Guest guest Posted February 4, 2006 Report Share Posted February 4, 2006 This sounds fairly close to proper treatment, but I would be leary about the lengthiness of casting. Did your doctor mention the Ponseti method? It sounds like this is what they are trying to use; however, they have made modifications. The Ponseti method is a way of casting the foot so that the parts of the foot are corrected to be a normal foot inside and out. This requires 5-7 casts. The last cast should be on after the tenotomy and will stay on for 3 weeks. The feet shold look overcorrected after the last cast. They should be set at around 70 degrees of outward rotation. Not all casting is equal. Some casting is more likely to relapse than others. Dr. Ponseti's method does not have relapse issues in greater than 95% of clubfoot cases and is backed-up by more than 50 years of research. My son was done with casting by 2 months. This is the age most children are finished with casting when it is started shortly after birth. Did your doctor say how long he would have to wear the brace after 3 months of 23 hour a day wear? This will not be enough to keep the foot corrected as children grow so quickly, the foot will regress back to its more normal position. The Ponseti method requires the 3 month wear, but then the hours are reduced slowly until 12 hours when the child is walking. The shoes are also set to 70 degrees of outward rotation. The brace it then worn until age 3-5, but on average 3-4. The children get use to this bar and it becomes part of their bedtime routine. My son, , knows it is bedtime when his shoes go on. There is an adjustment period, but if the feet are corrected properly, then there should be no major problem. Since you have time before your son is born, I would research other doctors in your area that may use the Ponseti method. Just because a doctor says they use it, it doesn't mean they do. In the file section, there is a question list to take to a doctor appt. It is very helpful. There is also a list of doctors who have become certified in this method. You can find this list at: http://www.uihealthcare.com/depts/med/orthopaedicsurgery/patients.htmlhttp://www\ ..uihealthcare.com/depts/med/orthopaedicsurgery/patients.html This provides many useful links. You may also get help from this group. There are many people from many different parts of the country and world. If you let us know the area you live in, we may be able to give you a doctor who has proven successful. Just because a doctor isn't on the list, doesn't mean they are not using the method properly, and just because they are on the list doesn't mean they haven't made harmful modifications. It is very important to do your research and ask many questions! If you let us know approximately where you are located, someone who has been where you are may be able to help! Congratulations on your little man! They bring so much happiness! 11/19/04 bilateral clubfeet( Ponseti method, DBB 16 hours), other congenital issues mmg174 wrote: I've had 2 ultrasounds that indicate my son's left foot is clubbed. My husband and I met with an orthapedist this week that explained treatment. 6-8 weeks of casting surgery to cut his achilles tendon 6-8 more weeks of casting then 3 months in a brace Is this a typical treatment?? Plus with the castings will he be able to wear normal baby pants? What about bathing? and skin care around the cast?? I have so many questions! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 4, 2006 Report Share Posted February 4, 2006 Hi! Congratulations on your pregnancy! Everything will be fine with your baby's feet, and it is wonderful that you have found this site early! Questions are good! That's what we are here for!Keep 'em coming! There are different methods of treatment, but the most successful is the Ponseti Method, and this does not sound quite like the Ponseti Method. The Ponseti Method consists of several (usually 6-8) long-legged casts. These casts are from toe to upper thigh. After the casting, about 85% of babies need what is called a tenetomy, but this isn't really like surgery. It is usually done in the office under local anethesia. There is a small prick with an instrument (like a thicker needle) that is inserted into the baby's heel. IF the tentomy is necessary, the healing casts stay on for another 3 weeks. After the healing casts come off, then the bracing begins. The bracing time is usually 23 hours/ day for the first 1-3 months, and then you are gradually reduced in hours, until eventually, your baby is wearing the brace only 12-14 hours/day (mostly naps and bedtime) until 3-4 years old. While this may sound daunting right now, it really isn't that big of a deal, provided you have the right doctor and the right treatment. Many of us here on this group found docs at first that weren't following Ponseti protocol for different reasons. Eventually, most have switched to Ponseti certified doctors, (or even traveled to Iowa to go to Ponseti himself.) after we realized that things weren't going well for our kids (some were uncomfortable, some weren't getting significantly better, etc.) with our first (sometimes second and third) doctors. Again, interview other doctors before you decide on one in particular. Where are you located? We can helo you find certified Ponseti Certified Doctors in your area. If nothing else, just go talk to one of them, and listen to what they have to say. You may find that you would rather see that doc instead. It would be wonderful to have a doctor that you are comfortable with before the baby comes! As far as clothes go, footed PJs are probably out of the question during the casts. During the winter, bigger pants (like a size or two up) are good. A Children's Place and Old Navy have a lot of those right now. If it is a girl, you are covered with dresses! Bathing is one of those things that you have to find the rythym, if you know what I mean. Your baby will take sponge baths during the casting process. It sounds worse than it is, but think about it...You wouldn't fill