Share Your Story: Too Hip for Dysplasia

Share Your Story: Too Hip for Dysplasia

Meet Sadie, a patient who is treated by our experts in our Center for Excellence in Hip. Learn more about her journey below.

Blog written by Sadie’s mom, Sarah Beth, of Longview. 

Sadie on her bed, smiling.

Sadie was diagnosed with Developmental Hip Dysplasia (DDH) at the age of 2 months old, when our pediatrician noticed a clicking in her right hip. We lived in Houston at the time and initially saw a pediatric orthopedic surgeon there. She wore a pavlik harness until she was 6 months old, with little to no improvement, and then switched to a Rhino brace. Both the Pavlik and the Rhino were worn for 23 hours a day, only giving her one hour of “freedom” each day. While she was hitting her development milestones, she was making little improvement on the angle of her hip. As we approached her second birthday, surgery became more and more of an option.
During this time, we moved to the Dallas area and made the switch to Texas Scottish Rite Hospital for Children.

We immediately felt a sense of calmness when we met with Dr. Herring and his staff for the first time.

His knowledge on her condition and his willingness to wait to let her body continue to grow was exactly what we were hoping for. For the first time in Sadie’s hip journey, I felt peace with her condition.

As time passed, we continued with her checkups and eventually decided that a pelvic osteotomy would be necessary for Sadie to gain adequate coverage of her hip socket.  The hospital staff did a great job answering all of our questions and helped us through this journey. Sadie likes to explain the surgery by telling people that her hip was shaped like an “L” and they had to shape it more like a “C.”
Deciding to have a major surgery did not come without some hesitation, but the doctors and nurses were incredibly patient with my lists of questions.

Dr. Herring with Saddie

The child life specialists were able to provide a sense of calm for Sadie in situations where my husband and I did not know how to keep her calm. 

They walked her through the surgery beforehand, helped keep her entertained throughout her inpatient stay, distracted her when different lines were removed and eventually told her that it was okay to giggle when the cast came off because it may tickle. That team was an absolute life-saver!

Sadie
Sadie spent six weeks in a Spica cast and during that time, learned to army crawl, maneuver herself and function with absolutely no problems. Her attitude and determination during this time was amazing.

Since having her cast removed, she has had two X-rays and they each show good coverage of her right hip socket. She quickly returned to normal activity and seeing her now, you would never know that there had ever been anything wrong with her hip or that she was in a cast for six weeks.

I completely trust the doctors, nurses, child life specialists and staff of the hospital. Their knowledge and welcoming atmosphere have made many potentially stressful situations a lot easier for our family.

From Sadie’s point of view – “My favorite part of staying in the hospital was getting to go the playroom and meeting the Texas Rangers. I love getting popcorn after each checkup and playing on the playground.”

Additional information on Developmental Dysplasia of the Hip

 

DO YOU HAVE A STORY? WE WANT TO HEAR IT! SHARE YOUR STORY WITH US.

Speak Now for Kids: Physical Therapy Month with Emmitt

Speak Now for Kids: Physical Therapy Month with Emmitt

View the original story on the Speak Now for Kids website here.

October is National Physical Therapy Month, and we invite you to read about our amazing little patients who have benefited from physical therapy services at our children’s hospitals. Today’s blog is about Emmitt from Texas Scottish Rite Hospital for Children!

Three-year old Emmitt got off to a rocky start. While he was in the utero he was positioned head up ―or breach― instead of head down. As a result, his hips were unable to develop correctly, and he was born with hip dysplasia― an unstable joint dislocation where the upper leg bone does not sit properly in the hip socket.

In an effort to treat the dysplasia, Dr. Rathjen first placed Emmitt in a detachable brace, however the family was soon told that surgery was inevitable. In preparation for the procedure, Emmitt’s legs were wrapped and stretched. This photo was taken at one of the pre-op stretch sessions.

At seven-months-old, Emmitt had his surgery. All went well, but afterwards he spent almost three months in a body cast that extended from his chest to his ankles. “The cast made everything challenging,” says Emmitt’s mother Jennifer. “We had to make adjustments to the way he rode in his car seat, the way he sat down, the way he got his diaper changed, and the way he was held. We are thankful to the extended McMurry family who really came together and also to Dr. Rathjen and the wonderful staff at Scottish Rite Hospital that took care of Emmitt as if he were one of their own.”

When at last the cast was taken off, Emmitt learned to walk in almost no time and―like any little boy―was into everything. “I couldn’t be more grateful for my child being able to run, walk and play like any other healthy two-year-old child,” states Jennifer.

Prince William Times: Haymarket mom launches national nonprofit for rare hip disorder affecting children

Prince William Times: Haymarket mom launches national nonprofit for rare hip disorder affecting children

View the original story on the Prince William Times website here.

