Tuesday, March 13, 2012

Living with a Hip Spica Body Cast

I wanted to jot this stuff down before baby comes. Life with a toddler in a hip spica cast is no picnic, and we wished we had known about some of this stuff from the beginning instead of stumbling upon ideas after weeks of struggling through. In case other parents, like us, are searching online for ways to make life a little easier for those 6-8 weeks I wanted to make note of some things that helped us.

Anyone in a cast will start to smell, it's just too hard to keep perfectly clean all the time. But a two-yr-old still in diapers? That's a whole different kind of stench! We started out giving Cody sponge baths as the cast brochure suggested, but realized a complete soak in the tub every 2-3 days was a better option. He could be scrubbed down with soap while playing with toys almost weightless in the water - it's  probably the only time when he doesn't feel weighed down by the cast. The down side to full baths is that Monte has to get in there with him as he's too tricky to man-handle from outside the tub, and it takes a good 30 minutes to dry his cast between letting him drip dry to toweling him down to using a hair dryer to eliminate moisture inside the cast. Baths are a good 45-minute, 2-person process. We also discovered that while we weren't allowed to put powder or lotions on his skin under the cast, we could sprinkle some baby powder on the outside of the cast, to the parts that were particularly stinky. It didn't take away the stench completely, but it did take it down a notch or two.

At first we would take turns doing other things while one of us just watched him to make sure he wasn't going to slip out of the kid-sized camping chair we had carefully set him in. We soon realized that our poang chair from Ikea was the ideal shape and angle for Cody, stuffing towels/blankets under his legs, bum and back to accomodate him at the 45 degree angle he'd been set in. Someone built a tray with extendable legs for him, to set over the arms of the chair so he can play with toys, colour and eat finger foods without assistance. We also realized quickly that even though the angle he's at doesn't allow him to either sit or lie down, he was still very comfortable playing on his tummy. He even started scooching himself around as his leg started to heal, and you could tell he enjoyed having a little sense of freedom.

Bodily functions posed a number of problems, even though we double-diapered him as the hospital suggested (a size 3 diaper inside and a size 5 or 6 on the outside). We'd pick him up out of bed and he'd be dripping pee everywhere out the sides of his diaper. We'd set him on his tummy to play and pee would either leak up the front of the diaper or up the front inside of the cast, soaking his shirt and the floor beneath him. We learned that tucking the large diaper on the outside into the leg parts of the cast (so it sealed around his skin) kept from leaking out the bottom, and a cloth stuffed down between his tummy and cast would catch pee from leaking out up top, and always having him lie on a towel would keep me from having to scrub the carpet from constant smelly messes! It's been a lot of laundry, but much easier to throw everything into the washer than to take a rag, water and cleaner to the floor when you're 8 months pregnant!

We couldn't figure out for the longest time the best way to feed him meals... we wanted him to be part of the family at the table but there didn't seem to be an option that worked. So we usually had him sitting on our lap, on a towel (to catch pee leaks!) so he could feed himself for the most part and feel included. The down side to this, for us, was that Cody is a very slow, picky eater and so most mealtimes last a good hour for him with us constantly motivating him to eat. An hour with a 50 lb toddler on your lap will get very uncomfortable and annoying! We finally figured out that an office chair with armrests and an adjustable height would allow him to sit on his own at the table. We have to help him eat, but it's a much more freeing alternative than having him keep you a prisoner at the table on your lap for forever! And, with a big brother around to liven things up, a ride around the main floor in an office chair on wheels will keep two otherwise very bored boys occupied for a good amount of time.

Nightmares. Nobody told us that nightmares are quite common in younger kids after going through a bad break like Cody's. He slept great the first few nights home, but then soon after that he was up screaming and crying every hour to every 10 minutes. We were getting almost no sleep which was making life during the day unbearable. We started talking to Cody about what happened, how his leg had owies caused by his brother, but it was an accident and Nate loved him very much and soon the owies would go away. We'd talk about it throughout the day, whenever Cody complained about the pain in his leg, and then again whenever he'd wake up with nightmares. It didn't occur to us at the beginning that he'd need to mentally process what had happened, but it makes sense to us now. It must've been pretty scary and traumatic for him but since he can't talk much we just didn't realize how important it was to work through it with him. Monte ended up sleeping on his floor for about a week, so he was there to catch the nightmares before they erupted into full screaming episodes, and they eventually went away after a few weeks. A fellow mom who's a public health nurse suggested looking into the infant mental health program offered, most likely through the health unit. We would've pursued that had he not gotten over the nightmares when he did. There are apparently health workers trained in "counseling" kids that are too young to talk through traumatic experiences, and it's usually done through therapeutic play. Something else we had no idea about until we were pretty much out of that stage.

We have hopefully only another week and a half left in the cast - we're excited to get out to BC Children's on the 22nd and see what they have to say (and hope that the baby doesn't decide to arrive around that time!).