Our Thursday routine...

So we had our typically Thursday morning again, complete with the rushing around so we could leave the house by 7:50 to get to physical therapy. I was actually very excited to show the doctor how good Mabel has been walking. I also was very nervous that she may pick up on something wrong with it too.

Mabel instantly started off by pointing out the new ball that was in the ball area. She also has taken to using "s" after words both for plural and possessives. I don't know why she focused on that detail but I think it is so cute. The other morning she pointed at my fork at breakfast and said "Mama's" and then hers "Mabel's" and of course "Papa's". She also will say cookies, babies for her two dolls and a books, stuff like that. I was impressed, but the doctor - she was blown away. She was also very happy with Mabel's walking, although (as I feared) she noticed that Mabel is pointing her left foot out as she steps. She also commented that Mabel may be flat footed? But then said it may just look that way because of her knee alignment so she can't tell for sure. So Mabel walked around holding two baby dolls, saying "Dolls", "Two Babies" and stuff like that and the doctor couldn't get over it. She keeps saying how smart Mabel is for her age and of course I think she's a genius, I mean what mother doesn't think that about her child, but the doctor said, "No, she is way ahead!". She said to me that with what she does she has to keep track of developmental skills as well as physical because with the kids she sees she needs to sometimes figure out if their physical problems are part of developmental set backs. She pulled out some books and looked through based on what Mabel was doing. She said that seeing Mabel identify red, green, yellow, purple and blue - by showing her the colored peg and saying the word was a 36 month skill. She then said using the possessive term and plural term is typically a 42-47 month skill. I thought she was going to die when I told her how Mabel makes her dolls say "Hi Mabel" in a high pitched voice...she was like "Pretend Play!" That's off the charts!

So yes, Mabel is gifted - but I knew that! I love hearing it. Seriously, Mabel is really smart and she always has had a focused personality even as a very young baby. I worry sometimes, I mean when she was younger she was never one of those babies that just sat there all goofy, drooling and laughing at their hands. She was always so serious and aware. She knows how to have fun, but I don't want her to over think things...like me!

Anyway, we had a great physical therapy session and go back next week. The doctor said it is just some tweaking of her walking. She put some kinesio tape on Mabel's leg to help encourage the foot to stay forward. It does seem to help. Mabel loves her tape, she gets it from time to time. The doctor puts band aids on it to hold it down and Mabel loves to point them out - this time it was "Finding Nemo" themed. So this week we just keep walking and the doctor will see how she looks next week. I guess the muscle group in the back of her left leg is still undeveloped and that is what is causing her to lock her knee and turn her foot out...that stupid spica cast. It has been six months and we are still working out the kinks! So we will keep going to our physical therapy sessions until everything looks good, I was a little disappointed we haven't graduated yet to "normal", but what is "normal anyway right? Honestly I'm fine with going back to our weekly visit, Mabel even likes going. I'm just so thankful we are in physical therapy, I would recommend it to anyone who's baby was in a spica cast - I guess the secret is to find a really good pediatric therapist too!

She's Trying...

Mabel is really trying to stand. The want is there, but the legs are still not too sure. While on the floor in the crawling position she will put her bum in the air and push up with her hands to try and stand, but falls right back down on her bum. But she tries and that is the first step. Zack and I were soooooo excited to see her do that the other day. She always looks so proud and we probably do too! She doesn't attempt it much, but she does occasionally get the gumption up to try here and there. She is cruising more during the day and also cruising one handed. I think she wants to make sure she can do this before she tries. Practice makes perfect!

Monday when we went to the park we met a 18 month old little girl who didn't really walk either! The little girl could stand and take one step, but was trying to crawl around instead - that made me so happy! Mabel was so excited when she saw the baby stand up and step, but she was even more excited when she saw her crawl! So Mabel played on the toddler area again in the park. She climbed both up and down the stairs this time and I allowed her to get a little dirty. Hey, that's big for me! She also loved playing on the toddler "climbing wall". It is a slightly inclined bumpy "slide" thing. She actually could climb pretty well. Her physical therapist will be so excited!

