Crooky feet repair

Sometimes moms make their kids do unpleasant things for their own good; like eat their veggies. I do that. Except for beets. I'm still not convinced beets were intended by God for human consumption. As a natural dye or something, maybe. So, in addition to making my kids eat their veggies--and also bathe regularly--I'm forcing my helpless baby boy to have his clubfeet repaired. This is a gradual process, involving serial casting, a little surgery, another set of casts, and then--the culmination of so much awesomeness--a LOVELY brace/boots & bar thingy, to be worn for about 3 years. If his little feet weren't corrected, it would be all kinds of terrible--he'd have to walk on the sides of his feet and become physically disabled, basically. I'm not even making that up--that's what happens in third world countries. So, obviously, they need to be fixed.
Here's a picture of Shriners Hospital, Salt Lake City:














It's a lovely place, with huge, immaculate grounds. Also, it's in the Federal Heights neighborhood, which is so gorgeous I slow down to 15 mph through there so I can have a good look at all the amazing landscaping in the yards (even when I'm running late, which is all 3 times we've been there now).

According to parents around the country (and my friend Angela, who's a nurse there), the clubfoot clinic at Shriners Hospital is THE place to have clubfeet repaired. They're the best, Jerry, the BEST. And we just happen to have a Shriners Hospital right down the road, in Salt Lake City. It's only an hour away! People come from all the surrounding states to have orthopedic needs taken care of at this awesome hospital. Shriners is so great, with healing going on all over the place. But, because it is a hospital, there are also a whole bunch of sick and disabled kids there. It breaks my heart. I've seen so many kids confined to wheelchairs--which a lot of them will never get to leave. I met a 13-year-old boy from Colorado whose leg had been amputated when he was an infant and who now has a prosthetic leg (which doesn't keep him from playing basketball in the Paralympics! So cool!). And a beautiful 16-month-old baby girl who can't sit up or hold her head up or push up on all fours or stand or crawl or walk, and the doctors are stumped--they've done MRIs and genetic testing and a bunch of other tests and still don't know what's going on with her. And a lady with a sweet little boy with some kind of chromosome deletion, which causes a whole laundry list of problems. (And get this, she's trying to adopt him for her very own! So sweet.) Each time I've been there I count my blessings that it's just my little boy's feet that are involved, and that they can be fixed.














Colin's little crooky feet. I think they're adorable, albeit not super useful in a number of ways. They were so perfect for cradling his little bum when he slept, though!

So, obviously, in relation to a lot of the BIG stuff going on at Shriners, Colin's clubfoot treatment is dang minor. I still don't like it, though. Don't like it one bit. Hate it, actually..... but then I'm also such a sucker for medical procedures, I thought I'd document the process.

Colin and I go down every Monday morning (every week for about 5-6 weeks. His 3rd set was done yesterday), which is when they hold the clubfoot clinic. While he's still asleep, I switch his oxygen tanks over from the big one on wheels to the little one in the striking shoulder bag (black, so it goes with any outfit. Especially my sweats!), then stick him in his car seat--jammies and loaded pee diaper and all--and we're on our way. I cry, off and on, the whole way down the canyon, picturing him snoozing away peacefully in his car seat behind me. He has no idea he's even out of his bed, I imagine, let alone heading down to his very least favorite part of the week (ranking even below waking up hungry AND the changing of the super-sticky nasal cannula tape on his cheeks--OUCH!)

When we get to the hospital and check in, we sit in the waiting area and I visit with the other clubfoot parents who are there with their little ones. It's nice to have other people who are going through the same thing--misery loves company and all that, right? We compare notes and give each other encouragement for today's casting. We feel super jealous of the mom whose baby is getting his final casts. We smile and tell her good luck and that we're happy for her, and inside, we seethe with envy.

Colin and I get called back to a room, where the nurse cuts the casts off with this hand-held circular saw. It frightens me, even though it doesn't spin like a Skilsaw; it vibrates (forgive me if this is just so obvious--hard as it may be to imagine, this is my very first experience with casts. But we just got a trampoline, so maybe this is just a preview). Last week the nurse showed me how safe it is by touching it to his fingers. What would you expect to happen after that little demonstration? He cut my baby with it, obviously! Nicked his leg. There was blood, and Colin screamed, and I cried. This almost never happens, I'm told.


Here's a different nurse, cutting his casts off yesterday. She didn't cut him. Bless her!















They cut up one side and down the other. It's loud, and they told me I could cover his ears so he won't be scared. He flinches a little when they turn the saw on and start cutting, but he doesn't cry. He's unbelievably patient, this kid.

