Questions and answers: The Kid out of his cast

"How's The Kid getting on now that he's out of his cast?" Rachelle

After 2 months of The Kid having both legs - or sometimes only one leg - in a cast (and now 5 months out of the cast), we are doing really well. 

Back when the casting started, we didn't really know what we were up against. The Kid had a tendency to walk on his toes and his left foot especially was stiff to a point that even if he had wanted to, he wouldn't have been able to put his heel down. The point of the casting was to 'stretch' his feet back into a position and then with physiotherapy to 're-train' him to use his feet differently.

But once the casts were on, The Kid had an MRI done on his brain, his spine and his leg - to find out where the problem was originating from - and it turned out that it wasn't just a habit that was keeping him on his toes. 

Turned out, it was his brain that was telling his calf-muscles to 'tighten up' every few seconds, all day, every day - and kind of like you would, too, if you were trying to 'point' your toes out like a ballerina all day every day, after years of doing it his feet weren't strong enough to put the heel down on the ground any more. The calf-muscles were just too stiff. And so it turned out that rather than 'bringing' his feet back into a usual position with casting and then a bit of physiotherapy, The Kid was going to need all that and a leg brace.

Which is what he is wearing now.

I haven't got many photos of this thing, which is surprising given that he wears it every day, but most of the time it's not even that visible.

For one, if he is wearing long pants then it's underneath his pants. Two, if someone's looking at it from the front then they'll only see the straps. But here, I've tried to find some photos of it:






It's a mostly stiff plastic brace that is especially shaped to fit his foot, and by wearing it every day we are making sure that his foot can't go back onto its toes any more. The only times he takes it off is when he is sleeping or swimming (and lately, also when he is playing rough with daddy because when they're tumbling around the floor of the living room, turns out getting whacked on the head with a plastic brace is a bit more painful than doing it with a plain naked foot).

We do continue with physiotherapy, and we have been warned that as The Kid grows and his muscles lengthen, it may get harder to keep his foot in a good position - until he stops growing sometime around 20 years of age, anyway - but so far, it's working really well.

He has taken really well to wearing it - it's become a routine of ours, putting it on in the morning. He's also been able to choose his own design, which I think helps a lot because he is able to tell people about the helicopter he has on the back of his blue brace :).

But it's also wonderful because it doesn't keep him from doing anything.

One of the reasons I find it hard to get photos of his brace is that most of the time, he's in a position other than standing sideways to me. When he is running, biking and climbing, I am either too busy to take photos, or he's too fast or too far to take good ones, or he's facing me in which case only the front straps are visible.

Which is another thing: now that his feet are almost flat due to casting and the brace is helping them stay that way, he has grown in confidence in relation to physical challenges. He is able to climb things better, and he has better balance. I do a lot of physical stuff with him - the sort of stuff 4-year-olds like - and it's wonderful to see how much enjoyment he gets out of it, and how well it works in terms of his physiotherapy.

That's one of the things our physiotherapist said to us: that rather than doing 'special' physiotherapy exercises which research has shown people get tired of and forget, physiotherapy is now 'woven' into people's lives so that can accomplish these exercises as part of their daily life.

In our case, for example, I try to make sure that every day The Kid gets to walk on a balance beam somewhere (a wooden edge of a sandpit works), he climbs stairs (we go on walks in places that have hills and steps), he gets a wide variety of exercise (ie, we go to playgrounds a lot!), and he swims.

In fact, we are doing so well that for the moment our physiotherapist only sees us about once a month so she can keep her eye on us, but apart from that we just continue in our own rhythm and do our own thing.

As The Kid is growing it does mean that we need a new brace made every time he grows out of his previous brace - for example this one has lasted us a whole of 5 months and we're getting a new one this week - but apart from that there's nothing special on the leg front. Our hospital team did warn me that he may need another set of leg casts if the physiotherapy isn't enough to keep things in good condition, but having been through casting once already I am determined to do as much as we can to prevent the need for another set of leg casts (not being able to get wet - ie go swimming or have a shower! - alone was enough to put me off the idea!), but either way we'll just tick along and see how we are doing.

For the moment we are doing well :)

5 comments:

  1. How wonderful to hear that the Kid is doing well!

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  2. I'm so glad it's working for him and sounds like it's working well too!

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  3. Leidsin lõpuks vastuse, miks need kipsid olid.

