New brace

Once the decision to continue bracing had been made, we had to gather a few utensils before planning another Skype appointment with Jerald to take Jonas's measurements. Since we were looking to avoid the trip to the US, we needed a seamstress tape measure and calipers to get precise measurement of Jonas's leg, tibia and foot (length, width and thickness).

Easter came and went, soon followed by Jonas's second birthday. Needless to say that the boy was spoilt rotten with a day trip to a local petting farm and more presents he can actually play with!

His new brace arrived on 24th April. It looked soooo CLEAN!! I'd actually forgotten it was meant to be bright white, not greyish 😅. I was eager to know whether it would fit or not. It looked just as small as his current one and pretty tight.

I knew the plastic would obviously stretch but I wondered why the brace wasn't any wider than the other one. Due to the time difference and Jerald's busy schedule, I couldn't get a hold of Jerald straight away so decided to slip it on and see.

I struggled a bit and had to take away most of the padding Jerald had stuck to the lower spiral, but eventually found a way and the fit looked absolutely perfect. The brace is a lot stronger and easily got Jonas's foot to those 45° external rotation we were aiming for, whilst not bothering him in the slightest.

I took a few pictures and sent them to Jerald. 

A few hours later, I got a reply, saying that indeed the brace looked perfect, and I should get Jonas used to the new stretch by using the brace a few hours here and there over the next few days, before going for his normal nap and night-time wear schedule.

Ooooops... Jonas had been asleep for a good couple of hours then...
Oh well... From day 1, back at the end of November 2016, the brace became a simple extension of his leg, I guess the added stretch must not have felt uncomfortable to him, he slept through his usual 12 hours and woke up with a smile.

Finding Our Feet: Bracing progress and daily routines

 The other day, our orthopedist said the goal of clubfoot treatment is to get a functional foot that can  fit properly into a shoe without pain. He said, at this point we'd reached that goal and Pearl could comfortably wear shoes.

Shoes.....I donated all of her shoes after we learned she had clubfeet. I knew she'd be in casts until she was three months old and braces 23 hours a day until she is about 1 year old. And then she can wear shoes because bracing will only happen while she's sleeping. But even then, I wonder if we will use reverse last shoes, which are specifically made for children with orthopedic issues. I wore them for in-toeing when I was a toddler. These shoes will help keep her feet turned outward, one more intervention to hopefully prevent relapse.

We traveled half way across the US for her
casting, tenotomy and braces. Her feet came out of casts in December and I was heart broken when I saw them. I knew right then that her feet weren't fully corrected. Her feet are atypical and she is at greater risk for relapse and failed treatment. Traditionally, a child in her situation would have additional stretching casts and another tendon release. I asked if we could see if the brace could be modified to continue to correct her feet. While it isn't advisable to brace when feet are not fully corrected, we did it anyway. Ultimately it was our decision. The x-rays show that the brace is working! Her bones are aligning properly and there is less flexion in the mid foot. She still has creases on the bottom of her feet. I suspect those will be there for several years. But her feet are pliable and have great flexibility. When the braces were made, she had 5 degrees of dorsiflexion in her right foot and 0 in the left. She is now at a 12 in the right and 7-10 degrees in the left. The braces were modified to facilitate the realignment of her forefoot and mid foot so that the entire foot will position properly under the tibia.

She is learning to stand and starting to take her first steps in the braces and out of the braces. We see a physical therapist once a week and we do massage and stretching/exercises 3 times a day.