I know what you're thinking by seeing the picture above. You're thinking "how in the actual f*&% do you survive that on your toddler?" Well, I am here to tell you that you can and you will...if you're ever faced with this like I was. Boo's spica cast ran from chest to toes with a big bar between his knees. There is an open hole in the cast large enough for his "little man parts" and "toosh" to be exposed for "bathroom purposes" (I will explain diapering below.) Remember, boo's leg break was a spiral fracture of the upper femur, a pretty sever break, so the cast kept any rotating joints from moving and disrupting proper healing. They did place him under anesthesia to put on the cast. We had no issues with that at all, thank goodness. After the cast was on, the most important thing is to try to keep it clean and dry. That seems like an impossible chore, but trust me it can be done (for the most part.) We had to deal with our spica cast for 10 weeks, and if that doesn't seem like enough of a nightmare, the healing after is a whole challenge in itself. I will also explain how we recovered from cast removal and rehabbing little man in enough time for the ever important SUMMER CAMP!
**Ask for two things before leaving the hospital: A wheelchair and a specialized car seat. The hospital may have resources where these can be donated to you only for the duration of time the cast needs to be on.
First thing's first: DIAPERING!
When Boo's cast went on we were potty training. We decided to put that on the back burner. Heres how I would diaper him to keep him clean, dry and healthy. **You may find yourself diapering a lot more than you used to before that cast, that great! Keeping the little ones hydrated and their tummies healthy is an important part of healing. Boo did not feel like eating much at all the entire time he was in the cast which is very normal. In the future I will post a blog on smoothie recipes that keep Boo full and happy. We lived on these for the 10 weeks during the cast.**
- Create a diapering area on the floor. I used his old crib mattress but you can use an old changing pad as well. This worked better for us. I could diaper him, sponge bathe him, "dress" him and brush his teeth all while sitting and not throwing my back out. (These casts are heavy and you'll be carrying them everywhere when they aren't in the wheelchair so save yourself the pain of a back injury.)
- Supplies: 2 different size diapers: I used a size 3/4 diaper and a size 6 diaper, Aquaphor, Honest Soothing Bottom Wash, wipes, and Moleskin Padding
- Place the the moleskin padding around the edges or the opening to prevent the cast from rubbing on the skin. (Your nurse will help you in the hospital. But it's nice to have replacement moleskin for cleanliness.)
- Tuck the smaller diaper back to front into the hole in the cast. Make sure the diaper is tucked in as for as it will go into the back and front to prevent any liquids from touching the cast.
- Place the large diaper over the other diaper and securing over the cast. The double diaper ensures dryness also looks ridiculous, but it works.
Bathing a kiddo in a Spica Cast:
I felt like this was very important to keeping our "nighttime routine" of dinner, bath, pjs, bedtime in tact. We did this on his diapering area.
- Warm bowl of water
- Johnson's Washcloths
- dry hand towel
Using the bowl of warm water, wet the washcloth and beginning with the head wash kiddo and dry each area one at a time. Face/ears, neck, chest, arms and arm-pitters, hands, then the diaper area, then…last but not least…stinky piggies. This cast is going to get dirty (despite all of our best efforts, it does and it SUCKS) but keeping their skin clean in paramount to good health so just try your best here. The Washcloths are also helpful in washing kiddo hair, but we didn't need to do this more than once a week, given nothing weird ended up rubbed all over his head.
Keeping kiddo entertained:
i propped Boo up on the couch with a series of pillow configurations that worked (it took a while to figure this out, but you will) and purchased a lap tray for playing Playdoh, legos, coloring, etc. Also, we have an iPad mini that was essential.
I used the wheelchair for meals, snacks, a change of position, etc. By placing two pillows (one to sit directly on and one to rest his back against) I created a more comfortable sitting position for him and used this travel tray to place these amazing PB Kids plates.
Like I have said. You make it work. My ways may not be exactly what you need to do for your situation, but trust me, I tried a many different solutions only to end up at the point where i had finally found what worked for Boo and I ran with it.
I actually took Boo to Walk Disney World while he was in the cast and it worked out pretty well. it was a short and sweet little trip and Disney made the whole experience very special and happy for all of us. I will eventually post a "how to" on Disney with the cast and Disney without the cast.
Healing post Spica Cast:
Don't be shocked when the cast comes off…I was. Your child will cry so have Motrin on hand at the doctors office. I used the special car seat on the way home. Remember, your child will feel very strange after the cast comes off so offer lots of snuggles and prepare for a long day ahead.
My sons skin was raw and red and it looked horrible. it was very itchy! I coated him in organic coconut oil with a drop of lavender oil added in for good measure.
Once he was home I got him into a luke warm bath to clean the areas well. He had a hard time sitting up, just a heads up. But he was extremely happy to be angle to get into the bath again!
Walking was very difficult at first. I used this Pewi YBike to help him move freely and regain strength in his legs and some confidence.
The key to our rehabbing Boo was swimming. The day after his cast came off I got him into the swimming pool. He was intimidated at first (which was new for my little fish) but once he realized how great it felt he became more comfortable and was smiling in no time.
Just remember that before it gets better , it gets harder. It takes a lot of physical and emotional work for these little guys to regain their full abilities. He would walk perfectly one day and the next day be unable to stand. You've got this! Just breathe and allow them to work at their own pace. Our doc didn't not think we needed the physical therapy so I was left to figure it all out on my own.
I really hope that this post can help someone navigate the world of what its like to deal with a situation like this.
Good luck and much love!
-W and Boo