Guest guest Posted June 27, 2006 Report Share Posted June 27, 2006 My current doctor has now recommended that our daughter have surgery for her club foot.He has said that it is a tiny nick in the tendon to help release her foot.Then she will be fitted with a plaster cast for four weeks.It sounds like he is using some of Dr Ponsetti's methods like manipulation of the foot and casting.However this cutting of the tendon is suppose to be done in a surgical center and it is terrifying to think of our three month old daughter being put under for this.Is this because the Dr is actually going to make a deeper cut than the tiny nick he describes? We have an appointment for another casting and of course I will pin him down on more details.Any feedback would be appreciated! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2006 Report Share Posted June 27, 2006 Hi, my son had this done younger than your daughter...he was like 2 months old when he had this done. The reason they put them under is because it makes them easier on the baby. WE had kaden stay overnight since he was so young....and you can request the same be done, and i would. And yes, it sounds like your doctor is doing the ponceti method, as this is how kaden has been treated with his club feet. He is now in the ponceti braces. Hope that this helps, and if u want more advice, dont hesitate to ask. KAitlyn > > My current doctor has now recommended that our daughter have surgery > for her club foot.He has said that it is a tiny nick in the tendon to > help release her foot.Then she will be fitted with a plaster cast for > four weeks.It sounds like he is using some of Dr Ponsetti's methods > like manipulation of the foot and casting.However this cutting of the > tendon is suppose to be done in a surgical center and it is terrifying > to think of our three month old daughter being put under for this.Is > this because the Dr is actually going to make a deeper cut than the > tiny nick he describes? We have an appointment for another casting and > of course I will pin him down on more details.Any feedback would be > appreciated! > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2006 Report Share Posted June 27, 2006 You need him to specify that it is a percutaneous tenotomy (percutaneous just means through the skin), and not an open incision release. Also a give away of what he has planned is to ask if there will be any stitches. The perc. tenotomy does not require stitches - it is indeed just a tiny nick. And about the general anesthesia, some doctors just prefer to do it this way, perhaps it makes them more comfortable so they don't have to hold the wriggly baby while making this precise cut. And also, some hospitals (especially Children's hospitals) require, for the " comfort " of the child, that any surgical procedure, no matter how small, be performed in the OR under general. My son actually had his tenotomy under general and he was just about 9 weeks old. Of course it is normal to be uneasy about anesthesia for a young baby, but complications are rare, especially for such a minor procedure. Is it being done at a Children's hospital? This is what I would recommend as you will be able to be certain that the Anesthesiologist will be a Pediatric specialist, which that's what they do, they put kids and babies to sleep for short procedures like this and eartubes, etc. and then they wake them up, almost no more than they are under. Hope this helps a little, > > My current doctor has now recommended that our daughter have surgery > for her club foot.He has said that it is a tiny nick in the tendon to > help release her foot.Then she will be fitted with a plaster cast for > four weeks.It sounds like he is using some of Dr Ponsetti's methods > like manipulation of the foot and casting.However this cutting of the > tendon is suppose to be done in a surgical center and it is terrifying > to think of our three month old daughter being put under for this.Is > this because the Dr is actually going to make a deeper cut than the > tiny nick he describes? We have an appointment for another casting and > of course I will pin him down on more details.Any feedback would be > appreciated! > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 28, 2006 Report Share Posted June 28, 2006 Hi. You are in great hands here with a alot of very knowledgeable moms and dads. They are giving you all the right advice and giving you the right questions to ask. What I have to offer is more on the emotional side. I have a daughter (14 months) with several bilateral clubfeet. Lily is now seeing Dr. Ponseti but did NOT for the first 11.5 months of her life (saw another doctor in our area). Lily had her tenotomy at 3 months without general anesthesia. I will spare you the details, but it was pretty horrible. She was clearly in alot of pain. When I asked the doctor why the terrible screaming from my mild tempered, high pain tolerance daughter, he explained that the numbing cream only numbs the outside but she felt the tendons being severed. Ouch! If I have another clubfoot child, I would have no qualms whatsoever about general anesthesia (at a safe age of course). There was no reason for her to go through that. In addition, when we eventually saw Dr. Ponseti, he told us her tenotomy was quite low. How annoying to have