Re: Keeping the shoes on at night

October 10, 2005

Hi there!

Can you tell us how his brace is set up? Is it wide enough for

him? The inside edges of the heels of the shoes should be at a

distance that's approximately equal to the width of his shoulders.

Does he have the open-toed Markell shoes? Is the clubfoot shoe set

outward at a 70 degree rotation?

What kind of dorsiflexion does he have? (This is when you place your

hand under his foot and flex the front part [toes] up toward his

shin) Ideally, he'd be able to flex the foot at least 10-15 degrees

past neutral.

How does his foot look- does he have good range of motion? You can

share pictures with us if you want.

If there's any doubt in your mind at all, you could always consider

going to see Dr. Herzenberg in Baltimore for a second opinion that

everything is perfect with his foot.

Have you seen the tips and tricks document for the brace?

Hope this helps!

& (3-16-00, left cf)

http://ponseticlubfoot.freeservers.com/

>

> We desperately need help keeping the shoes on at night.

>

> Brief history:

>

> Left club foot. Right foot is normal. Treated for about 7 months

> by non-Ponseti doctor. Casting, but not enough. Almost at

surgery -

> but we stopped before that. Went to three other doctors before

> hitting on the right guy (Dr. Tuck). He did a few more

casts

> (the other casts had done some good), and then we did the shoes as

> much as possible for a month or so, then just at night. He took

his

> first steps at about 17 months, walking big time at about 18

> months. It's hard to keep up with him now, and his foot looks

> pretty normal when he's walking, running, climbing, and driving us

> crazy - wearing regular shoes, which he loves.

>

> The problem is keeping his shoes with the bar on at night. The

> current routine, which doesn't always work, is to let him fall

> asleep, then we put on the shoes and then attach the bar (no way

to

> get his feet in while the bar is attached). If we try to get the

> shoes on while he's awake, he fights too much. Some nights, I can

> get him into his crib, still asleep. When he gets up in the

> morning, at least the left foot is out, and often the right as

> well. Other nights he won't even stay asleep when I attach the

> bar. Or he'll wake up five minutes after I put him in the crib,

> cries for a few minutes, then I check on him and his left foot is

> out - probably about 2 seconds before he stopped crying.

>

> I use the strap as tight as possible, double knotted, etc. But

> it's just really hard to keep him in the shoes.

>

> Any thoughts?

>

October 10, 2005

If I recall correctly, and I could be wrong - and I'm not at home to

measure right now... I think it was 15 degrees on each side, to point the

feet up. Then the shoes are set on the brace at 70 degrees for the club

foot, 35 for the normal foot. The doctor has been checking the width at

each visit. We have a longer bar, but haven't switched yet (as of last

visit, doctor didn't want to switch). I'll try measuring and see if we

should switch.

Don't know what the shoes are called, but they are open toed.

Dorsiflexion - he'll go a little past neutral.

Looks - pretty normal when walking. When he's sitting, it still tends a

little towards club.

I'll check out the tips & tricks. From your website, or is there one on

the Ponseti site as well I should be looking for?

Thanks.

- Seth

At 03:41 PM 10/10/2005 +0000, you wrote:

>Hi there!

>Can you tell us how his brace is set up? Is it wide enough for

>him? The inside edges of the heels of the shoes should be at a

>distance that's approximately equal to the width of his shoulders.

>Does he have the open-toed Markell shoes? Is the clubfoot shoe set

>outward at a 70 degree rotation?

>What kind of dorsiflexion does he have? (This is when you place your

>hand under his foot and flex the front part [toes] up toward his

>shin) Ideally, he'd be able to flex the foot at least 10-15 degrees

>past neutral.

>How does his foot look- does he have good range of motion? You can

>share pictures with us if you want.

>If there's any doubt in your mind at all, you could always consider

>going to see Dr. Herzenberg in Baltimore for a second opinion that

>everything is perfect with his foot.

>Have you seen the tips and tricks document for the brace?

>Hope this helps!

> & (3-16-00, left cf)

><http://ponseticlubfoot.freeservers.com/>http://ponseticlubfoot.freeservers.com\

/

>

> >

> > We desperately need help keeping the shoes on at night.

> >

> > Brief history:

> >

> > Left club foot. Right foot is normal. Treated for about 7 months

> > by non-Ponseti doctor. Casting, but not enough. Almost at

>surgery -

> > but we stopped before that. Went to three other doctors before

> > hitting on the right guy (Dr. Tuck). He did a few more

>casts

> > (the other casts had done some good), and then we did the shoes as

> > much as possible for a month or so, then just at night. He took

>his

> > first steps at about 17 months, walking big time at about 18

> > months. It's hard to keep up with him now, and his foot looks

> > pretty normal when he's walking, running, climbing, and driving us

> > crazy - wearing regular shoes, which he loves.

> >

> > The problem is keeping his shoes with the bar on at night. The

> > current routine, which doesn't always work, is to let him fall

> > asleep, then we put on the shoes and then attach the bar (no way

>to

> > get his feet in while the bar is attached). If we try to get the

> > shoes on while he's awake, he fights too much. Some nights, I can

> > get him into his crib, still asleep. When he gets up in the

> > morning, at least the left foot is out, and often the right as

> > well. Other nights he won't even stay asleep when I attach the

> > bar. Or he'll wake up five minutes after I put him in the crib,

> > cries for a few minutes, then I check on him and his left foot is

> > out - probably about 2 seconds before he stopped crying.

> >

> > I use the strap as tight as possible, double knotted, etc. But

> > it's just really hard to keep him in the shoes.

> >

> > Any thoughts?

> >

>

October 10, 2005

An additional question to add to what is asking here: is he

undoing the shoes to get out of them or is he just pulling his feet

out? If he is just pulling his feet out it is likely something like

bar length that is causing the problem. If he is actually undoing the

shoes, the answer sounds silly, but really does work -- duct tape!

> >