Tuesday, March 6, 2012

through the casting journey

so, now that we’re done with the casting part of this whole saga, I thought I should write up a thorough update about how the whole thing went. we’re nowhere near done with this whole journey, but at least the casting portion is done, so I can speak to that.
if you need some background information, or need to refresh your memory, I have several posts full of the information which led up to this point, and how I wound up yanking my 6 year old out of school early 2 days a week so she could walk around with both feet in casts. you can read those here, here, here, here, or here.
so basically, on february 2, layla got her first set of casts. at this point, her heel cords were very tight, especially the right, and even with her feet casted into a flexed position, she had to have a little ‘lift’ under her heels in her cast shoes, because they were not flat. they stretched her feet some, but not too much, because they didn’t want to make her too uncomfortable the first time around while she was just getting used to them. the casts took some getting used to, but she was so excited about decorating them, that it was all very exciting. she was able to walk without much difficulty, but was a little bit frustrated by how slow and clonky she felt – as well as the instructions to avoid puddles, woodchips, and sand… (so basically everything a grade school kid in western washington might encounter.) 033
after a couple of days, the novelty had worn off and the casts were not so fun anymore, but still not too much of a big deal. the following monday, we went back in for the next set. of course, this meant getting the first set cut off, and our first experience with the cast saw. that was a little intimidating, but turned out not to be a big deal.027029
her second set were also a colorful fashion statement, but these ones proved to be the most problematic. I think with this set, they gave her a good stretch first so her feet were really flexed inside the casts. this led to some restless nights and a little complaining about being uncomfortable. but really, it wasn’t terrible.032
after the second set came off, they had her try walking around in her bare feet. this was a little alarming for me to watch. she’d been wearing casts for 1 full week, and she couldn’t walk normally anymore! the PT assured me this was normal because 1) the floor felt really weird on her feet without anything on them, and 2) her leg muscles were really weakened from not having used them at all for a week.016
the third set of casts took very little time to get used to, and connie, our PT, was noticing a difference in layla’s posture already (which is why her dress is all wadded up and stuffed into the back of her shorts). before the casting, layla was unable to stand comfortably on flat feet. her posture was comparable to that of someone standing in very high heels. her back, her hips, and most of all her balance, was adjusted for standing on her toes. when she wasn’t on her toes, she couldn’t stand up straight. she had to stick her butt out and lean forward to keep from falling over.019
in general, the casts were just part of life, and didn’t really get in the way much.023172
set 4 – 2 weeks later. these ones were a breeze. she was running in them by the end of the first day.003
and finally, set 5. the final set. at this appointment, connie got the best stretch out of her ever. every week they would measure her foot flexibility to see how much progress had been made with each set. that right there, is the most flexed I think I have ever seen layla’s right foot. it’s still tighter than the left, which it has been all along, but so much better than when we started.013
layla’s final set of casts were both red, and got decorated with some fancy jewels and wiggle eyes, sent to her by her cousin. excuse my lack of artistic ability when drawing cats on casts… she didn’t tell me she wanted it to be a cat until I was half way through drawing it!015016
once again, you can see that she didn’t really let them get in her way… 001005
but we were all looking forward to the 21st. almost 3 weeks since her first appointment, the casts came off and didn’t go back on. we have moved on to some orthotics. also known as AFOs or braces. they go up her calf in the back, and wrap around her foot and ankle in the front. the allow for forward bending motion, but not for going up on the toes. these also took some getting used to – and are quite challenging to shove into her shoes. BUT, at least she can wear pants and socks and a regular pair of shoes.001003
of course the best part of not having casts on is getting to take a full-body bath! she has to sleep with the orthotics on, but can have them off for about 3 hours a day. this time period will gradually grow longer, and soon will be all night. eventually that time period will swap, where she won’t wear them at all during the day, but will wear them at night.005
so now we go to PT once a week, and she has stretches and exercises she has to do. 001003005
her walking is a little funky now, especially without the orthotics on. she limps a little, favoring the right. mainly because it’s still tighter than the left. her feet are trained not to go up on her toes, but because it’s a little tight, she kind of catches when she steps forward on the left, because that’s when she feels the biggest stretch on her right. if that makes sense. 003
but she’s been able to ride her scooter, and her bike without any issues. and you can see here, that foot is flat on the ground, mid-step.004
so at this point, it’s gait therapy, strengthening her leg muscles, and maintaining the flexibility and range of motion accomplished by the casting.
hopefully she’ll get to a new ‘normal’ soon, where she can run around comfortably, without even thinking about it.

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