had it done incorrectly on top of it all, so just make sure you are confident that your doctor has the desire to follow Ponseti's treatment and the knowledge to. Best of luck. -- In nosurgery4clubfoot , " " wrote: > > You need him to specify that it is a percutaneous tenotomy > (percutaneous just means through the skin), and not an open incision > release. Also a give away of what he has planned is to ask if there > will be any stitches. The perc. tenotomy does not require stitches - > it is indeed just a tiny nick. > And about the general anesthesia, some doctors just prefer to do it > this way, perhaps it makes them more comfortable so they don't have to > hold the wriggly baby while making this precise cut. And also, some > hospitals (especially Children's hospitals) require, for the " comfort " > of the child, that any surgical procedure, no matter how small, be > performed in the OR under general. My son actually had his tenotomy > under general and he was just about 9 weeks old. Of course it is > normal to be uneasy about anesthesia for a young baby, but > complications are rare, especially for such a minor procedure. Is it > being done at a Children's hospital? This is what I would recommend > as you will be able to be certain that the Anesthesiologist will be a > Pediatric specialist, which that's what they do, they put kids and > babies to sleep for short procedures like this and eartubes, etc. and > then they wake them up, almost no more than they are under. > > Hope this helps a little, > > > > > > > > My current doctor has now recommended that our daughter have surgery > > for her club foot.He has said that it is a tiny nick in the tendon to > > help release her foot.Then she will be fitted with a plaster cast for > > four weeks.It sounds like he is using some of Dr Ponsetti's methods > > like manipulation of the foot and casting.However this cutting of the > > tendon is suppose to be done in a surgical center and it is terrifying > > to think of our three month old daughter being put under for this.Is > > this because the Dr is actually going to make a deeper cut than the > > tiny nick he describes? We have an appointment for another casting and > > of course I will pin him down on more details.Any feedback would be > > appreciated! > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 29, 2006 Report Share Posted June 29, 2006 --- wrote: > Lily had her tenotomy at 3 months without general > anesthesia. I will spare you the details, but it > was pretty horrible. She was clearly in alot of > pain. When I asked the doctor why the terrible > screaming from my mild tempered, high pain > tolerance daughter, he explained that the numbing > cream only numbs the outside but she felt the > tendons being severed. I just thought I'd tell you our experience with the tenotomy, in case this scared any new parents out there... My son had the tenotomy under local anaesthetics at about 2 months old. They put numbing cream on his heel first, then once the area was numb they gave him an injection in there (I assume to numb the inside as well reading the above) which he didn't mind. Once that was working it looked to me like the surgeon simply stuck his scalpel in, wriggled it about, and pulled it out again. Alister only cried while his foot was being held, not a 'pain-cry' but an 'annoyed-cry' if you know what I mean. As soon as the surgeon let go of his foot he stopped crying, so I assume he wasn't in any pain but just didn't like his foot being held so tightly. He was perfectly happy during the casting and fell asleep soon afterwards. with (3.5y) and Alister (3.5y, right CF, Ponseti method, UK) ___________________________________________________________ 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 June 30, 2006 Report Share Posted June 30, 2006 Hi and others. I know Lily's tenotomy sounds bad...but it was bad. I was not trying to scare other parents--I just want other parents to ask the right questions so their children don't experience similar pain. I appreciate you sharing your positive experience. I thought Lily's experience would be similar to your son's as well. My daughter's cry was clearly a pain cry (she had never cried like that before nor has she since) and I still question whether I did the right thing. Perhaps Lily's experience had to do with her practitioner or her age? But I also know that pain management continues to be an evolving field--the medical community used to believe that circumcision should be done without pain management because newborns couldn't feel pain. I know many parents had a positive tenotomy experience, but I expect we aren't alone in our experience either. P.S. I just reread your email. Lily did not have an injection--only the numbing cream. Maybe the lesson is to make sure your doctor gives the injection NOT just the numbing cream when doing a tenotomy under local. > > Lily had her tenotomy at 3 months without general > > anesthesia. I will spare you the details, but it > > was pretty horrible. She was clearly in alot of > > pain. When I asked the doctor why the terrible > > screaming from my mild tempered, high pain > > tolerance daughter, he explained that the numbing > > cream only numbs the outside but she felt the > > tendons being severed. > > I just thought I'd tell you our experience