Here's the process. We do botox about every three months (another love that I have- I'll work on that story for later -remember HUGE catch up here). It takes about 7-10 days to really have the botox take affect. So within about a week of botox we schedule our first serial casting appointment. We've been doing therapy with Primary Children's and have just in the last 3 months changed to Shriner's so this was our 1st experience with casting at Shriner's. Their procedure is to leave her in the same cast for 2 weeks. In the past it was only for a week. I like not having to travel every week for 5 weeks to have it re-cast. And the 1st two castings at Shriner's went well. Even the 3rd (so now a total of 6 weeks in the cast) went well but I just wasn't as pleased with the end result as I had been with Primary Children's. When we start the casting, her flexibilty (probably there is a technical word for this) is about -3 or -4. With Primary's we've been able to get her to a flexibility of +8 to +10. But with Shriner's we were only at a +4. That just doesn't seem like enough but still the results are always so positive. I don't see eliminating serial casing any time soon! When she is in the cast she is just so much more stable and I love that!
The concern with her leg and the tightness is that her bones are going to start growing and her muscles are not going to keep up with them because they are too tight. The way to fix this is to have a heel cord release. It doesn't sound bad. But what that means is that they do surgery on her achilles tendon by cutting little "V"s on the tendon so that it gives some room to stretch. But if we have to do this, it means we will likely continue to have to do it every time she grows. I DO NOT want to have to do this surgery. So if it means that I cast her every 3 months along with botox, then yep I'm all over that!
Last night we got home from taking off her last cast again its been 6 weeks since she really had it off. Her little skin is all dry and just looks a little red she definitely was a little more irritated. I don't know that these pics really show very well what it looks like.
Her poor little toes curl in so much. I don't know that this is something that will ever be fixed. No Doctor, therapist, etc seem to be concerned about it. But can you see a difference between the two? The foot on the left the toes are straight and on the right they are all curved and turned in.
I'm sure there is so much more about casting but for now this will have to do!