It was Halloween 2016. Colleen and Drew Rathgeber were taking their three children on a neighborhood candy walk. After “tricking” out five houses, their middle child, Kaelan, complained of an aching left leg and had to return home.

What should have been a fun evening for the young lass turned into an alarming ordeal for her parents. Within a few months, the girl would be diagnosed with a rare hip disorder known as Legg Calve Perthes.

Named after three surgeons who discovered the disorder, it is commonly known as Perthes and primarily strikes children. When it affects adults, it’s vascular necrosis.

To envision its impact on a youngster’s life, think of any adult who suffers from a degenerative hip disease.

Debilitating. Painful. And a loss of lifestyle for those afflicted. But snatching joy from a youngster’s life is particularly difficult to dealwith, especially if they become wheelchair-bound.

“It was rare for a 3-year-old not be able to go further than a few nearby houses on Halloween. We took her to the doctor who diagnosed the problem as a virus affecting her joints,” said Colleen Rathgeber. “They said it would clear up in two weeks.”

Indeed, the problem faded until the Christmas holidays a few months later. Kaelan began limping again and displaying considerable pain with everyday movements.

While attending a neighborhood Super Bowl party in February 2017, one of their friends pointed out the child’s limp appeared to be more pronounced than ever.

After extensive blood tests by their pediatrician and X-rays from an orthopedic surgeon, the parents were assured their daughter was fine and would shake the limp over time.

Yet one month later, Kaelan was sent home by her gymnastics teacher because of the painful leg.

“When she walked into the house her leg looked like it was detached from her body. She was dragging it behind her,” Colleen Rathgeber said. “It was scary and traumatizing and we immediately took her to the pediatrician again.”

“After a full examination, the doctor said it was either cancer or a rare bone disease that he had not seen in his 24 years of practice. He tended to rule out cancer since her white blood count was normal,” said Rathgeber.

The parents scheduled an appointment with a specialist at Children’s Hospital in Fairfax. “The doctor walked in with the original film in his hand and said, ‘It’s right there on the X-ray.’” She had Perthes.

Birth of foundation  

Roughly five in 100,000 have Perthes, which most often strikeschildren between the ages of 4 and 8. It is more common in boys. It evolves slowly as the blood supply to the affected hip is interrupted causing the femoral head, or hip ball, to ultimately fragment away.

If the hip receives constant high impact during the youthful stage it can alter its shape and lead to ongoing pain in adults.

Rathgeber began to research the disease in an effort to have Kaelan enrolled in a study group. Her singular most important contact was Dr. Harry Kim with the Scottish Rite Hospital for Children in Dallas, Texas. Kim specialized in the disease and had formed a study group targeted at 6- to 8-year-olds.

“The doctor said he had been working with Perthes for 25 years and couldn’t understand why there was no foundation to support research and awareness of the condition,” Rathgeber said.

“The more I thought about that, the more I could not shake the idea there was no single point of reference for parents seeking to better understand the disease and help treat their children.”

The working mom and mother of three — sons Kade, 8, and Bode, 3, round out the family –seemingly had little time to build and launch such a foundation. But never underestimate the power of a mother’s love.

With the decision to move forward, Rathgeber applied for a 501(c)(3) nonprofit status. She was required to form a board of directors and asked a friend, Shelley Crawford, who was studying for her physician assistant’s degree and Kim to serve on the board with her. They agreed. The Legg Calve Perthes Foundation was born.

Her motivation to act accelerated when Kaelan was subsequently diagnosed as suffering from Perthes in both hips. The child is not wheelchair-bound but does require the use of one on long day trips or whenever her hip pain dictates.

Kim also pointed out there was no event that enabled parents to meet annually and discuss their children’s conditions and receive updates on research.

So Rathgeber planned and hosted, in concert with Kim, the first annual Perthes conference, which was held in Dallas in October 2017. The daylong event was attended by 25 parents from across the country with 15 surgeons and 10 hospital employees presenting insights into the disease and its research.

“The parents felt they got more out of attending that conference than they had ever learned from their doctor or online. The disease affects the entire family, and it was amazing to see these parents sharing their stories and crying together.

“They were all feeling similar pain, isolation and sadness because Perthes robs their child of their childhood. Restrictions include no running or jumping, and it’s really hard to stop young kids from such activities,” said Rathgeber.

The positive news is 70 percent of cases resolve themselves by the age of 10 when the femoral cap recovers its blood supply and regrows the hip ball.

“But that requires parents to restrict their children’s activities. If the hip ball is constantly pounded, it will flatten the head and require surgery, which is very painful.”

