Guest guest Posted September 28, 2004 Report Share Posted September 28, 2004 hi, my son was born 10 days ago with a unilateral clubfoot (left). We took him to the ortho today (9/27), who has not been through Ponceti courses--and admitted as such--but his training subscribed to the fundamentals of the methodology. Anyhow, had a few questions to appeal to the group prior to going, but post(s) did not make it to the board. So we went for the evaluation today and left with a cast. Couple of my concerns are: 1) This is obviously an opportune time him to undergo the process and at the same time you only get one first go at it. 2) Should I be concerned if the doc knows his way around the method but not necessarily certified? What kind of questions should I ask this particular doc? Did you folks use baby tylenol or anything for discomfort or pain with intial castings?? Thanks for the help. Best... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 28, 2004 Report Share Posted September 28, 2004 Welcome, & Weston, The first thing that you'll have to do is educate yourself about what is and what is not the Ponseti method so that you can make confident decisions on your son's behalf about his care. We can help you with that. If you don't mind telling us what region you're in, we can perhaps refer you to a recommended doctor in your area. The ortho that you're seeing now probably doesn't know what the Ponseti method is, because if he's saying that he wasn't trained in the method, then there is *no way* that " his training subscribed to the fundamentals of the methodology " . There are no other methods fundamentally similar to the Ponseti method; either a doctor was trained in the Ponseti method, or he was trained in some other method (i.e. Kite method). The " fundamentals " of Ponseti are what makes it as successful as it is, and " different " than other methods. Perhaps if your doctor did personal research on the method by reading Dr. P's book- then he may be using a variation of the method (he's tweaked Dr. P's method), but I would think that he would tell you that he had completed some " personal training " in that case. Here is Dr. Ponseti's website, you can look to see if there is a doctor listed near you: http://www.vh.org/pediatric/patient/orthopaedics/clubfeet/index.html Here is a website where you can do a lot of internet research on the method, and it also has a parents' checklist to help you " interview " doctors: http://pages.ivillage.com/ponseti_links Here is the link to the Global-HELP booklet that you can download a pdf version of...it describes in very precise detail how to use the Ponseti method- it is a medical booklet- and your doctor can review it and tell you how what he does deviates from the method as described in the book: http://www.global-help.org/publications/pubclubfoot.html It is pertinent that you find a competent doctor for your son. It is possible for a doctor to do more damage than good by improperly applying casts. Not all casting is equal. Even if the cast is applied toe-to-groin it may not be right. The only time I gave Tylenol was for her percutaneous tenotomy procedure. She never needed pain meds for the casting sessions themselves, even with our first non-Ponseti doctor. The sessions should use gentle examinations and manipulations- never anything forceful or painful. Hope this helps some- Regards, & (3-16-00) left clubfoot, switched to Ponseti method at 4 mo. old http://ponseticlubfoot.freeservers.com/ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 28, 2004 Report Share Posted September 28, 2004 Welcome, & Weston, The first thing that you'll have to do is educate yourself about what is and what is not the Ponseti method so that you can make confident decisions on your son's behalf about his care. We can help you with that. If you don't mind telling us what region you're in, we can perhaps refer you to a recommended doctor in your area. The ortho that you're seeing now probably doesn't know what the Ponseti method is, because if he's saying that he wasn't trained in the method, then there is *no way* that " his training subscribed to the fundamentals of the methodology " . There are no other methods fundamentally similar to the Ponseti method; either a doctor was trained in the Ponseti method, or he was trained in some other method (i.e. Kite method). The " fundamentals " of Ponseti are what makes it as successful as it is, and " different " than other methods. Perhaps if your doctor did personal research on the method by reading Dr. P's book- then he may be using a variation of the method (he's tweaked Dr. P's method), but I would think that he would tell you that he had completed some " personal training " in that case. Here is Dr. Ponseti's website, you can look to see if there is a doctor listed near you: http://www.vh.org/pediatric/patient/orthopaedics/clubfeet/index.html Here is a website where you can do a lot of internet research on the method, and it also has a parents' checklist to help you " interview " doctors: http://pages.ivillage.com/ponseti_links Here is the link to the Global-HELP booklet that you can download a pdf version of...it describes in very precise detail how to use the Ponseti method- it is a medical booklet- and your doctor can review it and tell you how what he does deviates from the method as described in the book: http://www.global-help.org/publications/pubclubfoot.html It is pertinent that you find a competent doctor for your son. It is possible for a doctor to do more damage than good by improperly applying casts. Not all casting is equal. Even if the cast is applied toe-to-groin it may not be right. The only time I gave Tylenol was for her percutaneous tenotomy procedure. She never needed pain meds for the casting sessions themselves, even with our first non-Ponseti doctor. The sessions should use gentle examinations and manipulations- never anything forceful or painful. Hope this helps some- Regards, & (3-16-00) left clubfoot, switched to Ponseti method at 4 mo. old http://ponseticlubfoot.freeservers.com/ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 28, 2004 Report Share Posted September 28, 2004 Welcome, & Weston, The first thing that you'll have to do is educate yourself about what is and what is not the Ponseti method so that you can make confident decisions on your son's behalf about his care. We can help you with that. If you don't mind telling us what region you're in, we can perhaps refer you to a recommended doctor in your area. The ortho that you're seeing now probably doesn't know what the Ponseti method is, because if he's saying that he wasn't trained in the method, then there is *no way* that " his training subscribed to the fundamentals of the methodology " . There are no other methods fundamentally similar to the Ponseti method; either a doctor was trained in the Ponseti method, or he was trained in some other method (i.e. Kite method). The " fundamentals " of Ponseti are what makes it as successful as it is, and " different " than other methods. Perhaps if your doctor did personal research on the method by reading Dr. P's book- then he may be using a variation of the method (he's tweaked Dr. P's method), but I would think that he would tell you that he had completed some " personal training " in that case. Here is Dr. Ponseti's website, you can look to see if there is a doctor listed near you: http://www.vh.org/pediatric/patient/orthopaedics/clubfeet/index.html Here is a website where you can do a lot of internet research on the method, and it also has a parents' checklist to help you " interview " doctors: http://pages.ivillage.com/ponseti_links Here is the link to the Global-HELP booklet that you can download a pdf version of...it describes in very precise detail how to use the Ponseti method- it is a medical booklet- and your doctor can review it and tell you how what he does deviates from the method as described in the book: http://www.global-help.org/publications/pubclubfoot.html It is pertinent that you find a competent doctor for your son. It is possible for a doctor to do more damage than good by improperly applying casts. Not all casting is equal. Even if the cast is applied toe-to-groin it may not be right. The only time I gave Tylenol was for her percutaneous tenotomy procedure. She never needed pain meds for the casting sessions themselves, even with our first non-Ponseti doctor. The sessions should use gentle examinations and manipulations- never anything forceful or painful. Hope this helps some- Regards, & (3-16-00) left clubfoot, switched to Ponseti method at 4 mo. old http://ponseticlubfoot.freeservers.com/ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 28, 2004 Report Share Posted September 28, 2004 , You have a fairly large window of opportunity with a new born to get appropriate treatment, so don't be in a rush - your baby isn't even a month old yet, and while yes the Ponseti Method advises the sooner you start the better, it's not terrible to wait a little while so you may get your ducks in a row. The " fundamentals " of the Ponseti Method is to use serial casting followed by a DBB (Dennis Brown Bar). That's a pretty vague description, dont' you think? Where non-ponseti doctors fail is that they do not have a bedrock level of understanding about the bones, tendons, etc., in the foot and that they must be moved in a very specific fashion in order to achieve the goal of " Corrected " feet as is by Dr. Ponseti and those following his exacting standards/protocol. Not all casting is created equeal. How many casts did your doctor think it was going to take to correct your baby's foot? Is