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<<What makes me sad is when parents KNOW of the options and still

CHOSE surgery. I can understand if they didn't know, and was treated

surgically>>

As a parent who's child has had surgery, I'm going to jump in here for a

second. Particularlrly since I have one of the children with regression.

1. Even Ponsetti doesn't recommend his method for children with

Arthrogryposis. (SEVERE clubfoot; Arthrogryposis also includes global

malformations of muscle and joints). and Todd both have

Arthrogyrposis.

2. has been wearing AFOs' since his surgery. And a DBB at night

since last Fall (for 4 mos he wore his AFOs in the DBB).

3. receives 3 hours of PT a week, with someone who specializes in

Arthrogyrposis and has been receiving that level of therapy since birth.

4. I'm not sure that there is anyone on the list who chose surgery OVER

Ponsetti. We didn't even hear about Ponsetti until well after our surgery,

and we have been online since 's birth and have traveled to the top

doctors in NYC, and those specializing in Arthrogryposis in Seattle and

Delaware. In fact, our surgeon was surprised to learn that I know all about

the Ilizarov method, Ponsetti method and French physiotherapy method.

5. While I understand everyone's zeal on the Ponsetti method, there are

relapse rates with it as well. Further, most orthopedists don't discuss the

Ponsetti method as an option. However, for our child with Arthrogryposis,

the radical PMR using the HSS method only has a 10% recurrance rate, and

thats a 25 year study.

Thanks for the image of the wounded animal. My son is going in for hand

surgery in 2 weeks and has undergone anesthesia four times, and no not once

has he sounded like a wounded animal, in fact on 3 of those four occasions he

has woken up smiling. And yes we used the equivalent of Ponsetti on his

hands--Myofascial Release, 24 hour serial splinting of the hands, and

Occupational Therapy for 3 hours a week. since birth. However, when a

child's joint is malformed and the tendon resembles spaghetti the only viable

option is to do a tendon transfer.

~Maureen

PS: I lurk here, as I want to learn more about the Ponsetti method.

Additionally, my sister is a foot surgeon who will be attending Ponsetti's

next training session to learn his method.

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CaseyWaid@... wrote:

> 1. Even Ponsetti doesn't recommend his method for children with

> Arthrogryposis. (SEVERE clubfoot; Arthrogryposis also includes global

> malformations of muscle and joints). and Todd both have

> Arthrogyrposis.

Yeah, I was going to mention that a couple of parents on the

clubfoot list (including yourself) have arthrogrypotic children.

Surgery is indeed the only option for them.

Masoner

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(((Maureen))),

Please don't be offended by this discussion on using non-surgical

techniques as opposed to surgery. I think all of us are painfully

aware that non-surgical techniques are not a panacea and do not work

for all. We whose children have been candidates to use these methods

have been the lucky, no blessed ones, and maybe we need to state that

once in a while. Not every child and family dealing with this problem

can do that.

My used the French Physiotherapy method, yet still needed a

heel cord release and a soft tissue release on each foot. The

advantage in doing the non-surgical technique is that is minimized

the need for surgery and sometimes that is the best we could have

hoped for, under the circumstances.

In other situations, like your little one's, surgery may very well be

the only option. No shame in that. I think whay everyone is saying is

that the surgery rate could be lowered in some cases if parents would

look into the non-surgical techniques of treatment. Unfortunately,

more severe cases still require surgery, and aren't we blessed that

there are some wonderful, caring, and competent pediatric orthropedic

surgeons out there.

Much luck with your little one's treatment...

Blessings,

Pam

> <<What makes me sad is when parents KNOW of the options and still

> CHOSE surgery. I can understand if they didn't know, and was

treated

> surgically>>

>

> As a parent who's child has had surgery, I'm going to jump in here

for a

> second. Particularlrly since I have one of the children with

regression.

>

> 1. Even Ponsetti doesn't recommend his method for children with

> Arthrogryposis. (SEVERE clubfoot; Arthrogryposis also includes

global

> malformations of muscle and joints). and Todd both have

> Arthrogyrposis.

> 2. has been wearing AFOs' since his surgery. And a DBB at

night

> since last Fall (for 4 mos he wore his AFOs in the DBB).

> 3. receives 3 hours of PT a week, with someone who

specializes in

> Arthrogyrposis and has been receiving that level of therapy since

birth.

> 4. I'm not sure that there is anyone on the list who chose surgery

OVER

> Ponsetti. We didn't even hear about Ponsetti until well after our

surgery,

> and we have been online since 's birth and have traveled to

the top

> doctors in NYC, and those specializing in Arthrogryposis in Seattle

and

> Delaware. In fact, our surgeon was surprised to learn that I know

all about

> the Ilizarov method, Ponsetti method and French physiotherapy

method.

> 5. While I understand everyone's zeal on the Ponsetti method,

there are

> relapse rates with it as well. Further, most orthopedists don't

discuss the

> Ponsetti method as an option. However, for our child with

Arthrogryposis,

> the radical PMR using the HSS method only has a 10% recurrance

rate, and

> thats a 25 year study.

>

> Thanks for the image of the wounded animal. My son is going in for

hand

> surgery in 2 weeks and has undergone anesthesia four times, and no

not once

> has he sounded like a wounded animal, in fact on 3 of those four

occasions he

> has woken up smiling. And yes we used the equivalent of Ponsetti

on his

> hands--Myofascial Release, 24 hour serial splinting of the hands,

and

> Occupational Therapy for 3 hours a week. since birth. However,

when a

> child's joint is malformed and the tendon resembles spaghetti the

only viable

> option is to do a tendon transfer.

>

> ~Maureen

>

> PS: I lurk here, as I want to learn more about the Ponsetti

method.