with the > tenotomy, in case this scared any new parents out > there... > > My son had the tenotomy under local anaesthetics at > about 2 months old. They put numbing cream on his > heel first, then once the area was numb they gave him > an injection in there (I assume to numb the inside as > well reading the above) which he didn't mind. Once > that was working it looked to me like the surgeon > simply stuck his scalpel in, wriggled it about, and > pulled it out again. Alister only cried while his > foot was being held, not a 'pain-cry' but an > 'annoyed-cry' if you know what I mean. As soon as the > surgeon let go of his foot he stopped crying, so I > assume he wasn't in any pain but just didn't like his > foot being held so tightly. He was perfectly happy > during the casting and fell asleep soon afterwards. > > > with (3.5y) > and Alister (3.5y, right CF, Ponseti method, UK) > > > > > > > > > ___________________________________________________________ > 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 June 30, 2006 Report Share Posted June 30, 2006 Hi , I'm sorry, I didn't want my email to sound as if I thought you wanted to scare other parents or it wasn't as bad as you said! Not at all! I only thought that if I was a new parent reading that I would be very scared about it (nothing wrong with you posting your experience of course!), so I just wanted to show that it doesn't have to be such a bad experience. I feel really sorry for your daughter and you that you had to go through this! I think you might be right and the injection did make all the difference. I don't think you did the wrong thing at all by the way, how could you have known that it would turn out so awful... I personally was glad that they only gave him a local, he had a general anaesthesia at 7 weeks old for a hernia operation and I found that much scarier! Take care, with (3.5y) and Alister (3.5y, right CF, Ponseti method, UK) --- wrote: > Hi and others. I know Lily's tenotomy sounds > bad...but it was > bad. I was not trying to scare other parents--I > just want other > parents to ask the right questions so their children > don't experience > similar pain. I appreciate you sharing your > positive experience. I > thought Lily's experience would be similar to your > son's as well. My > daughter's cry was clearly a pain cry (she had never > cried like that > before nor has she since) and I still question > whether I did the > right thing. > > Perhaps Lily's experience had to do with her > practitioner or her > age? But I also know that pain management continues > to be an > evolving field--the medical community used to > believe that > circumcision should be done without pain management > because newborns > couldn't feel pain. I know many parents had a > positive tenotomy > experience, but I expect we aren't alone in our > experience either. > > > > P.S. I just reread your email. Lily did not have > an injection--only > the numbing cream. Maybe the lesson is to make sure > your doctor > gives the injection NOT just the numbing cream when > doing a tenotomy > under local. > > > > > > > Lily had her tenotomy at 3 months without > general > > > anesthesia. I will spare you the details, but > it > > > was pretty horrible. She was clearly in alot of > > > pain. When I asked the doctor why the terrible > > > screaming from my mild tempered, high pain > > > tolerance daughter, he explained that the > numbing > > > cream only numbs the outside but she felt the > > > tendons being severed. > > > > I just thought I'd tell you our experience with > the > > tenotomy, in case this scared any new parents out > > there... > > > > My son had the tenotomy under local anaesthetics > at > > about 2 months old. They put numbing cream on his > > heel first, then once the area was numb they gave > him > > an injection in there (I assume to numb the inside > as > > well reading the above) which he didn't mind. > Once > > that was working it looked to me like the surgeon > > simply stuck his scalpel in, wriggled it about, > and > > pulled it out again. Alister only cried while his > > foot was being held, not a 'pain-cry' but an > > 'annoyed-cry' if you know what I mean. As soon as > the > > surgeon let go of his foot he stopped crying, so I > > assume he wasn't in any pain but just didn't like > his > > foot being held so tightly. He was perfectly > happy > > during the casting and fell asleep soon > afterwards. > > > > > > with (3.5y) > > and Alister (3.5y, right CF, Ponseti method, UK) > > > > > > > > > > > > > > > > > > > ___________________________________________________________ > > > Now you can scan emails quickly with a reading > pane. Get the new > Yahoo! Mail. http://uk.docs.yahoo.com/nowyoucan.html > > > > > > > > ___________________________________________________________ The all-new Yahoo! Mail goes wherever you go - free your email address from your Internet provider. http://uk.docs.yahoo.com/nowyoucan.html Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 30, 2006 Report Share Posted June 30, 2006 Now, I'm sorry! I didn't think you were critical. When I realized today that Lily didn't have to go through that, I was just sick. I feel physically sick thinking about it. I feel very angry with our doctor that on top of 24 hours of straight crying after every cast change (I would just sit in the family room in the middle of the night, holding her, scared), not correcting her feet, telling me they were corrected, lying to me about practicing Ponseti's method, he put her through that terrible pain of the tenotomy unnecessarily. You're right...new parents of cf children should know that is not necessary! I read up today and saw that the local referred to in the Ponseti literature appears to be an injection. It makes me even more sad to think there is another little Lillian who will go through it with our former doctor this month, if not this week. What can I do? I hope parents take heed, and ask for an injection. If the pain can be managed that way, a general anesthesia would be an unnecessary risk. Thanks, . I don't know if you are in the U.S.