Re: Re: Severity vs. relapse

[Guest guest]

Hi Angel,

I just wanted to respond to your comments here. You said that it was your

understanding that children with loose ligaments were at the 2 year end of the

spectrum. It is my understanding that the children with loose ligaments are

separate from 2-4 years. My understanding is that children with less severe

clubfoot are at the 2 year end and children with very severe club foot are at

the four-year end. I suppose I could be wrong about this but I am reasonably

sure that I am not.

As far as what Dr. Mosca told us, it is absolutely true. He said if we did

everything he said until she is 2 1/2 there is an 80% chance she will not need

surgery. I understand you being " bugged " but please don't be. I think the

point was that the vast majority of children (in fact 80%) will be cured by the

time they are 2 1/2. I know that 95% sounds really good, but I just don't know

if I want my daughter to wear that brace for an extra

2 1/2 YEARS worth of nights on the off chance that she is in that 15%.

I know that you said you would keep Kai in the brace till puberty if necessary

and I respect your opinion. Also, Kai has some other issues that, at the very

least, put him at the top of the 4 year mark.

I was really sold on the fact that Rose would be out of the brace before she

could remember it. It makes me really sad to think of keeping her trapped in

that thing for 2 1/2 extra years. I really want to avoid surgery for her, but

the ATTT surgery does not sound that bad AND there is only a 20% chance that she

would even need it. Balance that against 730 more nights and a memory of the

brace, not being able to get out of bed in the middle of the night for a drink

or to go to the bathroom or if she has a nightmare,,,,I just don't know if it is

worth when she already has a 3 in 4 chance of being totally corrected.

Just some things banging around in my head. I appreciate all input and

comments. Virtually anything could happen in the next 1 1/2 years to change my

mind, or not. As I have said before, we will do what ever the Dr. recommends,

including keeping her in the brace extra if necessary. I am just not ready to

jump on the bandwagon when I have a written prescription for Rose saying 10-12

hours per night till age 2 1/2.

Robin & Rose

3/12/03

Right club foot.

angelmommy23 m_kitaki@...> wrote:

>

> I am trying not to be too skeptical, but it sure seems like an

awful drastic change in protocol for something that has been used

virtually unaltered for 50+years.

>

Robin,

According to the Virtual Hospital site - which is Dr Ponseti's

informational site - the bracing protocal has always (or for a very

long time) been " Following correction the clubfoot deformity tends to

relapse. To prevent relapses, when the last plaster cast is removed a

splint must be worn full-time for two to three months and thereafter

at night for 2 to 4 years. "

I was my understanding from the beginning that those children who

were on the 2 year end of the spectrum were those diagnosed with

loose ligament whose feet tended to be damaged by the 70 degree

exterior rotation. It has since been found that many children with

loose ligaments who were released from the brace in their second year

subsequentally had a relapse. In turn, Dr Ponseti now has the angle

reduced in the brace rather than discontinuing use so early.

I honestly cant say for certain if Dr Mosca ever even discussed this

with us, but I always assumed from the beginning that the brace wear

would be 3-4 years. This is the impression I have always gotten from

this group, and nothing in the last year changed that perception.

That being the case, it is not a far reach for me to accept 4-5

years.

Also, having a 6 year old, I can attest to the fact that there is a

large growth spurt in the third year. I also know from my 2 year old

who has moderate to severe metatarsus adductus that every time there

is a growth spurt her feet become grossly curved and she suffers a

great deal of tripping and stumbling. Putting those two bits of

information together led me to the natural conclusion that 3.5 to 4

years is a good, conservative time in the brace.

I completely understand how daunting it seems to be hearing the

number of years go up. It seems like forever. But it really is

not. I can honestly say that I would rather Kai wear a brace while

sleeping until puberty that to face surgery.

By the time Rose is 2.5 years old, there will be more definitive

information available. I suggest the best thing is to get used to

the idea that it *might* be longer than 2.5 years, and then if it is

not, you can be plesantly surprised rather than disappointed if it is.

Angel