Re: Dilemma about brace hours...

[Guest guest]

Carol,

real quick here... if she's in the PM's one has to wonder how those

shoes would put any pressure on her toes at all. The toe box is very

roomy and I'm pretty sure that can make her a shoe that would

accommodate that better if her current shoes are too narrow

there. Pretty soon, her toes won't be anywhere near anything that

could compress them at all.

Also, what about some kind of splinting? There's plenty of room in

these shoes for a splint. If you do the time during sleep too (naps

- not the whole time in one stretch), you maximize her time out of

them for standing. Standing seems to be something that could help

the toe move out I suppose, not sure what else the doc is referring

to with time out of them because the abduction is the same still

right? I think I'd want to know if the abduction is really a

problem, and maybe if it really is you'll want to reduce that some

instead? I think you're a prime candidate for tolerance issues due

to her age if you go to nights only right now but maybe not. There

is a relapse risk too but most likely that wouldn't be immediately noticed.

Not sure exactly what to say, Dr. P. will probably have some good

input too. But maybe investigate some options and check out what

exactly the shoes themselves are doing to this toe, if they even are,

or what they are hindering and exactly how before you decide what to

do. And talk to too, he may be able to help.

Kori

At 08:20 AM 4/1/2006, you wrote:

> is five months old and is one month away from ending her 23/7

>brace wear. She is bilateral. We visited her ortho yesterday and I

>asked about her big toes, which have always rolled outward on the

>outer edges, causing them to curve inward toward the rest of her

>toes. (if you can picture that) He expressed a concern that, while

>the brace has not caused this issue with her toes since it was

>present at birth, it is aggravating it with the degree of abduction

>her feet are being held at. He wants her to be in the brace nights

>only starting after our 23/7 brace wear is over, so that would be

>12/7. Of course, that scared me to death, but I do see his point,

>as well. The issue with the toes, if it doesn't improve, will cause

>problems with shoes fitting properly and possibly with the function

>of her feet. It is also an aesthetic issue, which is secondary but

>must be at least considered. These toes make her feet look deformed

>right now and I would hate for that to continue. But I don't want

>to risk a relapse of her feet. It feels a bit like a catch 22.

>

>I am very confused about what to do and think that I will email Dr.

>Ponseti about this issue since he saw her in January. BTW, on a

>summary of our visit which Dr. Ponseti's office sent to us after our

>January visit, he recommended that she wear the brace " full time for

>2 1/2 months, then 18/7, then 16/7 " but doesn't specify for how long

>she is to wear the brace at each interval. Given this advice, I

>feel that we could reduce to 18/7 after our full-time wear is over.

>

>Any thoughts? I am still pondering all of this and feeling like the

>weight of this decision rests all on me....a bit

>overwhelming! Thanks in advance,

>

>Carol and , 10-27-05, bcf, s 23/7 for one more month

>

>

[Guest guest]

Carol, I was thinking the same as Kori. It's hard to imagine that the 's

constrain the toes at all since they're so open in the toe area. However, if is

is squishing the toes, then maybe you can just keep in the brace longer

and maybe just reduce the angle of abduction? I mean, a reduction in the

abduction would be better than not wearing the shoes at all, right?. That's just

what I'm thinking. Marcus' big toe curls out toward his other toes and his

second toe kind of sits on top of the big toe. I can't " fix " the position of the

toe no matter how much I try. I, too, looked to see if the shoes were

constraining the toe in any way, but they are not. In fact, his toes have plenty

of room. It's probably not much help, just my 2 cents.

frogabog wrote: Carol,

real quick here... if she's in the PM's one has to wonder how those

shoes would put any pressure on her toes at all. The toe box is very

roomy and I'm pretty sure that can make her a shoe that would

accommodate that better if her current shoes are too narrow

there. Pretty soon, her toes won't be anywhere near anything that

could compress them at all.

Also, what about some kind of splinting? There's plenty of room in

these shoes for a splint. If you do the time during sleep too (naps

- not the whole time in one stretch), you maximize her time out of

them for standing. Standing seems to be something that could help

the toe move out I suppose, not sure what else the doc is referring

to with time out of them because the abduction is the same still

right? I think I'd want to know if the abduction is really a

problem, and maybe if it really is you'll want to reduce that some

instead? I think you're a prime candidate for tolerance issues due

to her age if you go to nights only right now but maybe not. There

is a relapse risk too but most likely that wouldn't be immediately noticed.

