Re: Re: question about new Markell shoes

[Guest guest]

The hole in the Pre-holed Markells isn't going to prevent a sore just

because it's a hole. The sores do not form in this area in most

cases. This hole should only be used to view the heel of the foot,

to know if it's rising or not. I'm not exactly sure about whether or

not it should be on one side or another, because it's not meant to

release pressure on the heel as far as I can tell. Most of the sores

I've seen (and I have seen quite a few from parents emailing me

privately in addition to any that have been sent to CFPics) are much

more centralized than the ones we saw on Isabella's foot. The

bottom line is, that the shoe should be fitting properly and sores

then will not be an issue. Not only does a heel that is rising up

put pressure on the WRONG part of the heel from the built in counter

(or the plastizode counter), a foot that is pointing down in the shoe

is not being held in proper correction. PLUS... with a rising heel

the strap cannot be tightened fully (this is shown time and again

when parents do get the heel down fully, they usually gain at least 1

if not 2 or more holes tighter in the strap buckle).

Our hole was cut out of desperation to remove any pressure from the

affected area so she could heal. It was only then that I was able to

see inside and notice that 1) her sore wasn't even in the middle of

the hole like it should have been, and 2) the heel wasn't seated

properly. Our hole was higher up than the one in the new Markells,

even so I could see enough to know things were totally wrong

inside. At that point, I went home and worked to figure out how to

put her shoes on properly. The rest is history. Combined with

taking the shoes off the bar and all the other tips we had available

at the time (Beth and 's tips, anything on any web pages I could

find) I finally figured out how I needed to press her foot into the

shoe at the knee and dorsiflex at the same time. I swear... no one

ever told me how to do this. Even after so many trips to the Ortho.

shop and sores for weeks... I thank my lucky stars for that one

Ortho who did so much work with us and finally cut the hole because

without that I honestly don't know where we'd be now. Unfortunately

he left about 2w after he did this for us and I haven't seen him

since. Even so, I don't think he knew the importance of how even a

few mm heel rising could make such a difference because at one point

we actually knew her heel was rising about 4mm but it seemed so

slight that it probably didn't matter. So much for slightness...

I should go back and read my posts from when all this

happened. Probably have more detailed info about how stupid I was lol.

Kori

At 06:35 PM 1/20/2006, you wrote:

>Hi Halley,

>

>Wow time flies, can't believe Keira is going into the shoes already -

>congrats!

>

>The new style Markells already do have a hole cut out in the back and

>she should be fine in them as long as you are getting her heel all

>the way down in the shoes and doing them up super tight.

>

>I was trying to say (not so successfully in that post I guess) that I

>think that the hole would be better placed on the rear side of the

>shoe instead of right on the back of it.

>

>As for the shoe size, there isn't even a full size difference between

>Graces cf and her noncf at this point. She went into a 00 at 2 mos.

>With our first pair, our ortho didn't give us a pair that were too

>big to make sure that we didn't have any issues with getting them on

>tight tight tight. Now when we get new shoes, we get them quite big

>on her so that they last longer. So when your ortho measures her

>noncf, as long as it fits that foot comfortably and isn't too too big

>then you shouldn't have any issue with her cf fitting as it will be a

>bit smaller.

>

>As for keeping the tenotomy cast on for 2 weeks instead of three, as

>long as her tenotomy incision has healed well and her foot moves out

>to (or even better a bit past) a 70 degree outward rotation and she

>has good dorsiflection, I personally would be ok with it.

>

>Hope you are all well and that you have a smooth move into the shoes=)

>

> & Grace

>

>ps. I was in Calgary recently and had planned to call you but my bags

>got lost with Grace's brace in her suitcase (direct flight so I

>thought no prob ha) and it was a total nightmare to get it sorted out

>as Air Canada is one of those co's that have farmed out their C/S to

>India so didn't get a chance =(. Definately will give you a shout

>next time I am back though (will carry on her brace this time!).

>

>

>

>

> >

> > Hello,

> >

> > I need to order the new Markells for Keira right away as she just

>has her

> > tenotomy done on Thursday. When you say cut a hole in the heel, I

>have a

> > hard time picturing it as there is already an opening in the heel

>of the new

> > shoe style. Sorry to sound so daft but I want to be able to know

>what I am

> > talking about when I see the orthotist.

