Guest guest Posted July 6, 2006 Report Share Posted July 6, 2006 Our baby, (6 weeks old), had his tenotomy yesterday and seems to be doing really well. How do you know if they are having any pain? Should they be in much pain after that minor surgery? He seems to be acting about the same as just after getting new casts. We are still working out the details of how to get his braces fitted and ready so that there isn't a lapse in correction after he gets his casts off on August 1st. It's all a bit confusing so I'm trying to keep up with the info provided on this site and see how other parents are working out issues that come along. I did ask the doctor about the articulating bar and he said he wants to stick strictly with Ponseti's instructions and not try anything new. Which was disappointing on one hand because I want the baby to be as comfortable as possible but on the other hand it's really reassuring that he's staying with the strict treatment process. I'm just really excited that some one has figured out how to treat these club feet and fix them without the years of surgery and the pain you end up with as an adult. I had 13 surgeries from 10 months to 36 years for one club foot and it almost makes me angry that the doctors didn't listen to Dr. Ponseti along time ago! Why was he ignored for like 40 years? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2006 Report Share Posted July 7, 2006 My baby slept through the tenotomy, waking up enough to go 'ah' before going right back to sleep. He was fine afterwards, didn't even need tylenol. If is in pain he'll do the one thing he can do at 6 weeks - cry! If he's acting fine I'd assume there's no pain. Fitting the booties took about 5 mins for us. They were ready the day he had his procedure, the docs put them on a shelf for when we came back 3 weeks later. I scheduled both apts on the same day. I was told most insurances don't cover the shoes (and mine didn't) and Sully was boarderline between sizes, I got the larger size to squeeze all the wear I could out of them. Sully was pretty mad the first few days that his feet were in the booties and attached (non-articulating bars here!) but he got over it - now he does not even cry when I put them on... just squirm!!! There's a great group of folks here, don't be afraid to ask anything!!! mommy to Sully 3/16/06 Left club Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2006 Report Share Posted July 7, 2006 had no problems after the tenotomy either. We also had the " vintage " FAB with the standard red adjustable length bar and the old Markell shoes with the plastizode insert (foam heel counter) and we never had a single issue or sore/blister to speak of. Hopefully you'll have no problems either! It's easy to anticipate all kinds of trouble when you read the posts on a " support board " since the majority of posts are from people who need *help*, but so many more families have no issues and don't often take the time to share " success stories " on a support board. , I noticed that our kids share the same birthday and the same left clubfoot, only was born in 2000. & (3-16-00, lcf) > > My baby slept through the tenotomy, waking up enough to go 'ah' before > going right back to sleep. He was fine afterwards, didn't even need > tylenol. If is in pain he'll do the one thing he can do at 6 > weeks - cry! If he's acting fine I'd assume there's no pain. > Fitting the booties took about 5 mins for us. They were ready the day > he had his procedure, the docs put them on a shelf for when we came > back 3 weeks later. I scheduled both apts on the same day. I was told > most insurances don't cover the shoes (and mine didn't) and Sully was > boarderline between sizes, I got the larger size to squeeze all the > wear I could out of them. Sully was pretty mad the first few days > that his feet were in the booties and attached (non-articulating bars > here!) but he got over it - now he does not even cry when I put them > on... just squirm!!! > There's a great group of folks here, don't be afraid to ask anything!!! > > > mommy to Sully 3/16/06 Left club > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2006 Report Share Posted July 7, 2006 Generally the child is fitted for the shoes prior to the tenotomy. This way they can go straight into the bar. It is the 's that s/he is getting? If so, it takes about 2 weeks to get those! They have to custom size them. If it's the Markell's it's possible they may have a stock pile of different sizes. I would definatley call and ask you Dr. who the Orthotist is, and then call them! If they dont have them they may be able to do a quick change of the Tenotomy cast and measure, take impressions of the feet for fitting in the brace, then reapply a new Tenotomy cast? Also, if they dont have the brace right away, you may want to insist on a 'holding cast' until you get them! Their newly little corrected feet can relapse in a days time! As far as the articulating bar, my daughter has never had one. She adjusted to the 's in a day or 