> Additionally, my sister is a foot surgeon who will be attending

Ponsetti's

> next training session to learn his method.

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how do you know if your child has what type of clubfoot? We were never told

of any name except that he had clubfoot and it was severe. We are doing the

Ponseti Method and are using the DBB . Zach has had some tightening of his

heal cord but we were told to do a excersise to help keep it flexible. His

foot looks good now but will it stay is the question. Kathy

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In a message dated 09/23/2000 6:42:18 PM Eastern Daylight Time,

kwitkos862@... writes:

> how do you know if your child has what type of clubfoot? We were never

told

> of any name except that he had clubfoot and it was severe.

Arthrogryposis means that your child has more than one joint contracted and

more than one muscle group that is malfored.

Idiopathic simply means of unkown orgin.

~Maureen

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> Arthrogryposis means that your child has more than one joint

contracted and

> more than one muscle group that is malfored.

That's what I thought. I met a woman the other day with a young

baby. She told me her son, who has clubfoot, has arthrogryposis. I

asked her what joints are malformed in addition to the feet, and she

told me that it was just his feet, but the doctor told her he has

arthogryposis.

As you can imagine, I was pretty confused. Would you know why she

might have been saying her son is arthrogrypotic? I even said that I

thought AMC (you know, MULTIPLEX as in MULTIPLE) diagnosis required

involvment by several joints, and she just gave me that stare usually

reserved for people talking about encounters with aliens.

Masoner

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> As you can imagine, I was pretty confused. Would you know why she

> might have been saying her son is arthrogrypotic? I even said that I

> thought AMC (you know, MULTIPLEX as in MULTIPLE) diagnosis required

> involvment by several joints, and she just gave me that stare usually

> reserved for people talking about encounters with aliens.

I guess her doctor doesn't know the difference. And if she has been told a

specific diagnosis...

There has to be more than one joint involved--and bilateral clubfoot doesn't

count. We even asked if my sister might have AMC--she had bilateral

dislocated hips and mettatarsus adductus and we were told nope, the feet

weren't severe enough... I'm thinking her feet might have been mild clubfoot

but at the time the protocal was casting from feet to armpit, and her

orthopedist may have manipulated her feet, he's since retired... but its

another thing to look into.

~Maureen

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[i initally intended to send this message only to Sara, but as I am blocked

from emailing her directly--it will have to go to the group. I didn't want to

reopen this can of worms, but I did want to respond.]

Sara--Thanks for the response.

1. I think those of you who haven't gone the surgery route need to remember

two very important things:

A. Doctors make the surgery route seem easier, doctors make surgery seem

better. Therefore, you cannot blame parents who despite learning of both

methods, don't fully understand them. Not everyone has the ability to

accurately compare the two methods, and most rely on their doctors to give

them guidance.

Analogy: Formula vs. breastmilk. There are many intelligent parents out

there, who despite knowing that breastmilk exists, and formula is inferior to

breastmilk, decide to use formula. Why??? Mainly because they are ignorant

of the facts, even when they have done some research. I don't think it helps

to publicly have pity on them, or to make comments to them after the fact

that giving their child breastmilk would have been a better choice... you

cannot go back (ok some people are able to relactate, but most aren't)....

Instead, those who support breastmilk need to understand why people (who

biologically can breastfeed--and that is every biological mother save

5%--many women have difficulties bc they introduce bottles at the same time

and actually sabotage their feeding method--sort of akin to short-leg casts)

choose formula (an inferior and actually harder feeding method) over

breastmilk (a better and actually easier feeding method) and how to reach

people BEFORE they make their decision.

B. It is never an easy decision to have surgery performed on your child.

But again, here, doctors hold the most power. Many parents simply want the

process DONE. And surgeons push surgery... Here the focus should be on

surgeons-- and 's discussion with the surgeons on why others are

resistent to the Ponsetti method is a good starting place. I would think

that getting Dr. Ponsetti to help you all with an article for the Journal of

American Orthopedics would be a good next step. That would reach the widest

surgical audience.

{As for those who choose surgery bc of monetary concerns or distances for

traveling: I'm sure that happens, and I don't blame the parents, rather I

place that blame squarely on the insurance industry... for us we have pulled

out a credit card whenever alternative care, no matter the distance, is

denied by our insurance company, we have filed appeals. However, not

everyone has the financial ability--to go to whichever doctors they

want--instead write a letter to your Congressmembers and Senators and tell

them what you had to go through just to get your kid the healthcare she

deserved, and what a crying shame it is that some kids don't have that care

bc their insurance company says we'll pay for surgery but not months of casts

and a DBB bar. Support the Family Opportunity Act!!}

2. While I understand that the no-surgery site is a haven for people and a

support group it really is annoying to see a discussion about oneself and

others similarly situated taken from the clubfoot list to the no-surgery

list--the assumption (whether consious or unconcious): the kids with relapse

had surgery, therefore they won't be on this list..) Me, I'm from Brooklyn,

we're pretty up front about our opinions... I'd rather have someone on the

clubfoot list, say " Wow, there seems to be a few relapses here... what do you

guys think that is about? " As we've discussed some of the kids facing relapse

don't have idiopathic clubfoot. And I think the other part of the answer is

simply the age of the children... If you'll look the relapsee's are two or

older...Many of the children on the list are about that age, and going

through the first big growth spurt since infancy. A poll could be done...

etc.,

3. For us we saw the best surgeons in the States... They specialized in

AMC,

one doctor said they wouldn't do a thing with 's feet til 18mos and he

should be standing on them and cruising before surgery (poor kid wouldn't

even touch the ground with them, they hurt so much... so standing or walking

seemed an absurd expectation) then he'd have another surgery at 2, another

between 6-8 ,another in his teens..... (4 surgeries at least). Another

surgeon said, no way, we'll do casts for a few months, then we'll do ONE

surgery, relapse rate is 10%.

