Anyone with experience with full leg casts?

[slsh]

Diva is having surgery on 01/02/2013. I'm not crazy about it at *all* but have reviewed pros/cons with- her and ... well, the kid is in so much pain for so many reasons, have no choice but to try to address some of it.

Anyhoo.... She will be in a cast from top of thigh to either ankle or toes, depending on what has to be done. Wheelchair for at least a while, if not the full 6 weeks.

Anyone been there done that? Any suggestions for showering? We do have a roll-in shower and a tall (accessible) toilet. I'm already in full on panic mode over keeping her clean, comfortable, and sane. Just the logistics of managing this is going to be ... um .... interesting.

 

[confuzzled]

i do.

its a nightmare for all the reasons you mention and then some.

they do sell these inflatable cast covers but they are expensive and our cast guy didnt feel they were really the be all end all. we used large garbage bags with a stretchy headband to secure it at the thigh and did baths (with leg on tub ledge) instead of showers. since you have a roll in shower, she could probably be 1/2 in-1/2 out with the bag covering just in case.

extra pillows for bed to prop it up, and pillows to get comfortable in the wc--if you have one with adjustable foot rests thats good, but it can still not be the perfect angle, if that makes sense. you'll want to ask if she needs to keep it elevated, just keep weight off of it or any other special instructions they might have. oh, and if toes are bare you'll probably want so THICK, short, cheapo socks (they'll be too stretched out afterward to be worn again).

you also might want to call her school and ask if you can get some kind of temporary accomodation so that she can leave class early to get to the next one--someone who is not used to crutches or a wc might have a lot of difficulty in the hallway throng of kids--and if you have some weird backpack rules, ask if an exception can be made so she can carry her stuff. and dont forget the excuse for gym. if she is formally in the wc, you will probably need to deal with transportation too--a lift equipped bus.

one of the biggest issues we had was skin breakdown and staph under the cast. he was asymptomatic of course until it was removed and had no rx for an antibiotic or topical cream or anything since they wouldnt do it PRN...and ended up having to go to a walk in clinic with a fever hours after the removal. so you might want to ask how they handle any issues like that.

and tell her to expect skin to peel once its off. and her leg to stink. its normal ;-)

if i think of anything else i'll let you know....oh, and it *will* itch. and she's not supposed to scratch it....but um, a very thin skewer or dull knitting needle works wonders as long as she is vvvverrrry careful.

but i never said that.

 

[slsh]

I've already touched base with HS. They will have a classmate move her from class to class before bell - and I'm just so anxious about this postop leg sticking out like a sore.... leg. Wonder how many times it's going to get bumped. We have a wheelchair lift in van so transportation is good (though I'm thinking it will be a 3-ring circus with 2 kids in wheelchairs - must find sense of humor, and FAST!!!). I'm going to get her a bunch of goofy socks for Christmas. She obviously won't be able to wear school uniform, so I'm thinking sweat pants with- left leg cut off.

The whole skin thing has me worried. Seems counter-intuitive to cast a surgical incision, but... ok. Definitely will be keeping an eye on that. She did have a cast on her hand in first grade, so she remembers the itching etc., but I don't think she realizes that it won't just be hand/wrist itching, it will be entire leg, and she won't be able to reach her toes.

Pillows - thank you! Will make sure our extras are washed and ready to go. And will make sure we have lots of garbage bags (though I don't think her leg will fit in one - she's 5'10".... maybe one bag with- hole in it over first bag).

She's in marching band instead of gym, and marching season is over (and probably what exacerbated this), so we're good there.

 

[InsaneCdn]

Go to your local dry cleaners and ask them for a few dress-length bags - tell them your situation.
We have a "regular" one we use - we're only there one a year or so, but they recognize us, and are glad to "help out" with something like this.

 

[Tiapet]

Omgosh yes! Ms. Queen has LOTS of experience with casts, albeight it was when she was little as she was in serial casts since 4 days (she had both her feet all the way up to thighs and any given time) old up until she was about a year and then periodically again after each surgery over the years. Confuzzled gave some good ideas.

Some schools have weird rules about the backpacks and won't allow them to have them through the day with them. This is a mandatory request that they can NOT deny her to carry her things. Wheel chair she can hook it on and then if she goes to crutches have them go to having a "helper" carry things because there is no way she can maneuver with a backpack too at that point in time. You must do this ahead of time and not wait.

Having a roll in shower will be good IF the wheelchair can get wet! Some the seats can't but ask the orthopedic doctor for a script for a shower chair. That will be more helpful actually to her. Do you have a shower head with a detachable hose? If not, invest in a very cheap attachment (they go on faucet head or shower head depending on what you choose) as that will also make life a heck of a lot easier and, if is embarrassed to have someone with her, will make her feel more independent and comfortable being able to shower alone safely to a degree.
Garbage bags can work but I'm not so sure that a head band may be tight enough to keep water out. If you get ANY water inside that cast, you are going to have a mess of macerated skin (broken down) and ick! You do NOT want to have to go through that! Trust me. What you can do is use the bags but use duck tape just above the line you put the head band so that area is nice and tight around the leg and THEN put the head band at the top. This way it's tight around leg so not to get the water in and then the head band allows for comfort on the leg itself (the part that actually touches).

