Re: Reverse/last shoes

January 29, 2004

Hi,

Someone posted here last week that their child wears a straight/last shoe on one

foot and a reverse/last shoe on the other. I would be really interested in

talking to that person. Rose's foot is curving a little bit and the non-Ponseti

Dr says a reverse last shoe would correct that. I emailed Dr. Mosca and he said

Rose has to have 1-2 more casts and then back to the DBB. He said this can

occur even when the DBB is used correctly. Anyway, I would like to try the shoe

and am wondering about other experiences with this. If we could put the

reverse/last shoe right onto the DBB and see if that would correct her foot, I

think that would be the way to go. I really hate to put her back in a cast just

as she is starting to walk AND THEN get her used to the DBB all over again.

Thanks,

Robin

iditwagner wrote:

Thanks,

Can I ask if the so overhang bar on either side can be dangerus?

thanks

idit

> > > Hi Idit-

> > >

> > > I use Ease Distributers at for ordering shoes and

> the

> > > adjustable bar. They are located in central California and

their

> > number is

> > > . You have to leave a message and they will call

> you

> > back. I'm

> > > not sure if they ship international or not but they ship

within

> the

> > US. The

> > > shoes cost $66.95 plus shipping from them. The bar is close to

> $60

> > too. If

> > > you can find a way to purchase all the web I would propably

just

> do

> > that

> > > route though.

> > >

> > > I've never heard/seen a blue bar. I'm just aware of the gold

> (non

> > > adjustable) and red (adjustable)ones. The red adjustable bar

is

> the

> > best

> > > because you can adjust it yourself and it saves lots of money

> down

> > the road.

> > >

> > > Hope this helps,

> > >

> > > >From: " iditwagner " <iditwagner@h...>

> > > >Reply-To: nosurgery4clubfoot

> > > >To: nosurgery4clubfoot

> > > >Subject: Questions about the new Red bar

> and

> > where to

> > > >find it

> > > >Date: Wed, 28 Jan 2004 11:14:11 -0000

> > > >

> > > >Hello dear parents.

> > > >This forum helped me so much. I have a 5-month-old son with

> > > >bilateral clubfeet. I learned here about the New Markel

> products

> > and

> > > >I have 3 questions:

> > > >1. What is the deference between the old blue bar to the new

> > > >adjustable red one? Since the products are unavailable in

> Israel I

> > > >want to know if it will be worth it to buy from a dealer

> through

> > the

> > > >web or not.

> > > >2. Dose anyone know a dealer/place in US or Canada that I can

> > > >contact? I will need shipment to Israel or to friends in US

and

> > > >Canada.

> > > >3. Dose anyone know someone who is willing to sell a second

> hand

> > red

> > > >adjustable bar 9 " -15 " ?

> > > >Thanks and have a great day

> > > >Idit

> > > >

> > >

_________________________________________________________________

> > > Learn how to choose, serve, and enjoy wine at Wine @ MSN.

> > > http://wine.msn.com/

>

January 29, 2004

Robin,

I would wonder about that. Being that Dr. Mosca seems to feel (this is

just what I'm getting from him wanting her in casts) that she's relapsing

that the shoes wouldn't correct that. From what I get, a relapse will need

Ponseti manipulations to put the bones back where they are supposed to

be. Reverse last shoes wouldn't seem to work to do that as far as I can

tell. Is it the travel you are shying away from? Do you think there are

any Dr's up there who could take a look at Dr. Ponseti's instructions

(maybe the booklet or his book or even the instructions on his website) and

try the casting up there for you? I would think, after all this time in

the DBB Rose wouldn't have a difficult time adjusting to the DBB after only

1-2 casts. Dr. Ponseti changes the out of town babies every 5 days

right? So 1-2 casts could theoretically only be a week and a half.

do you know if she would have to go back in the DBB full time? If so, for

how long? I'd be very wary of a relapse like that. Personally I wouldn't

want to waste time or $ on a shoe that doesn't apply the technique for

manipulating the foot back to the correct position. How long would you let

her wear it without signs of improvement before you went back to casts

anyway and how old would she be at that point? Not to say it wouldn't

work, but I personally wouldn't trust it. And I also wouldn't trust a Dr.

who doesn't do the Ponseti method in the first place to understand how and

why the foot is relapsing at this point. I would think if you're going to

trust her care to a Dr. that one would go with the Dr. who knows about her

treatment protocol rather than one who apparently isn't confident in it

enough to try or consider it with his patients in lieu of surgical or

traditional casting corrections.

Just out of curiosity, didn't you say that you only had Rose in the DBB 10

or 12 hours and she never did the 16-18? Will she go back into the DBB and

would you do longer hours if it was indicated in her relapse?

Kori

At 09:20 AM 1/29/04, you wrote:

>Hi,

>

>Someone posted here last week that their child wears a straight/last shoe

>on one foot and a reverse/last shoe on the other. I would be really

>interested in talking to that person. Rose's foot is curving a little bit

>and the non-Ponseti Dr says a reverse last shoe would correct that. I

>emailed Dr. Mosca and he said Rose has to have 1-2 more casts and then

>back to the DBB. He said this can occur even when the DBB is used

>correctly. Anyway, I would like to try the shoe and am wondering about

>other experiences with this. If we could put the reverse/last shoe

>right onto the DBB and see if that would correct her foot, I think that

>would be the way to go. I really hate to put her back in a cast just as

>she is starting to walk AND THEN get her used to the DBB all over again.

>

>Thanks,

>

>Robin

>

>iditwagner wrote:

>Thanks,

>

>Can I ask if the so overhang bar on either side can be dangerus?

