Today Eli is doing much better with his casts. He gets frustrated a lot less when he tries to pull his knees up to his stomach. Moving his legs up and down (with the extra weight) seems to be a lot less difficult for him - no chicken legs there; they are strong!
When Eli is done eating, he is definitely done eating, and he won't be swayed to continue if he's full. He tends to imitate Will Ferrell imitating "W" - lips pursed in as tight and small as possible. We haven't been able to catch a picture of it yet, but we'll keep trying.
This morning Lehr and I took Eli for his first visit with the pediatric orthopedist. He got two 'soft' fiberglass casts put on; he was NOT happy about that. (Or maybe he was unhappy because lame-o white was the only color he had to choose from, instead of red and blue, as originally planned.) Eli was fine while the doctors were assessing his legs and feet, but as soon as they started to apply the first cast he started to wail. It was hard to see him fussing so much, and now he's extremely frustrated (probably because he cannot pull his legs in and out), but it's for the best, and I know he'll adjust in a few days. Upon the initial assessment, Eli's legs, hips, and spine appear to be fine; they are only concerned with correcting the feet. They plan to do six casts and a tenotomy on each foot (small procedure where they cut a tendon to release tightness), and then shoes/bracing.
Today Eli had his newborn appointment with the doctor. He weighed 7lb. 6 oz., so he's only down 2 oz. from birth. He also measured at 20 1/2 inches today, so he's either already 'stretched' one inch, or there is just a discrepancy between the person who measured him at the hospital and today. He did really well at the appointment; the only time he cried was when the nurse pricked his foot for a blood sample. He is changing so much already - his neck and leg muscles are already crazy strong. Tonight we're going to try on a bunch of Eli's clothes and take pictures. It's less about a fashion show and more about keeping him awake. We kept him up more last night before we went to bed, and it was WONDERFUL for me because he slept two nice sets of two hours (which means I got to sleep two long sets of two hours). I feel as though I could run a marathon today!
David and Carolyn came over and brought dinner tonight. There was no dinner conversation as all parties present did nothing but stare at and comment on the 'bay-bee'... Lehr and I asked Dave and Carolyn to be Eli's Godparents and they happily accepted. Now Carolyn is the 'Fairy Godmother' she always wanted to be.
After a brief check-out at the hospital, Lehr and I brought Eli home today. His ride home was uneventful (he slept the whole way), as was his first day (again - the sleep). We are SO excited to finally have him home! I can't be sure, but I think he approves of his new living space.
FINALLY HE'S HERE! Friday night my parents flew into town to join me in waiting for the Hulk to arrive. No contractions or anything Friday or Saturday. We went to bed around midnight Saturday night planning nothing more than church for the next day. However, the Hulk had other plans... I woke up at 2:00am for one of my routine trips to the restroom and my water broke. I called my doula and midwife and they told me since the contractions had just started to labor at home as long as I wanted (or as long as the contractions were at least 3 min. apart), and then head to the hospital. Once they started, they never let up, and they were mostly in my back (lucky me!). I labored on my own for almost two hours and then gave Lehr a wake up call at 3:30am because the pain was starting to get a little intense and I knew I'd want to head to the hospital within the hour. He showered and loaded up the car (by then the pain was very intense), and we arrived at 4:30am. We were admitted pretty quickly and my doula arrived right after us. The nurse checked me and I was dilated to a 7 and fully effaced. The midwife was called and things started happening really fast. I remember not opening my eyes from the time I entered the labor and delivery room until he was born, and I remember screaming a lot. Lehr had to fill in some of the other details for me. There was a time right when I started pushing when the Hulk's heartbeat dropped a little too low, so the midwife paged the doctor. I remember her telling me that she paged him, but she wanted me to deliver before he got there. I didn't, and a c-section was discussed. Fortunately, the midwife had me change my position (several times), and his heartbeat picked up immediately. Unfortunately, I had to push for 90 full minutes thanks to Eli's posterior positioning - that was not fun. I was very lucky to have Lehr and Stephanie (doula) there to help - they kept giving me encouragement from opposite sides of the table throughout the entire thing. Without them I would have never been able to deliver 'au natural'. The Hulk was posterior (sunny side up), which caused a LOT of back labor/pain, but that was nothing compared to the pushing (I think I gave everyone in the room a splitting headache!). At 8:20am I opened my eyes briefly and the midwife said I'd have the baby within 10 minutes; she was right! At 8:28am with one final push, Eli was born. He was very healthy (apgars: 8/9), so they let me hold him right away for about 40 minutes. His feet were clubbed (as expected), but everything else about him is perfect. Lehr and I stayed at the hospital exactly 48 hours before we brought him home.
At my 20-week ultrasound, the OB/GYN noticed that Eli's feet were turned in. She suspected clubfeet, but sent us to a maternal-fetal specialist to verify. Although we'd never considered this possibility, I was born with my left foot 'clubbed', so in hindsight, it should have been expected. The specialist confirmed bilateral clubfeet, and ordered a monthly ultrasound to monitor the situation and to ensure there were no other skeletal deformities. Luckily, Eli's condition is very treatable, and he should walk right on schedule with other kids his age.
We are following the Ponseti method of treatment (non-surgical), which includes approximately 6 sets of casts (applied once a week), followed by a likely procedure referred to as a tenotomy (clipping of a tendon to release tightness in the heel) and one final set of casts, and finished off by temporary use of a foot abduction brace (a bar worn between the feet to keep them turned out). This bar was worn for 23hours/day for the first three or four months, and as Eli's feet improved and he gained mobility, the time spent in the bar was decreased so that it was worn only during nap/sleep times.
