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Clubfoot
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Progress of Heather Amy's Feet

Heather Amy was born with Clubfoot (Bilateral Talipes). Thankfully, we were expecting it after having it picked up on the 20-week ultrasound scan. Even we, with untrained eyes, could see that something wasn't quite right with her legs. The radiographer wasn't all that forthcoming. The midwifes tried their best to explain things at the next appointment, but none had experienced the condition before. The paediatric consultant, however, was downright thoughtless. Briony had to go and see him after the diagnosis, and he put a lot of pressure on for a second scan so we could 'consider a termination'! We were horrified at the thought, despite the fact that we didn't really know what talipes was (no one had told us). I wasn't with Briony at the time, but thankfully her mum was.

We did quite a bit of research on the internet, mainly to find out what talipes was. There's a few sites we found, the most useful being www.clubfoot.co.uk and the Yahoo groups nosurgery4clubfoot and clubfoot. We also spoke to family and friends about it. We were surprised, and comforted by the fact that some people we knew had been born with the condition – proof that it certainly was NOT worthy of termination!!!

We had read a bit about the 'Ponsetti method' for treating clubfoot, and had decided to pursue getting Heather treated this way, through the company health scheme. However, we were blessed with a wonderful Physiotherapist, Steve Wildon at Lancaster, who was already practicing the Ponsetti method, with excellent results. We've since found out exactly HOW blessed we are: Many people either don't have access at all, or have to travel hundreds of miles for the treatment. Steve has a couple who travel up from Kent once a week, whereas we've got a half hour trip if the traffic is bad.

Back to Heather's treatment! Steve came over when Heather was about two hours old to see Heather, and have a short chat with us both (through a bathroom wall to Briony!). Then Steve and I took Heather over to the hospital plaster room, where she had here first casts applied. These casts were a water-cured epoxy bandage applied over a cotton tube sock and cotton wadding. I think these first casts were the easiest to apply – it only took three of us to do it!!

Two days later, we were all ready for Briony and Heather to be discharged to the care of the Midwives at Helme Chase in Kendal. Unfortunately, Heather had other ideas. Just after the nice paediatrician came to check them both over, she decided to escape from her right cast. This was probably a sign of things to come!! The cast she escaped from has been turned into a little memento, mounted on a wooden plinth with a little plaque. It makes a change from cross-stitch samplers or painted plates.

Since we were finally released (probably not the right word!) to Helme Chase, we've gone back down to Lancaster to see Steve. Until six weeks of age, Heather had new casts each week.

 

After the last casts came off, Steve taught us 3 exercises to do with Heather's feet. These we did every nappy change at first, and gradually got more frequent. She thinks its a game, giggling and gurgling through them. We usually sing to here whilst we're doing them, or count.

Steve attended a training symposium in Manchester, run by Dr Dietz, a colleague of Dr Ponsetti. There they mentioned the preferred treatment after casting was to perform a tenotomy (cutting the heal tendon) and wearing a Foot Abduction Brace (FAB) for 23 hours a day for 3 months. Steve ordered a FAB from a company in Germany, and this was given to us on October 31st 2002. As the progress using just exercise was good, not just with us but all Steve's patients, he does not feel a tenotomy is required.  The FAB is worn just at night, as long as we keep up with the exercises. This really helps a lot – we get a HUGE grin when it comes off in the morning and she realisises its off! She takes after her dad, taking a while to come round and notice things!

One of Adrian's Aunts knitted several clothes for Heather. One of these was a little sleeping bag, which proved invaluable. It's virtually impossible to wrap Heather in a blanket when she's wearing the FAB, and so this means we can keep her a little warmer, which anyone who's visited the lake district during winter will appreciate!  As she grew, we moved into larger and larger snuggle sacs.  Now she's happily in a bed with a duvet, it's not such an issue.

Since Heather started walking around her 1st birthday, we have continued to do the exercises but less frequently.  She's not needed any further treatment, just a check every few months and new boots as she outgrows the old ones.

The best thing is that to the untrained eye, Heather is a perfect little toddler!  She's usually a really happy little soul, and gets even the grumpiest teenagers on her side!


After 4 years, the treatment seemed to be over!  Heather no longer had to wear the FAB at night.  Since the boots came off, she's slept better, which is really helpful!

In February 2007, Heather's right foot began to relapse.  Her movement became a little more limited and she was beginning to walk on the outside of her foot.  She was given some special lilac boots to help correct this.  All seemed to be going OK with these and nightly stretches.  However, in September her right foot started getting worse again.  She is now booked for surgery in early December  This will involve cutting the tendon at the rear of her heal and a tendon transfer at the front of her foot.  She'll be in pot over Christmas.  In some ways it means she'll get more attention than she would, as she's also due to become a big sister the day before her surgery.  Couldn't have been timed better!  She's being very brave about it all.

Heather and her parents would like to extend a huge THANKYOU to Steve, the LRI plaster room staff and the Paediatric Physio department at Westmorland General Hospital!

We would encourage anyone who's discovered their baby is going to be born with talipes to investigate the Ponsetti method!

Copyright © Adrian North 2007