Re: Re: Dr. Update and thanks to all...

November 10, 2005

He is on his 3rd cast and his foot does point slightly down and outward already.

He actually commented that Cam's foot is making great progress in a short period

of time.

To be honest I really feel overwhelmed by what everyone is telling me about my

Dr. and his modifications. I thought that the reason Cam has 5 - 6 more casts

after the tenotomy was to ensure the tendon healed in the correct position.

This makes sense to me.

Thank you for the tip about the Global Help booklet. I'll print it off.

Jen

jennyandkelly wrote:

Jen,

Perhaps your doctor has had issues with the babies' feet being too

small and not fitting properly into the shoes and that is why he

prefers to cast for a few additional weeks in order to obtain that

growth.

Although this is an unusual modification in the fact that he's doing

it for all babies as general practice, I don't see a major problem

with this if he is following the method correctly otherwise. In

order to determine this, you would need to observe/know the

following:

The shape of the casts at the end of correction, just before the

tenotomy, the toes would kind of point down and outward. There is a

good picture of the succession of the casts in that Global HELP

booklet so you can see what the casts should look like each step of

the way. The foot should be abducted outward to 70 degrees at the

last post-tenotomy cast. Does your doctor abduct the foot to 70°?

Did he tell you that the casts after the tenotomy are just to

maintain correction? After the tenotomy, the foot should be

completely corrected. If he says that the last 5-6 weeks are to get

more correction after the tenotomy, then he is not using the proper

casting and manipulation techniques per Ponseti.

I guess my take on what you've told us thus far is that if your

doctor is just using more casts in order to get the foot a little

bigger for better results in the transition to the brace, that is

not as big of a deal to me as if he says that he needs those

additional casts are needed in order to get better results for the

correction of the foot. We have read statements to the effect of if

the doctor needs more than 9 casts to achieve correction (barring

any unusual circumstances), then they are not grasping the method

properly. Most kids need only 5-7 casts- up to 9 for the most

severe. You could always print off that Global HELP booklet and ask

your doctor to review it to see if that is the

manipulation/casting/bracing protocol that he follows.

I hope this helps a little bit. Maybe I'm reading too much into

your letter. I know how hard it is understand everything the doctor

is telling you at the appointment and remember to ask all the

questions you wanted to, much less try to go back and communicate it

with the group here.

Regards,

& (3-16-00, lcf)

November 10, 2005

, what an interesting thing to hear from Dr. Ponseti. has very thin

calves (tons of casting!) where Everett's little calves are just as fat and

plumb as you could want on a kid ( Ponseti casting).

s.

Recently, at a checkup, Dr. Ponseti and a visiting doctor noted that

her calf is thinner than average. And then Dr. Ponseti said that the

difference could be due to her having had so many casts.

I had never heard that from him before. I had always thought that

casting itself couldn't cause atrophy. But, there it is; he said it.

November 11, 2005

And we continue to thank you for it, . I said it before and I'll say it

again, you were the main driving force who carried me to Iowa in my time of

need! I found you only 2 months after you started the group, just in the nick

of time! You even came to the RMD to visit me! I don't forget you ever.

s.

Re: Re: Dr. Update and thanks to all...

As the " Local Iowa City Old timer " who got thrown into true Ponseti

castings right away (Jakob was 9 days old on his first appointment), I

started this group as a way to help others. As I posted a couple days

ago on CFPics, we didn't get referred to " the Master himself " , but I

wouldn't trade Dr. Weinstein for anything. For us, going through the

castings and even many of our bracing days, it was very lonely. We had

no one to talk to about our issues - which, thankfully, we didn't have

any problems. We didn't know about Jakob's clubfeet until after he was

born. Upon finding out, I was told, " don't worry, it's fully

correctable. He'll wear casts and a brace - no big deal. " We didn't

see other children with clubfoot at any of our casting appointment, or

at any of our follow up appointments until the day Jakob got out of the

FAB at 3 1/2 years old. It wasn't until Jakob was nearly 2 years old

that we found out about the many people who were coming to Iowa City

just to see a doctor for clubfoot. At that time, I realized that I

could help others by sharing all we learned by trial and error.

and Claire wrote:

> As ee said, I don't blame anyone but myself.. and maybe that's

> part of why I feeled called to be here. To help and alert those of

> you going through the same thing... because it happens over, and

> over, and over again.. in such a predicatble way. The feedback is not

> always well received, I know.. perhaps perceived as nosy, critical,

> presumptuous. But honestly, we're just trying to help other moms and

> dads avoid what we went through. The situations and pitfalls are SO

> common. As said, us 'old timers' don't need to be hanging

> around on the boards.. other than hoping to support and help other

> parents. We have nothing to gain but that..

>

> and Claire

November 11, 2005