Kori's repley to a few beginner questions

[Guest guest]

Kori, A really excellent description of the devices and wonderful

explanations. I vote that you add your reply to the " Files " section

to help other new parents. Wish I'd had something like when we were

newbies. -- Pamela Karydas

> >Hey All,

> >

> >As I posted earlier, I am new. I have a few questions. I'm not

> >familer with all the abbreveations, DBB I figured out is Dennis

Brown

> >Bar. Are they all short for different types of bars/braces/shoes?

>

> The DBB brace is not exactly what is used today but most Dr's and

> Orthotists still call it a Dennis Browne Bar. The standard brace

is the

> Markell open toe shoes attached to either a gold or red bar. The

red bar

> is adjustable in length. The gold bar is fixed and comes in

various sizes

> from 6 " to 14 " . The gold bar may also be adjustable, either with

three

> holes on both ends in which the shoes can be moved (i.e. a small

bar would

> be 6, 8, and 10 " width depending on which holes you put the shoes

into, and

> medium and large bars in the sizes above), or the shoes may be

moved out on

> a sort of track and you tighten them down at the width you

desire. Both

> these adjustable gold bars may stick out on the sides which I

think would

> be annoying. But they'd work.

>

> The correct term for the brace is a Foot Abduction Bar/Brace or

FAB. There

> are now a few other versions with different shoes and bars

available. The

> newest braces are the Ponseti/ FAB and Dr. Dobbs

Articulating

> FAB. The PM FAB looks kind of like a pair of Birkenstocks on a

flat bar

> and is much gentler on a newborns foot than the Markell shoes. It

was/is

> however not intended to be used for the entire bracing treatment

and most

> babes will switch to the Markell shoes when their feet are more

> mature. Some parents will not switch, and some feet such as

atypical will

> need this brace for the entire treatment. Dr. Dobbs has designed

an

> articulating brace that allows more mobility for the baby's legs

although

> he's using AFO's for the shoes instead of the Markells (the first

versions

> of this brace used the Markells, and the sole plates he uses for

the AFO's

> are the same as the plates for the Markells so they're

interchangeable at

> this time). Personally I'm not sold on the AFO's and I think Dr.

Dobbs

> needs to put the Ponseti shoes on his brace instead.

>

>

> >For those of you seeing Dr. Dobbs, after casting how often do you

go

> >back for checks? I understand there is the 3 months of 23hrs a

day.

> >Then 14-15 hrs a day mostly sleeping for 2-4 years, is that right?

>

> 3 mo's at 23/7 then you drop 4 hours and do 18 for a month or so,

maybe two

> or three. Then another 2hr drop to 16 and then drop to 14 till

walking.

> For us, having treatment started when she was an infant, it ended

up that

> the reductions came aproximately every 3mo's. For older babes it

may be

> accelerated a bit. Once walking you should be able to comfortably

drop to

> 12-14 for the duration of the rest of the treatment which is after

age

> 3-1/2, and depending on severity and of course other factors such

as a foot

> that has relapsed and needed additional casting it could be up to

and

> perhaps past the age of 4. But most will be done with treatment

and

> bracing by 3-1/2yo. Reducing hours too soon after the 23/7 can

cause a

> whole host of problems including relapse and rejection of the

brace. By

> bracing them long hours in the first year you also end up with a

babe who

> doesn't object to wearing the shoes much because it's second

nature. They

> don't know all babies don't wear shoes at night. So maintaining

the long

> hours when they're little serves multiple purposes, not only to

maintain

> correction.

>

> Some parents do nights and naps, but we do the whole stretch at

one

> time. Easier for me that way because naps are not scheduled

around

> here. We put the shoes on at night (around 8pm) and they stay on

till at

> least 8am the next morning and more often than not, 10am or

later. You

> wouldn't believe the things these kids can do while wearing their

> shoes... it does not delay them or stop them from getting up into

things

> either!

>

>

>

> >Thanks everyone for your support as I try to figure all this out.