Not sure exactly what to say, Dr. P. will probably have some good

input too. But maybe investigate some options and check out what

exactly the shoes themselves are doing to this toe, if they even are,

or what they are hindering and exactly how before you decide what to

do. And talk to too, he may be able to help.

Kori

At 08:20 AM 4/1/2006, you wrote:

> is five months old and is one month away from ending her 23/7

>brace wear. She is bilateral. We visited her ortho yesterday and I

>asked about her big toes, which have always rolled outward on the

>outer edges, causing them to curve inward toward the rest of her

>toes. (if you can picture that) He expressed a concern that, while

>the brace has not caused this issue with her toes since it was

>present at birth, it is aggravating it with the degree of abduction

>her feet are being held at. He wants her to be in the brace nights

>only starting after our 23/7 brace wear is over, so that would be

>12/7. Of course, that scared me to death, but I do see his point,

>as well. The issue with the toes, if it doesn't improve, will cause

>problems with shoes fitting properly and possibly with the function

>of her feet. It is also an aesthetic issue, which is secondary but

>must be at least considered. These toes make her feet look deformed

>right now and I would hate for that to continue. But I don't want

>to risk a relapse of her feet. It feels a bit like a catch 22.

>

>I am very confused about what to do and think that I will email Dr.

>Ponseti about this issue since he saw her in January. BTW, on a

>summary of our visit which Dr. Ponseti's office sent to us after our

>January visit, he recommended that she wear the brace " full time for

>2 1/2 months, then 18/7, then 16/7 " but doesn't specify for how long

>she is to wear the brace at each interval. Given this advice, I

>feel that we could reduce to 18/7 after our full-time wear is over.

>

>Any thoughts? I am still pondering all of this and feeling like the

>weight of this decision rests all on me....a bit

>overwhelming! Thanks in advance,

>

>Carol and , 10-27-05, bcf, s 23/7 for one more month

>

>

[Guest guest]

Hi Kori,

I think it is not that the brace constrains her toes in any way. I agree that

the s are very roomy and open at the toes. The doc's point was that, at

the 60 degrees of abduction, the brace is forcing her foot into a position which

encourages the big toes to roll inward rather than to straighten out, more

because of the mechanism of the muscles in the feet rather than the brace.

He also told me not to lengthen the bar, either, although it is at the shortest

setting, because that encourages the toes to roll inward, as well. I believe

that his thinking is that being out of the brace would encourage her toes to go

into a more normal position. The abduction could be reduced, I suppose, but

that makes me nervous, too. Everything makes me nervous! LOL

I don't know that I am able to explain the problem, or his reasoning, very well.

He said that this is a very uncommon issue to have with toes and is not common

even with club foot babies. This is part of what makes her club feet atypical

or complex. I will try to post pictures. It is a hard thing to capture in a

photo, but I will give it a shot. Thanks!

Carol

Re: Dilemma about brace hours...

Carol,

real quick here... if she's in the PM's one has to wonder how those

shoes would put any pressure on her toes at all. The toe box is very

roomy and I'm pretty sure that can make her a shoe that would

accommodate that better if her current shoes are too narrow

there. Pretty soon, her toes won't be anywhere near anything that

could compress them at all.

Also, what about some kind of splinting? There's plenty of room in

these shoes for a splint. If you do the time during sleep too (naps

- not the whole time in one stretch), you maximize her time out of

them for standing. Standing seems to be something that could help

the toe move out I suppose, not sure what else the doc is referring

to with time out of them because the abduction is the same still

right? I think I'd want to know if the abduction is really a

problem, and maybe if it really is you'll want to reduce that some

instead? I think you're a prime candidate for tolerance issues due

to her age if you go to nights only right now but maybe not. There

is a relapse risk too but most likely that wouldn't be immediately noticed.

Not sure exactly what to say, Dr. P. will probably have some good

input too. But maybe investigate some options and check out what

exactly the shoes themselves are doing to this toe, if they even are,

or what they are hindering and exactly how before you decide what to

do. And talk to too, he may be able to help.