At four years old, Eli only wore the bar/shoes for 10-12 hours at night while he slept. He played soccer, ran like a madman, rode a bike and played baseball. The only limitation we'd found was in his jumping skills: he does not appear to have a lot of strength in the feet/calves to jump, must like I experience on my left (clubfoot) side. But Eli doesn't seem to notice any issues at all. If you ask him, he'll tell you that he can touch the sky when he jumps...
Eli is now seven years old and he's still very active and on-the-go. In the last few years he's played soccer, baseball, competed in swimming, dabbled in gymnastics, and run a few races including a triathlon. However, we have noticed some signs of relapse in the last 6-9 months. Eli tends to walk on the outside of his feet and often doesn't touch his heel all of the way down when using stairs. Even though we've tried doing extra stretching at home, there has not been an improvement in this area, so we are starting PT and night-splints.
There are links on the front blog page (to the right) to a few websites, should you have any questions. The following are video and pictures documenting the progress made on Eli's feet.
Below is the same video I've had on youtube for years now; the video and pictures of Eli's progress have been used in Dr. Ponseti's famous office (Eli cameo at 4:05) as well as in presentations on clubfeet.
Here are Eli's feet the week after he was born (before any casts).
Eli's first casting, 08/29/05, just 8 days after he was born.
Eli's second casting (before and after) 09/08/05
Eli's third casting (before and after) 09/14/05
Eli's fourth casting (before and after) 09/21/05
Eli's fifth casting (before and after) 09/29/05
Eli's sixth casting (before and after) 10/05/05
Eli's seventh casts removed (3-weeks post tenotomy); Denis Browne Bar applied: 11/02/05
Eli in the first 2-weeks after beginning the bar: November 2005 (DBB 23/7)
Eli 2-months after beginning the bar: January 2006 (DBB 23/7)
Eli 5-months after beginning the bar: April 2006 (DBB 20/7)
Eli 8.5-months after beginning the bar: July 2006 (DBB 12/7)
Eli over 1 1/2 years after beginning the bar: November 2007 (DBB 12/7 - only during night sleep)
Eli over 2 1/2 years after beginning the bar: October 2008 (DBB 12/7 - only during night sleep)
Eli over 3 1/2 years after beginning the bar: August 2009 (DBB 12/7 - only during night sleep)
Eli over 4 1/2 years after beginning the bar: August 2010 (DBB 12/7 - only during night sleep)
Eli over 5 1/2 years after beginning the bar: August 2011 (no DBB)
Eli over 6 1/2 years after beginning the bar: August 20012 (no DBB - starting to see some possible signs of relapse)
I had my 39week appointment today. My progression is the same, so the midwife is assuming the only thing holding the Hulk up is a possible posterior positioning (sunny side up). She gave me a few exercises to do to 'coax' him into turning, but they are the same ones I've been doing throughout my pregnancy, and they haven't worked yet! As of today, I'm giving the Hulk an eviction notice: AT EXACTLY 1 WEEK FROM DUE DATE, I AM HEREBY POSTING AN EVICTION NOTICE. HULK, TENANT, WILL THEN HAVE 7 DAYS IN WHICH HE CAN EITHER GATHER HIS BELONGINGS AND PROMPTLY VACATE THE PREMISES, OR WAIT UNTIL THE FINAL DAY, AFTER WHICH HE WILL BE PHYSICALLY REMOVED FROM THE PROPERTY. HE IS BEING EVICTED DUE TO BREECH OF CONTRACT AND DESTRUCTION OF PROPERTY. EXPANSIONS ONLY TO THE FRONT OF THE HOUSE, WITHIN REASONABLE LIMITS, WERE DISCUSSED. NOT ONLY HAVE THESE LIMITS BEEN EXCEEDED, BUT INFRINGEMENTS ON THE HOUSE WERE ALSO MADE. REMODELING AND GUTTING OF THE HOME WAS NEVER APPROVED, NOR WAS CHANGING THE INITIAL LAYOUT AND BASE STRUCTURE. DUE TO PROPERTY DAMAGE, THERE ARE WEAK SPOTS IN THE FOUNDATION. ANY FURTHER PROBLEMS WILL RESULT IN IMMEDIATE AND FORCEFUL REMOVAL.
We went for the 38week appointment today and they sent us home; not to the hospital... I probably jinxed that though because about a month back I made all of my weekly appointments in advance, through today's appointment only. (I thought there was NO WAY I'd go past this appointment.) As of today, I am at 3-4cm, 80% effaced, so we've made a little bit of progress, but not enough. The midwife we met with today also had her baby au natural, so she seemed very supportive of my choice, and said my progress to date is very encouraging. Also, the Hulk is estimated to weigh 6lb 9oz.
Carolyn was nice enough to take me out for an eggplant parmesan dinner afterwards, to try to get things moving - we'll see if this old wives' tale works!
We had the 37.5 week appointment with the midwife today. I'm still at 3cm, 70% effaced. I've been having all sorts of contrax this last week, but they haven't 'worked' I guess. They gave me a non-stress test, just to make sure everything was fine and to make sure the Hulk's heartbeat was doing what it should when he moves and when I have contrax (it is). The tech made the comment that he was very active...trust me - I'm aware!
y Eli is doing much better with his casts. He gets frustrated a lot less when he tries to pull his knees up to his stomach. Moving his legs up and down (with the extra weight) seems to be a lot less difficult for him - no chicken legs there; they are strong!