Tell me, which one would you have picked?

~Maureen

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> We need, perhaps, to be a little more sensitive to each other in that

> regard. It is easy, without meaning to, to plug a method of medical

> treatment, child care or education, or anything else so strongly that

> it sounds like it is the only route that is right for all to use. I

> don't believe that anyone here would intentionally do that, but I

> guess, even without it meaning to, it could come off that way if we

> are not too careful.

And I'm not trying to stop people from plugging the Ponsetti method, just

saying please:

1. In every post to newbies--please remind people that there is a difference

between idiopathic and arthrogrypotic.

2. Really focus on getting the word out to DOCTORS... for most families by

the time they've found out about Ponsetti or French physiotherapy they are

already down the road to surgery.

3. BTW, interesting discussion with our surgeon: I had a journal article on

the use of botox for clubfeet (so far works on kids who do not have any

neuromuscular involvement)--they've been using it on kids with CP for awhile

with great success, now trying it on idiopathic clubfoot to increase the ROM

during manipulations. Anyway, the study is out of Dallas ish Rite,

which is apparently doing a whole series of clubfoot studies: CPM, French

Physiotherapy, Ilizrov, Ponsetti, Botox and PMR. My doc was pooh poohing the

studies...essentially, your kid could end up with any range of things being

done... I thought it looked like a good idea, to have one place study each of

the different methods, replicating past studies adn being able to compare

results on site with the same set of doctors....

~Maureen

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> [i initally intended to send this message only to Sara, but as I am

blocked

> from emailing her directly--it will have to go to the group. I

didn't want to

> reopen this can of worms, but I did want to respond.]

>

> Sara--Thanks for the response.

>

> 1. I think those of you who haven't gone the surgery route need to

remember

> two very important things:

>

> A. Doctors make the surgery route seem easier, doctors make

surgery

seem

> better. Therefore, you cannot blame parents who despite learning

of

both

> methods, don't fully understand them. Not everyone has the ability

to

> accurately compare the two methods, and most rely on their doctors

to give

> them guidance.

>

> Analogy: Formula vs. breastmilk. There are many intelligent

parents out

> there, who despite knowing that breastmilk exists, and formula is

inferior to

> breastmilk, decide to use formula. Why??? Mainly because they are

ignorant

> of the facts, even when they have done some research. I don't

think

it helps

> to publicly have pity on them, or to make comments to them after

the fact

> that giving their child breastmilk would have been a better

choice... you

> cannot go back (ok some people are able to relactate, but most

aren't)....

> Instead, those who support breastmilk need to understand why people

(who

> biologically can breastfeed--and that is every biological mother

save

> 5%--many women have difficulties bc they introduce bottles at the

same time

> and actually sabotage their feeding method--sort of akin to

short-leg casts)

> choose formula (an inferior and actually harder feeding method)

over

> breastmilk (a better and actually easier feeding method) and how to

reach

> people BEFORE they make their decision.

>

> B. It is never an easy decision to have surgery performed on your

child.

> But again, here, doctors hold the most power. Many parents simply

want the

> process DONE. And surgeons push surgery... Here the focus should

be

on

> surgeons-- and 's discussion with the surgeons on why

others are

> resistent to the Ponsetti method is a good starting place. I would

think

> that getting Dr. Ponsetti to help you all with an article for the

Journal of

> American Orthopedics would be a good next step. That would reach

the widest

> surgical audience.

>

>

> {As for those who choose surgery bc of monetary concerns or

distances for

> traveling: I'm sure that happens, and I don't blame the parents,

rather I

> place that blame squarely on the insurance industry... for us we

have pulled

> out a credit card whenever alternative care, no matter the

distance,

is

> denied by our insurance company, we have filed appeals. However,

not

> everyone has the financial ability--to go to whichever doctors they

> want--instead write a letter to your Congressmembers and Senators

and tell

> them what you had to go through just to get your kid the healthcare

she

> deserved, and what a crying shame it is that some kids don't have

that care

> bc their insurance company says we'll pay for surgery but not

months

of casts

> and a DBB bar. Support the Family Opportunity Act!!}

>

> 2. While I understand that the no-surgery site is a haven for

people and a

> support group it really is annoying to see a discussion about

oneself and

> others similarly situated taken from the clubfoot list to the

no-surgery

> list--the assumption (whether consious or unconcious): the kids

with relapse

> had surgery, therefore they won't be on this list..) Me, I'm from

Brooklyn,

> we're pretty up front about our opinions... I'd rather have someone

on the

> clubfoot list, say " Wow, there seems to be a few relapses here...

what do you

> guys think that is about? " As we've discussed some of the kids

facing relapse

> don't have idiopathic clubfoot. And I think the other part of the

answer is

> simply the age of the children... If you'll look the relapsee's are

two or

> older...Many of the children on the list are about that age, and

going

> through the first big growth spurt since infancy. A poll could be

done...

> etc.,

>

> 3. For us we saw the best surgeons in the States... They

specialized in

> AMC,

> one doctor said they wouldn't do a thing with 's feet til

18mos and he

> should be standing on them and cruising before surgery (poor kid

wouldn't

> even touch the ground with them, they hurt so much... so standing

or

walking

> seemed an absurd expectation) then he'd have another surgery at 2,

another

> between 6-8 ,another in his teens..... (4 surgeries at least).

Another

> surgeon said, no way, we'll do casts for a few months, then we'll

do

ONE

> surgery, relapse rate is 10%.

>

> Tell me, which one would you have picked?

>

> ~Maureen

Maureen brings up a very good point, No parent should ever feel

guilty

for a choice they have made for their child,I am sure there are enough

" self-battering " feelings in the hearts of parents with children born

with different-abilities.