2. There is some mixed opinions here about it, but I can say that it is not necessary. Christee 3 boys Lilee A-Typical (11 months) P/M's 10hrs Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2006 Report Share Posted July 7, 2006 --- The Portell Family wrote: > Our baby, (6 weeks old), had his tenotomy > yesterday and seems to be doing really well. How do > you know if they are having any pain? Should they > be in much pain after that minor surgery? He seems > to be acting about the same as just after getting > new casts. I'd say if he's acting the same then he definitely isn't in any pain, otherwise I'm sure you'd notice a difference. My son didn't seem to be in any pain after the tenotomy either, we didn't give him any pain killers and he was fine. > We are still working out the details of how to get > his braces fitted and ready so that there isn't a > lapse in correction after he gets his casts off on > August 1st. Our doctor ordered the shoes before the tenotomy so we got them straight after the last cast came off. I definitely wouldn't leave him without cast or braces for even a day since at that stage a relapse can happen within hours I think. We use the Markell shoes and they don't need 'fitting' as such, we just got the smallest size available and put them on him. It took us about 10 minutes each time at first but it doesn't take long to get that down to 10 seconds a foot. > I did ask the doctor about the articulating bar and > he said he wants to stick strictly with Ponseti's > instructions and not try anything new. Which was > disappointing on one hand because I want the baby > to be as comfortable as possible but on the other > hand it's really reassuring that he's staying with > the strict treatment process. My son Alister has just the normal bar and I don't think he's uncomfortable with it. The main thing is to make sure that the widths is correct, ie the heels should be about shoulder width apart. He learned to crawl, stand, and even walk with the bar on. Now he only wears it at night and he sleeps 'like a baby'. He even asks for his shoes when he goes to bed and thinks I've forgotten. All the best, with (3.5y) and Alister (3.5y, right CF, Ponseti method, UK) ___________________________________________________________ All new Yahoo! Mail " The new Interface is stunning in its simplicity and ease of use. " - PC Magazine http://uk.docs.yahoo.com/nowyoucan.html Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2006 Report Share Posted July 7, 2006 At 04:25 PM 7/7/2006, you wrote: >Well, we didn't get him fitted before the tenotomy so it looks like >our best bet, according to the orthotics office, is for them to get >permission to cut the cast off a few days before he is due to get >the tenotomy cast off, measure, order shoes (Markell's) if not in >stock, then put the casts back on (taped up), she had a name for >doing this to the cast but I can't remember what it was. You guys >know what I'm talking about though. hummm... really never heard of this being done. I would suggest that you ask them to re-cast him from scratch. It doesn't sound like a good idea to me to tape the cast back up. You really want that cast to hold tight, any movement inside could be problematic to his correction. Really, now that I think harder on it, I think that is a bad idea. Is the doctor not able to be there when you do this or what? When they cut the cast off it ends up cracking it a bit anyway. I just wouldn't trust it. Do you know what kind of shoes you're getting? > Ugh, all this new terminology. >They do have a supply of those on hand but if not his size it take a >couple days for them to get them. I think it will work out doing it >that way since we're dealing with commuting all around the central >valley of California to do all this. I so appreciate everyone's >suggestions and input on this because then I knew what questions to >ask when I called. > >Now, no one has answered my last question- Why did all the doctors >in this country ignore Dr. Ponseti for 40 years? It seems like many >children have suffered because the doctors weren't staying on top of >the latest treatment methods, especially something that was working. you know... this is the big unanswered question. I don't think anyone really knows *why*. It's as crazy to us as it is to you that it was ignored for so long. Only thing I can come up with is egotism or perhaps surgery is simply too lucrative? The orthopaedic community embraced Dr. Ponseti's paper about metatarsus adductus in the late 60's and abandoned nearly all treatment of MA due to the paper/research of Dr. Ponseti's saying it corrects itself with time. And the clubfoot paper published shortly thereafter... not embraced. Ignored for 40+ years. Actually... his work is still ignored by many but it's getting better for sure. Sad really. Sorry I don't have any real answer for you. We all probably wonder at this regularly as we look at our children's feet working so nice and perfect... WHY???? Kori > > > > > Generally the child