your opinion on drs

[Guest guest]

Hello,

I have a couple of things to share with you. First of all, I had an amnio a

couple of weeks ago due to a soft marker scare on our initial ultrasound at

the end of July. I know it is unconventional to have an amnio at 35 weeks

but this was the compromise my husband and I made so that I would know the

results before labour without risking the baby. Anyway, I got the call today

that the results are normal! Today is my birthday and I can't imagine a

better birthday present! I feel like I've been living with a current of

anxiety running through me for months and it feels like a weight has been

lifted!

The other thing I just wanted to run by you just to get some insight, is

your opinion on what you might do if you were may as it relates to what

doctor to choose.

I met with Dr. Kiefer on Tuesday and he was trained by Dr. Pirani from

Vancouver who is highly recommended by Dr. Ponseti.

Anyway, there are six orthopedic doctors that work together at the

Children's Hospital. I have now met with two of them who both seem to follow

the Ponseti method.

There were a couple of things Dr. Kiefer said that I wondered about. First

of all, he uses fibreglass casts (as does Dr. Pirani in Vancouver w/ good

results) but says that b/c of that, the babies are casted an average of 8-9

weeks as opposed to the avg of 6 that Ponseti states. Is this too many or

does using fibreglass increase the number of casts it takes to achieve

correction b/c it is not quite as rigid?

Also, he mentioned that Ponseti says that many kids need some sort of

surgery around 7-10 yrs of age when they have a growth spurt. I didn't say

that I think he is wrong about that....but I think he is wrong about that.

Isn't the whole point of Ponseti to avoid surgery beyond just the tenotomy?

He was very helpful in answering questions and said not to feel obligated to

any one doctor here or to him b/c we've had a consult. He did say that if I

am looking for a doctor that is a true Ponseti purist, that Dr.

would be the best choice. He uses only plaster b/c he doesn't deviate from

what Ponseti says. I think that sounds like the best option to me. He is

slightly more junior than Dr. Kiefer and maybe doesn't have quite as many

years of experience but it sounds like he is very committed to the method.

That's who I am leaning towards...what do you think?

If we start casting before the New Year, there is a week where Dr. is

gone and it would be Dr. Goldstein (who uses fibreglass, sometimes only half

leg casts but not always and generally would be further from true Ponseti

then the other drs there). Would it be okay to have the first cast by Dr.

and then have this other doctor cast for one week or might that mess

things up since he does his own thing it sounds like?

Okay (sorry this is long!), just something of interest is that one of Dr.

Hertzenberg's partners is coming up here to be a visiting physician in the

New Year sometime. That is great b/c I hear so many things about Dr.

Hertzenberg and his group. They are starting a study here in the New Year so

that parents choose either plaster or fiberglass casts and the dr must use

what the parents wants despite what they themselves prefer. They want to see

if the convenience of fiberglass casts is worth a couple of extra weeks of

casting or if the rigidity of the plaster has a positive effect on the

outcome.

Thanks for your feedback!

Take care,

Halley

[Guest guest]

When Collin saw Dr. Ponseti in Septmber the 1st 2 casts he did was

plaster, but the third one was plaster and he broke it the next day

somehow, he could totally turn his foot back and forth, so they ended

up putting a fiberglass overlay ontop of it to keep it stronger.

Same with the after surgery cast he came out in plaster but before we

left the hospital they put fiberglass over it, it really helped to

protect it and keep it stonger. It's so hard to keep a 4 year old

crawing, etc so he really needed it.

MIchele

Collin's story at http://www.geocities.com/chele323232

Wetness on

the plaster can be an issue- not in small amounts, but

> large amounts.....mostly, though because of the cotton layers

> underneath getting wet, just like the fiberglass......then it

would

> get pretty rank.

> I have seen them do a fiberglass overlay on the plaster for the

kids

> who are rough on them. =)

>

>

>

>

>

>

>

>

[Guest guest]

Halley,

My son had the fiberglass casts and it did take 8 castings, I

believe. I can NOT believe I have forgotten the exact number. Take

heart in the fact that eventually this fades from your memory!!!!

Anyway, he achieved perfect correction and I gladly would accept a

couple of extra castings to avoid plaster. (I know many will

disagree with me on this one!!) We got to remove the casts at home

on the morning of the appointment and then go at lightning speed to

have a real bath and get up to the hospital for the next cast. I

wouldn't trade those real baths and those few minutes alone with my

uncasted baby for anything. Removing them was so easy and from what

I read on here about others' experiences with plaster, those casts

can be a challenge to get off even if they do let you do it at home.

