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

[Guest guest]

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

[Guest guest]

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

[Guest guest]

Halley,

While it sounds like Dr. Joughin is committed to the

Ponseti method as far as correction is concerned (at

least from what you said), I want to mention that Dr.

Ponseti himself says that there is no need to continue

full time brace wear for such an extended period of

time. 3 months is certainly sufficient. It is at

that time that the babies are starting to get more

active, sitting and scooting etc. and he doesn't feel

it is necessary to keep them in the brace full time.

He actually recommends dropping hours in the brace

gradually and giving them more and more time out of

the brace until they are down to 12 hours, it is

during the time when they start bearing weight out of

the brace that helps finalize the dropping of the heel

bone into the soft fatty part of the heel - he

believes that there is no better exercise or " therapy "

for them than weight bearing and walking, thus his

recommendation to begin reducing hours after 3 months

of full-time wear.

Regarding your questions about the " certification "

process, this is actually a mis-nomer, what Ponseti

does is not really a certification, it is just listing

doctors who have submitted case studies to him as

" qualified in the method " . It is possible that what

Dr. Joughin was referring to was the expense of

attending a symposium, which I am not sure if that is

necessarily required to get on the " list " .

If you think you will deliver shortly before Christmas

and both doctors are due back on Jan. 6th, that should

be fine, it is certainly okay to wait 2 weeks

(especially at that special time of year) to spend

some bonding time with the baby before beginning

casting. My basic advice would be that if you feel

comfortable with Dr. Joughin personally and you know

she has a good track record, then go with her and

watch. If you see red flags or have any questions

along the way, you know the questions to ask her, plus

you have access to all the knowledge on this group.

And, you know you can always go to Pirani if needed.

I think if your overall feeling for her was a good one

then you should trust your instincts.

HTH,

--- Halley Prestage wrote:

> 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

>

>

>

>

>

__________________________________

Yahoo! Mail - PC Magazine Editors' Choice 2005

http://mail.yahoo.com

[Guest guest]

Halley,

While it sounds like Dr. Joughin is committed to the

Ponseti method as far as correction is concerned (at

least from what you said), I want to mention that Dr.

Ponseti himself says that there is no need to continue

full time brace wear for such an extended period of

time. 3 months is certainly sufficient. It is at

that time that the babies are starting to get more

active, sitting and scooting etc. and he doesn't feel

it is necessary to keep them in the brace full time.

He actually recommends dropping hours in the brace

gradually and giving them more and more time out of

the brace until they are down to 12 hours, it is

during the time when they start bearing weight out of

the brace that helps finalize the dropping of the heel

bone into the soft fatty part of the heel - he

believes that there is no better exercise or " therapy "

for them than weight bearing and walking, thus his

recommendation to begin reducing hours after 3 months

of full-time wear.

Regarding your questions about the " certification "

process, this is actually a mis-nomer, what Ponseti

does is not really a certification, it is just listing

doctors who have submitted case studies to him as

" qualified in the method " . It is possible that what

Dr. Joughin was referring to was the expense of

attending a symposium, which I am not sure if that is

necessarily required to get on the " list " .

If you think you will deliver shortly before Christmas

and both doctors are due back on Jan. 6th, that should

be fine, it is certainly okay to wait 2 weeks

(especially at that special time of year) to spend

some bonding time with the baby before beginning

casting. My basic advice would be that if you feel

comfortable with Dr. Joughin personally and you know

she has a good track record, then go with her and

watch. If you see red flags or have any questions

along the way, you know the questions to ask her, plus

you have access to all the knowledge on this group.

And, you know you can always go to Pirani if needed.

I think if your overall feeling for her was a good one

then you should trust your instincts.

HTH,

--- Halley Prestage wrote:

> 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

>

>

>

>

>

__________________________________

Yahoo! Mail - PC Magazine Editors' Choice 2005

http://mail.yahoo.com

[Guest guest]

Hi Halley,

You must be getting excited, what a neat time of year to be having a

baby!

I think you got some great advise from and Kathleen. There is

really no need to have your baby in the brace 23/7 for more than 3

months barring any unusual circumstances. And trust me, after 3

months of 23/7, it is sooo nice to get those extra hours out of the

brace! I wouldn't have wanted Grace to be in her brace full time any

longer than necessary.

Dr. Keifer is the doctor that Dr. Pirani recommended right (we see

Pirani here in Vancouver). Hopefully he is having continued sucess

with the method and is following the bracing protocols, then you

could see him.

Have you posted on the Canada board as well? There may be someone who

has seen Dr. Joughin there.

Also wanted to say that if I had to do it again, I would have waited

longer to get her started with the casting / bracing. Her cf was

undiagnosed and we knew nothing about clubfoot and rushed to get her

into a cast (4 days old). I also would have taken so many more pics

of her little foot! As it is, I only have 2 and they are not great.

Wait the 2 weeks, bond and spend a cast free Christmas!

& Grace

>

> > 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

> >

> >

> >

> >

> >

>

>

>

>

>

> __________________________________

> Yahoo! Mail - PC Magazine Editors' Choice 2005

> http://mail.yahoo.com

>

[Guest guest]

Hi Halley,

You must be getting excited, what a neat time of year to be having a

baby!

I think you got some great advise from and Kathleen. There is

really no need to have your baby in the brace 23/7 for more than 3

months barring any unusual circumstances. And trust me, after 3

months of 23/7, it is sooo nice to get those extra hours out of the

brace! I wouldn't have wanted Grace to be in her brace full time any

longer than necessary.

Dr. Keifer is the doctor that Dr. Pirani recommended right (we see

Pirani here in Vancouver). Hopefully he is having continued sucess

with the method and is following the bracing protocols, then you

could see him.