--if so, have a great fourth! Thanks also for the enlightenment. I am better educated now on clubfoot. Ever feel like you are ready for the " education " to be over?! =-) , > > > > Lily had her tenotomy at 3 months without > > general > > > > anesthesia. I will spare you the details, but > > it > > > > was pretty horrible. She was clearly in alot of > > > > pain. When I asked the doctor why the terrible > > > > screaming from my mild tempered, high pain > > > > tolerance daughter, he explained that the > > numbing > > > > cream only numbs the outside but she felt the > > > > tendons being severed. > > > > > > I just thought I'd tell you our experience with > > the > > > tenotomy, in case this scared any new parents out > > > there... > > > > > > My son had the tenotomy under local anaesthetics > > at > > > about 2 months old. They put numbing cream on his > > > heel first, then once the area was numb they gave > > him > > > an injection in there (I assume to numb the inside > > as > > > well reading the above) which he didn't mind. > > Once > > > that was working it looked to me like the surgeon > > > simply stuck his scalpel in, wriggled it about, > > and > > > pulled it out again. Alister only cried while his > > > foot was being held, not a 'pain-cry' but an > > > 'annoyed-cry' if you know what I mean. As soon as > > the > > > surgeon let go of his foot he stopped crying, so I > > > assume he wasn't in any pain but just didn't like > > his > > > foot being held so tightly. He was perfectly > > happy > > > during the casting and fell asleep soon > > afterwards. > > > > > > > > > with (3.5y) > > > and Alister (3.5y, right CF, Ponseti method, UK) > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > ___________________________________________________________ > > > > > Now you can scan emails quickly with a reading > > pane. Get the new > > Yahoo! Mail. http://uk.docs.yahoo.com/nowyoucan.html > > > > > > > > > > > > > > > > > > > > ___________________________________________________________ > The all-new Yahoo! Mail goes wherever you go - free your email address from your Internet provider. http://uk.docs.yahoo.com/nowyoucan.html > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 1, 2006 Report Share Posted July 1, 2006 , had her tenotomy in Iowa City. They used a local anesthesia, and yes, it was an injection. If your doctor only used the topical numbing cream and not the injection, that is totally unacceptable. The topical cream does little to actually " numb " the area, it just numbs the surface of the skin. I have never heard of a baby undergoing a tenotomy without a local or general anesthesia (and the numbing cream doesn't count as local). There is something that you can do. Write a letter to your former doctor and copy the head of the department where he practices. Tell him about everything that you've learned and encourage him to seek more training in the method. There are lots of moms here who would be happy to proofread the letter for you after you've written it to help you take out the " emotion " and make it " factual " (it's hard to do when it's your own child and your own story-) so that the letter is accepted as constructive criticism and not just some crazy emotional mom that's venting. Even if they don't read the letter, it will make you feel better knowing that you tried in an effort to help other children in your area. You can also contact the local pediatricians and ob/gyns and tell them that you'd be willing to be a contact if they happen to come into contact with families who have a newborn with clubfoot. Make yourself a little business card or flyer with your contact info and this group's web address. (there's a poster you can print off in the files section here if you wanted to use that) Hugs! > > > > > Lily had her tenotomy at 3 months without > > > general > > > > > anesthesia. I will spare you the details, but > > > it > > > > > was pretty horrible. She was clearly in alot of > > > > > pain. When I asked the doctor why the terrible > > > > > screaming from my mild tempered, high pain > > > > > tolerance daughter, he explained that the > > > numbing > > > > > cream only numbs the outside but she felt the > > > > > tendons being severed. > > > > > > > > I just thought I'd tell you our experience with > > > the > > > > tenotomy, in case this scared any new parents out > > > > there... > > > > > > > > My son had the tenotomy under local anaesthetics > > > at > > > > about 2 months old. They put numbing cream on his > > > > heel