    Paar kuud tagasi nägin kuidas TÜ kliinikumis tehti ühele lapsele, kes ka aastaid käis kikivarvul operatsioon, kus lõigati see kannakõõlus lahti, pandi jalg mõneks ajaks kipsi ja pärast fysiot peaks kõik ok olema.

    Olen ise praegu samas olukorras ja mul on see juba psühholoogiline probleem, mitte niivõrd füüsiline enam. Murdsin eelmise aasta septembris parema jala nii sääre kui pindluu seal pekse piirkonnas. Kõik oli nii sodi et kinnitati plaadi ja kruviga. 6 nädalat olin kipsis ja siis enam kand maha ei läinud, kuna peale oppi pandi jalg sirutusasendisse. Tulemuseks lühenenud säärelihas ja kannakõõlus. Taastusravi jäi hiljaks ja praegu mõtlen et selle vägisi kõndima surumise asemel oleks pidanud tegelema hirmuga, sest ma ei julgenud jalga maha panna ja kasutasin varbaotsi. Basseinis soojas vees läks kõik paremaks. Praegu ma ikka jõhkralt lonkan ja kui jalg väsib siis hakkan automaatselt varvastel kõndima. Peaksin väga tihedalt jalga venitama, aga 2 last, kodune majapidamine ja kodukontoris töötamine võtavad oma aja.

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    1. Selle kipsimisega on, jah, see asi, et erinevatel inimestel käib varvastel kõndimine erinevatel põhjustel. Kuna minu poisil kujuneb varvastel kõndimine sel põhjusel, et aju pidevalt "tõmbab" teda varvaste peale, siis temal ei ole eriti suurt mõtet operatsiooni teha ja kõõlust lõdvemaks lasta, sest isegi, kui me teeks operatsiooni - paari aastaga läheks jalg jälle tagasi varvaste peale. Opiga on ju see lugu, et teda saab ainult kaks, maksimum kolm korda teha - pärast seda jääb kõõlust nii vähe alles, et ei ole enam, mida "õhemaks" teha. Nii et hetkel me püüame senikaua, kuniks jaksame, kipsimisega tegeleda, nii et iga aasta on paar kuud kipsis. Kuniks ta kasvab, on kõõlus ju veel eriliselt suure pinge all, sest jalgade pikenemine "venitab" seda kõõlust pidevalt pikemaks ja kangemaks. Aga kui ta ühel päeval on täiskasvanud, ehk kusagil 20 aasta kandis?, võib operatsiooni proovida küll, sest see annaks talle hästi painduva jala, mida ta suudaks siis spetsiaalsete harjutustega heas asendis hoida. Aga praegu, 5-aastase mudilase peal, ei ole sel suurt mõtet...

      Küll aga tean ma teisi lapsi, kel on operatsiooni tehtud, aga neil käis varvastel kõndimine teistel põhjustel. Üks oli näiteks kerge autismiga, kus varvastel kõnd on üsna levinud "kõrvalnäht". Kuna temal ei olnud neuroloogilisi põhjusi, mis jala pärast uuesti varvastele "tõmbaks", siis temal oligi üks operatsioon, siis tükk aega füsioteraapiat, ja oligi valmis.

      Kuidas sa jala niimoodi ära murdsid?

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  4. Too laps seal telekas oli jah kusagil 15 juba, põhjust miks ta varvastel käis ei öeldud.

    Minu enda puhul on ka kõõluse pikendamise operatsioon viimane variant. Kogu selle värgi puhul on kõik segaseks teinud see, et mul oli 4 erinevat füsioterapeuti taastusperioodil, kes suht erinevat juttu ajasid ja mind see hullult vihastas, et mis see õige siis on. Lõppkokkuvõttes olid kõige paremad nõuanded mu sugulasel kes töötab ühes tipportopeedia kliinikus füsioterapeudina ja kes nägi mind vahetult peale haiglast väljasaamist. Ta aga elab Tallinnas ja mina Põlvas, karguga ei oleks olnud ka eriti mugav Talinnasse käia iga natukese aja tagant.

    Kukkumine oli aga eriti rumal - seisin mingi kipaka maalriredeli otsas ja üritasin õunapuud raputada, millegipärast pehkinud oksast. Oks murdus, mina kukkusin selg ees muru peale, aga nii kehva nurga all, et kogu oma keharaskusega jala peale.

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