We are in a society that brought us up beleiving in our Dr's and

that we are to do as they say. I am happy that the world has opened

up

and we are able to have information available in many forms so we can

have options and hopefully make a correct decision individual to our

personal situations. I am sure many physicians/surgeons look back and

wish at times that they had techniques or surgeries that would have

better served patients in the past.

As far as recurrence goes it is my feeling that no matter what

treatment has been chosen if a clubfoot is going to have a recurrence

it happens and at that time you sit down with the Dr./Dr's and

disscus

the options. I also belive there will be feet that need more surgery

then casting and there were cases talked about in Iowa. The clubfoot

can be a Neuromuscular nightmare and they are tough feet.

We have children who have had recurrence so early or severe that

an

MRI of the spine was ordered and they were found to have a tethered

cord.Once they were released the correction of the foot was easier.

Have any of you experienced this?

The Cast Lady

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Maureen,

Didn't know you were from NY. I'm a Long Islander by way of the

Bronx, Yonkers and a small town outside of Monticello. We don't mince

words here either. :-)

Sounds like you guys have been through the mill. In all honesty,

ultimately had to have one minor surgical procedure besides the

tenonomy. His original orthopaedist on the Island was a bit of a jerk

and missed a badly misaligned talus and calcanus bone on the right

foot and a slight and similar problem on the left, so a capsillectomy

was done on each foot at the same time as the tenonomies, this past

June. This was after 18 months of the French Physiotherapy method.

We really felt bad at first that would have to endure surgery

and do still worry about the possible foot pain and early onset of

osteoarthritis that surgery can bring with it, but the good

outweighed the bad. The bottom line was getting walking and he

was not getting beyond cruising before the surgery. Now, thank God,

can walk. So if the surgery was the only way to do it, then it

had to be done, and we did it, doing everything we could to take the

fear out of it for and make his recovery as comfortable as

possible.

Am I glad that we did the non-surgical treatment first? Absolutely.

We have been told that, in his case, it lessened the need for surgery.

Additionally, the surgery went extremely well. Much of the credit

goes to the guided and talented hands of Dr. Gail Chorney and a whole

lot of prayer, but some of it also goes to the fact that all of the

previous treatment had non-surgically just made the whole thing

easier.

I think the problem here is that we all have to remember that

although the non-surgical treatments for clubfeet can work

beautifully for some, for others, like your little one, it is not

even in the realm of possibility. There are also those that may be

candidates for non-surgical treatments, but circumstances - lack of

information, distance, money, etc., may make it impossible.

For example, when I found out about the Ponseti method, was

already too old to use it. Would it have saved him surgery? Who

knows? Maybe, maybe not. The bottom line is, Ralph and I did all that

we could with the information that we had at the time. Travel was not

an option with recovery from a c-section and 4 other children to care

for and teach with no other help from family or others. If I couldn't

have gotten training from a video on the French Physiotherapy method,

I don't know what we would have done, besides agonizing about it all.

But we were blessed and got the training via video and it opening up

a lot of doors for our son.

We were also blessed in that our insurance covered the orthopaedists,

hospital, AFO's, DBB's and 2 months of P/T to date with only co-pays

for us to handle. We additionally had wonderful help from our circle

of holistic practitioners, who all treated for free or a

reduced rate. Many folks are not so fortunate and medical care, as

all of us know, can cost a small (or not so small) fortune. It wasn't

too long ago that we had lousy insurance, and more than once, I've

wondered, " My God, what would we have done if our insurance wasn't so

good, with 4 other children, and a house, and recovering from 5 yrs

of severe underemployment and the debts incurred to survive that time

to deal with? "

The bottom line is that all of us must do what is in the best

interest for our children, each and every one. Sometimes, that may

take different directions. Does that make the route one takes better

than the route another does? Of course not. I homeschool my children.

I breastfeed my baby. Does that make me superior as a parent to the

parent who does not homeschool or breastfeed? Of course not. I am

doing what is, IMHO, the very best thing for my children. If you

believe that you are doing the same, and I believe you do and are

too, then you too are doing the very best that you can do for yours.

We need, perhaps, to be a little more sensitive to each other in that

regard. It is easy, without meaning to, to plug a method of medical

treatment, child care or education, or anything else so strongly that

it sounds like it is the only route that is right for all to use. I

don't believe that anyone here would intentionally do that, but I

guess, even without it meaning to, it could come off that way if we

are not too careful.

My apologies, Maureen, if I, in any of my posts, have said anything

that could have made you feel that way. With all my heart, I wish you

and your little guy all the best.

Blessings,

Pam

> [i initally intended to send this message only to Sara, but as I am

blocked

> from emailing her directly--it will have to go to the group. I

didn't want to

> reopen this can of worms, but I did want to respond.]

>

> Sara--Thanks for the response.

>

> 1. I think those of you who haven't gone the surgery route need to

remember

> two very important things:

>

> A. Doctors make the surgery route seem easier, doctors make

surgery seem

> better. Therefore, you cannot blame parents who despite learning

of both

> methods, don't fully understand them. Not everyone has the ability

to

> accurately compare the two methods, and most rely on their doctors

to give

> them guidance.

>

> Analogy: Formula vs. breastmilk. There are many intelligent

parents out

> there, who despite knowing that breastmilk exists, and formula is

inferior to

> breastmilk, decide to use formula. Why??? Mainly because they are

ignorant

> of the facts, even when they have done some research. I don't

think it helps

> to publicly have pity on them, or to make comments to them after

the fact

> that giving their child breastmilk would have been a better

choice... you

> cannot go back (ok some people are able to relactate, but most

aren't)....

