Cast Day #1

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.

A Fairy Godmother is Born

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.

Homecoming

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.

Happy Birthday, Eli!

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.

Eli's Feet

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)

Enough Already!!

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.

Silly, stubborn baby!!

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!

No Change..

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!

Free at last!

I never thought I'd make it...I've been on a self-imposed bed rest for the last 4 1/2 days (to give the Hulk more time to grow and to wait for my doula to come back from vacation). These have been the LONGEST 4 1/2 days ever - doing nothing is not all it's cracked up to be. My hat really goes off to those that have to be on bed rest for months on end. Finally it is over - starting tomorrow I will be resuming my walks, gym visits, and all activity in general.....I may never read another book or watch TV again! :)

The early bird gets the worm

Today was the 36-week appointment. I told the midwife about the low back pain I had Sunday night and she said she'd go ahead and 'check' me to see what was going on. It turns out the walking has been working because I am 70% effaced, 3cm dilated, and the Hulk is at a -1 station (translation: he's moved down into eject position). Then she measured my stomach and it was measuring small (31-weeks), so she sent me in for an ultrasound, just to be safe. The ultrasound showed everything was fine (I measured 36w1d - Hulk heartbeat was at 131), including the amniotic fluid levels (her concern), so the small measurement was just the result of the Hulk moving so far down. This is great news to me because all along I've felt that he would be here before 8/24. However, both my doula and her back-up are out of town at the moment. So until Monday, I am putting myself on modified bed rest (no more walking or gym visits). I am anxious for this guy to get here, but I'd rather wait until my support staff is available.

The Homestretch

I had my 35-week appointment with the midwife today, but there is nothing new to report. From here until the end I will be getting weekly check-ups, but no more ultrasounds.

Tonight Lehr and I took a baby sign language class. For as long as I can remember I've wanted to use sign language with my kids, and for the last 8 months, I've been learning via books and the Internet ASL Browser. The class was pretty informative and dispelled any misconceptions regarding sign language delaying speech, etc. (not that we had any). (The name of the organization teaching the class is Little Signers).

You hired a what?

Tonight we met with our doula and her back-up (in case she cannot be at the birth). The meeting went very well, and we feel very confident either of the two women will be a strong support throughout the labor. However, this was the last 'major' meeting/class/appointment we had before the birth. From here on out, it's just routine midwife appointments and one sign language class (obviously not a necessity for the main event). It's all becoming very real!

BTW - for those of you who, like my dad, are asking "What the hell is a doula", our doula has a web page.

System Overload

This afternoon we met with the pediatrician, and then went right on to the hospital tour. Talk about overload! I was fine until we passed a labor/delivery room that had not yet been cleaned from it's last occupant. It really took my breath away that I'm going to be in one of those soon. Add that to the fact that the beds are high off the ground - how am I supposed to get in and out of bed?! I guess I need to pack a step-stool in my overnight bag.

Happy 4th of July

I had my 33-week appointment with the midwife today. Yet another ultrasound, but this time I went solo. The Hulk wasn't nearly as active as he usually is for the ultrasounds, so although he is shy with his movements, he obviously likes having an audience. He is (as am I) measuring right on target for 33 weeks, which means the 8/24 due date is sticking. Today his weight was estimated at 4lb 7oz. The midwife said everything else looks good also: blood pressure still low (110/70), baby is head down, placenta is healthy and where it needs to be, umbilical cord is sending enough of what it needs to be sending to our little guy...

Yesterday Lehr and I walked the Atlanta Peachtree Road Race (10K). I couldn't bear to give up the tradition, so I took all necessary precautions and went for it. I still finished with a respectable time of 1hr 30min (4 miles/hour 15 min. miles). We were lucky it was overcast for most of the day, so I had to battle the humidity, but not the sun. The toughest part was the walk (after the race) back to MARTA. Lehr offered to carry me, or get a cab, but because I'm so stubborn, I refused. My feet were a little sore, but not enough to keep me from taking the Hulk to his first Cubs game last night. Unfortunately the Braves won, but we were there to support, nonetheless.

Baby Shower

Today we were fortunate enough to have another baby shower thrown for us. Dave, Carolyn, Tom & Megan threw a GREAT Hawaiian themed shower (to match the nursery) at Dave & Carolyn's house. All of our friends were there, and we received a lot of wonderful gifts. I think the highlight was watching everyone try to identify the candy bar in the 'messy diaper' game. This little guy is lucky to be born into such a wonderful 'family' of friends!

Update on the Hulk

We had our third ultrasound this last Friday. The Hulk is growing right on schedule – he’s up to a whopping 2lb 7oz now. I assure you that he’s stretching everyday – the kicks and punches are now accompanied by a double stretch he likes – I feel pressure on both sides (up and down or left and right) simultaneously. He’s also been moving slower across my belly and started using knees and elbows, just to keep me on my toes – it’s quite the circus act to watch each night. Everything else looks great – lungs, heart, blood flow to him, fluid in there, etc…. the ultrasound tech and midwife had nothing but good to say about how everything is progressing with The Hulk and I, which is GREAT news for us. Mom is in town visiting for a few weeks, so she got to accompany us to the ultrasound, though she hasn’t been able to see much of the ‘circus’ at night – this little guy gets very shy around new people apparently.