>

>thanks

>

>idit

>

> > > > Hi Idit-

> > > >

> > > > I use Ease Distributers at for ordering shoes and

> > the

> > > > adjustable bar. They are located in central California and

>their

> > > number is

> > > > . You have to leave a message and they will call

> > you

> > > back. I'm

> > > > not sure if they ship international or not but they ship

>within

> > the

> > > US. The

> > > > shoes cost $66.95 plus shipping from them. The bar is close to

> > $60

> > > too. If

> > > > you can find a way to purchase all the web I would propably

>just

> > do

> > > that

> > > > route though.

> > > >

> > > > I've never heard/seen a blue bar. I'm just aware of the gold

> > (non

> > > > adjustable) and red (adjustable)ones. The red adjustable bar

>is

> > the

> > > best

> > > > because you can adjust it yourself and it saves lots of money

> > down

> > > the road.

> > > >

> > > > Hope this helps,

> > > >

> > > > >From: " iditwagner " <iditwagner@h...>

> > > > >Reply-To: nosurgery4clubfoot

> > > > >To: nosurgery4clubfoot

> > > > >Subject: Questions about the new Red bar

> > and

> > > where to

> > > > >find it

> > > > >Date: Wed, 28 Jan 2004 11:14:11 -0000

> > > > >

> > > > >Hello dear parents.

> > > > >This forum helped me so much. I have a 5-month-old son with

> > > > >bilateral clubfeet. I learned here about the New Markel

> > products

> > > and

> > > > >I have 3 questions:

> > > > >1. What is the deference between the old blue bar to the new

> > > > >adjustable red one? Since the products are unavailable in

> > Israel I

> > > > >want to know if it will be worth it to buy from a dealer

> > through

> > > the

> > > > >web or not.

> > > > >2. Dose anyone know a dealer/place in US or Canada that I can

> > > > >contact? I will need shipment to Israel or to friends in US

>and

> > > > >Canada.

> > > > >3. Dose anyone know someone who is willing to sell a second

> > hand

> > > red

> > > > >adjustable bar 9 " -15 " ?

> > > > >Thanks and have a great day

> > > > >Idit

> > > > >

> > > >

>_________________________________________________________________

> > > > Learn how to choose, serve, and enjoy wine at Wine @ MSN.

> > > > http://wine.msn.com/

> >

January 29, 2004

Kori,

Thanks for your reply. I am going to answer your questions from back to front

(so to speak). First of all, yes, if Dr. Mosca said she had to wear the DBB

16-18 hours per day that is what we would do. However, her perscription was

10-12 hours per day and Dr. Mosca said in his email that after the casts, she

would just go back to 10-12. I have looked on Dr. Ponseti's website and found

that he has also perscribed 10-12 hours per day in some cases. I don't know

what the criteria is, although we were told at birth that she had a mild case.

Second, Rose's Dr. in Ketchikan is Dr. Schwartz and he is, although not Ponseti

trained, an excellent Dr and the nearest thing to GOD that I have found. I

trust him completely and he is the one who sent us to Dr. Mosca in the first

place. Although he has worked with/referred to Dr. Mosca for years, Rose is his

first Ponseti-treated paitent. Dr. Schwartz did all of Rose's casts except the

last one after the tenotmy. Dr. Mosca said he did an excellent job and fully

corrected her foot. Dr. Mosca set us up with checkup's every three months with

Dr. Schwartz who reports his findings to Dr. Mosca.

I asked Dr. Mosca specifically about the reverse/last shoe and he did not

address that, just said casts. He did not call her condition a relapse, just

said that this happens sometimes. He did say that if her foot was curved and

could not be moved from concave to convex that 1-2 stretching casts would have

to be used. Dr. Schwartz showed me that her foot could be easily moved from

concave to convex. I emailed him again and said I would really like to try the

shoe first unless it would hurt her in some way. He has emailed me back and

said as long as her foot is flexible we can put the shoe on her bar and see if

that straightens out her foot.

OK, I get that casts will straighten her foot, absolutely. The R/L shoe is a

bit riskier but not very much. If it dosn't work, the casts will still be

there. The shoe will cost me roughly $100 and, provided it dosn't seem to hurt

her, I would do this for three months until time for her next appointment with

Dr. Schwartz. Assuming her foot is straight at that time, I would confer with

Dr. Mosca and see if she should go back to a straight/last shoe or stay with the

reverse last. If it didn't work, I would make arrangements to have the casts

done. Her initial casts cost me $368 each, of which my insurance only paid $82.

This is a new year so even that wouldn't be paid. When you add the cost of

travel and lodging too and from Ketchikan twice, we are looking at easily

$1500-$2000 for two weeks of casts. Also, that's assuming Dr. Schwartz would be

comfortable in doing the casting that Dr. Mosca requests. Remember, he is not

Ponseti trained and may not be familiar with the type

of casting being requested by Dr. Mosca. So, I might end up having to make

two trips to Seattle instead of Ketchikan. And no, there is no Dr. here in

sburg that I would trust to " try " and cast my baby. I am willing to try

the reverse/last shoe myself and I will know if it is hurting her. I don't

think it will because my own brother had to wear these shoes when he started

walking because his feet were turning in really bad. I would rather not have

to deal with getting her back in the DBB after casts AT ALL so if the shoe

works, I can bypass that ordeal. Yes, I firmly believe it would be a HUGE

ordeal to get her back in the shoes after having them off for two weeks. Not

only do I know my child, I have paid attention to other parent's experiences.

I have absolute faith in Dr. Schwartz that if he says the shoe will work, it

will work. I also realise that he is not Ponseti trained and just because the

shoe works on a giraffe does not mean it will work on a elephant. So, Dr. Mosca

has given the green light to try it, for which I think he is being extremely

progressive and we will see. I will keep you posted.

Robin & Rose

right club foot.

Kori Rush wrote: