1 month follow up with Dr. Nelson

Here we are a month post-cast removal, and things have improved significantly. He is now walking on his own without a walker.. and he's not crawling around the house anymore.
His foot is still pretty stiff and he is more comfortable turning his foot and leg out to the left to hobble on it instead of pointing it straight to "heel-toe" it....
We saw Dr. Nelson today and he is not worried about that. He thinks it will come with time. He is pleased to see it so over corrected that Josiah likes to walk with it pointing out. This is because he knows it will eventually start to turn in and then, hopefully, be right where it should be.
We discussed the right foot today, and he is thinking that it does not need to go through the TSF operation, at least not anytime soon. He is thinking that when Josiah is a teenager, he can have an operation on it if it continues to turn or he starts walking more on the outside of it like he was on the left. We've been doing physical therapy for 2 weeks, and have 2 weeks left. We could continue it, but it's expensive for us ($60/week) and Dr. Nelson said that we could just work with him at home. He said that, really, the best thing for Josiah would be to take him to the park and let him play on it. PT is all about gaining flexibility & strength, so play is the best medicine.

We'll return to see Dr. Nelson in 3 months. Prayerfully, by then, Josiah will be running.

3 weeks post-cast

It's been 3 weeks since Josiah's cast came off.
The fixator seems like a distant memory, and when I look at pictures, it's shocking all over again.

I knew his foot would be stiff, but I didn't realize just how hard it would be for him to get around.

It's going to be a long road to full recovery; I wonder how long it will be before he can walk and run freely, without thinking, as he did before... will he ever get there?

Another fixator patient I'm in contact with, who had his frame off in May, is still not back to where he was before and his mother told me she was disappointed to see how much "memory" the clubfoot had (which I interpret to mean that it's pulling in already).

Hearing that and seeing him struggle to just walk a short distance makes me worry that all this will have all been in vain, or my biggest fear, that we've made him worse.

His foot looks so much better than the right... but it's not as functional.

He's started physical therapy yesterday. It was not painful, but difficult (and he got frustrated easily). He'll go 3x a week for at least 4 weeks. That's at least 2.5 hours on Mon.,Wed. & Fri. for which I need to find a babysitter or someone to take him. I know I'll figure it out... it's just I feel like I'm imposing on other people's time... losing my own grading/prep time.

Lots to pray for.

Thank God that Josiah's personality-- his sweet, God-loving, funny, carefree attitude-- is still intact. His faith has grown through all this, and for that alone, it's been worth it. I know that God has a plan in all this, and I can't help but believe that it'll be related to Josiah's ministry as an adult.

We made it!

5 months.
22 weeks.
153 days.
June 21-November 14.

What a journey we've been on the last 5 months, (well, 6 years, really).
Though we're not done yet, we are blessed to be where we are today.

Josiah got his cast removed this morning.
Here's the last "cast shot"
He's happy that he won't have to use this Aqua Sock anymore (which is super cool by the way! You put it on, pump the air out of it, and it creates a water-tight seal enabling the cast-wearer to completely submerge the cast under water! Buy them here: http://www.ithacasports.com/wacaco1.html)

He had been getting around on the cast better and better.
I meant to post about this, but forgot.
For the first 3 weeks, he only walked using his walker. He was so stubborn! I knew he didn't need it, but it was a mental thing.
Here he is even using it on the playground!
He put it up there, climbed up, and then pushed it down the slide so it'd be waiting for him at the bottom. (I refused to help him... tough love... trying to get him to go without it).
After Dr. Nelson questioned Josiah about why he was still using the walker, Josiah decided he didn't need it after all. :) Lol...
He began to nearly run around the house without the walker, and was stoked to discover he could ride a Big Wheel at my moms. (He could have ridden his actual bike, but it was flat).