is fitted for the shoes prior to the tenotomy. >This way they can go straight into the bar. It is the 's >that s/he is getting? If so, it takes about 2 weeks to get those! >They have to custom size them. If it's the Markell's it's possible >they may have a stock pile of different sizes. I would definatley >call and ask you Dr. who the Orthotist is, and then call them! If >they dont have them they may be able to do a quick change of the >Tenotomy cast and measure, take impressions of the feet for fitting >in the brace, then reapply a new Tenotomy cast? Also, if they dont >have the brace right away, you may want to insist on a 'holding >cast' until you get them! Their newly little corrected feet can >relapse in a days time! As far as the articulating bar, my daughter >has never had one. She adjusted to the 's in a day or 2. >There is some mixed opinions here about it, but I can say that it is >not necessary. > > Christee > > 3 boys > > Lilee A-Typical (11 months) > > P/M's 10hrs > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2006 Report Share Posted July 7, 2006 Jodi, I'm not so sure about this putting the cast back together thing, I actually can't say I've heard of this being done. I gotta run, I have tired cranky boy here. I'll get back to you on that other question, hopefuuly tomorrow. allison > > > > Generally the child is fitted for the shoes prior to the tenotomy. > This way they can go straight into the bar. It is the 's > that s/he is getting? If so, it takes about 2 weeks to get those! > They have to custom size them. If it's the Markell's it's possible > they may have a stock pile of different sizes. I would definatley > call and ask you Dr. who the Orthotist is, and then call them! If > they dont have them they may be able to do a quick change of the > Tenotomy cast and measure, take impressions of the feet for fitting > in the brace, then reapply a new Tenotomy cast? Also, if they dont > have the brace right away, you may want to insist on a 'holding > cast' until you get them! Their newly little corrected feet can > relapse in a days time! As far as the articulating bar, my daughter > has never had one. She adjusted to the 's in a day or 2. > There is some mixed opinions here about it, but I can say that it is > not necessary. > > Christee > > 3 boys > > Lilee A-Typical (11 months) > > P/M's 10hrs > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2006 Report Share Posted July 7, 2006 Really! Now you see how on top of it you have to be. Well, it was the receptionist at the brace office that said that would be a possibility and not the doctor. I'm glad I asked on the message board about it before calling the doctor and he thinks I'm nuts. This is the problem we have- the casts come off at 9:45 a.m. on August 1st in Fresno which is about 3 hours north of us, the brace office is a two hour drive back to the south but on the way home and I can get an appointment for the same day in the early afternoon, hopefully right after the drive leaving Fresno. If they have the shoes (Markell's) in his size wouldn't it be ok for that long and they are able to fit him and give us instructions? Then I am guessing we go back to Doctor Halsey in Fresno a few days later for him to check it. The receptionist said they've worked with Dr. Halsey before so this shouldn't be so difficult to arrange, unless it wasn't for a clubfoot patient then that might be where the bad info is coming in. > > > > > > Generally the child is fitted for the shoes prior to the tenotomy. > > This way they can go straight into the bar. It is the 's > > that s/he is getting? If so, it takes about 2 weeks to get those! > > They have to custom size them. If it's the Markell's it's possible > > they may have a stock pile of different sizes. I would definatley > > call and ask you Dr. who the Orthotist is, and then call them! If > > they dont have them they may be able to do a quick change of the > > Tenotomy cast and measure, take impressions of the feet for fitting > > in the brace, then reapply a new Tenotomy cast? Also, if they dont > > have the brace right away, you may want to insist on a 'holding > > cast' until you get them! Their newly little corrected feet can > > relapse in a days time! As far as the articulating bar, my daughter > > has never had one. She adjusted to the 's in a day or 2. > > There is some mixed opinions here about it, but I can say that it is > > not necessary. > > > Christee > > > 3 boys > > > Lilee A-Typical (11 months) > > > P/M's 10hrs > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2006 Report Share Posted July 7, 2006 NO. I wouldn't do that. Have the cast removed, fit the kid to shoes and RE cast with NEW casts!!! s. Re: New Member with Questions Jodi, I'm not so sure about this putting the cast back together thing, I actually can't say I've heard of this being done. I gotta run, I have tired cranky boy here. I'll get back to you on that other question, hopefuuly tomorrow. allison > > > > Generally the child is fitted for the shoes