Body Cast

Happy Day! Nathan is about to have his body cast removed at Children's Hospital in New Orleans

When Nathan was born, we soon discovered that he had Scimitar Syndrome and would need open heart surgery to correct Partial Anomalous Pulmonary Venous Return. It was a frightening time in our lives.  Bryan and I were tremendously relieved when surgery in Michigan proved to be successful.  End of story?  I wish.

About three months later, a checkup revealed that a congenital heart defect was not his only problem. Nathan had a back defect that would paralyze him if left untreated.

After spinal fusion surgery to correct congenital kyphosis, Nathan spent several months in a body cast that started just under the armpits and ended about mid-hip. In the summer of 2007, I searched around the internet to see if a parent had posted their experiences with helping a child under these circumstances, but there was not much to be found on the subject.  Perhaps, writing about our experience will be helpful to another family.

One of the first tricks we learned was how to “petal a cast.” The edges of a fiberglass cast can be rough and uncomfortable, so we were given a roll of “Hy-tape,” a peach-colored adhesive tape, to line the exposed edges of the cast.  This tape is latex-free and has a zinc oxide formula that is supposed to be “soothing to delicate skin.”  Using short three to four inch strips, we worked our way around the top edges, the bottom edges, and the circular cut-out area that allowed his diaphram/abdominal area breathing room.

During his first body cast check-up, it was noted that the cast was slightly high under one of his armpits, so we were sent to the cast technicians to cut away a small section. After the adjustment, the technician gave us a different adhesive tape to re-peddle the cast under his armpits.  Nathan liked this tape much better.  Instead of a rubbery feel, this soft brown tape had a suede-like texture that was more comfortable against the skin.  The name of this tape escapes me (anyone out there know?)*, but if given Hy-tape, you might want to inquire about the tape I’ve described.

Although I heard Nathan’s cast referred to as a “spica cast” by a young resident at the hospital, I believe a true spica cast immobilizes the hips and thighs.  At a certain point in Nathan’s recovery, he was able to walk as his cast stopped short of his legs.  It is still important to escort a small child when using steps, chairs, and bathroom facilities, because the rigid cast can cause problems with balance.

Fiberglass casting material is waterproof, but the lining is a combination of cotton batting and cotton gauze.  You do not want this to get wet!

Bath time needs to be well-planned.  This is what worked well for us:

It's important to prepare for bath time when your child is in a body cast.

1. Lay a large waterproof pad on a bed.  Top it with a bath or beach towel.
2. To the side of this, have your bath supplies ready–washcloth(s), a towel for the body, a hand towel for hair, liquid bath soap, a plastic basin for warm soapy water, a second basin for clear water, “No Rinse” Shampoo.
3. Place child on the towel and clean one quadrant at a time (wash cloth with soapy water, then clear water), using care not to get the inside of the cast wet.  Dry thoroughly between quadrants to keep child from getting cold.  In cooler temperatures, you may want to place the towel in the dryer a couple minutes for added warmth.
4. Keep child warm with a towel or blanket while washing hair.  With “No Rinse” Shampoo (drug store should carry this), you can lather up the child’s hair, and then use a hand towel to fluff hair until dry–no water necessary.  I like this better than trying to shampoo and dangle a child’s head under water to rinse.

Another challenge we faced was the “itchies.” We found that we were able to use chopsticks to carefully reach a few miserable places  inside the body cast.  Depending on your child’s age, it is probably a good idea to supervise playing with small toys such as legos.  Small items could get lodged in the cast and cause skin irritation.

This is no picnic, but… if you can keep your child entertained with books, movies, toys, games, and upbeat conversations, this, too, shall pass!

Related posts:  The Principle of Finders Keepers, Before the Back Surgery.

Also see my article in Parents magazine:  “Nathan’s Wonder Slide”

*April 29,2009 Update:  “Moleskin tape.”

Tags: body cast, body cast bath, Children's Hospital in New Orleans, congenital heart defect, congenital kyphosis, moleskin tape, Nathan, Nathan's Wonder Slide, No-Rinse shampoo, Parents Magazine, Partial Anomalous Pulmonary Venous Return, petaling a cast, Scimitar Syndrome, spica cast, spinal fusion