Wednesday, March 23, 2011

2nd Casting

So it would seem at this point that I'm posting a summary at the end of a new 7-day period.  We'll see if I change my ways :)

It's St. Patrick's day!
Jonathan's 1st St. Patrick's Day


Removing the casts

Dr. Gamble showed us how to remove Jonathan's casts today.  This way we can give him a nice soaking bath the morning of our next appointment.  It was WAY easier than I thought.  I imagined using a saw or something to remove them.  It's easy.  You just find the end and unravel!

Me unwrapping his casts for the first time
Progression

Dr. Gamble said today that Jonathan's right foot is a little more stiff than the left.  It will just take some extra-correction positioning.  You can see in later pics here how his right foot was casted at a more extreme angle this time than the left.

Look at how much only ONE week of casting has progressed his foot position!  Amazing!

Look at how much more straight his feet are after ONE WEEK!
Look at how much more straight his feet are after ONE WEEK!
On goes cast #2
Not liking it very much
Mom swoops in with the bottle to calm him
Almost done!
All done.  Look how his right foot has been casted at a more extreme angle than his left.
One more shot after completion
Ready to go home with Mom

After care

It's been so hard to keep his cast and cast-socks clean.  He is a newborn pooping machine after all.  They gave us an extra pair of cast socks to take home.  Hopefully that will help.

 This week he was still cranky and uncomfortable for a few days after casting.  Low-dose children's Tylenol seemed to help.  Not nearly as bad as the first week.

 What's happening next

Tomorrow is casting #3 at Stanford.

In the morning, we're going to pull his casts off for the first time at home so that he can have his VERY FIRST tub bath!

Stay tuned....

Wednesday, March 16, 2011

The First Casting

I'm actually writing this blog entry a day before casting #2.  Having a 1-year old and a 1-week old in the house is tiring to say the least!

Driving to casting #1 - 3/9/11

Mary and I are driving to Palo Alto, CA to Lucile Packard Children's Hospital.  I'm imagining all sorts of procedures that will need to be done on Jonathan (x-rays, consultations, etc...).

I read some more forums online over the last few days.  Parents said that you baby won't be able to wear pants or footie pajamas.  No big deal.

We don't know quite what to expect and we're prepared for an ordeal today.

At the office
 
We arrive at Dr. Gamble's office on time.  The last time we were here it took several hours for just a consult.

To our surprise, we get in the office quickly.

Mary and Jonathan in the exam room

Dr. Gamble enters and we have a nice conversation about club feet in general again.  He mentions that it's great that the baby is here within a few days of birth and says that if you wait even two weeks to begin treatment, it becomes more difficult.

He examines Jonathan's feet and says "Oh yeah.  I can fix this.  This is a moderate case of club feet."

MODERATE!?!?  How can that be?  They look bent 90 degrees to me.  How can this be right?

Dr. Gamble says "It's not that bad, watch this..."

He then takes one of Jonathan's little feet and after a series of purposeful movements....BENDS IT STRAIGHT WITH HIS HANDS!

He says "That's it that's all there is to it.  No big deal."

Dr. Gamble goes on to explain our planned course of treatment:
  • 6 weeks of weekly casting and physical foot manipulation.
  • 6 weeks of wearing some brace 23hours a day
  • Keeping Jonathan in a brace at night until he's three if we can.
I know that things don't always go as planned, but if that's all that is involved, we feel very blessed.

Time to cast

Dr. Gamble again manipulates Jonathan's feet straight.  His assistant comes in and wraps one leg with a cast (I guess it's plaster) in about two minutes.  It's dry and hard in 5 mins.  Jonathan doesn't seem to mind.


First leg about to be wrapped

First leg done, waiting a minute to dry
He fusses a little bit between castings, but a pacifier and bottle seem to calm him down.

Second leg starting

After just a few more minutes, the casting is done.  They set his legs in a semi-bent pose.

All done!



They tell us that we can't bathe him in a tub.  Before our next appointment they'll show us how to remove the casts and give him a bath in the morning.

