Re: From 8 to 10 - WOW!!!!

[Guest guest]

I would say yes it may take a day or two to get comfortable-however,

it should be more comfortable for him when he is laying down. This

should also help him keep his feet in his shoes!!

take care and let us knowif anything comes up!

kathleen

>

> I measured Nick's shoulders & came up with 6 1/2 " apart. You were

all

> right, I had to move it out 2 spaces!!!!! Still pretty upset -

takes

> a day or so?

>

[Guest guest]

,

If you've got bar length correct now - Did you hold the brace up to

the back of his shoulders? See how it is done in the photo in the

tips document - he should be happier pretty quickly if that was the

only issue.

The other thing I'm seeing in the photos is not so much outward

rotation of the foot. The last cast should have been set to 70

degrees of outward rotation so that the 70 degrees on the brace is not

painful to him. I also agree with Kori about the front part of his

foot curving in, it's somewhat minor, but looks like maybe his

metatarsal bones would not be lined up quite right as it is. I can't

quite tell if this is deceptive in the photos or if it is because he's

not abducted to the 70 degrees. The toe curling thing is often caused

by the casts but should correct itself with time and growth. If he

needs another cast you might want to address this so they can try to

give just a little more room for his toes to go straight in the cast.

Definitely make sure to run your finger under the toes, blouse out

the toes of the socks a little if need be, as you are putting the

shoes on to be sure they are not being pinched by the shoes. Now darn

it, I've forgotten who Nick's doctor is, if you've mentioned, is it

someone we know? My personal opinion is that he probably could use

another cast. If the doc is not in agreement you should probably get

a second opinion, you can always send pics to Dr. P for this if there

is no one else good near you.

One other suggestion on the shoes, right now they are set up on the

bar with the buckles on the outside of his feet. Switch the shoes on

the bar so that the buckles are on the inside, this makes it SO much

easier to buckle and get the strap tight. Also, see how on the sides

of the shoes there are two slots that the strap can go through? Put

the strap through the lower slot on both sides of the shoe. This will

help it stay tighter for sure. Then, as he grows, you can get a

little extra room out of the shoes by moving the strap to the higher

holes on one side or both depending on how his foot grows. Now on the

s, his feet look a little thick to me and might fit more

comfortably in them but I would 1) try these other adjustments to the

shoes, 2) talk to the doctor about an additional cast for more outward

rotation and the " C " shape and *then*, if all else fails, 3) go for

the s.

Hang in there !

Hope this helps,

>

> I measured Nick's shoulders & came up with 6 1/2 " apart. You were all

> right, I had to move it out 2 spaces!!!!! Still pretty upset - takes

> a day or so?

>

[Guest guest]

I just looked at the bar set up pic again and I really, really don't

like the dorsiflexion on that bar. 1) it's too much, and 2) it's way

too much on the non-affected foot side. That twist on his ankle

looks very uncomfortable to me.

Darbi had her bar bent on both sides for a couple of years, never

bothered her. She is unilateral too. But it sure wasn't bent that

much or I'm sure she would have complained. With her PM's, her

non-affected side is nice and flat and only dorsiflexed on the other

side. I like that.

I would bend it back if it were me. Bend the bar so the non-affected

foot is flatter. Get yourself a protractor and measure the degree of

dorsiflexion. It should be no more than 15 degrees, no less than

10. You measure this by lying the protractor flat on a table and

put the bar against the protractor so that the middle is flat

(imagine this with your bent bar). Then see where the protractor

reads against the bar.

To bend it back just use your mama power. I would make the

non-affected side 0 degrees or flat, and the other 10-15 degrees.

As said, yes, absolutely put the shoes so the buckle is on

the inside. It makes it much easier to buckle if you don't have to

twist baby to the side to get to it. And do put the straps in the

bottom slot, it really helps, and also makes them that much more

secure because the strap embraces the top of the foot from further

down on each side rather than over the leather and then on top of the foot.

Do put them up to his shoulder, most kids are happiest at heel to

heel although some of course are happy at bolt to bolt.