Here is Josiah with Dr. Nelson (our hero!)
He had literally just returned from Haiti (the night before). This is Dr. Nelson's blog (where he describes what he's up to over there). It is heart-warming and heart-wrenching at the same time. I can't imagine all he sees and experiences there. I wish I could help somehow. How blessed we are to be living in the states! My heart goes out to those living in such dire conditions and I thank God for Dr. Nelson, and others like him, who give of their talent, time, and resources, sacrificing their own comfort, health, and family-time to serve others so selflessly.
May God bless them abundantly!

We didn't have to wait very long to be seen today. I know better now & got the 1st appointment of the day... it just gets busier & busier there.
Josiah yelled a bit when they cut the cast off. He was really scared that it was going to hurt him, but it didn't and it was over quickly. He was not able to walk on it, so I had to carry him out of there (gonna break my back!).

Here it is in all its filthy, stinky, stiff glory:


BEFORE:

AFTER:


You can see how much the inside of the left foot has been stretched out to the left (right side of picture)... It's SO straight! If you compare the left to his right foot (left in picture) you can see the curve on the inside of the R foot. It's not severe, anymore, by any stretch of the imagination, but can see the difference between the corrected & uncorrected now.

What's "funny" to me is that when "relaxed" right now, his right foot falls in and his left foot falls out. They used to point towards each other.

The left foot is currently "over corrected," which is what we want. Clubfoot tendons want to tighten up and pull the foot back in (always)... so they over-correct to fight against that.
It won't stay that way, but the goal is to get it straight, and maintain the stretch as best we can.


Here he is in his first "normal" bath in many months (with Ava who "had" to join in)

Clean (wrinkly) feet & legs!






He is ecstatic to be done with the fixator & cast, but realizes that it's going to take time & effort to get his foot functioning again. It is super stiff and very tender.
Praise the Lord for his faithfulness to us these past 5 months, and praise God for Dr. Nelson & his team!

Next up... PHYSICAL THERAPY!

Almost done!

In 10 days Josiah will get his cast off!

He has not had to change it since it was put on 10/4/11, and has learned to walk on it using a walker. He can walk on it without the walker now, but it's not easy for him because the cast is very rounded on the bottom, not flat.

He has not had any pain, praise God.

It's been easier for us to go out as a family now.

Pumpkin Train with sister & cousin

Halloween- the whole fam

Right on time.

God is always on time.

We reported to Loma Linda at 7am on Tuesday morning without insurance approval.
We got all checked in; Josiah got in his gown; Nurses took his vitals; Anesthesia came by to consult with us; Dr. Nelson stopped by to say hello.

At 8:45am, I heard a nurse on the phone mention Navarro, and "Oh, well, they're all set to go back in a few minutes. (Pause). Oh. Ok. I'll let her know."
I was waiting for her to come over and tell me that we did not have authorization to go through with the procedure...
but she didn't!
I took some last TSF pictures...

Look at his SUPER LONG toe nail! Gross! Lol. I asked the doctors to PLEASE trim them. I even signed a hand-written consent for it! :)

Then at around 9am, Josiah was given some pre-op "silly medicine" before the anesthesia team came to take him back.
They later told me Jo informed them all that he was going to be Batman for Halloween, that his sister Ava was 2, and that his brother Jack was "this big" (showing about an inch between forefinger & thumb) :)
Every surgery they've told me that he has been very calm and brave.
(Peace of God!)

Surgery started at 9:30.
He was out by 10:30.
While we were waiting, we went downstairs to the cafeteria. While there, I got a voicemail (there's no signal upstairs). I listened to it and it was Kim, the surgery scheduler. She said that a little after 8:30am, "they received the approval directly from Health Net. Everything was good to go."
Amazing.
Though it was a big headache on Monday, I am thankful for Anna (from Health Net) and Tammi (from Loma Linda) for working diligently to get it resolved in time. (I still have to figure out my Primary Care situation, and make sure we will be able to go back to Dr. Nelson in the future, but for that day, it was all good).

After surgery, Dr. Nelson informed us that everything went great.
He casted the foot in the hyper-corrected position (stretched to the left) for good measure, and said Josiah should be able to walk around on it soon. (Can't wait!) He also told me he had already enjoyed a post-op cupcake. :D (We had brought the surgerical team cupcakes (from My Delight Cupcakery, of course).