prior to the tenotomy. > This way they can go straight into the bar. It is the 's > that s/he is getting? If so, it takes about 2 weeks to get those! > They have to custom size them. If it's the Markell's it's possible > they may have a stock pile of different sizes. I would definatley > call and ask you Dr. who the Orthotist is, and then call them! If > they dont have them they may be able to do a quick change of the > Tenotomy cast and measure, take impressions of the feet for fitting > in the brace, then reapply a new Tenotomy cast? Also, if they dont > have the brace right away, you may want to insist on a 'holding > cast' until you get them! Their newly little corrected feet can > relapse in a days time! As far as the articulating bar, my daughter > has never had one. She adjusted to the 's in a day or 2. > There is some mixed opinions here about it, but I can say that it is > not necessary. > > Christee > > 3 boys > > Lilee A-Typical (11 months) > > P/M's 10hrs > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 8, 2006 Report Share Posted July 8, 2006 I suppose if it's just for a couple of hours then the 'putting the cast back together' thing might be ok? At least better than nothing. Or can't you go past the brace shop on the way to the hospital so that you have the shoes straight away? Or maybe soak the cast off yourself to get the shoes fitted and then drive to the hospital for the appointment? I think what would worry me most would be that the shoes might not be available when you get there and then you're kind of stuck with nothing to prevent a relapse if you know what I mean... with (3.5y) and Alister (3.5y, right CF, Ponseti method, UK) --- The Portell Family wrote: > Really! Now you see how on top of it you have to be. > Well, it was > the receptionist at the brace office that said that > would be a > possibility and not the doctor. I'm glad I asked on > the message > board about it before calling the doctor and he > thinks I'm nuts. > > This is the problem we have- the casts come off at > 9:45 a.m. on > August 1st in Fresno which is about 3 hours north of > us, the brace > office is a two hour drive back to the south but on > the way home and > I can get an appointment for the same day in the > early afternoon, > hopefully right after the drive leaving Fresno. If > they have the > shoes (Markell's) in his size wouldn't it be ok for > that long and > they are able to fit him and give us instructions? > Then I am > guessing we go back to Doctor Halsey in Fresno a few > days later for > him to check it. The receptionist said they've > worked with Dr. > Halsey before so this shouldn't be so difficult to > arrange, unless > it wasn't for a clubfoot patient then that might be > where the bad > info is coming in. > > > > > > > > > > Generally the child is fitted for the shoes > prior to the > tenotomy. > > > This way they can go straight into the bar. It > is the 's > > > that s/he is getting? If so, it takes about 2 > weeks to get > those! > > > They have to custom size them. If it's the > Markell's it's > possible > > > they may have a stock pile of different sizes. I > would > definatley > > > call and ask you Dr. who the Orthotist is, and > then call them! > If > > > they dont have them they may be able to do a > quick change of the > > > Tenotomy cast and measure, take impressions of > the feet for > fitting > > > in the brace, then reapply a new Tenotomy cast? > Also, if they > dont > > > have the brace right away, you may want to > insist on a 'holding > > > cast' until you get them! Their newly little > corrected feet can > > > relapse in a days time! As far as the > articulating bar, my > daughter > > > has never had one. She adjusted to the > 's in a day or 2. > > > There is some mixed opinions here about it, but > I can say that > it is > > > not necessary. > > > > Christee > > > > 3 boys > > > > Lilee A-Typical (11 months) > > > > P/M's 10hrs > > > > > > > > [Non-text portions of this message have been > removed] > > > > > > > > > > > > > > ___________________________________________________________ Now you can scan emails quickly with a reading pane. Get the new Yahoo! Mail. http://uk.docs.yahoo.com/nowyoucan.html Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 10, 2006 Report Share Posted July 10, 2006 Jodi, Sorry it has taken me so long to get back to you, I was away from the computer most of the weekend. Here's what i would do, did you print off the Markell size sheet from their website like we talked about? If so, and this is going to be really rough, you could use that to make your best guess on shoe size. He's not a little tiny baby, and the Markells come in sizes 0000, 000, 00, 0 etc. If he is average I would guess either a 000 or 00. Call the orthotics place and tell them you need to know what they have in stock. If they have an assortment of 0, 00 and 000 in stock (and probably in an assortment of widths, I'm guessing from his pictures narrow or medium) then you could go with the plan to have the cast