This is the hip journey of my oldest daughter, Ashlea. I have 2 daughters, Ashlea and Ava, and they both have their own hip Journeys. Ava’s is a completely different and quicker journey. But I will begin with Ashlea’s.
Ashlea was born 9 days overdue, her birth was everything a woman wished a birth would be. It was an amazing. She weighed in at 7lb4oz. She did have comlplications from bathing in and swallowing meconium. But she was a lucky baby girl who came home at 9 days old. She was perfect!
After a few months I began to notice Ashlea’s pant legs were shorter on her left side. I didn’t really take too much notice. She was a happy baby, even with reflux that had her projectile vomiting after every feed. She was a baby that didn’t roll and didn’t learn to crawl. By 13 months old Ashlea had learn to bottom scoot, she did this with her left leg straight out in front of her. It was now that I was getting worried that there was something wrong. I ended up making an appointment for her to see a pediatrician. He took one look at her and said she was fine. I didn’t agree. So much so, I booked in to see a different pediatrician. Again, she was perfect, apart from a slight leg length descrepancy. “Everyone has a longer leg!” I did agree, but not to the degree that Ashlea had. After talking to her father about her head shape (flat on one side from sleeping on her back) we decided to make another appointment with yet another pediatrician. Finally, when he put Ashlea’s legs together, he saw the length discrepancy.
He didn’t say much but sent us to see an orthopedic surgeon. Finally someone agreed with me! There was a length discrepancy that needed attention! We went to the orthopedic surgeon and he sent us straight down the hall for an X-ray. I will admit, I was not expecting to hear or see what we heard or saw when he placed Ashlea’s X-ray up on the lighted screen. There it was. My sweet girl, only a toddler, only 18 months old had a completely dislocated left hip! Over the last 18 months, Ashlea passed her maternal child health nurse appointments with flying colours. The times she went to gp’s I did get them to check her legs and it took 3 peds to realise something wasn’t right and send us to a specialist!
I didn’t know what to think, apart from happiness, that my mothers intuition had finally paid off! We were told Ashlea needed to have an open reduction. This was to happen 3 weeks after she was diagnosed. During these 3 weeks, Ashlea learnt to walk. She has a cute limp and fell a lot. But she accomplished something I thought she never would. She walked. Then 2 weeks later, she went in for her 1st of many surgeries.
I had no idea what to expect. Her surgeon wasn’t the best at informing parents what he was going to do their precious children. I knew she was going to come out in a spica cast. Spica cast! What was that? The internet was my best friend and worst nightmare at the same time.
Ashlea and I spent 4 nights in hospital, learning to care for Ashlea in her new appendage. The 1st time I saw her in recovery stuck in her plaster cast. I cried! At that time I didn’t know how we were going to get through this. I just found out I was expecting my 2nd child. I have touch and go pregnancies. I was told not to lift more than 10kg…..My Ashlea now in her spica cast weighed 20kg! I can’t not lift my daughter at the best of times, but now she relied on épée even more! So I just got on with it and crossed my fingers that my pregnancy would be ok.
Ashlea was such a good little girl. She adapted so quickly! She spent only 6 weeks in her spica (looking back now, I believe she should have been in it longer). It only took her 1 week to sleep through the night again. I started turning her every 3-4 hours during the night, but she could only sleep on her back. While on her tummy she would vomit (reflux) I spoke to her surgeon and they were happy with us to leave her on her back as long as she was happy and not uncomfortable.
On the day of her spica coming off (2nd surgery, even though no operation was needed) she was placed in a rhino brace. It was so good seeing her little legs again and giving her a bath! Her skin was really good. Only a few small patches of dry skin. It wasn’t long before Ashlea realised she could move around in her brace. She began bottom scooting again and after 3 months in the rhino, she learnt to walk, again. For the 2nd time. The brace didn’t keep her back. She went to the park, played with her counsins and was a happy toddler.
After 6 months in the rhino brace full time (23 hours a day) she graduated to part time. Ashlea now only had to wear her brace while asleep. With her new found freedom, she learned so much more. Climbing stairs, running, climbing onto the couch and lots lots more. By this stage, Ashlea became a big sister.