> Instead, those who support breastmilk need to understand why people

(who

> biologically can breastfeed--and that is every biological mother

save

> 5%--many women have difficulties bc they introduce bottles at the

same time

> and actually sabotage their feeding method--sort of akin to short-

leg casts)

> choose formula (an inferior and actually harder feeding method)

over

> breastmilk (a better and actually easier feeding method) and how to

reach

> people BEFORE they make their decision.

>

> B. It is never an easy decision to have surgery performed on your

child.

> But again, here, doctors hold the most power. Many parents simply

want the

> process DONE. And surgeons push surgery... Here the focus should

be on

> surgeons-- and 's discussion with the surgeons on why

others are

> resistent to the Ponsetti method is a good starting place. I would

think

> that getting Dr. Ponsetti to help you all with an article for the

Journal of

> American Orthopedics would be a good next step. That would reach

the widest

> surgical audience.

>

>

> {As for those who choose surgery bc of monetary concerns or

distances for

> traveling: I'm sure that happens, and I don't blame the parents,

rather I

> place that blame squarely on the insurance industry... for us we

have pulled

> out a credit card whenever alternative care, no matter the

distance, is

> denied by our insurance company, we have filed appeals. However,

not

> everyone has the financial ability--to go to whichever doctors they

> want--instead write a letter to your Congressmembers and Senators

and tell

> them what you had to go through just to get your kid the healthcare

she

> deserved, and what a crying shame it is that some kids don't have

that care

> bc their insurance company says we'll pay for surgery but not

months of casts

> and a DBB bar. Support the Family Opportunity Act!!}

>

> 2. While I understand that the no-surgery site is a haven for

people and a

> support group it really is annoying to see a discussion about

oneself and

> others similarly situated taken from the clubfoot list to the no-

surgery

> list--the assumption (whether consious or unconcious): the kids

with relapse

> had surgery, therefore they won't be on this list..) Me, I'm from

Brooklyn,

> we're pretty up front about our opinions... I'd rather have someone

on the

> clubfoot list, say " Wow, there seems to be a few relapses here...

what do you

> guys think that is about? " As we've discussed some of the kids

facing relapse

> don't have idiopathic clubfoot. And I think the other part of the

answer is

> simply the age of the children... If you'll look the relapsee's are

two or

> older...Many of the children on the list are about that age, and

going

> through the first big growth spurt since infancy. A poll could be

done...

> etc.,

>

> 3. For us we saw the best surgeons in the States... They

specialized in

> AMC,

> one doctor said they wouldn't do a thing with 's feet til

18mos and he

> should be standing on them and cruising before surgery (poor kid

wouldn't

> even touch the ground with them, they hurt so much... so standing

or walking

> seemed an absurd expectation) then he'd have another surgery at 2,

another

> between 6-8 ,another in his teens..... (4 surgeries at least).

Another

> surgeon said, no way, we'll do casts for a few months, then we'll

do ONE

> surgery, relapse rate is 10%.

>

> Tell me, which one would you have picked?

>

> ~Maureen

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Not my son, Beth, and I pray that never becomes part of the picture...

Counting My Blessings,

Pam, Ralph, and Raphael

> > [i initally intended to send this message only to Sara, but as I

am

> blocked

> > from emailing her directly--it will have to go to the group. I

> didn't want to

> > reopen this can of worms, but I did want to respond.]

> >

> > Sara--Thanks for the response.

> >

> > 1. I think those of you who haven't gone the surgery route need

to

> remember

> > two very important things:

> >

> > A. Doctors make the surgery route seem easier, doctors make

> surgery

> seem

> > better. Therefore, you cannot blame parents who despite learning

> of

> both

> > methods, don't fully understand them. Not everyone has the

ability

> to

> > accurately compare the two methods, and most rely on their

doctors

> to give

> > them guidance.

> >

> > Analogy: Formula vs. breastmilk. There are many intelligent

> parents out

> > there, who despite knowing that breastmilk exists, and formula is

> inferior to

> > breastmilk, decide to use formula. Why??? Mainly because they

are

> ignorant

> > of the facts, even when they have done some research. I don't

> think

> it helps

> > to publicly have pity on them, or to make comments to them after

> the fact

> > that giving their child breastmilk would have been a better

> choice... you

> > cannot go back (ok some people are able to relactate, but most

> aren't)....

> > Instead, those who support breastmilk need to understand why

people

> (who

> > biologically can breastfeed--and that is every biological mother

> save

> > 5%--many women have difficulties bc they introduce bottles at the

> same time

> > and actually sabotage their feeding method--sort of akin to

> short-leg casts)

> > choose formula (an inferior and actually harder feeding method)

> over

> > breastmilk (a better and actually easier feeding method) and how

to

> reach

> > people BEFORE they make their decision.

> >

> > B. It is never an easy decision to have surgery performed on

your

> child.

> > But again, here, doctors hold the most power. Many parents

simply

> want the

> > process DONE. And surgeons push surgery... Here the focus should

> be

> on

> > surgeons-- and 's discussion with the surgeons on

why

> others are

> > resistent to the Ponsetti method is a good starting place. I

would

> think

> > that getting Dr. Ponsetti to help you all with an article for the

> Journal of

> > American Orthopedics would be a good next step. That would reach

> the widest

> > surgical audience.