removed and drive down there and get sized and pick them up the same day. If they don't have an assortment of sizes in stock then I would plan to soak the casts off, go there first and be sized for them to order shoes and then go to Dr. Halsey for him to check 's feet and re-cast him until the shoes come in. Of course you should run this by Dr. Halsey, but tell him people do this all the time, and we know what we're talking about. : ) We can also help you with how to soak off the casts. Now, your other question...I think there are a combination of factors as to why the medical community hasn't embraced the Ponseti method -- or at least why it has taken them so long to at least start getting with the program. The first of which is misunderstanding, which is still prevalent today; to a great many orthopaedic physicians casting is casting - they already know about serial casting, it's been around 'forever', it has LONG been the practice to begin correction via serial casting. The difference is in how the manipulation of the bones takes place, and of course in the precision in which the cast is molded. One of the leaders in the field at the time was JH Kite, and I think the difference between his method and Dr. Ponseti's was just not understood, either through indifference or incompetence. Even as recently as 2004 there have been journal articles published that show a complete lack of understanding of the technique, even by those who purport to use the method. So much of the technique is based on a doctor's knowledge of the kinematics of the bones of the foot, all they have to do is look at it closely to see the difference between what Dr. Ponseti does and traditional serial casting, but they just don't get it. Also, Dr. P says that he takes the blame (as if) for not being more vocal about " pushing " his method, I do think that it was difficult for him to say that Kite was wrong, which he did say in his 1996 book, but I don't think that people in 1950 would have taken kindly to some 'young kid' saying that Dr. Kite was wrong (Kite first published about his conservative treatment, I believe, in 1939). Some of the problem is ego, some doctors don't want to be shown to be wrong, they don't want to conform to do things someone else's way, and they want to make their own mark in the world - thus all the 'tweaking' of the method that goes on. Another major factor was VJ Turco, who was pretty much the founder of clubfoot surgery as we know it today, he was bigtime in the late 60's when we were born and had our feet corrected. Jescie, who is a member of this group (and the CF group) was actually treated by him. CF surgery was a sign of the times, they could correct it with surgery, much more easily than with all the casting that Kite's method required (sometimes a year or more of casting!) and of course the Kite method didn't succeed a lot of the time - there would still be residual problems, so surgery was 'the way it was done'. It wasn't until Ponseti and others started seeing the long-term results of the surgeries that they realized that the surgery was not all it was cracked up to be (to say the least), actually Kite said this all the way back in '39 but they didn't listen to him either. It really is sad that STILL it is such a struggle to find a good physician who is practicing the Ponseti method and doing it well. And, there are STILL doctors out there who consider the method to be a " fad " that will go away after Dr. P is no longer with us. So...sorry to be so long winded, but that's my take on it, AND the reason so many of us come here to help the new parents who come along to find their way to a doctor who can correct their child's feet the " right way " . HTH, > > > > > > > > Generally the child is fitted for the shoes prior to the > tenotomy. > > > This way they can go straight into the bar. It is the 's > > > that s/he is getting? If so, it takes about 2 weeks to get > those! > > > They have to custom size them. If it's the Markell's it's > possible > > > they may have a stock pile of different sizes. I would > definatley > > > call and ask you Dr. who the Orthotist is, and then call them! > If > > > they dont have them they may be able to do a quick change of the > > > Tenotomy cast and measure, take impressions of the feet for > fitting > > > in the brace, then reapply a new Tenotomy cast? Also, if they > dont > > > have the brace right away, you may want to insist on a 'holding > > > cast' until you get them! Their newly little corrected feet can > > > relapse in a days time! As far as the articulating bar, my > daughter > > > has never had one. She adjusted to the 's in a day or 2. > > > There is some mixed opinions here about it, but I can say that > it is > > > not necessary. > > > > Christee > > > > 3 boys > > > > Lilee A-Typical (11 months) > > > > P/M's 10hrs > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 10, 2006 Report Share Posted July 10, 2006 No problem, it's probably good for you to get away for your computer and enjoy