Guest guest Posted December 13, 2004 Report Share Posted December 13, 2004 I cut the heels out of my sons shoes and haven't looked back. He was fine after that. Rach -- sores w/ DBB Can anyone give me some input on dealing with sores with the DBB? My son Sammy just started with the brace on Thursday and by Friday afternoon had some serious dark purple bruises on his heels. I have done everything I can think of aside from cutting out the backs of the shoes -- I feel confident the heels are down in the shoes but the sores seem to be getting worse, I don't see him slipping in them either. We are using blister block bandaids which Dr. Dobbs recommended -- they are a lightly cushioned pad which seals out moisture and is supposed to protect the skin from further irritation. However, the sores are not improving, at first they were just dark bruises, now there are places where the skin is broken (no bleeding). The most amazing part is how well Sammy is doing through all of this. He cries when I put the brace on and off but he seems to be doing very well, doesn't really complain as if he is in pain. His biggest obstacle seems to be gas pains which has had since he was born but now he can't move his legs like he wants to make it feel better. Anyway, we are going to see the orthotic guy today but I was just wondering if anyone had any suggestions on what may be going on with the DBB/shoes and what I can do. Also, how long does it take for these types of sores to heal? Is there a point at which the Dr. says yes, you need a healing cast, or how do they decide when the sores are severe enough to warrant another cast? If the baby is not complaining doesn't this indicate that the shoes are on right and then shouldn't that mean they will get better? thanks for any input! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 13, 2004 Report Share Posted December 13, 2004 , Can you call or email Dr. Dobbs and get into see him soon? He might just want to put a cast on so that those sores heal up and figure out what is causing the problem with the shoes. Are there plastizode inserts in the heels that are pushing on his feet? Are his heels slipping in the shoe where the rubbing is causing the sores? Let us know how it's going.....you don't want the skin to start breaking down so you have a longer time to heal.... You may just have a very tolerant little guy- my guess is that there's something wrong with the shoes or that his foot is slipping in them. & (3-16-00) left clubfoot Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 13, 2004 Report Share Posted December 13, 2004 Hi , When sores like this form, something it wrong. You wouldn't be the first to think the heels are down when they just aren't. It's hard to tell. The thing is, once the sore is there it will never heal in the boot, even if you get the heel down. My suggestion is to just cut out that hole. It will serve two purposes, both are very important. First it'll remove any pressure on that sore so he can continue to wear the brace and allow the sore to heal (it takes a few weeks, depending on severity to heal them. But if you heal them and then again put the shoes back on with the same issue that caused the sore it'll just come right back - which is why the hole is a good idea regardless of whether you go to a healing cast or not), The second purpose is to give you a chance to SEE if you're really getting those heels down enough. So far, not one parent who has cut the hole has come back to the list or me and said *I cut the hole and his feet are indeed down in the shoe*. In fact, it's always the opposite where the parent is surprised to see it rising up even though they believed they had it all the way down. Dr. Dobbs is a good doc so it's less likely that the feet aren't corrected than it is for there to be just a better way for you to get that heel down in the shoe. Cut the hole, it won't harm the integrity of the shoe and it is the only way to heal the sore without going to a healing cast for a couple of weeks. Go to the healing cast, you start your 23/7 all over again and you might put the shoe on wrong again and make the sore come back (this was me - I did this), cut the hole and you still get to count the time he's put into 23/7 plus you then KNOW what's going on in those shoes. Your baby may just have a high tolerance for pain, but as the sore gets worse or scabs over it's going to hurt him. Have you tried to put the shoes on by following the instructions in the DBB/ Tips & Tricks post? This really helps get the feet into the shoes well. Make sure to bend the knee and dorsiflex the foot when you push the heel into the back of the shoe. And if possible, take the shoes off the bar to put them on. I so wish all these bars were easy to do that with. Let us know how it goes - big hugs! We understand how frustrating this is! Kori At 05:46 AM 12/13/2004, you wrote: >Can anyone give me some input on dealing with sores with the DBB? My >son Sammy just started with the brace on Thursday and by Friday >afternoon had some serious dark purple bruises on his heels. I have >done everything I can think of aside from cutting out the backs of >the shoes -- I feel confident the heels are down in the shoes but the >sores seem to be getting worse, I don't see him slipping in them >either. We are using blister block bandaids which Dr. Dobbs >recommended -- they are a lightly cushioned pad which seals out >moisture and is supposed to protect the skin from further >irritation. However, the sores are not improving, at first they were >just dark bruises, now there are places where the skin is broken (no >bleeding). The most amazing part is how well Sammy is doing through >all of this. He cries when I put the brace on and off but he seems >to be doing very well, doesn't really complain as if he is in pain. >His biggest obstacle seems to be gas pains which has had since he was >born but now he can't move his legs like he wants to make it feel >better. Anyway, we are going to see the orthotic guy today but I was >just wondering if anyone had any