> >

> > Also, we weren't sure she'd have her tenotomy last week as he

>thought she

> > may have needed one more cast so we weren't really thinking about

>ordering

> > the shoes. In any case, if I'd known that she'd have it done last

>week, I

> > would have stopped at the store that orders Markell's and have them

>measure

> > her foot while out of the cast. There are shoes available through

>the

> > hospital but they are the old style and in any case, they didn't

>have any

> > there last week to size her with.

> >

> > So, I guess we'll just have her non-clubfoot measured but I

>wondered if this

> > would be a problem. Her clubfoot is a wee bit smaller but I guess

>she'll be

> > wearing them on both feet not just the clubfoot and I imagine that

>in most

> > cases, you order one size for both feet.

> > Any advice would be great as I would like to order right away since

>they'll

> > take a week or two to arrive.

> >

> > Also, my doctor, who I've been very pleased with, is a " Ponseti-

>purist " and

> > has been recommended by Dr. Pirani, said that sometimes he leaves

>the

> > tenotomy cast on for only two weeks. He said that he has had great

>results

> > and no concerns about it but he knows that Ponseti says three weeks

>and it

> > is our choice. Any ideas about this? Perhaps it is better to leave

>it on

> > three weeks. My husband figures we should just go with the two

>weeks as he

> > suggested.

> >

> > Thanks very much for any feedback you might have.

> >

> > Have a great weekend!

> >

> > Halley

> >

> >

> >

> >

> > The new Markell shoes

> >

> > Hey all,

> >

> > I was thinking of sending an email to Jay regarding his new

>shoes...I

> > think that having a hole cut in the heel's of the shoes is a great

> > great idea. Our orthotist (who has a rcf also) has been doing this

>for

> > a couple of years now. I actually didn't even realise that they

>didn't

> > come that way. But she cuts the hole in the rear inside of the

>shoe,

> > it's right where the heel comes down but not where the heel would

>have

> > any chance of rubbing.

> >

> > She says that she cuts the hole's there so that there wouldn't be

>any

> > chance of the heel rubbing the outside edges of the hole and

>causing

> > blisters or sores hmmmmm. Makes me really wonder if this is what

> > happened with Isabella's poor heels.

> >

> > Would like to get some feedback from you all though before I send

>the

> > email.

> >

> > Thanks

> >

> > & Grace

> >

> >

> >

> >

> >

> >

> >

[Guest guest]

I do think it is something we might want to pursue. Dr. Dobbs has an orthotist

that he works with very closely - they do the mold to make the rubber inserts

for the AFO's. They actually take a quick plaster mold of the whole foot and

lower leg. When I get a chance I may have to email Jay Markell about this!

wrote: ,

I think that this is just a fanatastic idea!! I would guess that

is super busy and I know that the wait for the 's can be

frustrating for parents (especially those who have had their kids in

a lot of casts - Hang in there =).

I wonder if Jay would be recptive to this? Who does the actual

impressions for Dr. Dobbs shoes? Is it him or an orthotist that he

works closely with?

Just thinking what would be the best way to go about it...if it could

be done by the orthotist, Jay could just sell a kit of some sort so

that there wouldn't be a waiting period for the impressions to be

sent off, then made, then shipped back but maybe that would be the

way it would need to be done hmmm, wonder if an orthotist would be

able to provide this service. Maybe the kit could be simplified

enough so that the parent could even do the impression and then take

to the ortho for the fitting.

Very interesting idea ! If done right, you can see how this

could help a lot of little feet!

& Grace

> >

> > Whatever the case, the fact that your orthotist

> > > cuts the heels out and isn't screaming *it'll ruin the

> > > shoe!*... she's a gem and you should absolutely share her! I

say,

> > > whatever works... works. If it's a hole in the side, for

whatever

> > > reason... go for it. I am sure she knows more than I do about

this

> > > if she's working with CF babes regularly.

