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Hi,

Jasper is free of plasters and it's great to see his little feet. His plasters

had gotten quite

tight and the skin was very dry and sore but this will clear up now that they

are free. We

were fitted for boots and bar, size 000. Plan to go and buy some more socks

tomorrow.

Tamsin

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That's great Tamsin. Isn't it the best seeing those little feet

again! I touch and kiss Zoe's all of the time. She giggles. It is

great!

His skin will probably improve really quickly. It's best not to put

cream on his feet, even if they are dry. How big are his feet?

Louisa

6-27-99

Zoe 2-22-04 RCF FAB 18/7

> Hi,

> Jasper is free of plasters and it's great to see his little feet.

His plasters had gotten quite

> tight and the skin was very dry and sore but this will clear up now

that they are free. We

> were fitted for boots and bar, size 000. Plan to go and buy some

more socks tomorrow.

> Tamsin

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Hey Congratulations! :)

s.

Jasper's feet

Hi,

Jasper is free of plasters and it's great to see his little feet. His plasters

had gotten quite

tight and the skin was very dry and sore but this will clear up now that they

are free. We

were fitted for boots and bar, size 000. Plan to go and buy some more socks

tomorrow.

Tamsin

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Hey Tasmin,

So, how's it going? I'm hoping since we haven't heard from you that

everything is just great. I love the name Jasper too!

Kori

At 12:03 AM 8/23/2004, you wrote:

>Hi,

>Jasper is free of plasters and it's great to see his little feet. His

>plasters had gotten quite

>tight and the skin was very dry and sore but this will clear up now that

>they are free. We

>were fitted for boots and bar, size 000. Plan to go and buy some more

>socks tomorrow.

>Tamsin

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> So, how's it going? I'm hoping since we haven't heard from you that

> everything is just great. I love the name Jasper too!

>

> Kori

> \

Hi,

I wrote a huge reply and even though this computer told me it went through, it

hasn't

come up on the list, so (incase it does sorry for the repeat) here goes.

Not much sleep! About 3 hrs each night, although Jasper got heaps more than that

- he

can sleep in our arms realy well! He woke constantly for the first three nights

but tonight

seems great so far. Although our doctor is Ponseti certified, we have the DBB

for 15hrs

and do manipulations every 2 hrs when they are off. We have an appointment in 4

weeks

so we'll see how this goes as we were expecting 23hrs wear each day. We have

been

agonising over whether to follow the doctor's 12hrs/night or go 23hrs, and have

compromised at 15hrs straight wear for the 4 weeks - if he'll need more

casting... well

we'll tackle that if we get there. I'm hoping we'll notice any changes in his

correcton.

Yesterday we tried putting them on earlier (at 3pm) and we had one VERY angry

boy. He

wouldn't settle and tried to kick them off and cried. At 5pm I took them off to

check them

and rubbed his feet - there were no sore spots so it was pure frustration, and

when they

went back on it took ages to settle him and we had to cuddle him (even in his

sleep) until

midnight, then he woke from 3-4am, them again at 7 and they came off at 8. I

have been

lifting and moving the bar following his little movements to try and help him

get used to it

but it only made him madder.

Tonight though, things worked a treat. We plan to make them part of his bedtime

routine.

He had a bath, then half a feed, then DBB (by this time it was 5pm), then the

other half of

the feed, then a play on the rug until he got sleepy and into bed with a book at

6pm. He

woke crying at 7pm and had to be cuddled back to sleep - violently kicking those

little

feet at us- but has been sleeping since - it's now 9pm. So hopefully tonight

will bring

everyone sleep and this is how he will take to the boots and isn't just because

he is tired

out from the last few nights. It seems much easier when it is bedtime and he can

just

forget about his feet and go to sleep.

Jasper's feet have no big sores so far, on the first night we had the straps in

the top slit

and the heels seemed down and no sore bits checking two hourly. Night 2 we moved

the

straps down but there was crying and carrying on after about an hours wear and

on

checking they had been biting into his feet - so back to the upper slots and all

OK (he has

little but chubby feet). There was a tiny sore on the top of the feet where the

strap goes

through the tongue but this turned into a tiny scab (the size of half a poppy

seed) and has

now disappeared. Tonight I am not sure if his right foot is in properly - I

tried three times

but cant tighten the strap further without causing a cranky boy, I think he has

curled his

toes up and I am not sure if this is affecting the wear - the heel appears to be

in the right

place - bent knee and dorsifexed I cant push it in any further.

The size of his shoes is 000 but each foot is different as they come to

different points in

his boots (his right foot was always stiffer than his left and is about 5mm

shorter). I'm

finding nursing him a bit more difficult as he doesn't want to attach properly

but this only

happens every other feed and I think we'll both get used to his feet straight

out soon

enough.

Some questions:

What should we be looking out for to see if the feet relapse?

Do the feet in a relapse get pulled around by the toes or do the ligaments

tighten the foot

back around?

How tightly should the laces on the boots be done up?

How can you tell if you have the boots on properly in the beginning - so that I

can make a

penline in the correct spot? (Here the shop just sells you the shoes and bar -

you fit them

yourself)

How can you coax the toes out if they are curled up (Jasper curled his toes in

casts and

now in the boots - the toes are at a bent angle but the hospital says they are

corrected

and they seem to be straighter each day of DBB wear)?

How much do the shoes stretch -(tonight I have done them up one hole tighter)?