Kori

At 08:20 AM 4/1/2006, you wrote:

> is five months old and is one month away from ending her 23/7

>brace wear. She is bilateral. We visited her ortho yesterday and I

>asked about her big toes, which have always rolled outward on the

>outer edges, causing them to curve inward toward the rest of her

>toes. (if you can picture that) He expressed a concern that, while

>the brace has not caused this issue with her toes since it was

>present at birth, it is aggravating it with the degree of abduction

>her feet are being held at. He wants her to be in the brace nights

>only starting after our 23/7 brace wear is over, so that would be

>12/7. Of course, that scared me to death, but I do see his point,

>as well. The issue with the toes, if it doesn't improve, will cause

>problems with shoes fitting properly and possibly with the function

>of her feet. It is also an aesthetic issue, which is secondary but

>must be at least considered. These toes make her feet look deformed

>right now and I would hate for that to continue. But I don't want

>to risk a relapse of her feet. It feels a bit like a catch 22.

>

>I am very confused about what to do and think that I will email Dr.

>Ponseti about this issue since he saw her in January. BTW, on a

>summary of our visit which Dr. Ponseti's office sent to us after our

>January visit, he recommended that she wear the brace " full time for

>2 1/2 months, then 18/7, then 16/7 " but doesn't specify for how long

>she is to wear the brace at each interval. Given this advice, I

>feel that we could reduce to 18/7 after our full-time wear is over.

>

>Any thoughts? I am still pondering all of this and feeling like the

>weight of this decision rests all on me....a bit

>overwhelming! Thanks in advance,

>

>Carol and , 10-27-05, bcf, s 23/7 for one more month

>

>

[Guest guest]

Sorry, meant say that her big toes roll outward, not inward. Not enough sleep -

LOL.

Re: Dilemma about brace hours...

Carol,

real quick here... if she's in the PM's one has to wonder how those

shoes would put any pressure on her toes at all. The toe box is very

roomy and I'm pretty sure that can make her a shoe that would

accommodate that better if her current shoes are too narrow

there. Pretty soon, her toes won't be anywhere near anything that

could compress them at all.

Also, what about some kind of splinting? There's plenty of room in

these shoes for a splint. If you do the time during sleep too (naps

- not the whole time in one stretch), you maximize her time out of

them for standing. Standing seems to be something that could help

the toe move out I suppose, not sure what else the doc is referring

to with time out of them because the abduction is the same still

right? I think I'd want to know if the abduction is really a

problem, and maybe if it really is you'll want to reduce that some

instead? I think you're a prime candidate for tolerance issues due

to her age if you go to nights only right now but maybe not. There

is a relapse risk too but most likely that wouldn't be immediately noticed.

Not sure exactly what to say, Dr. P. will probably have some good

input too. But maybe investigate some options and check out what

exactly the shoes themselves are doing to this toe, if they even are,

or what they are hindering and exactly how before you decide what to

do. And talk to too, he may be able to help.

Kori

At 08:20 AM 4/1/2006, you wrote:

> is five months old and is one month away from ending her 23/7

>brace wear. She is bilateral. We visited her ortho yesterday and I

>asked about her big toes, which have always rolled outward on the

>outer edges, causing them to curve inward toward the rest of her

>toes. (if you can picture that) He expressed a concern that, while

>the brace has not caused this issue with her toes since it was

>present at birth, it is aggravating it with the degree of abduction

>her feet are being held at. He wants her to be in the brace nights

>only starting after our 23/7 brace wear is over, so that would be

>12/7. Of course, that scared me to death, but I do see his point,

>as well. The issue with the toes, if it doesn't improve, will cause

>problems with shoes fitting properly and possibly with the function

>of her feet. It is also an aesthetic issue, which is secondary but

>must be at least considered. These toes make her feet look deformed

>right now and I would hate for that to continue. But I don't want

>to risk a relapse of her feet. It feels a bit like a catch 22.

>

>I am very confused about what to do and think that I will email Dr.

>Ponseti about this issue since he saw her in January. BTW, on a

>summary of our visit which Dr. Ponseti's office sent to us after our

>January visit, he recommended that she wear the brace " full time for

>2 1/2 months, then 18/7, then 16/7 " but doesn't specify for how long

>she is to wear the brace at each interval. Given this advice, I

>feel that we could reduce to 18/7 after our full-time wear is over.