We're due to go back on Monday morning for them to remove the cast, check the pin sites, and recast him. I'm leery of having them take it off and recast him when he might be sore still. But then again, it'd be nice to check on those pin sites.

Jo did have pain when he woke up and he was pretty grouchy. He kept asking me, angrily, why God allows pain. (Another one of those teachable moments this frame has provided. I told him, "God does not promise to keep us from difficult things, but he does promise to be there with us. He strengthens us, and comforts us. He's also teaching you about compassion through all you're going through").
But by the time we were ready to go, he was doing ok.
We left Loma Linda at 1:30.






Here is Josiah today (Thursday) with the new Lego creation he just built. (Thanks Nana!)
He has not needed any pain medication since last night when we gave him Tylenol and Advil.
Praise the Lord!

I must say, I'm in love with his new cast. It's so little! :)
He'll have it on for 6 weeks.

We are all so excited to be done with the frame!
As you can see, we've been counting down the days.
106 down, 41 to go!


We're looking at the week of Nov. 13th for cast removal.
Guess we'll need some new Thanksgiving Shoes!

We have a lot to be thankful for.

One of the people on the top of our list this year will be Dr. Nelson and his team.

Thankful we have insurance... BUT

I am SO thankful we have insurance because without it, there's no way we could have done ANYTHING with Josiah's clubfeet. From castings, to surgeries, to custom orthotics, to the TSF, all of it would have been beyond our financial means without insurance.
BUT...
What.A.Pain HMOs can be!
If you don't have an HMO, how it works is this:
You have a Primary Care Provider (PCP). This is a family doctor who you is your first stop when anything is wrong. He will treat you. If he can not, or if it becomes a "specialist's issue," then the PCP write a referral; however, before you can just make an appointment with the specialist, the insurance must first give you authorization. This takes 1 to 3 weeks. Once authorization is established and sent to the specialist, they usually call YOU to make an appointment. (It's always good to call them after a week or two to see if they've received the authorization. (Don't trust the paper work system!) Occasionally, the specialist the PCP has referred you to is not someone the Insurance wants you to see. They have preferred doctors they want you to see. Of course, sometimes they just see what's on paper, and they send you to someone who is not what you need. (This happened to me with Josiah-- sent me to an orthopedist who doesn't deal with children... and it happened with Jackson-- sent me to an audiologist who doesn't test infant's hearing). Errrrr.
Anywho, in this particular case, we were authorized to see Dr. Nelson at Loma Linda. It turned out to be a God-send.
Of course, you know the rest... Josiah had the TSF put on in June, and we've been stretching & correcting it for 100+days now.
Surgery was set for Tuesday... just 3 nights away!

BUT THEN...

We got a letter last week. Our HMO plan renews each Oct. 1st. Usually this is uneventful.
However, John's company tried to save some money and changed us from the regular HMO to "HMO Silver Network." Apparently the Silver Network further restricts the doctors we can see.
We were told that we were reassigned to a new PCP, a doctor in FOUNTAIN VALLEY! I don't even know where that is, but it's not nearby.
So besides not wanting to lose Dr. Craig, the PCP we've had since I was pregnant with Josiah, the bigger issue was that our current authorization through Dr. Craig is the one we were going into surgery with.
Now that we've been "reassigned," we need a new referral from our current PCP to an orthopedist... this new "Silver Network" may not have Dr. Nelson/Loma Linda in its "network."
And even if they did, who knows how long it would take to #1 find a new PCP (because we're not going to Fountain Valley!) #2. Establish "care" with an appointment, #3. Request the referral to Dr. Nelson, #4. Wait for authorization #5. Make a new appointment with Dr. Nelson for surgery.

