New and need help with DBB!!

[Guest guest]

Hi, I'm new here. I apoligize in advance for the length of the post,

but I don't know how else to describe my problem. My son was

born 8/1/04 with severe bilateral club feet. He was casted at 1 week

and 2 days old. The casts came off on Oct 19th and we went to the

DBB. For 1st couple of weeks, he screamed bloody murder (but only

while we were putting them on - after they were on, he was fine).

After the 1st couple of weeks, he didn't even cry when we were

putting them on and he was oblivious to them. Then came the day that

I was so looking forward to...a little over a month ago, he got to go

to having them on only at nights and naps. That's when the nightmare

started. When we took him that time, they changed his shoes to

bigger ones. After a few days, I decided they were too big because I

didn't think his heel was going all the way down into the shoe. We

took him back and they agreed and put him in smaller shoes.

Somewhere around that time, he started really fussing when I'd put

them on at night and it was harder to get him to sleep. I thought he

was frustrated because where before he didn't know the difference

because he had them on all the time, now he knew how if felt to have

them off during the day so he wasn't liking having to get them back

on at night. Then 1 night he cried off and on all night..the next

morning he had a blister on 1 heel and a red spot on the other. I

was so upset because I knew that he was hurting that night, so I kept

the shoes off a couple of nights to let the sores heal. When I tried

putting them back on a Friday night, he screamed at the top of his

lungs and I was afraid he was hurting so I decided I wasn't putting

them on again until I took him back to ish Rite on Monday and

have them checked out. The specialist felt the shoes were the right

size, but she adjusted the heel area out so that his foot could get

down in there better and had me change the way I was putting them on

(I now completely unlace them and remove the tongue so that I'm sure

his heel is all the way down. His toes are in the right spot and

they seem to really be in there good. It's been sleepless nights

ever since (this is a baby who has slept thru the night since he was

6 weeks old). I thought he just needed to get used to them again.

But it's been a week and a half and I'm at my wits end. Has anyone

had this particular problem. I don't know if he just doesn't want

them on or if he's hurting. The thought of him hurting scares me to

death, but I'm also scared of taking them off anymore. Sorry for the

long post, but I didn't know how to shorten it. I'm so relieved to

have found this support group! Thanks for listening and any advise

is greatly appreciated!

[Guest guest]

Hello .

Welcome to this site! I hope to put your mind at ease a little by telling

you, you are not alone and this happens to many. This is not my area of

expertise, but I wanted to respond since you are anxiously awaitin'. I

would check a couple of things: first, do you know if his feet have lost

any correction during the times you had his shoes off? If his feet have

lost even a little correction, the DBB can be painful for him. Secondly,

check the length of the bar to make sure it is shoulder width. I think

most measure from inside heel to inside heel. Hold them up to his

shoulders, while the shoes are attached to the bar, the length between the

heels on the shoes should be shoulder width. I know others measure from

the bolts on the bottom of the shoes too. Also, what are the shoes set

at? They should be set at 70 degrees. You want to make sure the heels

are all the way down and the laces and strap are very tight. The tighter

the shoe, the less chance of them slipping or causing blisters.

If all the above seem to be okay in your opinion, is there a chance he is

just looking to see if you will cave and take them off everytime? Is he

crying in pain or whining because he wants the shoes off? Use your mommy

instinct. If you strongly feel something is wrong and he is in pain, then

he probably is. If this is the case, you may want to consider a second

opinion.

I hope this helps. Others will chime in will great advice. You have come

to the right place to get the answers you need.

Hang in there!

Shook

Retail Operations Manager/Baking Instructor

Vie de France Yamazaki, Inc.

2070 Chain Bridge Rd. Suite 500

Vienna, VA 22182

x374

x374

fax

[Guest guest]

,

I believe someone on here recently had this issue of reducing hours causing

sudden sleeplessness. If I remember right, she started back at zero, putting

them on for the 23 hours and reducing the time more slowly to give the baby time

to adjust to being free and it did the trick. Something to that nature, sorry I

do not remember it exactly.

s.

Re: New and need help with DBB!!

Hello .