>

>Any thoughts? I am still pondering all of this and feeling like the

>weight of this decision rests all on me....a bit

>overwhelming! Thanks in advance,

>

>Carol and , 10-27-05, bcf, s 23/7 for one more month

>

>

[Guest guest]

That is funny because has a second toe which tries to sit on top of her

big toe, too. It sticks up really crazy and always has, although it has gotten

better as she has gotten a bit older. When she was a newborn and for the first

few months it stuck up so far it looked like she was making an obscene gesture

with her toe. LOL Sorry for the silly clubfoot/crazy toe humor...I think I am

slap happy from months of no sleep! I believe I will go to bed now....

Carol

Re: Dilemma about brace hours...

Carol, I was thinking the same as Kori. It's hard to imagine that the

's constrain the toes at all since they're so open in the toe area.

However, if is is squishing the toes, then maybe you can just keep in the

brace longer and maybe just reduce the angle of abduction? I mean, a reduction

in the abduction would be better than not wearing the shoes at all, right?.

That's just what I'm thinking. Marcus' big toe curls out toward his other toes

and his second toe kind of sits on top of the big toe. I can't " fix " the

position of the toe no matter how much I try. I, too, looked to see if the shoes

were constraining the toe in any way, but they are not. In fact, his toes have

plenty of room. It's probably not much help, just my 2 cents.

frogabog wrote: Carol,

real quick here... if she's in the PM's one has to wonder how those

shoes would put any pressure on her toes at all. The toe box is very

roomy and I'm pretty sure that can make her a shoe that would

accommodate that better if her current shoes are too narrow

there. Pretty soon, her toes won't be anywhere near anything that

could compress them at all.

Also, what about some kind of splinting? There's plenty of room in

these shoes for a splint. If you do the time during sleep too (naps

- not the whole time in one stretch), you maximize her time out of

them for standing. Standing seems to be something that could help

the toe move out I suppose, not sure what else the doc is referring

to with time out of them because the abduction is the same still

right? I think I'd want to know if the abduction is really a

problem, and maybe if it really is you'll want to reduce that some

instead? I think you're a prime candidate for tolerance issues due

to her age if you go to nights only right now but maybe not. There

is a relapse risk too but most likely that wouldn't be immediately noticed.

Not sure exactly what to say, Dr. P. will probably have some good

input too. But maybe investigate some options and check out what

exactly the shoes themselves are doing to this toe, if they even are,

or what they are hindering and exactly how before you decide what to

do. And talk to too, he may be able to help.

Kori

At 08:20 AM 4/1/2006, you wrote:

> is five months old and is one month away from ending her 23/7

>brace wear. She is bilateral. We visited her ortho yesterday and I

>asked about her big toes, which have always rolled outward on the

>outer edges, causing them to curve inward toward the rest of her

>toes. (if you can picture that) He expressed a concern that, while

>the brace has not caused this issue with her toes since it was

>present at birth, it is aggravating it with the degree of abduction

>her feet are being held at. He wants her to be in the brace nights

>only starting after our 23/7 brace wear is over, so that would be

>12/7. Of course, that scared me to death, but I do see his point,

>as well. The issue with the toes, if it doesn't improve, will cause

>problems with shoes fitting properly and possibly with the function

>of her feet. It is also an aesthetic issue, which is secondary but

>must be at least considered. These toes make her feet look deformed

>right now and I would hate for that to continue. But I don't want

>to risk a relapse of her feet. It feels a bit like a catch 22.

>

>I am very confused about what to do and think that I will email Dr.

>Ponseti about this issue since he saw her in January. BTW, on a

>summary of our visit which Dr. Ponseti's office sent to us after our

>January visit, he recommended that she wear the brace " full time for

>2 1/2 months, then 18/7, then 16/7 " but doesn't specify for how long

>she is to wear the brace at each interval. Given this advice, I

>feel that we could reduce to 18/7 after our full-time wear is over.

>

>Any thoughts? I am still pondering all of this and feeling like the

>weight of this decision rests all on me....a bit

>overwhelming! Thanks in advance,

>

>Carol and , 10-27-05, bcf, s 23/7 for one more month

>

>