Last Thursday at her physical therapy session I told the physical therapist how the ortho said she didn't need to come anymore. I told her I trust he knows what he is talking about regarding Mabel's hip, but I didn't feel comfortable stopping PT yet. She agreed with me. She said that he's looking at one thing, and that is true. He wanted us to go to PT to improve Mabel's hip flexibility, but there is so much more that Mabel needs. Our physical therapist said that he looks at one thing, she's looking at the big picture. The game plan is to continue to go until Mabel can walk, then we'll go back to make sure she isn't developing a limp or strange gate. That's is a stellar plan if you ask me. The physical therapy has really helped her a lot and she's still turning her left foot in and her knee out as she tries to stand, I don't want all this hard work fixing her hip to be undone by her having an issue that will cause knee or hip problems when she's older due to her learning to walk in a modified way. Her body was in a cast for three very fundamental months of her physical development. Her body loss tone and muscle. She developed modified ways of crawling and rolling and she relied on her upper body much more than she would have. Her body doesn't know these things so she is continuing to do things in a slightly modified way, we are teaching her body to unlearn some of these modified things now. I think physical therapy is the best things we ever did in this process, I would recommend it to anyone going through life after the spica.

Another week...

Well, it has been another great week. Mabel is really trying to stand - actually she allows us to help her stand. If we hold her hips and tell her to get ready she can free stand with out holding on to anything for about three seconds. She really doesn't want us to help her "walk" much since she realizes that she can get there herself and so much quicker if she crawls. That's OK though, I know she'll get it soon.

Her physical therapy went well this week. She tolerated lots and lots of stretching and walking and standing. She wasn't allowed to crawl this week, only be upright and she did great. It seems like she's really locking her knees so we have to work on that and she still isn't really using her hips. It will come in time, her physical therapist said she just has to learn to trust her body and that her left leg is a strong as the right. She's a smart cookie so I know she'll get it!

Overall I'm happy with her progress every week. I think she really is learning well and she is now taking risks with her standing and stepping. She can use her little walking cart without assistance! Her physical therapist said she'd like to see her until she can walk since that is where she should be at. I'm fine with that - plus Mabel loves going there since there are tons of toys!

Oh, yes, the picture. Mabel playing banjo with papa. She's so funny and loves making music! She always uses her piano that Santa brought, her xylophone and drums. Actually everything to Mabel is a drum! She also dances if you say "dance" or if she hears any music of any kind. She'll even dance to the blender or food processor! That funny girl!

What a difference a week makes...

Ever since Mabel was born I've marveled at how quickly things can change from one week to another. In those first few weeks of life just watching the changes as she grew and changed was such an amazing and wonderful time. That amazement just hasn't stopped for me, I'm still in wonder of her as I watch her now just as much as in the earlier months. She's so interested in learning and so focused on it too.

So this week Mabel has really worked on her crawling skills. She's moving now, she's also more daring with her standing abilities, "Look Mom no hands" type of standing, not free standing yet, but standing with her belly against the ottoman and playing. She's also amazingly sweet with her stuffed animals trying to feed them her snacks or bottles and playing patty cake, itsy bitsy spider and other games with them. Right now her favorite is her stuffed cat Mineo. She's sooo cute! When she wants Mineo she meows.

Physical therapy this week went so well. Mabel showed off her new crawling and standing skills and our physical therapist was beyond impressed and happy. The therapist is still working on those tight back muscles and trying to get her to stand with more weight on the left leg, but overall Mabel had a blast "playing" on the giant yoga ball and blowing bubbles. She had a great nap in the late morning and now that I'm back to my part time work schedule I was able to be home at my usual 3:45 and have some fun playing time with my girl both Thursday and Friday! That makes a Mama happy!

Speaking of happy, look at this baby move!

Feeling Pretty Good...