Welcome to this site! I hope to put your mind at ease a little by telling

you, you are not alone and this happens to many. This is not my area of

expertise, but I wanted to respond since you are anxiously awaitin'. I

would check a couple of things: first, do you know if his feet have lost

any correction during the times you had his shoes off? If his feet have

lost even a little correction, the DBB can be painful for him. Secondly,

check the length of the bar to make sure it is shoulder width. I think

most measure from inside heel to inside heel. Hold them up to his

shoulders, while the shoes are attached to the bar, the length between the

heels on the shoes should be shoulder width. I know others measure from

the bolts on the bottom of the shoes too. Also, what are the shoes set

at? They should be set at 70 degrees. You want to make sure the heels

are all the way down and the laces and strap are very tight. The tighter

the shoe, the less chance of them slipping or causing blisters.

If all the above seem to be okay in your opinion, is there a chance he is

just looking to see if you will cave and take them off everytime? Is he

crying in pain or whining because he wants the shoes off? Use your mommy

instinct. If you strongly feel something is wrong and he is in pain, then

he probably is. If this is the case, you may want to consider a second

opinion.

I hope this helps. Others will chime in will great advice. You have come

to the right place to get the answers you need.

Hang in there!

Shook

Retail Operations Manager/Baking Instructor

Vie de France Yamazaki, Inc.

2070 Chain Bridge Rd. Suite 500

Vienna, VA 22182

x374

x374

fax

[Guest guest]

Oh boy do I know what you are going through! We had the same problem. My

son needed to start again at 23/7 for 2 days and then I gradually reduced

the hours over a week and a half. Now I put them on about an hour before

bedtime so he can get used to them again. I think it was very hard some

kids to go all day free as a bird and then get chained up at bedtime. Now,

he is fine going to bed with it on. I hope things get better for you.

Mommy to (12-17-98) and

Christian (1-30-04) LCF - DBB (nights only)

New and need help with DBB!!

Hi, I'm new here. I apoligize in advance for the length of the post,

but I don't know how else to describe my problem. My son was

born 8/1/04 with severe bilateral club feet. He was casted at 1 week

and 2 days old. The casts came off on Oct 19th and we went to the

DBB. For 1st couple of weeks, he screamed bloody murder (but only

while we were putting them on - after they were on, he was fine).

After the 1st couple of weeks, he didn't even cry when we were

putting them on and he was oblivious to them. Then came the day that

I was so looking forward to...a little over a month ago, he got to go

to having them on only at nights and naps. That's when the nightmare

started. When we took him that time, they changed his shoes to

bigger ones. After a few days, I decided they were too big because I

didn't think his heel was going all the way down into the shoe. We

took him back and they agreed and put him in smaller shoes.

Somewhere around that time, he started really fussing when I'd put

them on at night and it was harder to get him to sleep. I thought he

was frustrated because where before he didn't know the difference

because he had them on all the time, now he knew how if felt to have

them off during the day so he wasn't liking having to get them back

on at night. Then 1 night he cried off and on all night..the next

morning he had a blister on 1 heel and a red spot on the other. I

was so upset because I knew that he was hurting that night, so I kept

the shoes off a couple of nights to let the sores heal. When I tried

putting them back on a Friday night, he screamed at the top of his

lungs and I was afraid he was hurting so I decided I wasn't putting

them on again until I took him back to ish Rite on Monday and

have them checked out. The specialist felt the shoes were the right

size, but she adjusted the heel area out so that his foot could get

down in there better and had me change the way I was putting them on

(I now completely unlace them and remove the tongue so that I'm sure

his heel is all the way down. His toes are in the right spot and

they seem to really be in there good. It's been sleepless nights

ever since (this is a baby who has slept thru the night since he was

6 weeks old). I thought he just needed to get used to them again.

But it's been a week and a half and I'm at my wits end. Has anyone

had this particular problem. I don't know if he just doesn't want

them on or if he's hurting. The thought of him hurting scares me to

death, but I'm also scared of taking them off anymore. Sorry for the

long post, but I didn't know how to shorten it. I'm so relieved to

have found this support group! Thanks for listening and any advise

is greatly appreciated!

[Guest guest]

Hi ,

Welcome to the group.

My first thought was that they reduced his hours too much. After 3

months of 23 hours he should go down to about 18 hours/day. I am

wondering if he has lost some correction therefore making it

uncomfortable to be in the shoes. My daughter got a blister when she

first got her shoes. If you now have him back in the smaller shoes,

just make sure that they are on tight and not rubbing on the blister.

He can still where the shoes, just no rubbing. Also, check the width

of the bar. The heels of the shoes should be the width of his

shoulders. Did he have a tenotomy. What dr. do you go to? We go to

ish Rite in Atlanta.

Let us know how he is doing.

Louisa

Rachael 6-27-99

Zoe 2-22-04 RCF FAB 16/7

>

>

> Hi, I'm new here. I apoligize in advance for the length of the

post,

> but I don't know how else to describe my problem. My son was

> born 8/1/04 with severe bilateral club feet. He was casted at 1

week

> and 2 days old. The casts came off on Oct 19th and we went to the

> DBB. For 1st couple of weeks, he screamed bloody murder (but only

> while we were putting them on - after they were on, he was fine).

> After the 1st couple of weeks, he didn't even cry when we were

> putting them on and he was oblivious to them. Then came the day

that

> I was so looking forward to...a little over a month ago, he got to

go

> to having them on only at nights and naps. That's when the

nightmare

> started. When we took him that time, they changed his shoes to

> bigger ones. After a few days, I decided they were too big because

I

> didn't think his heel was going all the way down into the shoe. We

> took him back and they agreed and put him in smaller shoes.

> Somewhere around that time, he started really fussing when I'd put

> them on at night and it was harder to get him to sleep. I thought

he

> was frustrated because where before he didn't know the difference

> because he had them on all the time, now he knew how if felt to

have

> them off during the day so he wasn't liking having to get them back

> on at night. Then 1 night he cried off and on all night..the next

> morning he had a blister on 1 heel and a red spot on the other. I

> was so upset because I knew that he was hurting that night, so I

kept

> the shoes off a couple of nights to let the sores heal. When I

tried

> putting them back on a Friday night, he screamed at the top of his

> lungs and I was afraid he was hurting so I decided I wasn't putting

> them on again until I took him back to ish Rite on Monday and

> have them checked out. The specialist felt the shoes were the

right

> size, but she adjusted the heel area out so that his foot could get

> down in there better and had me change the way I was putting them

on

> (I now completely unlace them and remove the tongue so that I'm

sure

> his heel is all the way down. His toes are in the right spot and

> they seem to really be in there good. It's been sleepless nights

> ever since (this is a baby who has slept thru the night since he

was

> 6 weeks old). I thought he just needed to get used to them again.

> But it's been a week and a half and I'm at my wits end. Has anyone

> had this particular problem. I don't know if he just doesn't want

> them on or if he's hurting. The thought of him hurting scares me

to

> death, but I'm also scared of taking them off anymore. Sorry for

the

> long post, but I didn't know how to shorten it. I'm so relieved to

> have found this support group! Thanks for listening and any advise

> is greatly appreciated!

>

>

[Guest guest]

,

I'm sorry to hear that you and your son are having trouble with the FAB/DBB.

When you took him in to ish Rite on Monday did you see your doctor or only

the orthotist? These little feet can relapse very quickly when the brace is not

used. That loss of correction can in turn lead to the shoes being very

uncomfortable.

In addition to not wearing the shoes at all for a few days, there is also the

issue of being reduced straight down to 12-14 hours a day. Doctors differ in

how much they reduce the hours from 23/7, but the official protocol calls for

18/7 immediately following the period of 23/7 wear. It's not clear how much of

a difference this makes as far as loss of correction goes, however you might

want to consider having wear the FAB more than just at night and naptime.

It could also be that wearing the FAB during waking hours would help your son

get used to those sensations again so that it's not so much of an issue at

bedtime. This has helped with my own son whenever he goes through spells of

disliking or fighting the FAB. At 20 months, he still wears the FAB at least 14

hours a day(usually 2 hours for a nap and 8pm-8am).

Here are a few tips for getting the shoes on correctly. They are taken from a

longer document geared towards parents who are new to the FAB.

To start out, here are a few modifications you can make to the shoes in order to

make them more user friendly:

Take the laces out and tie a knot in the middle of each lace. Then re-lace the

shoes. Tie a knot at the very ends of each lace so they can’t slip back through

the holes. This way, you’ll be able to pull the laces very loose without having

to worry about needing to re-lace the shoes every time. The knot in the middle

will help you keep the laces even.

Consider slitting the tongue keeper slit up to the top of the tongue (don’t cut

through the stitching though). This allows the tongue to sit low on the top of

the foot. It also allows the top of the boot to be tightened up on the ankle

so that the fatty baby calf doesn't pull the heel up and out.

Install the strap in the lower slot on each side of the boot. For most feet,

this is the best position for keeping the foot in the shoe. Some parents

switch slots as the child’s foot grows. As long as the foot is staying securely

and deeply seated in the shoe, either slot is fine.

Installation Tips: how to put the FAB on a wiggly little baby without causing

pain or sores

Some parents feel most comfortable having the child sitting on their lap facing

away from them while they put the brace on; others say it’s easiest for them to

have the baby lying down in front of them. Many parents work together

installing the FAB, especially at first. If you can do it when your child is

relaxed and calm, you will probably have a much easier time. Find out what

works for you and your child.

Loosen the laces up all the way to the knots and pull the tongue up as far as it

will go. If your boots have short straps, buckle the strap into the last hole

loosely so that it doesn’t slip back into the shoe when the foot goes in. If

this is still too short, put an additional hole in the very end of the strap and

use that to keep it secured while you put the foot in. These short straps can

be very frustrating. The longer straps don’t need to be secured.

Insert the foot into the shoe and bend the knee 90 degrees. Push on the top of

the knee and hold the sole of the shoe. Press the heel deeply into the back of

the shoe and flex the toes upward (dorsiflex) as far as possible. Make SURE the

heel is seated well into the bottom and back of the shoe. When working with

the shoes attached to the bar, follow the same procedure one foot at a time.

If the child is unilateral, start with the clubfoot.

With the knee still bent, press a finger on the strap where it goes through the

tongue keeper slit to hold the heel into the back of the shoe. Buckle the strap

but don’t thread it through the lower portion of the buckle just yet. Dorsiflex

the foot again and press on the knee and sole of the shoe to make sure the heel

is in properly. Re-tighten the strap: you may get another hole or two tighter.

If there is any wiggle or looseness, press the foot into the shoe again, push

with your thumb on the strap and re-tighten. Center the tongue and pull it down

over the toes. The strap is essential to keeping the foot well seated in the

shoe, it needs to be tight—probably tighter than you think it should be at

first.

Pull the sock at the toes to make sure the seams aren't going to press into

baby's toes. This also helps make sure the heel is well seated. Run a

fingertip under the baby’s toes to make sure that they have a little room to

wiggle and that you haven’t folded any of them under.

Tighten the laces nice and snug all the way up and tie them. The shoe should

get a little tighter. If you’ve been having issues with slipping, try lacing

the shoes only to the second from the top hole and tying them off there.

Check whether the foot can slip out of the boot at all. If it can, you will

need to repeat the above instructions. Most important is to put pressure on the

knee and push the heel into the bottom of the shoe with the foot flexed up (toes

pointing toward the baby's head) all at the same time. This isn't easy at

first, but it will soon become second nature (I have caught myself doing this

with my older, non-clubfoot daughter’s feet when I help her put her shoes on).

It is absolutely essential that your baby’s feet not slip in the shoes.

Slipping feet are not held in correction and can compromise the effectiveness of

the FAB and lead to relapse.

Repeat the procedure with the other boot.

When both boots are on, put the bar back into place. If your baby is bilateral

it doesn't matter which side you do first. If baby is unilateral it's easier to

put the clubfoot side on first. When you apply the brace with the shoes

attached, it is also much easier to start with the clubfoot.

_________________________________________________

I do hope some of this can help you and . If you have any other issues,

please don't hesitate to ask.

All the best to you and yours,

Naomi

The Family

Naomi Hannah(02/21/01) Jonah(06/20/03, bilateral clubfoot, FAB 14/7)

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