I was on the phone for over an hour on Friday with Health Net trying to get this all straightened out. The good news is that Dr. Craig (our current PCP) is in the Silver Network. If they would have just "reassigned" us back to him, there'd be no problem... but apparently it's not that simple. That medical group is "at capacity" and not accepting new patients. I tried to explain, I'm NOT a new patient. We've been there 6+ years. The guy tried to call the supervisor to see if she'd override the system and reassign us. She said she couldn't. We can appeal it, but it takes 7-10 business days.
So I said, Ok, then what else can we do? He has to have surgery with THIS doctor on Tuesday. This TSF is not something just any surgeon can deal with! We NEED to get this thing off asap.

The best they could do was submit a "transitional care" request which I think will allow us to finish whatever was already authorized. It will take 1 business day to find out, which is Monday. I'm not sure if it will be enough time to get Loma Linda satisfied that we're authorized for a Tuesday surgery. I'm FERVENTLY praying that it can be squared away on Monday morning.

Sure, after 100+ days of this, you'd think another few days, even another week or two wouldn't be the end of the world... but for this 6 year old little boy who has been counting down the days to normalcy, it would be close to the end of the world. And for this weary mama, I would have to agree.

We'll deal with what comes, but we're praying that things go our way tomorrow.

Day 100!!! (Pre-Op)

We've made it 100 days with the TSF on.
It's been 14 weeks & 2 days...
Only 5 more "sleeps" until it's off.
Josiah & I start school each day with our calendar, and he gets more excited with every day that brings us closer to October. He keeps talking about all the things he's going to do once it comes off.

Two of his church friends gave him cards this week-- so sweet! They have been wonderful examples of unconditional love, acceptance, and compassion.

This fixator has been a wonderful teaching tool. It's stretched all of us as it stretched his foot!

Praise the Lord for his faithfulness in the midst of trials.

We can't wait for Tuesday!

The pre-op appointment was uneventful, though it's always nice to see Dr. Nelson and his team. His resident informed me that the scheduling dept. scheduled 20 patients for the 1pm-2pm hour. RIDICULOUS! It's out of their hands even though the doctors themselves plead for them to spread out the patients. That's 3 minutes per patient! MADNESS. It's good to know that they feel the same way and are not aloof about how inconvenient it is to spend an entire afternoon there.
We also had to go to PACE (pre- anesthesia appointment. There they have us sign all the paper work, pay our co-pay for surgery, take Jo's vitals, and go over his medical history to make sure he's capable of handling the operation. What's frustrating is that they did all this 3 months ago... nothing has changed. Can't they just ask me on the phone if anything has changed? O well... at least the day of surgery it should go smoother with all the paper work and insurance stuff out of the way.
One sad/funny thing that happened is that the nurse had to prick Jo's finger to see if he was anemic. (Last time he had to go for blood work, so they didn't do the finger prick). Josiah did know what was coming and I was talking to the nurse practitioner and didn't know the nurse was doing it right then. O. My. Gosh. You would have thought the nurse cut his finger off with the way he screamed and SOBBED. I know it hurts, but, man! I thought maybe his tolerance for pain would have increased by now... I shouldn't laugh, but it was a bit funny to me how dramatic he was over a finger prick when he has 8 pins going through his foot, shin and toe!

He was pretty mad about that.... the whole way home.

Poor guy.

We'll all be glad when this ordeal is over.

I pray we all agree it was worth it when it's all said and done.

No smooth sailing.

We're counting down the days... only 8 more!

Unfortunately, it hasn't been smooth sailing.

Josiah has had pain again the last 2 weeks.
It's not all day, but he does have it almost everyday, and has been waking up again at night;
he's been requesting ibuprofen a few times a day.

We're weary.

But thankful.

Pre Op on Thursday!

19 DAYS LEFT!

Our surgery date has been set: October 4th the TSF comes off!

Omygosh I can't wait. I may be more excited than Josiah.

It's been a LONG 3 1/2 months... (86days down + 19 more to go= 105 days with the TSF on).

We're ready for the cast.

Day 79 (11 weeks, 2 days post op)

We're here waiting for our appointment with Dr. Nelson.
I took these pictures of him with my lap top (I'm getting smarter about what to bring with me to pass the time!)



Look how far to the left it's turned out!
Those are some gnarly pins in his shin... yikes!
Kinda gunky & gross... but that's normal.
The top of his skin is SOOO dry. It feels like an elephant foot... but he REFUSES to let me put lotion on it. It's quite the battle when I force it... He's also never had his toe nails trimmed in 79 days!!!!

His knees look dirty & they probably are... but more than that they're super rough from crawling & "walking" on them.
It NEVER fails, though, that when I am prepared with snacks & ways to pass the time, we get seen quickly. Our appt. was at 3:30. It's now 4:20, and we've already had xrays & are currently in the back-room waiting for Dr. Nelson. Those days I leave the house in a rush & forget everything, we are here 3+ hours.

We're hoping that Dr. Nelson says everything looks good and that we can now start the 30 day count down to getting the frame off. (We are soooooo ready for that!)

I'll update once we get home :)



*******UPDATE ON THE UPDATE**************
Dr. Nelson said Josiah's foot looks great and that we can start the count down to removal!
Woooohoooooo!!!!
The TSF will be coming off the 1st week of October. We should be getting a call to schedule the surgery in a few days.
Praise the Lord! No more turns; the correction has been completed.
Next up... a "walking" cast for 6 weeks to 2 months.

TSF at the beach!

Last week, thanks to the help of my mom, we made it to the beach for the 1st time this summer... TSF and all :)

I carried Josiah from the car to the shore. Thankfully, it wasn't a super long walk, and the sand was not very deep. Seeing as how he's almost 60lbs, I know I won't be able to do this much longer! (My back is definitely stronger than day 1, that's for sure!)

Jo had a good ol' time "swimming"

NOT easy to get set up, but once we were out there, it was good.... also not easy to pack up 3 kids, carry them all the car, de-sand them, strap 'em in and then pack up/de-sand all the "stuff" .... but my mom definitely made it possible, if for nothing else than to keep me from getting arrested by leaving the kids unattended! (but of course, she did much more than that).

So glad that we got at least ONE beach trip this summer!

Day 63- Disappointed & Confused.

We saw Dr. Nelson yesterday (praise God he made it back safely from Haiti and was able to do a lot of admirable work there. He said he operated on at least 20 clubfeet cases! God bless him!)
That's the good news.
Now for the bad news (well, it's not bad, really... just disappointing).
(Before I get to that, I'd just like it noted that we left our house at 3pm and got home at 7:30!
I love Dr. Nelson, but I hate going to see him. Our appointment was at 3:40, and we did not see him until 6:30. It definitely provides an opportunity to practice patience and to model a good attitude to Josiah. Not easy! That said, I feel bad for Dr. Nelson though, too, because HE was there that late! I don't know anyone who works harder than that man).

Anyway, we had gone to the appointment with the mindset that we were done with the turns/correcting and that we would now begin our 30 days of "rest" (with the fixator on) and then the 3rd week of Sept we'd have the fixator replaced with a cast.
After Dr. Nelson looked at Jo's foot & xrays, he said that we needed to do 15 more days of turning to bring the foot up 15 degrees.
I had a suspicion that the foot was not flexed up enough, and I even emailed Dr. Nelson asking him about it last week ... I asked how much Josiah's foot should be flexed because right now it is pretty flat. I was right. Dr. Nelson said foot is currently in "neutral."

If you compare this picture to previous ones, you'll see that the bottom halo is now pretty level, whereas before, the front was angled down. It needs to come up.

(In this last picture, you can see the difference in the shape of his feet, how much "over" the left one is currently stretched, and his (in)ability to put them "flat" on the floor).

Our first prescription of turns (to bring the foot over) was 40 days. We assumed the 2nd prescription of turns (to bring the foot up) would also be 40 days. We were pleasantly surprised last month to see that the 2nd prescription was only 25. Turns out it will now be 40 after all!
I wonder if it should have been 40 all along? Dr. Nelson was leaving for Haiti when he gave us the last one. Maybe it was an oversight? I don't know. I guess it doesn't matter. The only change would have been our perception of "the end." Now instead of being in a cast by the last week of Sept, it will be the middle of October.