up your tub or even a baby tub and stick your baby in it to splash around when they are newborn...It doesn't last forever, just a couple of months. Skin care around the casts isn't usually an issue either. I think most of us had that occasional tiny " diaper spilage " but once it happens, you realize why it happened (you realize that the casts were tucked into the diaper accidently or something), and you just remember to check how you put it on the next time. Chafing chouldn't be a problem under a good doctor's care. Okay, now that I have bombarded you with all of this info, take a breath. It's going to be great! Enjoy what's left of the pregnancy, and enjoy that wonderful baby when he/she arrives. BTW, when are you due? Let us know how things are going! ( 2/1/05 bcf) > >Reply-To: nosurgery4clubfoot >To: nosurgery4clubfoot >Subject: Expecting Mom >Date: Sat, 04 Feb 2006 22:07:16 -0000 > >I've had 2 ultrasounds that indicate my son's left foot is clubbed. >My husband and I met with an orthapedist this week that explained >treatment. >6-8 weeks of casting >surgery to cut his achilles tendon >6-8 more weeks of casting >then 3 months in a brace >Is this a typical treatment?? > >Plus with the castings will he be able to wear normal baby pants? What >about bathing? and skin care around the cast?? I have so many >questions! > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 4, 2006 Report Share Posted February 4, 2006 Hello, welcome and congrats on your pregnancy =) I would echo everything that has said in her post...it is so very important to find the right doctor! I am sure that after you do your research on club foot that you will find that the Ponseti method is the way to go for treatment, it is the best possible cf treatment available! It is a non-surgical approach which will prevent all that scar tissue that forms from having surgery and causes a painful and stiff foot later in life. After you check out Dr. Ponseti's web site, you will see that your doctor's plan deviates in the amount of time your child is to be in casts. To me, this would be a red flag. You may want to ask your doctor what his success rates are. It is important for you to know that many doctor's out there claim to be using this method but are not following the protocol's and do not have nearly the same success rates (around 95%) that other Ponseti trained doctors do. The doctors trained in Dr. Ponseti's method manipulate the bones of the foot in a VERY specific order, all the bones are there, they are just twisted a bit. One of the mom's here put it in a neat way ( I think) that a club foot is kind of like a jigzaw puzzle, all the peices are there, they just need to be put back together in the right way. Do you mind my asking where you are located? We could make some suggestions on a qualified Ponseti doctor in your area for you to go and see. Great that you have time to do your research and find a great doc for your baby =), this is very important. We didn't know that our little girl Grace had club foot and really just lucked into finding our current doctor who is Ponseti trained, he corrected her foot in just 4 casts! She now wears her brace at night and won't sleep without her nighty night shoes =) Once again welcome, we are here to answer any question's you may have, we are also here to listen and support you - we have all been right where you are. & Grace 18 mos unilateral right club foot FAB (foot abduction brace) 13 hrs Vancouver BC Canada > > I've had 2 ultrasounds that indicate my son's left foot is clubbed. > My husband and I met with an orthapedist this week that explained > treatment. > 6-8 weeks of casting > surgery to cut his achilles tendon > 6-8 more weeks of casting > then 3 months in a brace > Is this a typical treatment?? > > Plus with the castings will he be able to wear normal baby pants? What > about bathing? and skin care around the cast?? I have so many > questions! > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 6, 2006 Report Share Posted February 6, 2006 We used the footed pj's throughout casting, too, after grew out of the sleep sacks for newborns. The heavy 's brand ones worked well for us. Carol Expecting Mom > > >Date: Sat, 04 Feb 2006 22:07:16 -0000 > > > > > >I've had 2 ultrasounds that indicate my son's left foot is clubbed. > > >My husband and I met with an orthapedist this week that explained > > >treatment. > > >6-8 weeks of casting > > >surgery to cut his achilles tendon > > >6-8 more weeks of casting > > >then 3 months in a brace > > >Is this a typical treatment?? > > > > > >Plus with the castings will he be able to wear normal baby pants? > What > > >about bathing? and skin care around the cast?? I have so many > > >questions! > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 6, 2006 Report Share Posted February 6, 2006 Hi and Welcome! Here are some tips on the casting portion of the treatment. Hope it helps.... Footie pajamas work fine with the casts, just not with the shoes Fleece pants work well on casting days. They breathe and allow the cast to dry quicker. Wet casts are COLD. Buy some warm socks to put over the ends of the casts to keep lil toes warm. Keep neosporin and cotton pads (makeup rounds) on hand in case of chaffing. Also safety scissors are good for trimming rough edges. Disposable diapers work best during casting, so if you are planning to use cloth, don't start until after the casts are done. Mason's doctor is Ponseti trained and his treatment went like this.... 5 weeks plaster thigh high casts tenotomy (done in operating room. They put him under for this) 3 weeks in healing casts also thigh high and plaster 3 months in shoes with Dennis-Browne Bar 23 hrs / day 3 years in shoes w bar at night and nap It is important that you are comfortable with your child's doctor. You are your child's advocate, so you have to be able to work with and question the doctor. Also, remember that you know your baby better than the doctors do. If he seems uncomfortable or overly fussy, make the doctor address it. But most importantly....enjoy