Re: bit of info on Calgary Dr and could use your opinion...

October 26, 2005

Halley-

It sounds like you had a good appointment as well as got good

answers to questions. The bracing protocol is 23/7 wear for 3 months

(12 weeks), then gradual decline to nights only(by walking). With

your research-you have probably read this already. It is not

necessary nor would it be good for the child to be in the brace for

1 year 23/7-I could see that delaying your child's development. If

you go to the links section-you can find to links-dr ponseti's

website as well as the global health booklet-both talk about in

detail the bracing protocol. You can also do a messag search-and

find in our archives dr p's own words on the bracing protocol. Good

luck with Dr Kiefer-I too would be hesitant to switch doctors while

either were on vacation. Trust your mommy instincts!!

HTH!

kathleen

mom to david bcf fab 12/7

>

> Hello,

>

> I just had an initial appt with Dr. Joughin today at Children's

Hospital in

> Calgary. Our baby is due on Dec. 18 w/suspected right club foot.

She was one

> of the two doctors that Dr. Pirani said that I should consult with

before

> deciding to travel out to Vancouver for treatment (though he said

he was

> perfectly happy to treat my baby too, but of course easier to be

in your own

> city).

>

> She is not certified but apparently had Dr. Ponseti show her the

technique

> some time ago. She mentioned that Dr. Pirani would place his hand

on hers

> to show her how to correctly manipulate the bones and tendons. The

reason

> she is not certified is b/c she doesn't want to spend the money to

do it. I

> thought certification only involved submitting case studies so

maybe she was

> referring to taking the course to become certified or something

like that.

>

> She said she usually does 4-6 casts, 90% have a tenotomy, uses

full length

> fiberglass casts (she feels it is easier for her to apply them

correctly

> using fiberglass), uses DBB (FAB), and also has some patients go

to the

> shoes (though most use Markells). As for sugery rate for

ATTs after

> relapse she said that she has only done that a couple of times.

One baby had

> arthogryposis (spelling?) and one that parents just didn't want to

go

> through more casting. So she sounds promising though we are going

to see one

> more Dr. here in November who was trained by Dr. Pirani, his name

is Dr.

> Keifer.

>

> I just had a question, Dr. Joughin has the baby wear the FAB full

time until

> one year old and then down to just nightime. I know that I would

alter that

> and probably decline hours of wear a little less suddenly after

the one

> year. Does one full year of full-time wear seem unusual or is that

fine?

>

> Also, both Dr. Keifer & Dr. Joughin are gone from Dec 21-Jan 5. I

am due on

> Dec 18 and am usually late. I was thinking of maybe going to see

Dr. Pirani

> (if he's in town then) for the first couple of casts and then

having Dr.

> Joughin or Dr. Keifer continue once they are back in town. I just

don't want

> to have the first cast put on and then have whatever Dr. is

filling in put

> on the next cast or two if they are not as adept at using the

method. Dr.

> Joughin said that as far as Ponseti method is concerned, she and

Dr. Keifer

> are the only ones that she feel are committed to the method and

have most

> experience. I think it's too good to switch doctors for castings

if the one

> doctor maybe doesn't quite have the knowledge experience with the

method.

> What do you think?

>

> I suppose I could just wait the couple of weeks and start

treatment in the

> New Year too but on the other hand, it might be nice to get things

started

> off on the right foot by seeing Dr. Pirani. Well, I am rambling

on so just

> wanted to give some info on Dr. Joughin since it's good to get

more info on

> Drs and to get the opinion of some of you here as to what you

would do.

>

> Thank you all!

>

> Halley

>

October 26, 2005