Itching, ah, now this is where she's going to get miserable! Do not ever put anything down into the cast. You will hear this over and over and over but you would be amazed at how often people do it, especially kids and then there is big problems! They use rulers, pens, pencils, back scratchers, opened coat hangers, etc. Then you risk scratching or cutting the skin and getting an infection (REALLY BIG problems them!) or those items get stuck/lost in there. At first there is going to be the swelling so itching probably won't happen until after it goes down (that's why they most likely will have her have it elevated to keep swelling down and believe me, it WILL help with pain. Let it not be elevated and see how much worse the pain gets!). Here are what you can do: give benedryl (make sure it's ok with your dr first please), use a hair dryer on COOL setting to blow air into the cast on either end (it' a little more tricky with a bend in the knee if she has one- we've had both kinds), use TALCUM or CORN STARCH powders to get down into the cast to soak up the sweat that is causing the itching. Do NOT use baby powder or anything like that! The other 2 suggested wicks up moisture and are meant to do the job safely and with out stink. A better idea when using the powder, if you can, is go it outside or in an area where you can also use the hair dryer on cool/low setting to blow the powder into the cast so it gets down in and evenly distributed. If you just pour it in it tends to get down in there but in BIG clumps in a single area then nicely dispersed. It's a little more tricky when you are trying to put it in from the ankle/foot end but it CAN be done with a little patience!

As for transportation, does your difficult child have an IEP? Get a temporary rider in it for her to have special transport (if she is a bus rider) for their lift buses to accomodate her wheelchair when in it and then later same private transport due to long leg casting as she will NOT be able to walk up the stairs on the normal bus, even with help real well since she does not use crutches on a daily bases in her life (aka, not an "experienced user"). Even if they have to provide a private vehicle of sorts, they must do it! This is ONLY if she has an IEP however. If no IEP, you may not get the later part of my suggestion. You SHOULD be able to get the first part though. Also, ask for them to allow her to get benedryl and the powder at school if necessary (do they have a school nurse?). She may need that too.

Finally, I wouldn't suggest she attempted to wear any shoe on that foot for the duration but I would suggest the booty kind of slippers like these. Her feet may go from hot to cold at times and you also will want to be able to roll up or down to the ankle as swelling goes up or down too. Of course there are many kinds and colors, just make sure that they can open up around the ankle area to allow for swelling.

Oh and for fun...for her and friends...give her a little gift bag with unique markers, all colors, glittery, etc for her classmates to sign. Even stickers if you like. It makes it much more fun and decorative besides just "signing". You could always, as a gag, give her one of those bells you put on bikes or something similar that makes noise so that when she walks through halls or where there are people she can ring it or make the noise to alert people she is coming through. They will turn and look and less risk of getting bumped!


As for post surgery infection casting...been there done that too and yes...we've experienced a very bad one. Enough that difficult child had a picture line for 3 months with antibiotic. Don't worry as it's rare BUT...if you start smelling a really foul smell, GET TO THE DR! That's infection!


If I can think of anything else I'll add to this. If you have any questions that you can think of that I didn't address or that come up, please feel free to ask here or PM. I'm very serious as I am very experienced with this. difficult child was born with severe bilateral club foot and a congential knee dislocation so I'm not kidding about serial casting and our experiences!

 

[confuzzled]

showers chairs are also pretty expensive for a short term need....

we used a white plastic cheapo patio chair--the kind you get everywhere in the summer, even the grocery stores sell them...probably tough to find this time of year if you dont have one, but surely someone you know can lend one if you dont.

 

[confuzzled]

....another thing you might want to have her do (if you know the approximate positioning of the cast) is get in your van with her leg in that position to make sure you can adjust the seat enough to accomodate it, and/or check your tiedown placement to make sure she'll have enough room.

i promise you thats not the kind of thing you'd like to find out in the parking lot the day of. ;-D

and resin patio chair-i couldnt think of the right word...and the headband (maybe thats not what the are called these days)--i meant those new kind of bands with the silicone that go all they way around the head--that silicone strip is what makes it work and be fixed enough.

 

[tiredmommy]

Duckie's wrist was broken over the summer and we handled the shower this way: put a thick plastic bag over the cast and secured with a rubber band. Then we wrapped a face cloth around the opening and seceured with a rubber band. Finally we placed a second thick plastic bag over the whole mess and secured with a rubber band. I would think you could do the same but with elastic head bands, large bags (maybe get contractor bags or even a few Christmas tree bags?) and hand towels.