>

> That's what we're here for, ask away. Any time :-*

>

> Kori

[Guest guest]

Kori, A really excellent description of the devices and wonderful

explanations. I vote that you add your reply to the " Files " section

to help other new parents. Wish I'd had something like when we were

newbies. -- Pamela Karydas

> >Hey All,

> >

> >As I posted earlier, I am new. I have a few questions. I'm not

> >familer with all the abbreveations, DBB I figured out is Dennis

Brown

> >Bar. Are they all short for different types of bars/braces/shoes?

>

> The DBB brace is not exactly what is used today but most Dr's and

> Orthotists still call it a Dennis Browne Bar. The standard brace

is the

> Markell open toe shoes attached to either a gold or red bar. The

red bar

> is adjustable in length. The gold bar is fixed and comes in

various sizes

> from 6 " to 14 " . The gold bar may also be adjustable, either with

three

> holes on both ends in which the shoes can be moved (i.e. a small

bar would

> be 6, 8, and 10 " width depending on which holes you put the shoes

into, and

> medium and large bars in the sizes above), or the shoes may be

moved out on

> a sort of track and you tighten them down at the width you

desire. Both

> these adjustable gold bars may stick out on the sides which I

think would

> be annoying. But they'd work.

>

> The correct term for the brace is a Foot Abduction Bar/Brace or

FAB. There

> are now a few other versions with different shoes and bars

available. The

> newest braces are the Ponseti/ FAB and Dr. Dobbs

Articulating

> FAB. The PM FAB looks kind of like a pair of Birkenstocks on a

flat bar

> and is much gentler on a newborns foot than the Markell shoes. It

was/is

> however not intended to be used for the entire bracing treatment

and most

> babes will switch to the Markell shoes when their feet are more

> mature. Some parents will not switch, and some feet such as

atypical will

> need this brace for the entire treatment. Dr. Dobbs has designed

an

> articulating brace that allows more mobility for the baby's legs

although

> he's using AFO's for the shoes instead of the Markells (the first

versions

> of this brace used the Markells, and the sole plates he uses for

the AFO's

> are the same as the plates for the Markells so they're

interchangeable at

> this time). Personally I'm not sold on the AFO's and I think Dr.

Dobbs

> needs to put the Ponseti shoes on his brace instead.

>

>

> >For those of you seeing Dr. Dobbs, after casting how often do you

go

> >back for checks? I understand there is the 3 months of 23hrs a

day.

> >Then 14-15 hrs a day mostly sleeping for 2-4 years, is that right?

>

> 3 mo's at 23/7 then you drop 4 hours and do 18 for a month or so,

maybe two

> or three. Then another 2hr drop to 16 and then drop to 14 till

walking.

> For us, having treatment started when she was an infant, it ended

up that

> the reductions came aproximately every 3mo's. For older babes it

may be

> accelerated a bit. Once walking you should be able to comfortably

drop to

> 12-14 for the duration of the rest of the treatment which is after

age

> 3-1/2, and depending on severity and of course other factors such

as a foot

> that has relapsed and needed additional casting it could be up to

and

> perhaps past the age of 4. But most will be done with treatment

and

> bracing by 3-1/2yo. Reducing hours too soon after the 23/7 can

cause a

> whole host of problems including relapse and rejection of the

brace. By

> bracing them long hours in the first year you also end up with a

babe who

> doesn't object to wearing the shoes much because it's second

nature. They

> don't know all babies don't wear shoes at night. So maintaining

the long

> hours when they're little serves multiple purposes, not only to

maintain

> correction.

>

> Some parents do nights and naps, but we do the whole stretch at

one

> time. Easier for me that way because naps are not scheduled

around

> here. We put the shoes on at night (around 8pm) and they stay on

till at

> least 8am the next morning and more often than not, 10am or

later. You

> wouldn't believe the things these kids can do while wearing their

> shoes... it does not delay them or stop them from getting up into

things

> either!

>

>

>

> >Thanks everyone for your support as I try to figure all this out.

>

> That's what we're here for, ask away. Any time :-*

>

> Kori