Thanks everyone for the help,

Tamsin

mother of Jasper, bilateral 4.5, 5/13/04

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Hi Tamsin,

I am glad Jasper is doing a bit better! I can't answer the relapse

questions, but with regards to how tight to do the laces up. I do

them up as tight as possible, so that when I give a little tug on her

calf her toes do not move at all. I put a pen mark in her shoes in

the beginning so I could detect slipping. Zoe used to curl her toes

too, I would just kind of put my fingers on the bottom of her feet

(when they were in the shoe, but laces not done up yet) and gently

massage them out, until the seemed flat, then I would put my thumb

firmly on the top of her foot while I did up the strap and laces. If

she curled them up after that it was fine, but keep in mind that then

I could see the mark I had made with the pen, which freaked me out a

bit, but then If I uncurled her toes to check it was fine.

When you say they gave you the shoes and the bar and you fit them, do

you mean they did not attach the shoes to the bar for you? If that

is the case, I would be a little worried if I had the angle right.

On the shoe stretching. Zoe has been in hers since 2 mos old, she is

now 6 and we are just moving to the second notch on the strap. I

think it has stretched over time.

I look forward to hearing about how the rest of the night went!

Louisa

6-27-99

Zoe 2-22-04 RCF 18/7

> > So, how's it going? I'm hoping since we haven't heard from you

that

> > everything is just great. I love the name Jasper too!

> >

> > Kori

> > \

>

> Hi,

>

> I wrote a huge reply and even though this computer told me it went

through, it hasn't

> come up on the list, so (incase it does sorry for the repeat) here

goes.

>

> Not much sleep! About 3 hrs each night, although Jasper got heaps

more than that - he

> can sleep in our arms realy well! He woke constantly for the first

three nights but tonight

> seems great so far. Although our doctor is Ponseti certified, we

have the DBB for 15hrs

> and do manipulations every 2 hrs when they are off. We have an

appointment in 4 weeks

> so we'll see how this goes as we were expecting 23hrs wear each

day. We have been

> agonising over whether to follow the doctor's 12hrs/night or go

23hrs, and have

> compromised at 15hrs straight wear for the 4 weeks - if he'll need

more casting... well

> we'll tackle that if we get there. I'm hoping we'll notice any

changes in his correcton.

>

> Yesterday we tried putting them on earlier (at 3pm) and we had one

VERY angry boy. He

> wouldn't settle and tried to kick them off and cried. At 5pm I took

them off to check them

> and rubbed his feet - there were no sore spots so it was pure

frustration, and when they

> went back on it took ages to settle him and we had to cuddle him

(even in his sleep) until

> midnight, then he woke from 3-4am, them again at 7 and they came

off at 8. I have been

> lifting and moving the bar following his little movements to try

and help him get used to it

> but it only made him madder.

>

> Tonight though, things worked a treat. We plan to make them part of

his bedtime routine.

> He had a bath, then half a feed, then DBB (by this time it was

5pm), then the other half of

> the feed, then a play on the rug until he got sleepy and into bed

with a book at 6pm. He

> woke crying at 7pm and had to be cuddled back to sleep - violently

kicking those little

> feet at us- but has been sleeping since - it's now 9pm. So

hopefully tonight will bring

> everyone sleep and this is how he will take to the boots and isn't

just because he is tired

> out from the last few nights. It seems much easier when it is

bedtime and he can just

> forget about his feet and go to sleep.

>

> Jasper's feet have no big sores so far, on the first night we had

the straps in the top slit

> and the heels seemed down and no sore bits checking two hourly.

Night 2 we moved the

> straps down but there was crying and carrying on after about an

hours wear and on

> checking they had been biting into his feet - so back to the upper

slots and all OK (he has

> little but chubby feet). There was a tiny sore on the top of the

feet where the strap goes

> through the tongue but this turned into a tiny scab (the size of

half a poppy seed) and has

> now disappeared. Tonight I am not sure if his right foot is in

properly - I tried three times

> but cant tighten the strap further without causing a cranky boy, I

think he has curled his

> toes up and I am not sure if this is affecting the wear - the heel

appears to be in the right

> place - bent knee and dorsifexed I cant push it in any further.

>

> The size of his shoes is 000 but each foot is different as they

come to different points in

> his boots (his right foot was always stiffer than his left and is

about 5mm shorter). I'm

> finding nursing him a bit more difficult as he doesn't want to

attach properly but this only

> happens every other feed and I think we'll both get used to his

feet straight out soon

> enough.

>

> Some questions:

> What should we be looking out for to see if the feet relapse?

> Do the feet in a relapse get pulled around by the toes or do the

ligaments tighten the foot

> back around?

> How tightly should the laces on the boots be done up?

> How can you tell if you have the boots on properly in the

beginning - so that I can make a

> penline in the correct spot? (Here the shop just sells you the

shoes and bar - you fit them

> yourself)

> How can you coax the toes out if they are curled up (Jasper curled

his toes in casts and

> now in the boots - the toes are at a bent angle but the hospital

says they are corrected

> and they seem to be straighter each day of DBB wear)?

> How much do the shoes stretch -(tonight I have done them up one

hole tighter)?

>

> Thanks everyone for the help,

> Tamsin

> mother of Jasper, bilateral 4.5, 5/13/04

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Hi Tasmin,

The leather of the strap will indeed stretch as you break in the

shoes. Sometimes you even need to punch a new hole or two.

A quick answer about brace wear.. I would be concerned about having

him out of the shoes for so many hours so early. In the method, which

has been tested over many years, full time wear at first is what is

best at keeping the feet from relapsing. The risk of relapse is high

in the early months/years.

The feet should have been corrected with the last cast to an outward

angle of 70 degrees, which is where the shoes on the bar should also

be. What to watch for.. I'd look for signs of that overcorrection

being gone.. also the stretch in the heels tightening up, or the

heels turning in on their sides, that is, the lateral/outside edge of

the foot facing down.

Here is a link to an article by Dr. P on relapses which has much more

detail:

http://health.groups.yahoo.com/group/nosurgery4clubfoot/message/13223

Hope this helps.

and Claire

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