1 year after being placed in the rhino brace, Ashlea reached another milestone. No more brace! After 6 months in it full time then 6 months part time, she was now free from the brace.
Ashlea’s hips were going great. I never thought anything else would need to be done to her hips. That was until she was 4 years old (by this stage, Ashlea was now a patient of the RCH in Melbourne. I transferred her here once her sister was found to have hip dysplasia as well) On one of her many regular visits, it was found that her hip was nearly dislocated again. So at 4, she went in for her 3rd surgery, her 1st federal osteotomy. This surgery was awful as was the recovery! We stayed 4 nights. Ashlea was wheelchair bound for 6 weeks. Once we were home and back to normal, Ashlea adapted well. Zipping around in her new wheels at home, kinder, childcare and while out and about. She leaned to accept the stares from other kids and adults alike. Even though it did hurt her. After 6 weeks Ashlea was given the ok to learn to walk again, for the 3rd time in her 4 short years.
1 year later Ashlea had the hardware removed and recovered quickly. She began to suffer pain on what seemed to be a daily basis. Her surgeon said it was to be expected with growing and the surgeries she had. It kept her from being included in sported etc. But she was ok with this.
The next year was a good year with no hiccups. She aced her specialist appointments and X-rays with flying colours. Then when Ashlea was 7, one of her usual 6 month X-rays revealed that her hip wasn’t in optimal position. Back into surgery again. For her 2nd femoral osteotomy. Again, 3 nights stay at the RCH and recovery was again horrid. Ashlea had built up and adversion to nurses. Whenever a nurse came in she believed they were there to hurt her. So as you could imagine, it wasn’t a pleasant 3 nights! But once we were home and again in her beloved wheelchair, she was fine. She spent longer in the wheelchair this time. 12 weeks. Over christmas and the Sumer break. But it wasn’t nearly as bad as it sounds. We still did family trips to the beach and made memories.
1 year later at the age of 8 it was time for the hardware to be removed. We were getting use to this now and knew what to expect. So after 2 hours in surgery and no word from her surgeon, I became worried. Then 3 hours came and went. What felt like forever was 4 hours and we finally saw her surgeon. I could tell by his face that surgery didn’t go as planned. Instead of the hardware being removed, Ashlea had yet another femoral osteotomy, her 3rd. This time the hardware was a lot bigger and stronger. So much so that she didn’t need a wheelchair for as long. She also upgraded to her 1st set of crutches. Ashlea was proud to say the least. She mastered the crutches better at the age of 8 than I did at the age of 16 when I was on them. This time her recovery from surgery was a lot easier! I’m not sure if it was because of her age and getting older and more understanding of everything. What ever it was, I was grateful for.
At the age of 9 and 9 months after her last surgery, the hardware was scheduled to be removed. This time it was only an over night stay. Ashlea did so well and was up and walking 3 hours after coming out of recovery! She did come out of hospital with her 2nd set of crutches. More for safety reasons at school and while out and about, while the bone healed. It was during this surgery that her surgeon decided that no matter what he did, Ashlea’s cartalidge wouldn’t form bone to form a sufficient ‘roof’ to keep her femoral head nice and tight where it should be. We were told that yet another surgery will need to be performed, her 1st pelvic osteotomy. But when, he does not know. If know, he needs to avoid her growth plates. Which means he will need to do more cuts in her pelvis. Resulting in a much more difficult and in-depth surgery and recovery. If we wait until the age of 13-15, her growth plates will be closed and surgery will be a little easier. But Ashlea is still in pain, so 4 months after her last surgery, her surgeon decided that an MRI was the best option to see why Ashlea was still in pain. And it revealed just that! Not only does Ashlea have a shallow acetabulum, but she now also has a severe impingement and torn labrum.
We are yet to hear where we will go from here. Her recent diagnosis was only discovered 3 weeks ago. And being over the holiday period etc, her next appointment isn’t until early February. Actually, on her 10th birthday.
The one thing Ashlea has taught me is, life goes on and that she is one tough cookie!
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