Have you posted on the Canada board as well? There may be someone who

has seen Dr. Joughin there.

Also wanted to say that if I had to do it again, I would have waited

longer to get her started with the casting / bracing. Her cf was

undiagnosed and we knew nothing about clubfoot and rushed to get her

into a cast (4 days old). I also would have taken so many more pics

of her little foot! As it is, I only have 2 and they are not great.

Wait the 2 weeks, bond and spend a cast free Christmas!

& Grace

>

> > 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

> >

> >

> >

> >

> >

>

>

>

>

>

> __________________________________

> Yahoo! Mail - PC Magazine Editors' Choice 2005

> http://mail.yahoo.com

>

[Guest guest]

Hi ,

Thanks for the information! I think full-time wear for one year sounds

really long and cumbersome. Plus I think it's better to decrease the hours

of wear gradually, not full-time and then all of a sudden just 14 hours. How

gradually does Dr. Ponseti do the reduction?

I was impressed in that she seemed to know the protocol of the method and so

on but I'll decide after I meet Dr. Keifer (trained by Dr. Pirani) and see

what info/vibes I get from him.

I think you are right about the certification. When Dr. Ponseti e-mailed me

some weeks back, he said that they basically just submit case studies and

didn't say anything about a course. I didn't say anything to her, but I

should have mentioned that parents seeking the method feel much more

comfortable when they are " certified " or on Dr. Ponseti's list.

Thanks for help with making this decision. It's tough figuring out what is

the best dr. to go to. If this was my first baby, we'd probably not even

hesitate to go out to Vancouver to see Dr. Pirani for as long as necessary.

It gets a bit more difficult with two other little ones and what to do about

that if I was to go away. Too bad my mother-in-law hasn't quite retired yet

b/c that would sure make it easy!

Thanks very much, I appreciate your advice and info.

Halley

>

>Reply-To: nosurgery4clubfoot

>To: nosurgery4clubfoot

>Subject: Re: bit of info on Calgary Dr and could use

>your opinion...

>Date: Wed, 26 Oct 2005 13:26:34 -0700 (PDT)

>

>Halley,

>While it sounds like Dr. Joughin is committed to the

>Ponseti method as far as correction is concerned (at

>least from what you said), I want to mention that Dr.

>Ponseti himself says that there is no need to continue

>full time brace wear for such an extended period of

>time. 3 months is certainly sufficient. It is at

>that time that the babies are starting to get more

>active, sitting and scooting etc. and he doesn't feel

>it is necessary to keep them in the brace full time.

>He actually recommends dropping hours in the brace

>gradually and giving them more and more time out of

>the brace until they are down to 12 hours, it is

>during the time when they start bearing weight out of

>the brace that helps finalize the dropping of the heel

>bone into the soft fatty part of the heel - he

>believes that there is no better exercise or " therapy "

>for them than weight bearing and walking, thus his

>recommendation to begin reducing hours after 3 months

>of full-time wear.

>Regarding your questions about the " certification "

>process, this is actually a mis-nomer, what Ponseti

>does is not really a certification, it is just listing

>doctors who have submitted case studies to him as

> " qualified in the method " . It is possible that what

>Dr. Joughin was referring to was the expense of

>attending a symposium, which I am not sure if that is

>necessarily required to get on the " list " .

>If you think you will deliver shortly before Christmas

>and both doctors are due back on Jan. 6th, that should

>be fine, it is certainly okay to wait 2 weeks

>(especially at that special time of year) to spend

>some bonding time with the baby before beginning

>casting. My basic advice would be that if you feel

>comfortable with Dr. Joughin personally and you know

>she has a good track record, then go with her and

>watch. If you see red flags or have any questions

>along the way, you know the questions to ask her, plus

>you have access to all the knowledge on this group.

>And, you know you can always go to Pirani if needed.

>I think if your overall feeling for her was a good one

>then you should trust your instincts.

>

>HTH,

>

>

>

>--- Halley Prestage wrote:

>

> > 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

> >

> >

> >

> >

> >

>

>

>

>

>

>__________________________________

>Yahoo! Mail - PC Magazine Editors' Choice 2005

>http://mail.yahoo.com

[Guest guest]

Halley,

I'm glad you are going to check out Dr. Keifer as well, if you aren't

100% confident in your decision I think it would always leave you

wondering if you might have had a better experience with him.

I don't know that there is an " official " way of reducing the hours.

Even the Global Help booklet just refers to going to a nights and naps

protocol. Generally, I think people follow a schedule sort of like

this - after the 3 months of 23 hr/day wear, then they go to 18-20

hours for a few months, then 16-18 for a few more, then 14-16, and

finally 12-14 around the time they are 12-15 months old or really

walking. My doctor still has us at 16 hrs. a day and my son is 13

months, I think he plans to reduce us to 14 hrs. a day when we see him

in December. Some docs do like to be more conservative on this issue

and I think it is sometimes just a matter of a case by case basis or

just their own individual preference. In our case, I think Dr. Dobbs

feels that as long as the child is tolerating the brace well, it is

good to continue to do the long hours while it is practical, rather

than have to increase hours later if there would be a relapse. I

think this is the principle that the docs who want to do 23/7 for so

long are employing as well, but they are just going beyond being

cautious and crossing into the realm of having the brace interfere

with the benefits of normal weight bearing activities, kwim?

> >

> > > 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

> > >

> > >

> > >

> > >

> > >

> >

> >

> >

> >

> >

> >__________________________________

> >Yahoo! Mail - PC Magazine Editors' Choice 2005

> >http://mail.yahoo.com

>