> >

> >

> > {As for those who choose surgery bc of monetary concerns or

> distances for

> > traveling: I'm sure that happens, and I don't blame the parents,

> rather I

> > place that blame squarely on the insurance industry... for us we

> have pulled

> > out a credit card whenever alternative care, no matter the

> distance,

> is

> > denied by our insurance company, we have filed appeals. However,

> not

> > everyone has the financial ability--to go to whichever doctors

they

> > want--instead write a letter to your Congressmembers and Senators

> and tell

> > them what you had to go through just to get your kid the

healthcare

> she

> > deserved, and what a crying shame it is that some kids don't have

> that care

> > bc their insurance company says we'll pay for surgery but not

> months

> of casts

> > and a DBB bar. Support the Family Opportunity Act!!}

> >

> > 2. While I understand that the no-surgery site is a haven for

> people and a

> > support group it really is annoying to see a discussion about

> oneself and

> > others similarly situated taken from the clubfoot list to the

> no-surgery

> > list--the assumption (whether consious or unconcious): the kids

> with relapse

> > had surgery, therefore they won't be on this list..) Me, I'm

from

> Brooklyn,

> > we're pretty up front about our opinions... I'd rather have

someone

> on the

> > clubfoot list, say " Wow, there seems to be a few relapses here...

> what do you

> > guys think that is about? " As we've discussed some of the kids

> facing relapse

> > don't have idiopathic clubfoot. And I think the other part of

the

> answer is

> > simply the age of the children... If you'll look the relapsee's

are

> two or

> > older...Many of the children on the list are about that age, and

> going

> > through the first big growth spurt since infancy. A poll could

be

> done...

> > etc.,

> >

> > 3. For us we saw the best surgeons in the States... They

> specialized in

> > AMC,

> > one doctor said they wouldn't do a thing with 's feet til

> 18mos and he

> > should be standing on them and cruising before surgery (poor kid

> wouldn't

> > even touch the ground with them, they hurt so much... so standing

> or

> walking

> > seemed an absurd expectation) then he'd have another surgery at

2,

> another

> > between 6-8 ,another in his teens..... (4 surgeries at least).

> Another

> > surgeon said, no way, we'll do casts for a few months, then we'll

> do

> ONE

> > surgery, relapse rate is 10%.

> >

> > Tell me, which one would you have picked?

> >

> > ~Maureen

>

>

> Maureen brings up a very good point, No parent should ever feel

> guilty

> for a choice they have made for their child,I am sure there are

enough

> " self-battering " feelings in the hearts of parents with children

born

> with different-abilities.

> We are in a society that brought us up beleiving in our Dr's and

> that we are to do as they say. I am happy that the world has opened

> up

> and we are able to have information available in many forms so we

can

> have options and hopefully make a correct decision individual to our

> personal situations. I am sure many physicians/surgeons look back

and

> wish at times that they had techniques or surgeries that would have

> better served patients in the past.

> As far as recurrence goes it is my feeling that no matter what

> treatment has been chosen if a clubfoot is going to have a

recurrence

> it happens and at that time you sit down with the Dr./Dr's and

> disscus

> the options. I also belive there will be feet that need more

surgery

> then casting and there were cases talked about in Iowa. The

clubfoot

> can be a Neuromuscular nightmare and they are tough feet.

> We have children who have had recurrence so early or severe that

> an

> MRI of the spine was ordered and they were found to have a tethered

> cord.Once they were released the correction of the foot was easier.

> Have any of you experienced this?

>

> The Cast Lady

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Thanks for the links, Maureen. I'll check them out next week. This

week has been non-stop! Let me know about the Botox info.

Blessings,

Pam

> In a message dated 09/27/2000 11:37:32 PM Eastern Daylight Time,

> Rpc753@a... writes:

>

> >

> > I knew about Botox, but not ish rite's study. I have some

grave

> > concerns about it. Do you have any specific info on that study.

> >

> > Also, can you e-mail me any info and links on anthrogrypotic

(Did I

> > spell that right? :::giggle:::) clubfeet? I'd like to get myself

> > better educated on that issue...

> >

>

>

> It'll take me a day or two on the Botox study--so far its just the

> preliminary study (4 feet) but apparently there are more children

in that

> study--and it references other botox studies.

>

> Yes, agreed on the orthotists, pts etc.

> On a side note: We have found the BEST orthotists in the WORLD.

She is an

> OT who went back and got trained as an orthotist, she spends loads

of TIME

> observing with his braces, without, and really tries to work

with our

> team to get the best brace for . (Support by Design in

Manhattan).

>

> <A

HREF= " http://members.aol.com/amcchat/amcinfo.htm " >Arthrogryposis</A>

> <A HREF= " http://www.sonnet.com/avenues/ " >AVENUES</A>

> <A HREF= " http://www.pcnet.com/~orphan/ " >National Organization for

Rare

> Disorders, Inc...</A>

> <A

HREF= " http://www.sonnet.com/avenues/pamphlet.html " >Arthrogryposis

Pamphlet

> </A>

> <A HREF= " http://orthoweb.unicall.be/o12/110.htm " >Wheeless' Textbook

of

> Orthopaedics</A>

> <A

>

HREF= " http://www.northcott.org.au/html/arthrogryposis_and_related_cond

itions.h

>

> tml " >Arthrogryposis and related conditions</A>

> <A

> HREF= " http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?

form=4 & db=m & term=arm

>

> %5BMESH%

5DAND+arthrogryposis & dispmax=100 & relpubdate=No+Limit " >PubMed medline

> query-arthrogryposis</A>

> <A

HREF= " http://kidshealth.org/ai/service/arthrogryposis.html " >duPont

> Hospital for Children - Arthrogryposis...</A>

>

> ~Maureen

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Thanks for the info, . I'm going to check this and the other

links from Maureen out next week.

Blessings,

Pam

>

>

> BOTOX: I've seen a few studies in which botulism toxin is used in

> clubfoot treatment.

>

> Anyway, if you go to http://www.clubfoot.net/medical.php3 and type

> in " clubfoot botox " in the MEDLINE search box, you can see the

> studies for yourself. It's pretty neat stuff.

