Re: Re: afo question-

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My daughter Kelsey wore an AFO for a while and it was a miserable

experience. It was during the summer and I could not put light enough

socks on her to protect her feet. They came out of that thing every day

so wet that her skin would be pruny and it did not matter how long I had

it on and no matter how many times I changed her socks. Also, she was

trying to stand and cruise the furniture etc and could not maneuver her

foot/ankle at all in the AFO. it would just turn around backwards like

it was hanging from her leg with nu purpose. She absolutely HATED it.

Also, the AFO cost significantly more than the Markells and she can

maneuver her leg better in the Markells with the bar than she could with

the AFO. I don't know much about the brace that Dr. Dobbs uses but I

know that after the experience we had, I will run the other way with no

hesitiation if anyone were to suggest an AFO of any kind again. I may

hate the Markell shoes but they are nowhere near the pain that the AFO was.

The AFO was also expensive. Even though the insurance paid for a

portion of it and they won't pay for the markell shoes at all, we had

about the same out of pocket expense.

Jenni

jennyandkelly wrote:

>-

>Here's my feedback on using a hybrid AFO FAB based on our experience

>w/ an AFO prior to switching to Dr. Ponseti's care. We had two

>styles of AFO that we used, one was a " clam shell " type with two

>pieces; one fit the back and bottom of her foot and then the

>front/top half clamped on and was held together with velcro straps

>(like a two-piece ski boot I guess), the other was just a half shell

>that went from the back of her calf down under the foot and past her

>toes and again, was strapped on with velcro.

>

>The sweating in the AFO was atrocious for my daughter (the two piece

>being worse than the one piece unit). She wore it during cooler

>weather- I can't imagine how much worse it would have been during

>the dog days of summer! They did drill air holes in the plastic,

>but it did little to alleviate the sweating problem. As an aside-

>she wasn't what I'd consider a sweaty or " warm " baby either. We did

>deal with sweat issues in the leather Markell shoes also, but it was

>minor compared to the plastic AFO.

>I don't see how a custom molded AFO would be more economical than

>the Markell shoes or sandals. The plastic AFO would tend

>to be outgrown faster in my mind versus the shoes which conform to

>the foot, yet the material " gives " allowing for the foot to grow.

>You don't have this option with the plastic mold (and if it's

>made " large " to accomodate growth it might not fit the smaller foot

>properly, allowing slippage). We also had issues with detecting and

>correcting pressure points with the hard plastic since my daughter

>couldn't tell us where it touched or rubbed her foot so I had to

>have her wear it and then see if there were any spots irritating her-

> which meant lots of trips to the orthotist to work out the bugs on

>the newly molded braces.

>I would also be concerned about the affect that the AFO had on the

>calf muscle over time.

>About taking the standard Markell shoe brace on and off- I had no

>problems doing it by myself without an extra set of hands.

>

>I think using an AFO on the FAB is a great idea for children who

>have additional defects to their feet which make standard shoes or

>sandals more difficult to keep on the foot. For example, perhaps

>this concept would work better than the shoes for a child who is

>missing bones or toes. A narrower foot structure might benefit from

>the custom molded AFO.

>The other downside that I see to using an AFO is that when a child's

>foot is ready for the next size, you have to have the mold made

>(which in our case involved casting, then using the cast as a mold),

>then wait for the actual plastic piece(s) with the straps to be made

>by the orthotists. This is a time-consuming process that might not

>be bad for a " local " patient, but would be a pain for those who are

>traveling from out of town. At the time that was in the AFO,

>I lived an hour away from the orthotist and I was *constantly*

>driving there and back for fittings. I hated the orthotists by the

>time it was all over- though much of our problem was of course

>caused by the fact that her foot wasn't corrected either! I

>assume this custom molding/fitting process is also true for the

> sandals, but for the Markell shoes, they're a standard item

>on the shelf.

>That's my two cents!

>

> & (3-16-00)

>left clubfoot, switched to Ponseti method at 4 mo. old

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