Then, they crack the casts open with a splitter-opener thing. It sounds really cool, like cracking into a lobster, sort of:










At this point I'm getting pretty excited, because I get to see his little feet and legs for awhile!








The photographer guy comes and snaps a few photos of his feet so they can document the progress (they told me I could get copies when we're all done, but I took a few pictures last week anyhow). He takes a few--a couple laying on his tummy and a couple on his back. This is before the very first set of casts:



















What are those little chicken legs for, if not for nibbling? Right?


So, after the casts are off and they remind me not to handle his legs too much or too roughly because they're super-sensitive from not being exposed to the air all week or something, we head to the casting room, where they let you bathe your baby before the casting! In a baby tub in the sink! Oh, the joy!

Here's little Colin, getting ready for his bath. He doesn't quite know what to do with his legs. He actually keeps them really straight most of the time, I think because they're bent when they're casted, and he likes how it feels to straighten them out. That's why I would do it, anyway.






















The joy of taking a real bath:



(The color on this is so weird. Not sure what I did wrong...)
Well, joy for me, anyway. Colin wasn't so sure he liked it all that much. PS: It's really hard to record video on the iPhone and keep a baby from drowning in a tub, all at the same time. And also, cover up his private bits. I couldn't find the waschcloths yesterday to serve that purpose.

I wish I could linger at the bath area for a long while, but others behind me are waiting, so I get moved on to the casting table area.

Here, the orthopedic people have created as relaxing an atmosphere as possible. There's Bob Marley playing on a boom box, and the doctors and nurses pass around a joint. (Only kidding about the joint. But I love Bob Marley, and now Colin will probably hate him because reggae will forever = extreme discomfort in his sub-conscience.)

For the casting, they use this fluffy bandage wrap first--as an illusion of comfort and softness, is what I figure. They hold Colin's foot in the correct position--pulling it a little farther out each week to gradually stretch and lengthen the tight, too-short ligaments that pull his foot inward. And they wrap that fluffy bandage WAAAY tighter than can possibly be comfortable. Then they do the plaster part. They use really warm water, and I hope that it feels like a luxurious, warm mud wrap. This is your weekly spa treatment, little buddy. Colin sucks, sucks, sucks really hard on his binkie, closes his eyes tight, and tries to find his happy place.


















His eyes are open in this photo, obviously. Usually, I'm right by his head, holding both hands to his chest. He nuzzles his head into me and tries to forget what's going on with his legs. He's such a sweet boy (the doctor told me yesterday he's her favorite patient. I'm sure she says that to all the moms, but I'm going to pretend he's her only)! They cast all the way to his groin, which makes for great messes when he has a forceful, abundant bowel movement....

Here he is, all done and ready to go home! The plaster takes several hours to dry completely. In the meantime, it draws like chalk all over everything the casts come into contact with, and bits flake off all over, especially inside his diaper somehow. Such a mess!



















I wonder, if they made the casts flesh-colored, would it still be so sad...?
Oh, and see the little #1s on the casts? The photographer guy writes those on them and snaps a couple more pictures. My big kids sign their names (and the kitty's) on them when they get home from school.

So, there you have it. He gets 5-6 sets of weekly casts. With the 1st set, his toes were still slightly turned in, and then they gradually turn them out, with each new set, till, with the last set, his toes will be turned out like a ballet dancer's, or a duck or something. Here's a picture of the Ponseti casting sequence, which is the gold standard used in clubfoot correction:

After the casts, the Achilles tenotomy (where they cut the too-tight Achilles tendon, which makes the foot point down. If they left it alone, I guess he'd wind up walking on his tiptoes, maybe?), then one set of casts after that (which flexes the foot, and which they leave on for 3-4 weeks. The ends of the Achilles tendon grow back together, "like a salamander tail," as someone explained to me. Crazy, huh?), and finally, the boots-and-bar brace till he's about 3 years old. At the end, he will have "a functional foot. Not a perfect foot, but it'll be functional." This is what an orthopedic surgeon told me in a consultation in the NICU. Can you imagine how excited that glowing promise made me? The rapturous stirrings in my breast? It's the foot every mother dreams of for her children: the functional foot!

But, in all seriousness, it's pretty incredible that they can take little crooked, deformed feet, and fix them right up so that one day my little boy can run and jump and play. I realize that these couple months of casting are less than a blip on the radar of Colin's life. And even the 3 years of wearing the braces will be just barely a blip, right? I can handle less than a blip and barely a blip, no problem!