>

> Ricahrd Masoner

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Maureen,

I read your argument to Sara and realize you had only intended for her to

have to read it but you posted it so I'm going to comment on it. (Only on

the " breastfeeding Issue " . )

I personally took offense to your analogy of why some mothers prefer to

bottle feed because we must obviously be ignorant. Quite the contrary! I

have two beautiful , healthy girls that were both bottle fed by my and my

husband's choice. I have read all the reports and listened to all the

parents and doctors who claim that breast milk is better. I am by all means

not saying that it isn't but I believe that formula is just as healthy for

babies. They say that formula fed babies tend to be at a greater risk of ear

infections and can't fight off other infections as well as breast fed

babies. I have many friends who's children have been on antibiotics for

bacterial infections and ear infections and most of them were breast fed

infants. My 3 1/2 year old daughter and her 7 1/2 month old sister have

never had more that a cold (less than 3 a year) which I know in this day and

age is very unusual since many children are in daycare and are ''exposed " to

a lot more illnesses, and has only ever had the flu once in her 3 1/2

years. Neither of the girls have ever been put on an antibiotic for any

reason and I personally think that is amazing in itself.

I feel that the decision to breastfeed or not is a very personal decision

and no one should ever be condemned or feel they are doing their child some

great injustice because they chose to feed their babies with a bottle

instead of a breast. I personally am sick and tired of hearing about all

these remarks about us moms who chose the bottle because it was some kind of

convenience for us NOT to breastfeed. Well let me tell you, I stay home

with my girls every day and raise them and take care of them. I feel

fortunate that I can do that. I don't think there are many families now days

that can actually say they can " afford " it but we choose to do it anyway. I

know many families that can't for many different reasons but I know just as

many who can and simply don't. So to say that my life is " convenience " by

how I feed my children would be an all out untruth! Being a stay at home mom

I think is one of the most important things I could ever do for my children.

Believe me, I should know. My husband is a juvenile probation officer and he

comes home with the same stories every night. He deals with children who's

parents could care less about their own childs existence and only about

themselves and their personal needs.

Please remember Maureen, there are very good parents on this group and

although we all feel very free to express our thoughts and feelings we also

try to remember others feelings at the same time. I have not been on the

group for a very long time but up until now I have never felt judged by

another parent for my decisions. That is part of what is so nice about this

group. We are complete strangers that have come together because of a common

situation and gather strength from eachother.

I feel you need to re-evaluate why you are even on this group. I have been

keeping up with the postings and I find your comments somewhat informational

but also very defensive. I feel for your situation just as I do the other

families. I hope everything goes well for your children, children are

innocent and not one ever deserves anything less than a healthy, happy

existence. But as we all know unfortunately that is not always the case.

Holly

Re: Clubfoot Relapse

>[i initally intended to send this message only to Sara, but as I am blocked

>from emailing her directly--it will have to go to the group. I didn't want

to

>reopen this can of worms, but I did want to respond.]

>

>Sara--Thanks for the response.

>

>1. I think those of you who haven't gone the surgery route need to

remember

>two very important things:

>

>A. Doctors make the surgery route seem easier, doctors make surgery seem

>better. Therefore, you cannot blame parents who despite learning of both

>methods, don't fully understand them. Not everyone has the ability to

>accurately compare the two methods, and most rely on their doctors to give

>them guidance.

>

>Analogy: Formula vs. breastmilk. There are many intelligent parents out

>there, who despite knowing that breastmilk exists, and formula is inferior

to

>breastmilk, decide to use formula. Why??? Mainly because they are

ignorant

>of the facts, even when they have done some research. I don't think it

helps

>to publicly have pity on them, or to make comments to them after the fact

>that giving their child breastmilk would have been a better choice... you

>cannot go back (ok some people are able to relactate, but most aren't)....

>Instead, those who support breastmilk need to understand why people (who

>biologically can breastfeed--and that is every biological mother save

>5%--many women have difficulties bc they introduce bottles at the same time

>and actually sabotage their feeding method--sort of akin to short-leg

casts)

>choose formula (an inferior and actually harder feeding method) over

>breastmilk (a better and actually easier feeding method) and how to reach

>people BEFORE they make their decision.

>

>B. It is never an easy decision to have surgery performed on your child.

>But again, here, doctors hold the most power. Many parents simply want the

>process DONE. And surgeons push surgery... Here the focus should be on

>surgeons-- and 's discussion with the surgeons on why others

are

>resistent to the Ponsetti method is a good starting place. I would think

>that getting Dr. Ponsetti to help you all with an article for the Journal

of

>American Orthopedics would be a good next step. That would reach the

widest

>surgical audience.

>

>

>{As for those who choose surgery bc of monetary concerns or distances for

>traveling: I'm sure that happens, and I don't blame the parents, rather I

>place that blame squarely on the insurance industry... for us we have

pulled

>out a credit card whenever alternative care, no matter the distance, is

>denied by our insurance company, we have filed appeals. However, not

>everyone has the financial ability--to go to whichever doctors they

>want--instead write a letter to your Congressmembers and Senators and tell

>them what you had to go through just to get your kid the healthcare she

>deserved, and what a crying shame it is that some kids don't have that care

>bc their insurance company says we'll pay for surgery but not months of

casts

>and a DBB bar. Support the Family Opportunity Act!!}

>

>2. While I understand that the no-surgery site is a haven for people and a

>support group it really is annoying to see a discussion about oneself and

>others similarly situated taken from the clubfoot list to the no-surgery

>list--the assumption (whether consious or unconcious): the kids with

relapse

>had surgery, therefore they won't be on this list..) Me, I'm from

Brooklyn,

>we're pretty up front about our opinions... I'd rather have someone on the

>clubfoot list, say " Wow, there seems to be a few relapses here... what do

you

>guys think that is about? " As we've discussed some of the kids facing

relapse

>don't have idiopathic clubfoot. And I think the other part of the answer

is

>simply the age of the children... If you'll look the relapsee's are two or

>older...Many of the children on the list are about that age, and going

>through the first big growth spurt since infancy. A poll could be done...