It's not the end of the world; just disappointing.

It's like when your 9 months preggo & the doctor pushes your due date back 2 weeks... or when you're running with the finish line in sight, then suddenly it is pushed back another 2 miles.

I think I am more disappointed then Josiah.
I am weary of the TSF and the limitations it puts on our family.
Yes, things could be worse, and I am thankful that this is all we have to deal with...
but I'm still weary of it.

Another thing that kind of bothered me yesterday was a comment Dr. Nelson said referring to the right foot. I was asking him about Josiah's other foot and how soon we'd do anything to it (if we do anything at all). He said it was up to us-- that he could put a TSF on the right when he took it off the left-- but that he'd ideally like for us to wait and see what we think of the left's results--- to see if we think it was worth it.
Worth it?
Doesn't he think it's worth it?

I mentioned that I was already thinking it not wise to do anything immediately to the right for the sake of the left's complete recovery. How could he learn to walk/run and gain flexibility on the left again if the right was now immobile?
He agreed that he'd like to see him running around on the left before doing anything to the right. I asked about Treyton (another patient who is done with his TSF & cast) and about his mobility. The last time I talked to his mom, Treyton's foot was very stiff.
When I brought that up, Dr. Nelson explained that Josiah would always have limited mobility in his feet. This "correction" does not improve mobility (nothing can).
I don't know why I hadn't heard this before.
If not to increase the function of the feet, why did we do this?
Just for appearance? So that the foot is "straight"?

He explained that a normal foot's talus (ankle) is rounded and fits nicely in tibia (leg bone). Clubfeet kids have a flat talus, so the ability to flex the foot up will always be limited. (Something I had never been told before. I'm learning more about clubfeet now than ever. I wish I would have learned these things when Josiah was a baby). I found a couple great sites to help me understand:

Clubfoot Parent's Guide

• Offers a easy to follow explanation of what a clubfoot is, what bones are effected, and what a normal course of correction looks like.

Anatomy of a normal foot/leg

• This one helps me understand the anatomy of the foot and the vocab necessary to follow what the doctor says! It offers a 360 degree diagram of the foot and when you hover over different bones, it gives the name.
  

The 1st site helped me understand that the goal of clubfoot correction is to help the child be able to put his foot flat on the ground. As a baby, it was obvious that something needed to be done or he would not be able to walk on his feet.
Before this surgery, Josiah could walk, but he was not able not put his foot completely flat on the ground. He would put his weight on the outside of the foot instead of squarely on the heel & ball of the foot. You can tell by just looking at the correction we've achieved so far that his foot is much flatter than curved like before. Whether that will change his gait, I guess we will have to see.

The goals of his first operation were clear.
I guess I'm confused as to what the goal of this surgery is besides "straightening" the foot. I thought it would improve his foot's function and now I'm not sure.
I will email Dr. Nelson with these questions.

52 days in...

The 3 strut changes went off without a hitch.
Josiah hardly looked up from his Leapster.
(Thank the Lord!)
He has had NO pain, even after turnings.
He's getting around by crawling & walking on his knees.
He's been swimming and playing a lot on the floor.
Things are SO.MUCH.BETTER.

We only have 2 weeks left of "correction" and 30 days of stasis.

We can see the light!

Day 43: Things are going well.

8/3/11 Foot is straight & flat. Looking good.

The skin is shiny & red like that, I think, because of the stretching.
It has been that way almost since the beginning.

Nice stretch over to the left is completed.
Now we've begun dorsal flexion (bringing toes up towards sky).

