It's been a busy 3 months, and I've been lousy at keeping up with this blog. Death in the family, house under contract and closed, packing up the house, and chasing after a 21 month-old. Oh, and going through the first trimester of pregnancy. Lots of positives, but some things had to give, and unfortunately this blog didn't make the list.
When last we spoke, the hubby and I were discussing taking E to see Dr. Dobbs and whether or not to stay with Dr. H's protocol. Well, the more we talked, the more we decided that Dobbs protocol makes so much more sense, and it also made sense to take E to see him to have his foot checked to make sure it was healing correctly. We opted to take E out of the AFO during the day, and his gait improved SO much in a short amount of time, as long as he was wearing shoes. We added stretches, and I took E's brace to an orthotist friend of mine who showed me how to adjust it so the affected foot was in a neutral position. My only concern was in the last month - we were staying with my parents, who have a pool, and it really gave me an opportunity to watch E walk without shoes on.
I keep him in shoes, as I feel like given his history, he needs the support. With shoes on, you can't tell there's any difference right vs left. While barefoot though, he walks with the right (affected) leg rotated out and he does not roll off of his toes (termed toe-off in PT speak). This can be a common way to accommodate for a limb that is weaker (he was in casts for 5 months and then a solid AFO - weakness would not be surprising), and it can be habit (he favored the right side while casted because he couldn't use it), but it definitely made me nervous.
The visit to Dobbs however, helped put me at ease. He agreed with Dr. H that, according to the x-rays, E's foot was only partially corrected. While E's range of motion is fairly good, and he can use the foot in a functional matter, there is some rigidity at the end ranges that concerns Dobbs. If we lived closer he would suggest a re-do of the procedure (casting and pinning) to complete the correction. We don't, however. Dobbs said that most kids with a correction to E's level and some mild rigidity remaining go on to do fine, but there's no way to tell for sure (obviously). His recommendation was to continue with stretching, make a few further adjustments to the nighttime bracing (bringing the unaffected limb into a more neutral position because it makes no sense to have him braced into outward rotation anywhere and we'll try toeing him in a little bit on the affected side to increase the overnight stretch), and just to watch how E does. They like to have corrections done by the time the patient is 3, so we'll have until October of next year to see how he does. If he continues to do as well as he has up until now, we're good. If his foot gets tighter, the kids and I will be taking a trip to St. Louis for a few months next summer for a revision.
In the meantime, we're moving to south Florida and preparing for a new job (hubby) and a new baby and life with an increasingly active toddler. Life is good!
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