Do you have his last cast? Can we see it? Directly from the bottom

if possible.

So how's he doing now? It's been a few hours, he should be a little

happier now...

hugs,

Kori

At 08:31 AM 2/16/2006, you wrote:

>,

>If you've got bar length correct now - Did you hold the brace up to

>the back of his shoulders? See how it is done in the photo in the

>tips document - he should be happier pretty quickly if that was the

>only issue.

>The other thing I'm seeing in the photos is not so much outward

>rotation of the foot. The last cast should have been set to 70

>degrees of outward rotation so that the 70 degrees on the brace is not

>painful to him. I also agree with Kori about the front part of his

>foot curving in, it's somewhat minor, but looks like maybe his

>metatarsal bones would not be lined up quite right as it is. I can't

>quite tell if this is deceptive in the photos or if it is because he's

>not abducted to the 70 degrees. The toe curling thing is often caused

>by the casts but should correct itself with time and growth. If he

>needs another cast you might want to address this so they can try to

>give just a little more room for his toes to go straight in the cast.

> Definitely make sure to run your finger under the toes, blouse out

>the toes of the socks a little if need be, as you are putting the

>shoes on to be sure they are not being pinched by the shoes. Now darn

>it, I've forgotten who Nick's doctor is, if you've mentioned, is it

>someone we know? My personal opinion is that he probably could use

>another cast. If the doc is not in agreement you should probably get

>a second opinion, you can always send pics to Dr. P for this if there

>is no one else good near you.

>One other suggestion on the shoes, right now they are set up on the

>bar with the buckles on the outside of his feet. Switch the shoes on

>the bar so that the buckles are on the inside, this makes it SO much

>easier to buckle and get the strap tight. Also, see how on the sides

>of the shoes there are two slots that the strap can go through? Put

>the strap through the lower slot on both sides of the shoe. This will

>help it stay tighter for sure. Then, as he grows, you can get a

>little extra room out of the shoes by moving the strap to the higher

>holes on one side or both depending on how his foot grows. Now on the

>s, his feet look a little thick to me and might fit more

>comfortably in them but I would 1) try these other adjustments to the

>shoes, 2) talk to the doctor about an additional cast for more outward

>rotation and the " C " shape and *then*, if all else fails, 3) go for

>the s.

>Hang in there !

>

>Hope this helps,

>

>

>

>

> >

> > I measured Nick's shoulders & came up with 6 1/2 " apart. You were all

> > right, I had to move it out 2 spaces!!!!! Still pretty upset - takes

> > a day or so?

> >

>

>

>

>

>

>

>

>

[Guest guest]

From what I have seen on this list for the last year and a half, most

or almost all orthotists seem to fit the brace with the feet way way

too close together? Hope they are learning from these experiences so

the next babies that they fit are comfortable!

Glad that you got the length figured out and I would definately switch

the shoes as mentioned so that the buckles are on the inside,

so much easier to put them on that way! As for the bend in the bar,

Kori is really so knowledgable, try out what she is suggesting here

regarding the dorsiflexion. Once you get it to where it needs to be,

take the shoes off and put the brace on a piece of paper and make a

trace of the bend, that way you always know where it's supposed to be

cus they will flatten it over time from curising and you will need to

bend it back slightly.

& Grace 18mos

urcf FAB 13 hrs

>

> I measured Nick's shoulders & came up with 6 1/2 " apart. You were

all

> right, I had to move it out 2 spaces!!!!! Still pretty upset - takes

> a day or so?

>

[Guest guest]

I agree, the non affected foot does look to be at an awkward angle

because of the bend on that side of the bar. That has to be

contributing to his uncomfortableness. The bars are not hard to bend,

if you have a vice you can clamp it in there and it will bend easily

with your hands.

allison

> > >

> > > I measured Nick's shoulders & came up with 6 1/2 " apart. You

were all

> > > right, I had to move it out 2 spaces!!!!! Still pretty upset -

takes

> > > a day or so?

> > >

> >

> >

> >

> >

> >

> >

> >

> >