doing something else once in a while! I have to say that it's great to have so much knowledge available to us new members from all of the older members that really know they're stuff! What a blessing you and many others are, I love talking to someone who knows so much about something that I want to know about because of our urgent need. Anyway, thank you. This background on treatment methods is interesting. Aggrivating at the same time because some of us are living with the bad ideas of previous treatments! Seeing the difference in how is progressing and soooo quickly, I am absolutely shocked at how effective Dr. Ponseti's method is. The truth is I stumbled on a doctor who uses this method completely accidentally and had never heard the name Ponseti until 's first appointment so I feel incredibly blessed that we don't have to go through the (knock on wood) doctor switching and fix what some other doctor has done wrong like so many seem to have been through. I also stumbled on to these web groups accidentally at a perfect time because I saw a link from Web MD while researching something totally unrelated. Devine intervention I tell you, it's definately more than luck! Regarding his shoe fitting- I didn't take the Markell shoe charts up to Madera to have Dr. Halsey check his size before doing the tenotomy like you suggested so now I'm feeling dumb and trying to figure out how to make it right. But the orthotics shop did say they have those small sizes in stock. I think he'll be about a 00 or 000 in a medium width just judging from the last time I saw his little feet. The guy that will be fitting was the same guy that used to fit me with AFO's or the old school braces with the bars on the shoes before I had my ankle fused so I'm feeling comfortable with not having someone new. I think I will call them 2-3 days before his appointment and see if they still have stock and pray that it works out to get them a few hours after they are taken off- just enough time to drive from Madera/Fresno to Bakersfield and maybe feed a bottle in there too. It seems like if I soak them off at home and drive all around California his feet will be 'free' even longer. Sincerely, Jodi > > > > > > > > > > Generally the child is fitted for the shoes prior to the > > tenotomy. > > > > This way they can go straight into the bar. It is the 's > > > > that s/he is getting? If so, it takes about 2 weeks to get > > those! > > > > They have to custom size them. If it's the Markell's it's > > possible > > > > they may have a stock pile of different sizes. I would > > definatley > > > > call and ask you Dr. who the Orthotist is, and then call them! > > If > > > > they dont have them they may be able to do a quick change of the > > > > Tenotomy cast and measure, take impressions of the feet for > > fitting > > > > in the brace, then reapply a new Tenotomy cast? Also, if they > > dont > > > > have the brace right away, you may want to insist on a 'holding > > > > cast' until you get them! Their newly little corrected feet can > > > > relapse in a days time! As far as the articulating bar, my > > daughter > > > > has never had one. She adjusted to the 's in a day or 2. > > > > There is some mixed opinions here about it, but I can say that > > it is > > > > not necessary. > > > > > Christee > > > > > 3 boys > > > > > Lilee A-Typical (11 months) > > > > > P/M's 10hrs > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 10, 2006 Report Share Posted July 10, 2006 If they have them in stock and you are just driving from the doc to the othotics place I feel pretty confident that 's little tootsies will be just fine in that amount of time. allison > > > > > > > > > > > > Generally the child is fitted for the shoes prior to the > > > tenotomy. > > > > > This way they can go straight into the bar. It is the > 's > > > > > that s/he is getting? If so, it takes about 2 weeks to get > > > those! > > > > > They have to custom size them. If it's the Markell's it's > > > possible > > > > > they may have a stock pile of different sizes. I would > > > definatley > > > > > call and ask you Dr. who the Orthotist is, and then call > them! > > > If > > > > > they dont have them they may be able to do a quick change of > the > > > > > Tenotomy cast and measure, take impressions of the feet for > > > fitting > > > > > in the brace, then reapply a new Tenotomy cast? Also, if > they > > > dont > > > > > have the brace right away, you may want to insist on > a 'holding > > > > > cast' until you get them! Their newly little corrected feet > can > > > > > relapse in a days time! As far as the articulating bar, my > > > daughter > > > > > has never had one. She adjusted to the 's in a day > or 2. > > > > > There is some mixed opinions here about it, but I can say > that > > > it is > > > > > not necessary. > > > > > > Christee > > > > > > 3 boys > > > > > > Lilee A-Typical (11 months) > > > > > > P/M's 10hrs > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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