your pregnancy and your baby! This doesn't have to take over your life! Good luck! > > > > > > Hi! Congratulations on your pregnancy! Everything will be fine > with > > your > > > baby's feet, and it is wonderful that you have found this site > > early! > > > Questions are good! That's what we are here for!Keep 'em coming! > > > > > > There are different methods of treatment, but the most > successful > > is the > > > Ponseti Method, and this does not sound quite like the Ponseti > > Method. The > > > Ponseti Method consists of several (usually 6-8) long-legged > casts. > > These > > > casts are from toe to upper thigh. After the casting, about 85% > of > > babies > > > need what is called a tenetomy, but this isn't really like > surgery. > > It is > > > usually done in the office under local anethesia. There is a > small > > prick > > > with an instrument (like a thicker needle) that is inserted into > > the baby's > > > heel. IF the tentomy is necessary, the healing casts stay on for > > another 3 > > > weeks. After the healing casts come off, then the bracing > begins. > > The > > > bracing time is usually 23 hours/ day for the first 1-3 months, > and > > then you > > > are gradually reduced in hours, until eventually, your baby is > > wearing the > > > brace only 12-14 hours/day (mostly naps and bedtime) until 3- 4 > > years old. > > > While this may sound daunting right now, it really isn't that > big > > of a deal, > > > provided you have the right doctor and the right treatment. Many > of > > us here > > > on this group found docs at first that weren't following Ponseti > > protocol > > > for different reasons. Eventually, most have switched to Ponseti > > certified > > > doctors, (or even traveled to Iowa to go to Ponseti himself.) > after > > we > > > realized that things weren't going well for our kids (some were > > > uncomfortable, some weren't getting significantly better, etc.) > > with our > > > first (sometimes second and third) doctors. Again, interview > other > > doctors > > > before you decide on one in particular. Where are you located? > We > > can helo > > > you find certified Ponseti Certified Doctors in your area. If > > nothing else, > > > just go talk to one of them, and listen to what they have to > say. > > You may > > > find that you would rather see that doc instead. It would be > > wonderful to > > > have a doctor that you are comfortable with before the baby > comes! > > > > > > As far as clothes go, footed PJs are probably out of the > question > > during the > > > casts. During the winter, bigger pants (like a size or two up) > are > > good. A > > > Children's Place and Old Navy have a lot of those right now. If > it > > is a > > > girl, you are covered with dresses! Bathing is one of those > things > > that you > > > have to find the rythym, if you know what I mean. Your baby will > > take sponge > > > baths during the casting process. It sounds worse than it is, > but > > think > > > about it...You wouldn't fill up your tub or even a baby tub and > > stick your > > > baby in it to splash around when they are newborn...It doesn't > last > > forever, > > > just a couple of months. > > > > > > Skin care around the casts isn't usually an issue either. I > think > > most of us > > > had that occasional tiny " diaper spilage " but once it happens, > you > > realize > > > why it happened (you realize that the casts were tucked into the > > diaper > > > accidently or something), and you just remember to check how you > > put it on > > > the next time. Chafing chouldn't be a problem under a good > doctor's > > care. > > > > > > Okay, now that I have bombarded you with all of this info, take > a > > breath. > > > It's going to be great! Enjoy what's left of the pregnancy, and > > enjoy that > > > wonderful baby when he/she arrives. BTW, when are you due? > > > Let us know how things are going! > > > ( 2/1/05 bcf) > > > > > > > > > >From: " mmg174 " <mmg174@> > > > >Reply-To: nosurgery4clubfoot > > > >To: nosurgery4clubfoot > > > >Subject: Expecting Mom > > > >Date: Sat, 04 Feb 2006 22:07:16 -0000 > > > > > > > >I've had 2 ultrasounds that indicate my son's left foot is > clubbed. > > > >My husband and I met with an orthapedist this week that > explained > > > >treatment. > > > >6-8 weeks of casting > > > >surgery to cut his achilles tendon > > > >6-8 more weeks of casting > > > >then 3 months in a brace > > > >Is this a typical treatment?? > > > > > > > >Plus with the castings will he be able to wear normal baby > pants? > > What > > > >about bathing? and skin care around the cast?? I have so many > > > >questions! > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2006 Report Share Posted February 12, 2006 Hi ! I'm expecting a bcf baby and I'm due on March 11. (Looks like there might be a few of us going through the same steps in the next few months.) Although this is baby #4 for me, this almost seems like the first one. One of my husband's younger cousins was born bcf but that was almost 15 years ago and he went through surgery. Needless to say, by the end of every day his feet are constantly in pain. I'm lucky to have found this board as I'm sure you are too! As for stocking up on supplies: I've found that the only thing I really " look " for are pants, pj's or outfits with the snaps down the leg for easy dressing. I haven't really had to go out of my way to buy anything special because of his feet. Congrats on your upcoming bundle of joy! Keep us posted! Janice Ethan edd 03/11/06 > > Thank you so much for your responses. I'm due March 16 (only 5 weeks > away!) > Is there anything I should stalk up on now? is there a certain brand > of diapers that work better? certain cremes? or a bath tub that > works best with the casts? > This is my first baby so I feel clueless as it is...and with the club > foot I'm really anxious to start out right. > > I can't tell you all how much I appreciate the support and advice. > > > Quote Link to comment Share on other sites More sharing options...
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