first, then once the area was numb they gave > > > him > > > > an injection in there (I assume to numb the inside > > > as > > > > well reading the above) which he didn't mind. > > > Once > > > > that was working it looked to me like the surgeon > > > > simply stuck his scalpel in, wriggled it about, > > > and > > > > pulled it out again. Alister only cried while his > > > > foot was being held, not a 'pain-cry' but an > > > > 'annoyed-cry' if you know what I mean. As soon as > > > the > > > > surgeon let go of his foot he stopped crying, so I > > > > assume he wasn't in any pain but just didn't like > > > his > > > > foot being held so tightly. He was perfectly > > > happy > > > > during the casting and fell asleep soon > > > afterwards. > > > > > > > > > > > > with (3.5y) > > > > and Alister (3.5y, right CF, Ponseti method, UK) > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > ___________________________________________________________ > > > > > > > Now you can scan emails quickly with a reading > > > pane. Get the new > > > Yahoo! Mail. http://uk.docs.yahoo.com/nowyoucan.html > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > ___________________________________________________________ > > The all-new Yahoo! Mail goes wherever you go - free your email > address from your Internet provider. > http://uk.docs.yahoo.com/nowyoucan.html > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 1, 2006 Report Share Posted July 1, 2006 Hello I thought I would chip in here, and share our experience - our son did have the tenotomy on both legs without local or general anaesthetic. He did cry for a few seconds, but we put that down to his leg being held so firmly. He was absolutely fine within a minute (once he had his bottle back!) and there is no scar. He certainly did not scream as if he were in terrible pain or anything. We were advised that he could have local if we wished, but that the injection itself would be painful, and that the tenotomy piercing was only momentarily painful. We were also told taht if we really wanted to, then a general anaesthetic could be given. Having both had local anaesthetic injections before, we knew that an injection could be painful and stinging, so we decided against. At 8 weeks, we decided a GA was definitely out of the question. We were also assured by our doctor that he had done many like this before. We were very happy with our decision, and I have spoke to another consultant on Dr Ponseti's list who assured me that it is a perfectly acceptable procedure. I suppose we weighed up the risk of the GA, and the pain of a LA vs the pain of the tenotomy itself. Of course, it is a personal decision, and I am sure most doctors don't do the tenotomy without some form of anaesthesia. But I just wanted to share our experience. I have also met with, and spoken to other mum's who were treated by the same very experienced consultant, and they are all happy with the way the tenotomy was performed as well. Stella > > > > > > Lily had her tenotomy at 3 months without > > > > general > > > > > > anesthesia. I will spare you the details, but > > > > it > > > > > > was pretty horrible. She was clearly in alot of > > > > > > pain. When I asked the doctor why the terrible > > > > > > screaming from my mild tempered, high pain > > > > > > tolerance daughter, he explained that the > > > > numbing > > > > > > cream only numbs the outside but she felt the > > > > > > tendons being severed. > > > > > > > > > > I just thought I'd tell you our experience with > > > > the > > > > > tenotomy, in case this scared any new parents out > > > > > there... > > > > > > > > > > My son had the tenotomy under local anaesthetics > > > > at > > > > > about 2 months old. They put numbing cream on his > > > > > heel first, then once the area was numb they gave > > > > him > > > > > an injection in there (I assume to numb the inside > > > > as > > > > > well reading the above) which he didn't mind. > > > > Once > > > > > that was working it looked to me like the surgeon > > > > > simply stuck his scalpel in, wriggled it about, > > > > and > > > > > pulled it out again. Alister only cried while his > > > > > foot was being held, not a 'pain-cry' but an > > > > > 'annoyed-cry' if you know what I mean. As soon as > > > > the > > > > > surgeon let go of his foot he stopped crying, so I > > > > > assume he wasn't in any pain but just didn't like > > > > his > > > > > foot being held so tightly. He was perfectly > > > > happy > > > > > during the casting and fell asleep soon > > > > afterwards. > > > > > > > > > > > > > > > with (3.5y) > > > > > and Alister (3.5y, right CF, Ponseti method, UK) > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > ___________________________________________________________ > > > > > > > > > Now you can scan emails quickly with a reading > > > > pane. Get the new > > > > Yahoo! Mail. http://uk.docs.yahoo.com/nowyoucan.html > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > ___________________________________________________________ > > > The all-new Yahoo! Mail goes wherever you go - free your email > > address from your Internet provider. > > http://uk.docs.yahoo.com/nowyoucan.html > > > > > > Quote Link to comment Share on other sites More sharing options...
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