> >

> >

> >

> > Yes she is great (has a rcf as well, I think that this makes it a

> > passion for her), she has worked closely with Dr. Pirani with his

cf

> > babies for a number of years. We are very lucky to have her!

> >

> > I

> > > may have forgotten to mention that we did mark where he sore

was by

> > > opening the shoe and making an impression into the

> > > heel. See... when we did that her heel was pressed firmly

into

> > the

> > > shoe where it should have been all along. So that's where he

cut,

> > > and what we saw was the sore nowhere near the hole's center, in

> > fact

> > > it was up near the top right edge (hummm... maybe there's some

kind

> > > of correlation here... her sore was slightly off to the

outside

> > just

> > > a bit, nowhere near where Isabella's were though).

> >

> >

> >

> > This is what I was wondering...if the edge of the hole could

cause

> > any issues with the foot coming into contact with it and if it

rubbed

> > at all well that wouldn't be a good thing. But it isn't a good

thing

> > for the foot to rub anywhere in the shoe.

> >

> >

> > >

> > > Trust me, I'm not arguing real *knowledge as fact* about

anything

> > > here because I don't know for sure much at all about the new

shoes

> > > having never seen them personally. But imagining what they

are,

> > > based on Markell's PDF and now, the pics of Isabella in her

shoes

> > > where we got a peek at the hole a bit, I see that the hole

itself

> > is

> > > actually the heel pocket area on the other model without the

> > > hole. I'm only guessing here when I say that I feel that the

hole

> > > was not a contributing factor in this case but I really don't

think

> > > so being that the counter in the shoe designed to press into

the

> > > upper heel area is still there and fully functional because the

> > hole

> > > is so low. Not having leather in the lower heel area where no

> > > pressure sores have been reported being even near, PLUS the

well

> > > known fact that the heel in a freshly corrected foot is not

even

> > > formed well yet... I dunno... just not so sure the hole had

> > > anything to do with it. So many of us have done exactly what

her

> > > parents did (I hate talking about them like that... we don't

even

> > > know their names! lol) and not *FORCED* the foot deeply into

the

> > shoe

> > > before tightening. Once the bugger is in there, without that

> > window

> > > we don't know a darn thing. I like the hole though. I wish I

> > could

> > > do some more in depth work with it so I could talk about it

> > > intelligently lol.

> >

> >

> > I totally agree, there needs to be a hole there so that you can

see

> > where the foot/heel is! When you look at the new 1645 model

though,

> > the hole is large and stitched. I wondered if the top stitched

edge

> > may cause some problems.

> >

> >

> >

> > >

> > > oh, ok I think I'm getting what you're talking about now... I

see

> > > what you're saying, yes. It wouldn't there would it? ok, well

> > > either way I think both kinds would be effective as a window.

how

> > > far can you see inside this way? can you actually see the heel

in

> > > the back? I know that there were a couple times when I would

> > notice

> > > Darbi's foot coming up but I could only tell this from the

little

> > > change in the distance from the bottom of her heel to the lower

> > edge

> > > of the hole. I honestly don't know what the heel rising would

look

> > > like from the side. Oh, I gotta see your pics! The hole she

cuts

> > is

> > > in the lower edge right? at the sole?

> >

> >

> >

> > I will send another pic to the list. Our orthotist will be

punching

> > this hole for all our shoes. Parents could request this for their

> > older kids too, the orthotist should have a punch right there in

the

> > office. I always like to see where Grace's heel is, even now.

> >

> > Ya know, as long as the hole in the new shoes isn't causing any

> > probs, it's all good! If there are no issues, then great =) but

it

> > does make me wonder, that top stitched part of the hole in the

> > 1645's...Something to keep an eye out for. I won't bother Jay cus

> > really the hole is great if it isn't causing any problems =)

> >

> >

> >

> > > Thanks so much for offering this up ! Got my gears

> > > turning... I would love to experiment more with these shoes

and

> > > holes... lol! Darbi's like almost 3 though! not a baby

anymore :~

> > {

> >

> >

> > This group (with you leading the way!) is the reason that the

1645's

> > are now available! Pat yourself on the back girl!

> >

> >

> >

> > > Kori

> >

>