Thursday, August 9, 2012

Clubfoot Files: The First Cast

Motherhood has a way of making your heart grow and expand in ways you never thought possible, but also makes it ache in ways you never fully understand.  While you are still yourself, you are someone completely different. It's no longer about you - it's about that little girl who you want to never take your eyes off of or ever let go of (well, as long as she's not screaming :) ).  It's about the cries you wish you could stop with your own tears.  You do silly things like forget to eat or stare at her breathing or catch spit up with your hands.  If you're crazy like me, you have a moment while still in the hospital where you imagine your little girl grown up and having her own babies and you tear up wanting to stop time already.  It's already flying by too fast.

Friday was a hard day for me.  We had our first visit with Children's Orthopedics in Atlanta for Harper's clubfoot.  After her birth, we saw that indeed her foot was turned in, and although the pediatricians (ie - NOT ortho specialists) said they thought it was positional (meaning, it was caused by how she was situated in the womb, not a genetic issue) since it could be manipulated, I tried to not get my hopes up that we would get some sort of abbreviated treatment diagnosis.  

I knew it was a possibility that she might get her first cast on at that first appointment, but I guess I was just trying to pretend nothing was going to happen at all.  The night before the appointment, I was upset.  While Harper has been a great baby, we are still trying to figure out what works for her and how in the world to care for a newborn.  I didn't want the compounded issue of a cast that we would have to figure out how to deal with.  I didn't want to deal with the stress of driving to Atlanta and figuring out when and where I was going to feed her and what stuff I needed to bring.

But mostly, my heart ached for the little leg and foot that I wouldn't be able to touch or rub or even see.  I hadn't gotten enough pictures.  I hadn't kissed her little toes enough.  I hadn't snuggled my baby in my arms without the interference of a hard cast for long enough.  My heart wasn't ready.

We got to the appointment and met her newest doctor.  He was very nice and took the time to explain everything to us.  He even trained with the doctor who invented the modern treatment for clubfoot.  While we knew most of what he told us, it was so nice that he spent the time explaining it all and answering my questions.  I felt like a somewhat capable mother, since I did have some educated questions to ask and wasn't going in there completely blind.  After a quick look at Harper's foot, he confirmed the clubfoot and told us that regardless if it is positional or not, it doesn't affect the treatment process - it's all corrected the same way (which I described in detail in this post if you are interested) and there is no real way to determine what caused it.

He confirmed we would have to get weekly casts put on for the next six weeks or so, followed by a tenotomy (they have to cut the Achilles tendon to allow the foot to move more naturally - apparently it grows back on its own and is a relatively easy surgery).  She will then be put in boots connected by a bar that she will wear for three months, 23/7 (she gets an hour break a day).  From that point on, she will wear the brace only during sleeping times until she's about 4 years old, depending on how her foot responds.  The casts sound bad - but really, that's the easy part.  The hard part is the brace, which will require Tony and I to be extremely diligent to ensure she doesn't relapse.  After explaining it all, he said we could start the first cast that day.

He left the room to get the needed supplies, and I immediately began to cry.  I quickly took this one last picture of her little legs.

There was just no holding in the tears.  I know I'm raging with hormones right now, but I was just so sad to know the process was beginning - that her little foot would be hidden for the next few months and we were all in for a bumpy road.  I cried and cried, feeling silly as the nurse gave me a little hug.  Harper cried, but mostly because she was getting messed with.  She wasn't in pain and was definitely happy to get a few minutes to suck on her pacifier treated with some sugar water (an awesome nurse gave us a stash of those things at the hospital since we had to get so many heel pricks for her jaundice testing).  We haven't used it at home - it will just be for emergencies like getting a tiny cast put on :)  The doctor did a traditional plaster cast on just the foot itself, then covered that and the rest of her leg in the soft cast material (that's actually still hard, but I guess not as hard as the plaster kind... more so nylony).  The soft cast can be peeled away for removal, but the little plaster cast will be cut off (with a saw...).  At least it's just a small one - and bonus points - we get to keep it.  That will be fun to show her one day.

She seemed a bit fussy that day and the next... but really I don't know if that's just the unrelated product of her getting older or what.  The cast is pretty loose at the top -  I can stick my finger down in it, which I like - and she doesn't seem to be bothered by it rubbing when I hold her up against my chest.  Nursing is a little trickier, just because she's a little more unwieldy.  I was worried her other leg would get scratched up from it, so I had a little legwarmer on it the first day. However, it doesn't seem to rub at all so I stopped that.  Her toes stick out of the bottom and we can check to make sure they're getting proper circulation by pressing them.  

All in all, the first cast wasn't too terrible, although the doctor did warn us that subsequent casts are sometimes more uncomfortable for the baby, since the skin under it becomes super-sensitive over time from being covered up.  Can't wait.

Oh hey!  I'm ok!

The aftermath... days later...

It was certainly worse for us than it was for her.  While my head is telling me I'm glad the process is begun so she will be healed sooner, my heart just aches for my little girl.  And perhaps just a little for myself.

Check out all of my other Clubfoot Files posts here!


  1. Oh Claire! I'm so sorry that you guys are having to go through this. Everything you said about motherhood is spot-on. We took Katherine for her 2 month shots and despite the fact that I work in medicine! And I love vaccines! My heart completely broke over my little girl having to get those shots. I'd be a wreck at the ortho, too!
    You're amazing parents, you're doing the right thing, and I'm sending lots of love your way.

  2. Claire, you have such a big heart! I'm so sorry that this has already begun and caused a pain for you. Harper is still just as beautiful as ever and you still have your sense of humor [poop]. :)

  3. I'm so sorry you have to go through this. Motherhood is so tough, and adding something like this to it just makes it even tougher. She is duh a beauty, just like her momma. Hang in there.

  4. I love this sweet little baby. I can't imagine your emotions watching her get casted...but rest in knowing that it is harder for you than it is for her. She is such a trooper and is going to rock these casts!! And you are going to be the best support for somebody else some day who needs a resource for going through something like this.

  5. I can't imagine what you and Tony are going through with the whole process but I can hope that Harper will recover swiftly and beautifully. I think it's important to remember that this won't last forever -- thank God! Will be thinking about you guys!

  6. Did she eat less on the first day ?

  7. Hi there.. I know your thread is a little bit older, but at my 20 week ultrasound I was told our daughter also had a unilateral club foot (the right foot also). I have another 4 or 5 weeks to go yet so I'm still trying to take it all in but your first experiences finding out sounds pretty much dead on to what I went through when they told me. Yes, it's only a foot but she can't wear shoes?! How can my little cute baby girl not wear pretty little shoes on her pretty little feet?! And casts and braces?! It's not fair, I said that over and over again.. Why me.. Why us.. Why her?! It's not fair.. but then I realized like you said, "It's only a foot!!" Thankfully it's only a foot and we are blessed that this is the worst we have to overcome with our precious little girl. I will continue reading your stories as we go through our adventure with our own daughter and you have inspired me to do my own blog to help other moms who are as confused, scared and shocked as we were when we first found out. Thank you for this. :) And good luck with everything as you go on your journey with your little one!!

    1. hi there! nice to meet you!! it's certainly a difficult transition process to come to terms with it all, but once you start the treatment process you will see that it will go much more smoothly than you might imagine. good luck with your treatment process and congrats on your little one!


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