Mom and Jen were nice enough to throw us a family baby shower this last weekend. It was complete with frogs and ducks aplenty. We had a great time and received a pile of wonderful gifts. Unfortunately our camera batteries went out almost as soon as we got there, but Lehr's mom was nice enough to take (and forward) a few pictures for us.

"Birthin" classes

We took our childbirth prep class last week...I've never seen so many pregnant women try to share one bathroom before! Some friends signed up for the same class, so we had company for our day-long education. We didn't learn anything new; nothing we hadn't read in books or seen on the Discovery Health Channel. Lehr was one of only 2 'dads' with a wife crazy enough to attempt natural childbirth, however...

Speaking of which, we did hire the class teacher for her doula services. I'd researched doulas when I found out we were expecting, and I'd spoken with a few (just for info), but I'd never considered using one. My original plan was to rely on Lehr for all of my needs in labor & delivery. However, I think I was putting too much pressure on him, so after meeting the childbirth prep teacher, we decided to reserve her for our big day.

Still keeping everyone in the loop..

At our first ultrasound (20 weeks), the tech suspected bilateral clubfeet on our little boy. Although I was born with a left clubfoot, we did not expect this diagnosis. However, after reading up about current treatments/outcomes, we are very optimistic.

Yesterday we had our follow-up appointment with the maternal-fetal specialist. The intent was to determine if the club feet were diagnosed correctly, and to look for any other issues. It was a great appointment; we got about 1½ hours of ultrasound time with our little one (referred to as “The Hulk” from here on out)…he was quite active with the ultrasound tech, and very uncooperative when she was trying to get measurements (imagine that!!). We got to see everything: spine, legs, arms, head, feet, hands, even his face! After about 45 minutes the doctor/specialist came in and looked over the tech’s work and then performed her own ultrasound for another 30-40 minutes. By this time my stomach was quite tired of the constant probing, but at least The Hulk had settled down so the doc could get all follow up measurements she needed. The clubfeet are still there (honestly now… where would they have gone?), but everything else looked fine. The spine was very straight of a normal length and the legs and arms are measuring fine, so there is no evidence at this time that any genetic disorder is causing the club feet. Lehr and I will be seeing a pediatric orthopedist (hopefully) in the next month, to start discussing treatment once The Hulk makes his appearance. Another positive note, the specialist wants to have an ultrasound every 4-weeks to make sure growth is on-track, so we will be able to spend a lot more time with our little one before the rest of the world meets him. This is great news for me because I keep telling Lehr how anxious I get after the ultrasounds – I just want this kid to get here already!

We got an updated ultrasound photo of The Hulk; it’s another profile shot, but this time he has his hands in front of his face, and his knee is close to touching his nose (he’s already practicing yoga!).

Also, below are a few links to a few web sites Lehr and I have found useful – they explain the doctor’s method we hope to follow (Dr. Ponseti), and the condition itself. (Some of you have had some specific questions for us – thought this might help.)
Ponseti Treatment

Heads Up

Just to keep everyone in the loop, Lehr and I have been pretty busy researching this last week – the initial ultrasound showed that our little guy has bilateral (2) club feet. That is something I obviously plagued him with because I was born with one (I believe Lehr calls it my ‘freak’ leg?). We're not too concerned with long-term effects – if something has to be ‘wrong’, we're thankful it’s this because I turned out just fine. It will mean a lot of leg casting and braces on his feet the first few years though, so I’m glad we know now and can research our options. We go to a prenatal specialist in 10 days to do a more in-depth ultrasound and determine if there is anything they’re missing or misdiagnosing. We will have to wait until he gets out to start any treatments/correction; he’ll mostly likely be casted that first week. It’s not genetic, but it can be hereditary (kinda contradictory, I think). But we didn’t’ know it could be hereditary till after we found out about our little man…no one else in my family has it, and when I was born they said it was just because of the way my mom carried me inside of her (a little too cramped) that caused it – not biology. Anyway, we’ve been doing a lot of research, and the outlook is really good for long term. They use the same kind of treatment (basically) that they did when I was born, and it is really effective in correcting the problem within a year or so. He should still walk at a ‘normal’ age, and he probably won’t remember a thing. So not only are we glad we know now so that we can research and prepare, but also it saves us from buying clothes/socks/shoes he won’t be able to use. (Pants will have to be bigger (to fit over the full-leg casts) and shoes are not an option since he’ll wear a brace (with shoes attached) once he’s out of the casts.) Every little bit of preparing helps!! Be prepared for the red and blue casts when he comes home (it’ll be close to post-season Cubs baseball at that time).

Now You're All In BIG Trouble!

That’s right…we have another Lehr on the way….look out world!!!

All joking aside, we went for our first ultrasound today (20weeks) and the first shot the tech got was the money-shot; she said there was no doubt that it was a boy. As you all know, we would have been happy with either a boy or a girl (human, that is…Lehr really thought it might have been a horse for some reason), but I was secretly holding out for a little man (not sure how I’d deal with the whole ‘pink’ thing). All of the measurements were on track for me to keep the mid-August due date, so from here it’s just a countdown!