Thursday, August 29, 2013

Guest Post: Betsy Miller

Ask and you shall receive...
I wanted to have another 'hip' friend do a guest post on my blog.
I am SO very honored that Betsy Miller offered to help me out.

Hi, I’m Betsy Miller, the author of The Parents’ Guide to Hip Dysplasia. Today I’m going to talk a bit about my early childhood treatment for hip dysplasia. Back in 1962 when I was a baby, my mother noticed that something seemed wrong with my hips. I have two older brothers, so I think that’s one of the reasons my mom picked up the problem. Not to mention, she was a very smart person.
When a baby’s hips are both dislocated, it can be hard to spot hip dysplasia because both hips look the same. During a typical infant hip exam, doctors check for asymmetry (if only one hip is affected), and for a hip click—the sound of femoral head (the ball at the top of the thigh bone) going in and out of the socket when they move the baby’s legs a certain way. If the ball never goes into the socket, then there isn’t a hip click.
Sometimes these cases aren’t caught until a child is of walking age. The child isn’t in pain from the dislocations, but the hips tend to look wider than usual, sometimes the feet appear to turn out or in, and there’s a characteristic walk called a “waddling gait” once the child starts walking
Since we don’t have any family history of hip dysplasia, I’m not surprised that mine wasn’t caught when I was a newborn, but I’m forever grateful that I was diagnosed and treated. My parents took me in to be seen by a pediatric orthopedic surgeon. In fact, they took me to a number of doctors for second opinions because they were hoping to avoid an open reduction (surgery that involves cutting open the hip joint). They chose the only doctor who was willing to try for a closed reduction. With a closed reduction, the child is put to sleep with anesthesia, and the doctor maneuvers the hip into place.
So off I went to the hospital for traction to loosen my muscles for the closed reduction. I was a baby, so I don’t remember this, but my parents told me that my mother visited me every day and breastfed me. The nurses disapproved, because at that time, the prevailing wisdom was that bottle-feeding was much healthier, but my doctor said it was fine for my mom to keep breastfeeding. I’ve also been told that when I got bored I would fling my pacifier across the room and yell until a nurse came in to give it back to me. Hmm, maybe I wasn’t their favorite patient.
To get on with my story, after the traction, I had a bilateral closed reduction. Then I wore a Petrie cast with a bar between the legs. After the cast came off, I wore a soft, cotton brace that my mother had sewed for me. I don’t remember wearing the cast or brace, but I do remember being put to bed in a frog legs position. My mother showed me the brace once when I was an adult.
I grew up running around and playing like any other kid. The only restriction I remember is when I asked for ballet lessons when I was about five. The doctor was concerned that might loosen my hips too much, though he said dance in general was fine. So I tried tap dance with one of my brothers, but then I got bored and went on to the next thing—probably jump rope , hop scotch, or roller skating.
Now that I’m 51, I’ve had to slow down a bit. I get hip pain if I stand or walk on concrete for a long period of time. At some point I will probably need total hip replacements, but that’s years away. There’s
no doubt in my mind that without treatment I would have had significant problems from my teen years onward.
Every hip dysplasia story is different. Your child will have his or her own path. Just remember when you’re traveling that path together, that in the end, you’ll get through it and your child will have a better life. That will be the gift you have given your child.

Sunday, August 4, 2013

Baby carriers 101

Hello, and welcome to Baby Carriers 101!
I have been wanting to write this post for awhile, but going to the baby store the other day to look around really fueled my fire!
What happened you ask?!
I was walking by the baby carrier section.  Of course, the biggest end display was Baby Bjorn.  The sales lady was talking to a family about how great they are.  She said, 'it's great that your baby can face out and see.'  The lady said, 'I heard it's bad for their hips?' The sales lady said, 'oh no, that's not true.'
My blood is boiling at this point.  I am looking at her young daughter who is very pregnant, and thinking, OH MY GOSH what if she has to go through what we did with hip dysplasia?
I couldn't take it anymore.
Like a psycho stalker, I waited for the right moment and went over to them.  I said, 'I am SO sorry to bother you, and I don't mean to be weird, but my daughter was born with Hip Dysplasia.  These are the WORST carriers for any baby to be in.  It can cause their hips to dislocate.'
I went on to explain to them that my daughter has spent close to 1/3 of her life in casts and braces due to hip issues.  Thank goodness they didn't punch me in the face, and they were very receptive and asked a lot of questions... WHEW!  I led them to the good baby carrier section of the store, and they bought a BOBA carrier.  YAY!  Made my day.
So, let's get to WHY the front facing-crotch danglers are bad for your baby.

1.  Overstimulation.  A baby is learns from mom or dad's facial clues, and overstimulation of the world around them is NOT good.
2.  HIPS HIPS HIPS!  When a baby is facing forward, there is no support around the knee or thighs.  They are simply 'dangling' from the crotch.  With no support, the hips can slip out of socket.
3.  It's awful for the parent's back!  Front facing carriers are not good for the person wearing them, or the little person in them.

The pic on the left! YIKES!

Remember Lucy's cast?  Well, the cast keeps the baby's legs apart, in a frog leg position.  Why?  That is the best position for hip growth.  It forces the femur in to the socket of the hip, which makes for a happy hip joint.
Harnesses and braces that are used to treat hip dysplasia also keep the baby's legs frogged apart.

Any carriers, bouncers, slings, chairs that keep your baby's legs together or 'dangling' are NOT good choices for healthy hips.

With that said, do we use a bumbo chair?  Yes.  My 6 month old with good hips is allowed in there for about 10 minutes a day to watch me do dishes. :)  No more than that.
Same goes for jumperoos, excersaucers, and especially walkers.  Those contraptions do not allow the legs to be free, therefore can cause hip issues.  Again, if your baby is doing well at his/her hip checks with the doctor, a little bit of time in one of these things isn't going to hurt... just not for long.

