Children's Hospital Consultation Visit

I am SOOO glad this day finally came. After many months of worrying, fretting, crying, and coming to terms with the diagnosis of Cole's clubfoot, I met with the Pediatric Orthopedic Doctor at Children's Hospital who will be taking great care of our little guy and his foot!

First off, the Children's Hospital in Bellevue is absolutely stunning, and even has a Starbucks inside the waiting room (pretty sure I'll be hitting that up a few times!). From the moment we stepped in the office, the staff was amazing, smiling and helping to get everything set up. After being called into the back to meet Dr. Steinman I had peace about the whole situation as there were really only a few questions I had that were not answered by the numerous websites and research I had already conducted.

Since Mark does not have the time to take off work, my dad came with me as both a support as well as to make sure all his questions were answered about his soon-to-be-born grandson. Dr. Steinman first explained that in about 20% of the cases the clubfoot is actually what they call 'positional' and is correctable without any of the casting/boot-wearing/surgery. It will present itself just like clubfoot when he is born, but when we bring Cole in for the first time, she will make the exact diagnosis. The positional form of clubfoot has to do with where his foot has been located during most of the pregnancy in utero and can be treated with some mild stretching, whereas with clubfoot, the muscles and tendons are stronger on one side of the foot than the other.

I will make my appointment for Cole within 1-2 weeks after he arrives and if the determination is made at the first appointment that his case needs to be treated with the Ponseti method, they will put him in his first cast right there. From there it would be a cast change every week for 4-8 weeks (depending on severity), then they would determine if his Achilles tendon would need to be snipped (this is the case in about 50% of clubfoot cases), and then a final cast for 3 weeks. During this time he will have to be sponge bathed exclusively, and due to the fact that his cast will come up near his hip, we will have to watch diaper changes much more closely.

After the final casting he will be moved to the boot. The boot is actually on both feet and they are connected with a bar that will be adjusted to his growing body once a month (they keep it at the width of his shoulders). This is going to be a tough transition, and the doctor prepared me now that it will be a very rough first week with the boot. He will cry, a lot, but I can't give in as he needs to wear the boot 23-1/2 hours a day (other than for checking for sores and bathing) for the first 3 months. She did say that this could possibly delay him rolling over, but in the long run it should not affect any other physical development or milestone.

After the first 3 months in the boot full time, we will move to wearing the boot during nap times and bedtime until he is 4 years old. And again, around that time they will make a determination if another surgery would be needed that would move one of the tendons on top of his foot if the foot continue to turn in and regresses. This surgery would be conducted between the ages of 4 and 6.

The only other thing we will have to likely deal with is that in most cases, one, if not all of the following will be true:
* his feet will be different sizes, with the clubfoot being smaller
* the calf muscle on his right leg will be less developed and will be smaller than the left
* his right leg may be slightly shorter than his left
None of which should affect him severely, but may be something that he could potentially be self conscious of when he gets to junior high or high school. But, thank goodness for Nordstrom if it is the case that his one foot is smaller as they will fit his feet appropriately and not charge us for 2 pairs of shoes!

Dr. Steinman also mentioned that 2 famous 'clubfooters' are Michelle Kwan and Mia Hamm, so I know Mark would be happy to hear that his son could become the next Felix Hernandez down the road!

On a side note, I had my 34 week checkup on Monday and started discussing some of my concerns with my doctor about how quickly my delivery with Elizabeth went, especially after they broke my water (about 2-1/2 hours) as she mentioned it typically goes about twice as fast the second time around. She looked back at my progression of effacement and dilation with Ellie and said that what we may want to do is when I get to a point of showing that my body is truly prepared for delivery, to schedule a time to come in to the hospital to have my water broken here. As much as I would love to have my body do what it needs to do on it's own, the more I think about all of the variables from my blood thinners to Mark potentially not making it to the hospital if it happens during the work day, or having to deliver on the side of the road if my water breaks at home and there is traffic, having the option to schedule my water breaking might just be the best option.

All in all, I was very happy with both my appointments this week, and now, even more so than a week ago, I'm in countdown mode. All the important things are falling into place, a few more things to put up in his room, but his crib is set up, clothes are washed and folded, NB diapers are in the drawer, and big sister's overnight bag is at Nana and Papa's already. The car seat bases are going in soon and my bag will be packed in the next week or 2. Crazy to think it's almost here!