That said, I would not go to any doctor who wants to do short

casts. Why would he do that?

I, also, have never heard of any further surgery at age 7-10.

Good luck!

Shelley and Evan (8-17-00)

>

> Hello,

>

> I have a couple of things to share with you. First of all, I had

an amnio a

> couple of weeks ago due to a soft marker scare on our initial

ultrasound at

> the end of July. I know it is unconventional to have an amnio at

35 weeks

> but this was the compromise my husband and I made so that I would

know the

> results before labour without risking the baby. Anyway, I got the

call today

> that the results are normal! Today is my birthday and I can't

imagine a

> better birthday present! I feel like I've been living with a

current of

> anxiety running through me for months and it feels like a weight

has been

> lifted!

>

> The other thing I just wanted to run by you just to get some

insight, is

> your opinion on what you might do if you were may as it relates to

what

> doctor to choose.

> I met with Dr. Kiefer on Tuesday and he was trained by Dr. Pirani

from

> Vancouver who is highly recommended by Dr. Ponseti.

> Anyway, there are six orthopedic doctors that work together at the

> Children's Hospital. I have now met with two of them who both seem

to follow

> the Ponseti method.

> There were a couple of things Dr. Kiefer said that I wondered

about. First

> of all, he uses fibreglass casts (as does Dr. Pirani in Vancouver

w/ good

> results) but says that b/c of that, the babies are casted an

average of 8-9

> weeks as opposed to the avg of 6 that Ponseti states. Is this too

many or

> does using fibreglass increase the number of casts it takes to

achieve

> correction b/c it is not quite as rigid?

> Also, he mentioned that Ponseti says that many kids need some sort

of

> surgery around 7-10 yrs of age when they have a growth spurt. I

didn't say

> that I think he is wrong about that....but I think he is wrong

about that.

> Isn't the whole point of Ponseti to avoid surgery beyond just the

tenotomy?

> He was very helpful in answering questions and said not to feel

obligated to

> any one doctor here or to him b/c we've had a consult. He did say

that if I

> am looking for a doctor that is a true Ponseti purist, that Dr.

> would be the best choice. He uses only plaster b/c he doesn't

deviate from

> what Ponseti says. I think that sounds like the best option to me.

He is

> slightly more junior than Dr. Kiefer and maybe doesn't have quite

as many

> years of experience but it sounds like he is very committed to the

method.

> That's who I am leaning towards...what do you think?

> If we start casting before the New Year, there is a week where Dr.

is

> gone and it would be Dr. Goldstein (who uses fibreglass, sometimes

only half

> leg casts but not always and generally would be further from true

Ponseti

> then the other drs there). Would it be okay to have the first cast

by Dr.

> and then have this other doctor cast for one week or might

that mess

> things up since he does his own thing it sounds like?

>

> Okay (sorry this is long!), just something of interest is that one

of Dr.

> Hertzenberg's partners is coming up here to be a visiting

physician in the

> New Year sometime. That is great b/c I hear so many things about

Dr.

> Hertzenberg and his group. They are starting a study here in the

New Year so

> that parents choose either plaster or fiberglass casts and the dr

must use

> what the parents wants despite what they themselves prefer. They

want to see

> if the convenience of fiberglass casts is worth a couple of extra

weeks of

> casting or if the rigidity of the plaster has a positive effect on

the

> outcome.

>

> Thanks for your feedback!

>

> Take care,

> Halley

>

[Guest guest]

Not as cool as you might think.

Both the casts Dr P put on Kai required fiberglas over them - the

first after he had rubbed the ankle off until it was soft, and the

second to prevent that happening.

Fiberglas over plaster HAS to be sawed off ... there is no other way

because they use the hard fiberglas over the plaster. It takes

longer to saw off a cast with both materials on it.

FWIW, we have been thru all 3 materials: soft fiberglas w/Mosca when

Kai was a baby and last year, plaster (w/hard fiberglas over) w/Dr

Ponseti, and hard fiberglas the last 2 castings. I can't honestly

recommend one over the other, because each had their benefits. Dr

Mosca's cast tech is a wonder, and both he and Mosca work to mold the

fiberglas to the correct position in the small window they have

before it sets ... Dr M holds the foot in position and Sam wraps the

cast, then they both work with it.

Angel

Wetness on

the plaster can be an issue- not in small amounts, but

> large amounts.....mostly, though because of the cotton layers

> underneath getting wet, just like the fiberglass......then it

would

> get pretty rank.

> I have seen them do a fiberglass overlay on the plaster for the

kids

> who are rough on them. =)

>

>

>

>

>

>

>

>