Josiah has recovered well from the operation he had last week.
He has not needed over-the-counter meds at all since last Friday which is better than he was doing BEFORE the operation. Maybe it feels better now that it's more secure?
At any rate, things are back to normal here and we're hoping that the next 22 days of correction are uneventful.
I'm a tad worried about next Tuesday when we go in to have 3 of the 6 struts changed out.
The first time we had them switched, Josiah screamed in the guy's face for 20 minutes at the top of his lungs. It should not hurt at all. They put stabilizing struts in before removing any so that there is no movement of the halos. Josiah just freaks out at the potential pain and he doesn't like anyone handling his frame or even anything brushing up against his skin.
Dr. Nelson will still be in Haiti, so a colleague will be checking Jo out and the tech will do the strut change as usual.

I've been going a little stir crazy during the week, especially because my husband is away on business. It just makes the days feel long. We all look forward to daddy coming home each day, so it's hard when he doesn't.

My sister came over today and we went to the HOA pool next door to my house. It was so nice and Josiah loves to be in the water. It is definitely a challenge with 3 non-swimmers, but with my sister's & nephew's help, we made it work and everyone had a good time.

Photos of our Clubfeet Correction Journey thus far

Here's a quick photo-recap of our clubfeet journey thus far.

6 days old, before beginning serial casting.
Ponsetti casting is the most well-known & effective non-surgical method of treating clubfeet.
Dr. Ponsetti came up with a particular method & sequence for repositioning/stretching a clubfoot.

Here he is after his first casting... broke my heart.














5 months of casting. New cast every 10 days.
A baby with casts from toes to thighs... it was not fun... but we got through it.













I honestly don't think we got real "Ponsetti" casting.
I didn't know any better back then. I would have searched out a specialist.
Josiah often kicked his cast down out of position. It even came all the way off more than once. :/

After 5 months of casting, we got his feet to this:

They were relatively straight (pointing forward) but not able to flex up right. The casting became ineffective because Josiah started kicking and wiggling his casts out of place. Dr. Hohl (and a second opinion doctor) came to the conclusion that surgery was necessary.
In September, when he was 6 months old, Josiah had surgery.




He had a Posteromedial Release on both feet.


3 weeks post-op Josiah actually kicked off his surgical cast.
I was very upset. A pin through is big toe also came out 3 weeks post op.
A new cast was put on in the doctor's office. Surely he could not make sure it was the same correction achieved during surgery. It was painful for Josiah to be re-casted like that so soon after surgery. (I should have found a new doctor then! Hind sight....)

The other pin was removed, staples removed & casts changed under anesthesia 6 weeks later. New casts were put on.

On December 9th, when he was 9 months old, the casts were removed for good.
His feet were perfect. We praised the Lord:




To help maintain correction, we used a Dennis Brown bar at night to turn his feet out...



... and Ankle-Foot-Orthotics. At 2 years old, he got ones that went inside big ugly orthotic shoes.




At 4 years post-op. Josiah's feet were still remarkably better than where we started; however, like I've discussed in previous blogs, his feet still turn in, especially the left.

After several different opinions (read the whole story here), we finally decided to go with Dr. Nelson & the Taylor Spatial Frame (which is what this blog is all about!)

Here are Josiah's feet the week before surgery (June 17, 2011)

Here is the Taylor Spatial Frame on Jo's left foot, post-op June 21, 2011.

June 27th, Day 6.
(It is amazing how much straighter the foot is even just by pinning it in place in surgery).

July 11, 2011 (Day 20)

July 25th (Day 34) Complication: due to the last 2 metatarsals not being secured, the outside of the foot started to twist under as it is pushed over. Surgery was needed to re-pin (or as I like to say "skewer") the bones better.

July 27th (Day 37)- Post-op. Foot is flat & much more secured with repositioned pins through metatarsals & another new pin towards heel.

July 31st (Day 40)
Lookin' straight! Done with our 1st prescription that brought the foot "over" to the left.

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You can see the foot is pointing "down" (like tippy toes if he was standing). Now we are going to start bringing it "up" toward the body, which is called "dorsal flexion." That bottom (black) halo/ring is going to start angling so that the top is closer to the shin as we turn the struts (the up & down "poles").