The first appointment: a step in the right direction 

When our baby, June, was 17 days old we took her to the Nationwide Children’s Hospital in Columbus. Though barely over two weeks of age, June was already older than other babies going in for their first clubfoot treatment– with this particular medical challenge the sooner treatment starts, the better.

The appointment did not start off on the right foot. We were two very stressed out parents with a young baby who did not appreciate waiting around at a hospital and made sure we knew it. We had brought toys that jingled and squeaked that we relentlessly flittered around her, we were prepared with a pacifier and a bottle, but still, despite our efforts, being told to undress the baby down to a diaper in a chilly examination room, on a hard table, and then being made to wait over forty minutes for a med student to come in and ask us what brought us in was not our idea of a quality hospital experience.

My already stretched out patience given the usual lack of sleep that accompanies caring for a newborn and postpartum depression compounded with the additional stress and emotional turmoil that comes from dealing with an unforeseen medical condition were not receptive to the lack of organization at the hospital. Having attained a Masters degree in a business field,  snippets of text from my many courses in corporate structure , HR management,  customer service management,  and process streamlining,  all of which were lacking at this hospital ran through my mind.  While,  granted, a hospital is not a corporation, there are similar elements,  especially in the US where healthcare is so heavily paid for by “clients”. But that’s another post for another time. Back to cold,  naked baby.

  1. Seeing baby shiver in just a diaper on a hard table while waiting almost an hour to be consulted by a med student/resident/whatever he was, not even a doctor, was just adding insult to injury.
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    June at a casting session, wrapped up in blankets, with toys and trusty binky!

    Takeaway: parents, bring a blanket to put under the baby, and one to put over the baby. For the love of your sanity, bring toys that make noise and anything that will soothe baby (a pacifier and bottle work wonders).

 

  1. Said med student/resident/whatever-he-was-but-not-a-doctor asked us what brought us in (so I guess no one read the file in which we were referred to the specialist due to clubfoot) and after being told of the anomaly asked us if we had any concerns (excuse me, did he not just hear the part about clubfoot?). Patience is a virtue, patience is a virtue, patience is a virtue… 

 

  1. Finally the doctor came in and the whole procedure proved that it was completely unnecessary to undress the baby to just a diaper… Takeaway: dress baby in a shirt so that you can remove the bottom half of baby’s outfit to let the doctors work while baby doesn’t freeze up top. Also, make sure you bring another outfit and lots of extra diapers, as the casting material is messy, and no matter how good the technician is, that substance will get on baby’s clothes, will harden, and will become scratchy. On that note, clean baby thoroughly with baby wipes or towels soaked in warm water or the material will dry on baby’s skin and will pinch.
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June waiting for her fourth pair of casts (approximately four weeks into treatment)
  1. You may want to weigh baby at each appointment before the casting is done so you know baby’s real weight.  You can tell the pediatrician an accurate figure  (weighing baby with casts is irrelevant). Ditto for measuring her length as the casts keep baby’s knees bent at a pretty sharp angle.

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All this being said, we got lucky with the doctor who seemed well versed in the condition and comfortable with the procedure. He told us that the casting was completely necessary, and that we would go ahead and schedule a casting session every week for seven weeks (the last week just in case June would be not as responsive as hoped to the treatment) after which it would be absolutely necessary for baby to wear the brace as directed (directions to come later). He said that a majority of babies would need a small tendon release surgery after casting and a small percentage who were very unresponsive to treatment, in a few years, would need a tendon transfer operation (this part was downright traumatizing to me, though my husband urged that we not stress out before the time comes).

On the whole, though this doctor was much less blunt in his demeanor than our pediatrician so the news did settle slightly more gently over us, the prognosis was definitely that we were in for a long time of treatment and continuously demanding schedule to recondition her feet. There was no negotiating, the casts would be thigh high so as to avoid baby turning her ankles, and the procedure would be followed exactly so as to hopefully avoid more serious measures in the future (namely, the tendon transfer surgery).

So, we made it through the first appointment; and I’m not going to lie, I did cry as I looked at my baby after all the doctors and nurses had left us to dress her and take her home and examined her slight little frame in the bulky and rigid casts.img_0087

I wondered how all the great minds this world can boast had not come up with a better method of treating this deformity. The Ponsetti method (this method of casting and braces) is over sixty years old, and still the same technique is being used. I thought to myself, I wouldn’t buy a sixty-year-old car, or the ancestor of the computer, so why buy into a procedure that is so old? It seems so antiquated, the whole rigid, heavy, restrictive cast idea, is there really nothing better? Turns out the answer is no. Humanity has come up with methods to pretty much wipe out modern civilization at the push of a button, but the Ponsetti method hasn’t been revised yet. It seems horribly unfair, and a very bad review for humanity in general for prioritizing the way it has, but not being doctors or scientists, there was nothing my husband or I could do about it.

We took our baby home and dealt with it because in the end it was the only thing we could have done. Leaving our baby with a crippling deformity was not an option, so treatment it was. And that lack of choice, honestly, was my main comfort. This was it, this was the only way to proceed, so proceed we did.

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