 

[trinityroyal]

Do you know what type of cast they will use on Diva? easy child had a cast due to a crushed hand last summer. It was fibreglass, and he was able to go swimming with it. It dried very quickly, and we didn't have to use the hair dryer or anything.

Now, with the surgical incision it might be a different story. If that's the case, then all the advice above about resin patio chairs, plastic contractor bags with elastics, etc. holds.

It might be worth a chat with the doctor about the type of cast, whether it can get wet, how to handle the incision and skin breakdown, and all that.

 

[HaoZi]

Well I was in full length cast when I was 4, but it was a walking cast, so no crutches or chair. I used a bent coat hanger for when I was itchy, and sponge baths as I recall.

 

[StressedM0mma]

difficult child is in a short arm cast. Again. And hers is able to get wet. (she is in the shower right now.) Her lag cast that she had was fiberglass as well, and able to get wet. No need to cover it. Just be sure to have her shower at night, because it takes almost an hour for the cast to dry out.
And, difficult child had surgery on her foot, and had a cast on her leg. I know all surgeons do things diferently, but difficult child's placed some sort of antibiotic gauze or something over the incision prior to casting. It is a pain. But if my difficult child can make it through I am sure Diva can too.

 

[svengandhi]

PC16 broke his ankle badly right before his bar mitzvah. He had surgery with pinning and was in a full leg cast from June 4 till almost September.hee
He had a cast that was waterproof and he could be showered in it. It was a lifesaver and you should definitely ask about it.

We have a slab shower in the basement. H or oldest boy would wheel easy child outside, around the house and into the basement. We placed a shower chair there and easy child would be helped to undress and the shower would be turned on for him. When he was ready, he'd call upstairs to be retrieved. We took him to daughter's college orientation, the school is pretty hilly, in the chair. I didn't have to do the shower deal because he really didn't want me to.

He was in a Special Education school that had space in a church then and it wasn't accessible so he had home instruction for the last month of 7th grade. H and his teacher set it up so he could skype with his class and they loved it.

Good luck with the surgery.

 

[InsaneCdn]

Ask whether fiberglass cast is an option - we had a family member who needed a major cast (don't remember which limb...), and they were given the option of paying more for fiberglass. On top of being less of an issue with water, it is also LIGHTER. Which makes a lot of things easier.

 

[susiestar]

For a full leg cast, if you can get fiberglass, even at an extra cost, it would likely be worth it. Remember that the cast has to be hauled around all day, and not just by Diva. So that extra weight could be a problem for you, husband, whomever is helping her at any time. It would be worth it, in my opinion, simply from the savings from messed up backs from helping her get around.

No ideas for the itching as this isn't one I have dealt with yet. For the showering/bathing? Go to Sam's and get a case of their baby wipes. They are super gentle, more like cloth or those handi wipes that they used to sell for cleaning. Very durable and effective, designed to clean the human body, and super gentle. I have severe skin problems to the point of itching everywhere for weeks/months at a time. If I shower or even do too many sponge baths with water, my skin breaks down and itches and I end up with horrific sores. I have lots of scarring from this, largely because the itching makes me scratch in my sleep. I never knew you could do that, but I wake up with giant sores. Baby wipes are a major boon to helping me stay clean and unstinky with-o using a lot of water on my skin or lotion, because lotion is also difficult for my skin to handle.

Most people who meet me have no clue that I have this problem. in my opinion baby wipes are a big part of that reason. If you don't have a Sam's, the Walmart house brand of wipes is pretty good but not nearly as nice.

As for the powder, get a container of cornstarch from the flour/sugar aisle of the grocery instead of a shaker in the soap part of the store. It is the same thing but with-o scent and s cheaper than the other kind. Plus you get more, which can come in handy. It is also easier to handle instead of the big shaker bottle because you can get a small amount out easier and you don't have as many worries with getting too much or not enough out. If you don't have a shaker, use part of a piece of pantyhose over the end of a container (hold it in place with a rubber band).

If a scent is desired, put a drop or two of essential oil in a small amount of powder, work through in a ziploc or use a blender or food processor to mix well. This way you can avoid any reactions to unknown chemicals/fragrances in the powder. Remember, that powder will be next to her skin for a long time. It the powder tends to clump, put a bit of uncooked rice in the shaker with it.

I am sorry she is in so much pain. At least this can be repaired now rather than having her in so much pain and so restricted for more of her life.

 

[slsh]

Thank you all for the input. I'm sure I'll be coming back to review as we get closer.

I did find this for her for Christmas. It's a "casttoo" for the cast. Pandas are her thing.

 

[Marcie Mac]

Those are pretty cool Sue - wish I had those when I broke my leg in two places playing golf (don't ask) - was in a cast for 5 months - what a miserable experience.

Marcie