>etc.,

>

>3. For us we saw the best surgeons in the States... They specialized in

>AMC,

>one doctor said they wouldn't do a thing with 's feet til 18mos and

he

>should be standing on them and cruising before surgery (poor kid wouldn't

>even touch the ground with them, they hurt so much... so standing or

walking

>seemed an absurd expectation) then he'd have another surgery at 2, another

>between 6-8 ,another in his teens..... (4 surgeries at least). Another

>surgeon said, no way, we'll do casts for a few months, then we'll do ONE

>surgery, relapse rate is 10%.

>

>Tell me, which one would you have picked?

>

>~Maureen

>

>

>

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Holly--

As you rightly point out, I did not intend for my response to go the full

group only Sara.

And perhaps you did not get my analogy... I AGREE with you, and perhaps your

long post, truly illustrates my feelings exactly, I took my analogy from

another board... and simply tried to illustrate the differences between the

two methods.

In this context, ignorant does not mean dumb rather it means that perhaps

with more information or help someone might have made a different decision.

Perhaps not. If its perhaps not, then that is OK!! However, if you said if

you'd only had more help getting your child to latch, or if you had known

that early introduction of bottles would undermine your effort to breastfeed,

then if you'd had more information or more assistance (a knowledgeable doctor

who had laid out the whys and the hows) then the ignorance lies there... get

it??

Yes, I've had a recent spate of annoyed posts, here.

But in reality.... My sister is now on her way to bringing the Ponsetti to

her corner of the world, two other doctors I work with are also bringing

Ponsetti to their world.

Yes you are blessed that you heard about the Ponsetti method before surgery,

that your doctors where willing to try it, or you found someone before

surgery to help out. As someone who did tons of research, and only came

across the method briefly and thought that the shortleg casts being and

manipulations my infant son had for 2 months were the Ponsetti method, I'm

the devils advocate here reminding you all, what other things need to be done

so other parents choose Ponsetti. I was ignorant, and it wasn't my fault.

I'm sorry if I offended you, I only used the analogy to illustrate how those

of us who've chosen or had surgery chosen for us feel in this context. And

your post clearly illustrates my feelings on the matter. :-)

Friends??

~Maureen

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AMC does mean Arthrogryposis Multiplex Congentia, which is as the

name implies multiple (many) congenital (inherited) arthrogryposis

(joint contractures). The term " arthrogryposis " itself is just a

name for joint contractures and not a name for a specific disease or

illness. Dr. Ponseti diagnosed my son, , with arthrogryposis

and it is only in his ankles.

I hope that wasn't me you were talking about, because I studied up on

the subject the very day Dr. Ponseti diagnosed so the

question was certainly not " alien " to me!!!!

> > Arthrogryposis means that your child has more than one joint

> contracted and

> > more than one muscle group that is malfored.

>

>

> That's what I thought. I met a woman the other day with a young

> baby. She told me her son, who has clubfoot, has arthrogryposis.

I

> asked her what joints are malformed in addition to the feet, and

she

> told me that it was just his feet, but the doctor told her he has

> arthogryposis.

>

> As you can imagine, I was pretty confused. Would you know why she

> might have been saying her son is arthrogrypotic? I even said that

I

> thought AMC (you know, MULTIPLEX as in MULTIPLE) diagnosis required

> involvment by several joints, and she just gave me that stare

usually

> reserved for people talking about encounters with aliens.

>

> Masoner

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AMC does mean Arthrogryposis Multiplex Congentia, which is as the

name implies multiple (many) congenital (inherited) arthrogryposis

(joint contractures). The term " arthrogryposis " itself is just a

name for joint contractures and not a name for a specific disease or

illness. Dr. Ponseti diagnosed my son, , with arthrogryposis

and it is only in his ankles.

I hope that wasn't me you were talking about, because I studied up on

the subject the very day Dr. Ponseti diagnosed so the

question was certainly not " alien " to me!!!!

> > Arthrogryposis means that your child has more than one joint

> contracted and

> > more than one muscle group that is malfored.

>

>

> That's what I thought. I met a woman the other day with a young

> baby. She told me her son, who has clubfoot, has arthrogryposis.

I

> asked her what joints are malformed in addition to the feet, and

she

> told me that it was just his feet, but the doctor told her he has

> arthogryposis.

>

> As you can imagine, I was pretty confused. Would you know why she

> might have been saying her son is arthrogrypotic? I even said that

I

> thought AMC (you know, MULTIPLEX as in MULTIPLE) diagnosis required

> involvment by several joints, and she just gave me that stare

usually

> reserved for people talking about encounters with aliens.

>

> Masoner

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allison_red@... wrote:

> The term " arthrogryposis " itself is just a

> name for joint contractures and not a name for a specific disease or

> illness.

Okay.

> I hope that wasn't me you were talking about, because I studied up on

> the subject the very day Dr. Ponseti diagnosed so the

> question was certainly not " alien " to me!!!!

It was you and . I meant " alien " in terms of

" this-guy--doesn't-know-what-he's-talking-about-and-I-really-

don't-feel-like-explaining-it-right-now " kind of look. Alien was

just... shorter :-) I was the guy walking around with the

camera.

Peace,

Masoner

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I don't think I meant to give you that kind of look, I was probably just

distracted wondering where all my kids were...mind splitting in five

directions all the time. I hope I wasn't rude!?! If so, S-O-R-R-Y.

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