Saturday, October 31, 2009

The Spica came off early

Wed: 28th October 2009

Hello little Em,
Your Mom and Dad took you to Entabeni Hospital where Dr Stead removed the spica cast this morning.  Tammy said it was done very quickly but you screamed when you felt the saw near you anyway - I don't blame you, I would have screamed too!
Tammy brought you here and it was lovely to hold you close again without the Scotchcast.  I was a bit concerned because twice whilst you were sitting in the pram, you flinched and cried when moving your leg.  Perhaps your joints were stiff and it was sore to move the knee or hip.  I suggested to Tam that she massage your joints with baby oil just to get them pliable again. 
A couple of days ago you started leopard crawling in the cast.  You turned over onto your tummy, pushed down with your elbows and pushed off with your right foot - moving forwards at quite a pace.  Your Mom said that she had even caught you trying to pulll yourself up onto your little armchair in the lounge!  (It looks like this one but is bright orange.  Chris Degenaar - Abby's father - gave it to you.)

It is quite nerve wracking to bring a child home after having the cast removed.  Everyone sighs with relief that it is off but, unlike other children, the chances are that you could fracture more easily because of the three weeks spent immobile in a cast.  I told your Mom about the time we brought your Dad home after having skin traction plasters removed.  I think he was about your age.  He cried on the way home and fell asleep in the car so we put him in the cot as soon as we got home.  Finn and I went to make some tea and suddenly we heard Mark screaming.  He had woken up and tried to sit.  He fell forwards and broke the other femur!  It was unbelievable - really, really unbelievable.  We had to wrap him up and take him straight back to the hospital for x-rays and to be put be back into traction.  We certainly didn't want anything like that to happen to you.
We know that you are going to start getting mobile now and will want to crawl, pull yourself up on things and even try to stand but it would be best to wait until the fracture has completely healed - until the callus has been absorbed as new bone.  Its a bit like a plumber's weld - you need to wait until it is set hard before you start putting any weight onto it.  It looks something like this picture here - with new callus surrounding the fracture site on the shaft of the femur.  Your callus is good, quite exuberant, but it is also osteogenic and can fracture more easily than normal callus.
I'm sure you are going to sleep better now that the cast is off - but I'm not sure that your Mom and Dad will, they'll be listening out for every little peep from you!
Take care my little princess.
I love you.
Granny Silly.

Tuesday, October 20, 2009

First Birthday Party


Happy Birthday Emily,  You had a wonderful party at our house.  Mom bought a Winnie the Pooh table cloth for the diningroom table and made all sorts of snacks - quiche, sandwiches, sausage rolls, cheese rolls, pizza squares: I ordered cup-cakes and cheese cakes and Granny Laura brought a gorgeous No1 birthday cake with Winnie the Pooh characters on it. We had two birthday banners and pink and white balloons.   You gave lots of kisses - got lots of hugs - and enjoyed being the centre of attraction.  About 25 people came and you got quite shy when we sang happy birthday to you.  You got lots of presents and with Mom sitting on the floor in the TV room you had fun ripping off the wrapping paper and opening the boxes and presents.  You didn't let the spica cast bother you and even spent some time rolling on the carpet, playing with some of your presents.  Altogether, it was a wonderful day and you were the perfect little birthday girl! 


HAPPY FIRST BIRTHDAY EMILY ANN


16th October 2009

Hello my darling,
It was your birthday on Friday.  Because we were having a party for you here on Sunday we thought we might not even get to see you on your birthday, but Mark and Tammy took pity on us and brought you around for a visit.

At first they weren't sure how they would transport you in the car because you can't sit in the car seat.  I bought you a plastic dog bed!  I found a sheet of foam and covered it with an old duvet cover (made smaller to fit) and Tammy took the harness off your high chair and threaded it through the slits in the bottom of the plastic dog bed.  Voila!  You have a perfect, transportable bed complete with harness that fits on the back seat!

We bought you a baby doll that cries, breathes, laughs and burps after drinking from a bottle.  It really is a bit weird - very life like - and you were quite taken with it.  We also bought you a few books to add to your collection.  I hope that you will love reading like I do.  Your father hardly ever read anything besides computer books!
It was lovely to have you here for a little while and we all sang Happy Birthday to you.  Its just sad that you are in a cast on your first birthday.  Tammy found some lovely brightly coloured crepe bandages and will colour co-ordinate your birthday outifit on Sunday!
I have ordered special cup-cakes and cheese cakes for your birthday and Tammy will be making savoury snacks as well.
Big hug my darling,
Love you,
Granny Sil

Friday, October 9, 2009

FEMUR FRACTURE

Hello my darling,
Yesterday you fractured your left femur.  It was such a shock because you were in the pool with Jackie your swimming teacher when it happened. 
Tammy got you to Dr Bekker's rooms and he suggested she take you straight to Entabeni Hospital for X-rays.  The pictures showed an oblique fracture, starting about mid shaft.
"Oblique fracture implies a fracture line that is oblique to the long axis of the bone. These fractures generally result from bending, with superimposed axial compression. As a result of the obliquity of the fracture line, this fracture tends to override or rotate unless traction is maintained throughout the period of healing."
Mark and Tammy think that the fracture might have started earlier, in the morning at home.  Tam said that you spilled your milk on the tiled floor and when you tried to turn over into a crawling position your hand slipped and you fell forward and banged your head.  This is when you could have put stress on the leg.  But, you didn't cry when she dressed you and took you to swimming although it is possible that there might have been a hairline stress fracture from the fall.  Kicking your legs in the water would have aggravated the fracture and extended it. 
The staff at Entabeni were very kind to you and your Mom.  Tammy carried you into the hospital and held you to her chest the whole time.  Eventually, at mid-day a private ward was made ready and she was able to lie on the bed, still holding you. The theatre nurse didn't wan't to cause you any further pain so we took you and Mom on the bed down to theatre.  Even then, they wheeled the two of you into the operting room and applied the mask whilst you were lying on your Mom.  You didn't even know what was happening.
Instead of traction, Dr Stead applied a spica cast under anaeasthetic. This is a half spica.  There is a band around your waist and a cast on one leg only.  When your Dad had spica casts they always put both legs into plaster and had a broomstick between the legs, usually just above the ankles.  Your cast looks easier to handle but it still means that you can't sit or bend from the waist.
Em, we are all so sad that you have had another break.  Your Mom and Dad especially hoped to be able to protect you and prevent fractures until you were at least 3 years old - just to give you a chance to develop and grow fracture free.  Unfortunately its just not possible to prevent all fractures - they occur with little or no trauma and when you least expect them to happen.
When Mark phoned to tell us that you were at the hospital Finn answered the phone.  Your Gumpy got into such a state I couldn't understand what he was saying.  When he managed to say that you had fractured your femur I just went cold.  It was like a nightmare.
Today Patty and I visited you for a while.  Tammy needed to do some shopping so we baby-sat you for a while.  I put you in your pram and took you for a walk outside.  You like being outdoors and soon you went to sleep in the pram.  Its going to be hard for your Mom to keep you occupied whilst you are in the cast but we will help as much as we can.
I love you little Em.  I wish there was more we could do to help you and your Mom and Dad.
Sleep tight my darling.
Silly