Awareness and fundraising  

Bringing her extensive business experience to bear, Rathgeber, who holds an MBA, sponsored a Perthes awareness event at a Washington Nationals ballgame in June. She, board members Crawford, and Dr. Benjamin Martin were recognized on the ballfield for their work.

Locally, the City of Haymarket issued a town proclamation in support of her foundation in June of this year and lit the town hall in blue lights in recognition of all those who suffer from the disease.

The foundation has also been accepted into the National Organization of Rare Disorders. Acceptance resulted in two additional members joining the board, Drs. Wudbhav “Woody” N. Sankar and Jennifer Lane.

Additionally, an honorary member of the board is actor and TV host Cameron Mathison who had Perthes as a child.

Sankar believes the foundation provides a valuable role because of the limited information available on the disease.

“The Perthes Foundation helps plug these gaps by providing invaluable support and networking opportunities. It has been amazing what Colleen has accomplished. She and the foundation have made a real difference in the lives of patients,” said Sankar.

On Oct. 20, the Second Annual Perthes Family Conference will be held in Dallas, Texas. The full-day event will showcase topics that matter most to families as they navigate through the Perthes lifecycle. As with the first conference, nationally known Perthes physicians will be in attendance to answer questions posed directly to the experts.

All of these activities require a budget, and Rathgeber encourages anyone interested in her efforts to visit the foundation’s website and donate.

“There’s a lot of components to Perthes including the impact on the family. We’re really excited to continue to grow. Our efforts to address these issues have been personally rewarding for all of us involved in the effort.”

For more information on Legg Calve Perthes disease, its mission, educational efforts, research and donations visit https://perthes.org

Hip Dysplasia in Some Linked to Poor Swaddling

Hip Dysplasia in Some Linked to Poor Swaddling

Development dysplasia of the hip, also known as DDH, occurs in one in 1,000 births, and doctors at Texas Scottish Rite Hospital for Children warn how improper swaddling can lead to the condition.

DDH is a relationship between the ball and the socket of the hip joint, in which the socket of the pelvis doesn’t fully protect the ball of the upper femur.

“Very commonly, the doctor doing the exam can actually push the ball in and out of the socket and feel the hip to be loose,” said Dr. David Podeszwa, at Texas Scottish Rite Hospital for Children.

When swaddling, a baby’s legs should be in a frog-like position and should have enough room to move around. Read the full story here

Swaddling Tips to Avoid Hip Dysplasia

Swaddling Tips to Avoid Hip Dysplasia

Texas Scottish Rite Hospital for Children is dedicated to providing quality patient education to our families. Learn more about the correct to way to swaddle a baby and the importance of doing so to avoid hip dysplasia.

How is a baby swaddled?
A blanket is wrapped around the upper body of the baby to bring tightness/firmness so that the baby feels secure.

What is the right way to swaddle?

  • A parent/guardian should wrap the blanket around the upper part of the body while keeping the legs free to move and kick.
  • If the legs are wrapped in a tight, straight position, it could create abnormal stresses and pressures to the hip.

What is the incorrect way to swaddle?

  • The baby’s legs should not be wrapped straight and tight with the blanket when being swaddled.
  • If the legs are wrapped and put in a static position, the baby is unable to move his or her legs. The child will then try to fight against the swaddle causing the hip stress with abnormal forces which can encourage hip dysplasia.
  • In young babies, everything is very moldable, stretchable and soft. Keeping the legs free while in a swaddle allows the baby’s hips to develop normally.

What is developmental dysplasia of the hip (DDH)?
DDH occurs when there is an inadequate coverage of the ball by the socket or there is a dislocation of the hip (the ball is completely outside the socket).

When can DDH develop?

  • It can occur before birth.
  • During birth.
  • After birth.
  • During early childhood.

What are the possible causes of development dysplasia of the hip?

  • The cause of DDH is unknown.
  • It could be genetic – children with a family history of the hip condition are more likely to have DDH than children whose family does not have a history of the disease.
  • Studies have shown that if a baby is swaddled incorrectly, it could lead to DDH.

Learn more about hip dysplasia.
If you have further questions regarding the correct way to swaddle your baby, contact us at askadoc@tsrh.org.

Sam’s Moment – Hip Dysplasia

Sam’s Moment – Hip Dysplasia

Sam loves playing sports. After receiving a diagnosis of hip dysplasia, he temporarily needed a wheelchair and had to figure out a new way to play. He discovered wheelchair motocross. Flying down ramps, it’s Sam’s moment to be fearless.
This month, we will be giving you a deeper look at our Center for Excellence in Hip on our Facebook page. Join us for patient stories, flashbacks and interesting facts. For more information, visit our Hip Disorders page.