Need for more intervention for Miss K
Miss K’s surgery and hip spica cast was back in September and October. For one leg it’s made a massive difference as well as making her spine better. The other leg though is not working as well as hoped, because her muscle memory is still telling that leg to turn in. I can do her stretching work and position her well both outside and back in the ward, but she is not staying in those healthy hip positions when I’m not around. The staff have not understood the reason this is essential (even though they have had it explained) and so don’t correct her posture to prevent the hip dislocating again.
It does not help that Miss K fears the pain she remembers and that means she cries when being positioned or stretched. The staff would prefer for her to be happy and in bad posture.
Due to this, the muscles around the hip have got tight and the threat of dislocation again is real. The doctor’s and the hospital physio’s assessment is that it is not painful in the adbucted position, but she fears the pain she remembers and so her muscle tone increases, sending the legs into a bad posture. The conclusion is that she needs to be wearing a brace almost 24 hours a day for two months at least.
Waiting for a brace like this
She can take the brace off when I do her stretching and physio work and for showers, but she must be in it for the rest of the time. The challenge is getting this to happen. She was cast for the brace to be created and that will take a month to make. We will go back in January to get it.
Brace for now
In the meantime, Bann Fueng Fah physios had a similar style brace which thankfully fits her. (It is similar to the one in the image, but harder and wider.) She will use that until her custom-made one is ready. The one she is using now stops the turn in from the hips, but does not have a way to stop the legs pulling up to the waist. We are having to find alternative ways to prevent that. I’ve started to tie a towel from one side of the cot to the other as a means of resistance, so that the muscles can only pull the legs up as far as the towel permits. It does not hurt, but it hinders the spasm’s ability to get her in a bad posture.
I ask your prayers: that the staff would understand and embrace the essential need for this and that it is for the good of Miss K, and that Miss K would complain less, so people are willing to help her in this way. You can see it does not hurt, because there are no tears and if you distract her, the crying stops and she interacts, even though you are still holding her legs in the same position. It’s just so hard to have patience when she wants what’s bad for her and makes you look so mean. I have to remember the audience of the one who is all is the one who counts…. as in I do all I do for God alone and he knows my motives and reasons in what I do for Miss K are right and that I’ve checked and confirmed it’s what needs to happen.
One other thing that the physios said was needed is standing and weight bearing in a prone stander. This week coming I need to work that out and see if the store room has one that would suit her height, as she is smaller than the others who stand. She liked it at the physio centre, especially when I spun her around. I’m hoping that being in it with the others in the bigger one might motivate her. Please pray that the staff accept a new piece of equipment being brought in to my row of equipment and for wisdom for me in knowing how to manage getting her in it on my own. Please pray that Miss K’s moaning and complaining reduces and her stretch increases.
Nicola Anderson.
Update… The staff are reluctant to put the brace on even though after a day time in it I can see a marked improvement. Please join with me in praying we get there. The Physio and nurse are going to talk to them. Praying also for for the grumpy nature to reduce when she is around staff.
Extra update…. she worked real hard both in the morning and afternoon and had her first time in the stander on the ward, It was easier than i expected to get her in and she was not stressed about it at all. She seemed content. Im hopeful for success for her but need your prayers regarding carers attitudes to the brace. They are not willing to keep her in it as the doctor has said. They say she cries. Please pray she will stop so they have no reason to take her out and that they will realize this is preventing the hip from dislocating and strengthening up the right muscles to hold the leg correctly.
Glad the process was less stressful for her and you. Now praying for staff attitudes to change and see the benefits for her.