Total office visit time: 1 hour from check-in to walking out!

Care over the next week

The first two days were AWFUL.  He seemed to be in considerable discomfort.  He was up every 30 minutes crying and he was just inconsolable.  A call to LPCH provided some advice.  We could give Jonathan .4ml of Tylenol and after two day or so his feet should stretch and become more comfortable again.  This seemed to work.  At the time of this posting, we're on his 7th day of casting...he seems to be much more comfortable now.

The casts haven't really been a big deal.  Mary even is able to fit pants over them so no one notices.  It's not that I feel the need to hide his condition, it's more that I don't want to answer the same question from a million strangers.  Still, we've gotten a few interesting looks from people...but only a few easily-fieldable questions.

We took him to his 1-week follow up Pediatrician appt today.  He is 8lb, 8oz.  ( up from 7lb 5oz last week) Of course, we have no idea what he actually weighs due to the casts.  I'm going to try and weigh them tomorrow after removal.

Cleanliness

It's hard keeping casts clean on a 1-week old baby.  They poop about a MILLION times a day!  There are a couple of brown splatters at the top of his casts, but I have no idea what we could have done to prevent that. So far it's also just sponge baths for the little guy.

One more night of sleep for Jonathan before they bend his feet and re-cast tomorrow.  For now, he's sleeping soundly...in footie PJ's. ;-)

12 hours to go until casting #2

Tuesday, March 8, 2011

He's HERE He's HERE!!!!!!

Jonathan Bryan Lynch was born on March 4th, 2011 at 6:41PM.  

He was 7lb 7oz and 20 inches long!  I'm so excited!

Jonathan moments after being born with Dad


My wife and I are so happy that our beautiful son is finally here with us :)  He has been perfectly healthy except for a little jaundice that should go away.  Also, the stork left him with a very small "Stork Bite" on his forehead.

He is a little more fair-skinned than I am and I think he looks more like my wife then me. (lucky kid lol)

I was pretty nervous to see Jonathan's clubbed feet for the first time.  I know I shouldn't have been, but that's just the honest truth.  In reality, they really are not anything shocking to look at.  I also noticed that his calf muscles seem to be pretty small.  Apparently this is a normal symptom of having club feet.  The good news is that they won't stay small forever, he will build them back up through normal exercise over time.  The doctor even mentioned that in some cases it's better to have two clubbed feet instead of one, so that the calf muscles will be the same size.

One funny thing that I've noticed is that since they're turned inward, he seems to use them to grab on to things.  It's pretty cute :-)

Meet Jonathan:


And here's a close up of his little feet on Day 1: 

Bilateral Club Foot

Learning to answer questions 
One of the things that I was told to get used to was the answering of questions from people all of the time.  So far, we've been at home and not really had little Jonathan out anywhere, so I imagine that's to come.  That being said, even in the hospital, as each nurse would come on shift I could see their reaction.  They walk in to check on the baby in room 2xx.  They see his feet, feel his feet, some try to move them straight and then invariably they say "Are you already aware of his feet?"  "Do you have a doctor to talk to?" or "I think there's something wrong with his feet."

I calmly explain that we've known about it for months and that he has a treatment plan already set in motion.  That's usually the end of it.  After 4-5 times I started to get annoyed, but then I realized that being annoyed would serve no purpose.  I think it's better to talk about it and be open in discussion and I feel much better for doing just that.

Aftercare:

I just want to say how very fortunate we are to have a daycare provider that is so wonderful.  Julie runs a great program and she has become like a member of our family.  I don't worry one bit about her caring for my son on the days when my wife and I both eventually have to go back to work.  Jonathan will be making his first trip to Julie's house today to meet her and to discuss what's to come.


First appointment with Stanford:

Jonathan's first appointment with Dr. Gamble at Lucile Packard Children's Hospital is this coming Wednesday, March 9th.

According to our last consult with Dr. Gamble they will place his first casts on his feet at this appointment.  Cross your fingers!