dislocated again is currently out weighed by the stiffness in the joint, so we are discontinuing the use of the brace and starting physically therapy this week.

I'm concerned...there is no other way to put it, oh yeah there is, I'm worried and scared to death that her hip will dislocate again. I trust the doctors, I do. Our doctor is very good and seems very cautious and meticulous and the other doctor in the practice that has also been involved has been doing pediatric orthopedics for over 30 years, but I'm worried since all that I've read and researched says that babies don't need physical therapy after a spica, that only older babies like two or three need it and it is very rare for a baby Mabel's age to need any PT. Also frustrating is how little info I can even find about PT and hip dysplasia. Right now my excitement of not using the brace is clouded by my worry.

I've looked into the physical therapist that Mabel will be seeing this week and she looks wonderful, so hopefully that will ease my fears. I'm very anxious to see what she has to say and what she will want to do. We go this Thursday.

Mabel is doing so well brace free. She has slept beautifully the last two nights and she is so happy during the day. She is moving around really well and doing all kinds of new tricks, like winking. She's a funny girl! I'm so glad I have her to get me through this stuff!

Moving right along...

Well, things are going well with our brace-free hours of the day. Mabel loves her new freedom and when I get home from work she is eager to take the brace off for her afternoon three hours. When I lay her down to take the brace off she takes the belt strap off herself! Very cute.

Her right leg seems to have full movement back. She will even stand on her right leg and hold on to furniture to support herself. On the other hand, or foot that is, her left leg is still in the same position as it was in the cast. She will get up on her knees when she is on the floor, but she still army crawls. It has resulted in a raw spot on the inside of her left knee. I just bought her some more leggings to wear under her brace so when we take the brace off she is ready to go. I'm concerned with her leg being still so non-functional, but I'll talk to the doctor about that on Friday. It makes sense that she hasn't used it for about three months so it will take time, but I still worry.

Her next appointment is this coming Friday. I secretly hope he'll tell us she can be out of her brace all waking hours...but I don't think that is a possibility right now, and that is OK too, six hours is huge and totally unexpected so soon - I shouldn't get greedy.

Sleep has only gotten worst. Mabel's teething again and we are back to waking every hour or so...I'm just so tired. I know that it is hard for her to wake and then when she tries to get comfortable again she gets herself wedged in a weird position causing her to get really agitated and cry. It is hard, hopefully these teeth will pop through and she'll be able to sleep better...I sure hope it is just the teeth anyway, I mean she should be use to the brace by now right? She has been in it for three weeks now. An annoying feature of the brace is it has a screw that hold the position angle of the legs on the bar that runs between her legs and the more Mabel moves, the looser it gets causing her leg angle to change. She hates that, I assume it feels weird, we have to tighten the screw every morning and night. I wish I could find more info online about sleeping and the brace, it feels so isolating wondering if it is just us getting no sleep.