suggestions on what may be going on >with the DBB/shoes and what I can do. Also, how long does it take >for these types of sores to heal? Is there a point at which the Dr. >says yes, you need a healing cast, or how do they decide when the >sores are severe enough to warrant another cast? If the baby is not >complaining doesn't this indicate that the shoes are on right and >then shouldn't that mean they will get better? > >thanks for any input! > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 13, 2004 Report Share Posted December 13, 2004 Kori, Thanks for your response, and to the others who answered me. We went to see the orthotics guy today, he had already spoken to Dr. Dobbs and they've decided to put a healing cast on tomorrow. The sores were much worse today when I changed the bandaids. They told me it would be okay to leave the shoes off overnight tonight as long as we keep exercising his foot for the rest of the day and tomorrow a.m. before we see Dr. Dobbs again. I hate to take him out of the brace for fear of losing correction but I know Dr. Dobbs knows what he is doing, the sores are really bad, I think it must hurt him tremendously even if we are getting the heel down now. Do you think this is the wrong thing to do? (leaving the shoes off for nearly 1 full day???) Next question -- has anyone ever heard of using a shoe similar to a AFO, that is mounted on the DBB? This is what Dr. Dobbs is piloting with the othotic company. They take a plaster mold of the baby's foot and make a rubber " bootie " that slips over his foot and is then strapped into a hard plastic shell, looks like some AFO's I've seen pictures of which is then mounted on the DBB just like the shoes. They have done a few of them already and ***no*** problems with sores or blisters at all. Just wondering what you all think... Thanks again! > > > >Can anyone give me some input on dealing with sores with the DBB? My > >son Sammy just started with the brace on Thursday and by Friday > >afternoon had some serious dark purple bruises on his heels. I have > >done everything I can think of aside from cutting out the backs of > >the shoes -- I feel confident the heels are down in the shoes but the > >sores seem to be getting worse, I don't see him slipping in them > >either. We are using blister block bandaids which Dr. Dobbs > >recommended -- they are a lightly cushioned pad which seals out > >moisture and is supposed to protect the skin from further > >irritation. However, the sores are not improving, at first they were > >just dark bruises, now there are places where the skin is broken (no > >bleeding). The most amazing part is how well Sammy is doing through > >all of this. He cries when I put the brace on and off but he seems > >to be doing very well, doesn't really complain as if he is in pain. > >His biggest obstacle seems to be gas pains which has had since he was > >born but now he can't move his legs like he wants to make it feel > >better. Anyway, we are going to see the orthotic guy today but I was > >just wondering if anyone had any suggestions on what may be going on > >with the DBB/shoes and what I can do. Also, how long does it take > >for these types of sores to heal? Is there a point at which the Dr. > >says yes, you need a healing cast, or how do they decide when the > >sores are severe enough to warrant another cast? If the baby is not > >complaining doesn't this indicate that the shoes are on right and > >then shouldn't that mean they will get better? > > > >thanks for any input! > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 13, 2004 Report Share Posted December 13, 2004 , I wouldn't worry about leaving him out of the brace. Since he's going into a cast, any amount of correction that's lost will be regained with the cast. It's definitely better to keep him out of the brace since it's causing sores. I have heard of the AFO mounted to the bar. There was a family here from the Chicago area who had one. I think the baby's name was Brooklyn. There's nothing wrong with this concept- using an AFO instead of a shoe if it's mounted on the bar to obtain the outward and upward rotation....however, here are my concerns based on our own experience of using AFO's prior to switching over to Dr. P's method. 1) Even with air-holes drilled into the shell, the plastic AFO brace gets *very sweaty* for the baby. If your child's feet get sweaty in the leather open-toed shoes, it will be *drenched* in the plastic brace. 2) It can be very difficult to tell if the heel is down in the plastic brace (depending on the design, I guess, but I couldn't figure out how to tell where 's heel was in the two different styles that we had). 3) Since the brace is custom-molded for the foot, I would imagine that the baby will out-grow the AFO fairly quickly. This wouldn't be a problem for families who don't have to travel far for care, but might be an issue for those who do need to travel to the orthotist/orthopaedic surgeon. The brace takes time to make since they're custom-molded and this would have to be taken into account also when ready to move up to a larger size. 4) Expense of the custom molded AFO's may be an issue if insurance isn't covering them 100%. 