I'm happy to report that I'm feeling like a "normal" parent lately. Mabel is making such progress with her physical therapy and she can move around so well. She sits and stands on her knees and she's pulling herself up a lot more. She has come so far. Yesterday at physical therapy the doctor said she is very happy and impressed with Mabel's progress. She did some more stretching to loosen up Mabel's lower back and rib cage that is out of whack from being in the spica, but overall she was very happy with how far we've come in such a short time. The doctor helped Mabel "walk" while holding on to a toy shopping cart. Although Mabel is happy standing now, she doesn't want to lift her right leg at all, that is her stable strong leg, so the doctor is trying to encourage her to put weight on the left leg and lift that right one, she managed to get about 3 feet of walking out of her. Seeing that is just surreal to me, in fact seeing Mabel upright is still such a trill. I can't picture her standing unassisted, never mind walking. The doctor said her body is very adaptable, that is why she is so out of whack from the cast, she just adjusted her posture, but it makes the physical therapy easier because she just responds to it so well. For Mabel it is playing, but for her body it is hard work. She has so much fun, I'm so glad our orthopedic prescribed this, I was so worried when he did, but so happy now.

I've read online that the average age for babies to begin walking is 15 months, Mabel is there now, but some healthy active babies don't start until 18 months. 12-18 months is the average age range for normal baby walking to start, some ambitious few start around 9 months from what I read...I wonder if Mabel didn't have hip dysplasia when she would have started...I try my best to not focus on those average milestone ages, but it is hard. Every time someone who doesn't know that she has had the surgery and spica asks me old Mabel is and I tell them the first this they typically ask is, "Is she walking?" and then I have to say no, sometimes I explain, sometimes I don't feel like it. I try to interject that she talks up a storm though. Her new thing yesterday was if she wants something and you ask her to say please she goes: "Pleeezzz" so very cute! I mean the other day I met a couple and their 13 month old, their baby was just standing, no walking. Now I felt a little better thinking that since Mabel was born a month early her adjusted developmental age is 14 months and so she isn't that far behind, I know it is a stretch, but it made me feel better.

Anyway, we are doing good. Mabel's next orthopedic appointment isn't until the end of the month, she continues with physical therapy, but over I feel normal and the spica, surgery and brace feel really behind us now and we are moving forward.

The Doctors Agree...

I couldn't have been happier than when I heard the Physical Therapist say that Mabel has already shown a lot of improvement. She is excited about the progress that she has already seen in the past three visits. This past Thursday she said that Mabel is really doing great and to keep up the home work that we've been given. Mabel can now successfully get up to the sitting position herself and back to her belly without a thought. She also likes to pull herself up and although she doesn't crawl on all fours yet, her left knee does get moving when she's army crawling. She also keeps her left foot on the floor more when standing and she straightens that leg more.

Mabel's Orthopedic Surgeon agrees that her mobility is much better, but he wants to see more flexibility so he agreed to stick with the physical therapy. He took an x-ray to get a good look at that joint. I was relieved that he wanted to x-ray since he hadn't ordered one since Mabel's cast was removed on January 8th, I'm so worried that her hip will dislocated again. He said the joint still looked good, but he wants to see her in a couple of weeks to keep an eye on it, he too said right now it is a delicate balance of getting that joint to move but keeping it in the socket.

Every day I see more mobility improvements with Mabel. I sometimes wonder where she would be at if she hadn't had this problem, would she be walking? Running? Climbing? It is impossible to know and to picture. Our new PT homework is sitting on the floor with her legs straight out and knees straight so she can reach forward to stretch her lower back and upper thigh muscles. She doesn't seem to mind at all. When ever I have to legs lined up like that I make sure her heals touch and her legs are the same length, I still remember that realization when Zack and I saw her legs were different lengths, it was panic. I just keep my figures crossed that her left hip stays right where it needs to be, I have to honestly say I'd be devastated if we had to go through surgery and the cast again when we've come so far!

Oh, what do you think of Mabel's bow? Yes, I did that to her, but she looked so cute...poor Mabel hasn't she been through enough without her Mummy putting big bows in her hair?

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!

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!

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!