If a baby carrier has support for the baby through the back of the thighs to the knee, most likely it's a good one!  Carriers that keep the baby's legs together are not good.  Even though there may seem like the baby can move if he/she wanted to, usually a baby won't fight against the material.  You want the legs to be able to fall open, aka good hip position.

Baby's hips and joints as newborns are very laxed due to the hormone, relaxin, that the mother produces and passes on.  The more you can support the joints at the hip, the better your baby will be.


After birth, it takes several months for the joints to stretch out naturally. Babies that have been in the breech (bottom first) position may need even more time to stretch out naturally. The hip joint is a ball and socket joint. During the first few months of life the ball is more likely to be loose within the socket because babies are naturally flexible and because the edges of the socket are made of soft cartilage like the cartilage in the ear. If the hips are forced into a stretched-out position too early, the ball is at risk of permanently deforming the edges of the cup shaped socket (hip dysplasia) or gradually slipping out of the socket altogether (hip dislocation). Hip dysplasia or dislocation in babies is not painful so this may go undetected until walking age and may also result in painful arthritis during adulthood. The risk of hip dysplasia or dislocation is greatest in the first few months of life. By six months of age, most babies have nearly doubled in size, the hips are more developed and the ligaments are stronger, so are less susceptible to developing hip dysplasia.

The most unhealthy position for the hips during infancy is when the legs are held in extension with the hips and knees straight and the legs brought together, which is the opposite of the fetal position. 

The risk to the hips is greater when this unhealthy position is maintained for a long time. Healthy hip positioning avoids positions that may cause or contribute to development of hip dysplasia or dislocation. The healthiest position for the hips is for the hips to fall or spread (naturally) apart to the side, with the thighs supported and the hips and knees bent. This position has been called the jockey position, straddle position, frog position, spread-squat position or human position. Free movement of the hips without forcing them together promotes natural hip development.

See how bent and flexed the baby's legs are?  Forcing them to stretch after birth can hurt their hips! 

I really wish pediatricians would have this discussion with new parents.  Or at least pictures describing good and bad carriers in their office.  Since they don't, yours truly is here to help:

See how the baby's crotch is the only thing supported in the bottom left photo?
See how in the slings the baby's legs are forced straight and together?
Please don't!

YIKES!  I can't believe this company can make these with a good conscious!
BAD BAD BAD!  Zero hip support.
Crotch dangling.

Zero support anywhere for the legs and hips.  Even though these are inward facing, they still have NO support!

OK, Now let's get to the good ones!

See how the baby is supported through the back of the thigh?  Total support for baby.

YEP.  Good ones!  Support!  I can't imagine being dangled by my crotch!  This  looks way more comfortable.

Super cute wraps and carriers.  Right on.

She's got it!  GOOD JOB mama.

Thank you to my beautiful model, BRIER and her amazing daughter Jocelyn for this photo!
Carrier shown is my fave, BOBA

See on the right how the baby's legs can wrap around mom or dad?  WAY better than the one on the left!

Buying a good carrier may cost $20-$30 more than a crappy one.  But trust me.  Surgeries and hip issues for life will cost you way more.  Mentally and physically!

Here is a list of brands I recommend:

BOBA- rated best baby carrier 2012
So the reason I like the Boba is this.
It doesn't require an infant insert.  
Super easy to put on.  It can support an infant all the way up to a big kid!

I hope this post has helped!  I also hope you will share it and pass it on!

- Karen

aka Lucy and Lily's mama!

Thursday, August 1, 2013

Rate your Doctor

Hi all!

I have been meaning to put together this blog post for awhile.

As you know, we are truly blessed with Lucy's surgeon, Dr. Lee Segal at Phoenix Children's Hospital.
He has made a very bad situation a little more tolerable.  Trusting someone with your child is a big deal.  I am going to write PCH a letter telling them what a wonderful doctor he has been to Lucy.  They are a lucky hospital to have him there.

I think it's so important for us, as parents, to give credit where credit is due.  Many doctors, especially surgeons, have a bad reputation for poor bedside manner, for being hours late for appointments, and for not educating the parents about what is happening to their child.
BUT, like I said, I truly feel like the luckiest mom in the world.  God led us to Dr. Segal, no doubt about it.  I felt so comfortable with him on our first visit.  He was with us for quite awhile, explained things perfectly, and was up front and honest from the beginning.
Now, is the feeling mutual?!  Probably not!  HA!  He told me, 'Karen, you ask questions that no other parent has ever asked me before...'  I am sure I drive him crazy, but he knows me by now... he knows to just go with it. :)

There are a number of sites that you can 'rate your doctor.'
The good, the bad and the ugly ratings.

How nice would it be to be able to shout from the rooftops about how wonderful your doctor is, and how much they have helped your child?  Or, if you weren't happy with a doctor, shout that from the rooftops also!  The internet is amazing, and it's critical in today's society... Finding a competent doctor SHOULD be easy, right?!  WRONG!  It's hard as heck!  It's hard to find someone that  you and your child click with...
So come on moms and dads, let's help out others by recommending a great doctor.

So please, pass this on!

RATE your doctor.  Rate your surgeon.  Rate your physical therapist.
If we all do this, we could help some other family find a great doctor... or potentially steer clear of a doctor that we felt wasn't a good fit.

(Not all the available ratings or rankings sites provide correct information. It's up to us patients to figure out which ones are most useful as we judge a doctor's competence to diagnose and treat us.)

Here are a few sites!

Let's do this!!!!!




DR SCORE CARD--- Australia, UK and Canada too!