he talking yet about lengthening the archilese tendon, if so when does he think that may occur? How many other club feet has he treated? Even after recieving some " bad " casts your child can still be corrected with the Ponseti Method at a young age provided no other surgeries have been done (in about 99% of the cases). Knowing your way around a bank doesn't qualify a person to be a bank president - I would definately be worried but you can do your own research here and ask him the hard questions to base your decisions on. We occastionally used baby pain relievers (OTC) after casting but typically it's rather painless. Let us know how we can help you. s. Weston hi, my son was born 10 days ago with a unilateral clubfoot (left). We took him to the ortho today (9/27), who has not been through Ponceti courses--and admitted as such--but his training subscribed to the fundamentals of the methodology. Anyhow, had a few questions to appeal to the group prior to going, but post(s) did not make it to the board. So we went for the evaluation today and left with a cast. Couple of my concerns are: 1) This is obviously an opportune time him to undergo the process and at the same time you only get one first go at it. 2) Should I be concerned if the doc knows his way around the method but not necessarily certified? What kind of questions should I ask this particular doc? Did you folks use baby tylenol or anything for discomfort or pain with intial castings?? Thanks for the help. Best... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 28, 2004 Report Share Posted September 28, 2004 , You would be better off trying to find a Ponseti certified doctor if at all possible. If you don't have access to one some questions to ask are: 1. What does your son's foot score. 2. How often will they change the casts. 3. What knowledge do they have about clubfeet. 4. How often do they do surgery for clubfeet. I'm sure everyone else will have other questions as well to give to you. We all will probably tell you the same thing though. Get a Ponseti certified doc!! There have been several on the group who went to non-certified docs and have had to start over once they found one who was, they had to start the process over due to casting that was done incorrectly. Good Luck! Mia Addisyn 6/24/04 Atypical BL CF paul4weston paul.webb@...> wrote: hi, my son was born 10 days ago with a unilateral clubfoot (left). We took him to the ortho today (9/27), who has not been through Ponceti courses--and admitted as such--but his training subscribed to the fundamentals of the methodology. Anyhow, had a few questions to appeal to the group prior to going, but post(s) did not make it to the board. So we went for the evaluation today and left with a cast. Couple of my concerns are: 1) This is obviously an opportune time him to undergo the process and at the same time you only get one first go at it. 2) Should I be concerned if the doc knows his way around the method but not necessarily certified? What kind of questions should I ask this particular doc? Did you folks use baby tylenol or anything for discomfort or pain with intial castings?? Thanks for the help. Best... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 29, 2004 Report Share Posted September 29, 2004 , I saw your post on the yahoo clubfoot board asking about Dr. Schmale. If you look in the posts from last week, you'll see posts from Livi's mom, Darby, who is also taking her daughter to that same doctor. I am not certain about Dr. Schmale's use of the Ponseti method. Perhaps you could contact Dr. Mosca and see if he knows of Dr. Schamle's commitment and success with the method. As you know, Dr. Mosca is on Dr. P's list and many of the families on this list see him. Have you questioned Dr. Schmale about the number of cases that he's treated and what percentage are successful with casting/tenotomy alone? Please keep us posted! Regards, & (3-16-00) left clubfoot Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 29, 2004 Report Share Posted September 29, 2004 , I saw your post on the yahoo clubfoot board asking about Dr. Schmale. If you look in the posts from last week, you'll see posts from Livi's mom, Darby, who is also taking her daughter to that same doctor. I am not certain about Dr. Schmale's use of the Ponseti method. Perhaps you could contact Dr. Mosca and see if he knows of Dr. Schamle's commitment and success with the method. As you know, Dr. Mosca is on Dr. P's list and many of the families on this list see him. Have you questioned Dr. Schmale about the number of cases that he's treated and what percentage are successful with casting/tenotomy alone? Please keep us posted! Regards, & (3-16-00) left clubfoot Quote Link to comment Share on other sites More sharing options...
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