5) I didn't like that the AFO went part way up 's calf (I don't know what Dobbs' prototypes look like) and she couldn't use her calf muscles or ankles when it was on. That's our experience...... Keep us posted on what Dr. Dobbs says was the culprit of the sores! & (3-16-00) left clubfoot > > > > > > >Can anyone give me some input on dealing with sores with the DBB? > My > > >son Sammy just started with the brace on Thursday and by Friday > > >afternoon had some serious dark purple bruises on his heels. I > have > > >done everything I can think of aside from cutting out the backs of > > >the shoes -- I feel confident the heels are down in the shoes but > the > > >sores seem to be getting worse, I don't see him slipping in them > > >either. We are using blister block bandaids which Dr. Dobbs > > >recommended -- they are a lightly cushioned pad which seals out > > >moisture and is supposed to protect the skin from further > > >irritation. However, the sores are not improving, at first they > were > > >just dark bruises, now there are places where the skin is broken > (no > > >bleeding). The most amazing part is how well Sammy is doing > through > > >all of this. He cries when I put the brace on and off but he seems > > >to be doing very well, doesn't really complain as if he is in pain. > > >His biggest obstacle seems to be gas pains which has had since he > was > > >born but now he can't move his legs like he wants to make it feel > > >better. Anyway, we are going to see the orthotic guy today but I > was > > >just wondering if anyone had any suggestions on what may be going > on > > >with the DBB/shoes and what I can do. Also, how long does it take > > >for these types of sores to heal? Is there a point at which the > Dr. > > >says yes, you need a healing cast, or how do they decide when the > > >sores are severe enough to warrant another cast? If the baby is > not > > >complaining doesn't this indicate that the shoes are on right and > > >then shouldn't that mean they will get better? > > > > > >thanks for any input! > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 14, 2004 Report Share Posted December 14, 2004 , Does Dr. Dobbs know that there are places in the skin that are broken now? If he doesn't I would contact him and let him know. Where are you from? We are from KY and are going to see Dr. Dobbs on Wednesday. If you are already using the blister band-aids I would say the most important thing you can do know is contact the Dr. if he is not aware that the skin is broken. Good Luck. Pam and (8-12-01) > > Can anyone give me some input on dealing with sores with the DBB? My > son Sammy just started with the brace on Thursday and by Friday > afternoon had some serious dark purple bruises on his heels. I have > done everything I can think of aside from cutting out the backs of > the shoes -- I feel confident the heels are down in the shoes but the > sores seem to be getting worse, I don't see him slipping in them > either. We are using blister block bandaids which Dr. Dobbs > recommended -- they are a lightly cushioned pad which seals out > moisture and is supposed to protect the skin from further > irritation. However, the sores are not improving, at first they were > just dark bruises, now there are places where the skin is broken (no > bleeding). The most amazing part is how well Sammy is doing through > all of this. He cries when I put the brace on and off but he seems > to be doing very well, doesn't really complain as if he is in pain. > His biggest obstacle seems to be gas pains which has had since he was > born but now he can't move his legs like he wants to make it feel > better. Anyway, we are going to see the orthotic guy today but I was > just wondering if anyone had any suggestions on what may be going on > with the DBB/shoes and what I can do. Also, how long does it take > for these types of sores to heal? Is there a point at which the Dr. > says yes, you need a healing cast, or how do they decide when the > sores are severe enough to warrant another cast? If the baby is not > complaining doesn't this indicate that the shoes are on right and > then shouldn't that mean they will get better? > > thanks for any input! > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 14, 2004 Report Share Posted December 14, 2004 I don't think you are going wrong by keeping the shoes off (or I guess I should say that you kept the shoes off I just realized this is a yesterday post!). I have so much confidence in Dr. Dobbs. He is SO frustrated by the babies who are experiencing the sores, I'm sure this is why he is trying out a custom device. We have spoken with him about the sore issue many times at office visits (our son was not experiencing them he was just discussing the issue). And you can just see the frustration in his face that the babies/parents have to go through this. I'll have to say I don't know what I would do if I were at the beginning of my treatment. I am so glad that so many of those roller coaster issues are over! Good luck with the healing casts. Pam and (8-12-01) > > > > > > >Can anyone give me some input on dealing with sores with the DBB? > My > > >son Sammy just started with the brace on Thursday and by Friday > > >afternoon had some serious dark purple bruises on his heels. I > have > > >done everything I can think of aside from cutting out the backs of > > >the shoes -- I feel confident the heels are down in the shoes but > the > > >sores seem to be getting worse, I don't see him slipping in them > > >either. We are using blister block bandaids which Dr. Dobbs > > >recommended -- they are a lightly cushioned pad which seals out > > >moisture and is supposed to protect the skin from further > > >irritation. However, the sores are not improving, at first they > were > > >just dark bruises, now there are places where the skin is broken > (no > > >bleeding). The most amazing part is how well Sammy is doing > through > > >all of this. He cries when I put the brace on and off but he seems > > >to be doing very well, doesn't really complain as if he is in pain. > > >His biggest obstacle seems to be gas pains which has had since he > was > > >born but now he can't move his legs like he wants to make it feel > > >better. Anyway, we are going to see the orthotic guy today but I > was > > >just wondering if anyone had any suggestions on what may be going > on > > >with the DBB/shoes and what I can do. Also, how long does it take > > >for these types of sores to heal? Is there a point at which the > Dr. > > >says yes, you need a healing cast, or how do they decide when the > > >sores are severe enough to warrant another cast? If the baby is > not > > >complaining doesn't this indicate that the shoes are on right and > > >then shouldn't that mean they will get better? > > > > > >thanks for any input! > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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