The History

Kai (pronounced Ky) was diagnosed at birth with right clubfoot.  I had something like 11-13 ultrasounds due to a high-risk pregnancy, but none caught the clubfoot.  We were not shocked or upset because our next child up was born with positional clubfoot (no need to treat) and moderate metatarsus adductus.  It just seemed normal to us to have a child with a crooked foot! 

The local ortho who confirmed the diagnosis told us to get ahold of Children's Hospital in Seattle and get him in there for treatment no later than 3 weeks.  I did just that and Kai's first appointment with Dr Mosca was on January 17 - a full week before his due date!  In the time between a member of my Expecting Club contacted me with information about the Ponseti Method.  It just so happened that Dr Mosca was a well respected Ponseti doctor.  We were very happy about this and never thought Kai would face surgery.

 Kai had severe clubfoot - a 5.5 of 6 on the Pirani Scale - but his foot was corrected to the point of being ready for tenotomy in three casts, which is actually less than the bare minimum recognized!  He had the tenotomy and we were very eager to see the perfect little foot when that cast came off. That is when the trouble began ...

When the cast came off, his foot did NOT look perfect. Dr Mosca said he had great flexibility and just seemed to have a "fat" foot.  A month later I took him to see Dr Mosca again because it looked like his foot was drawing up in an inverted V.  Dr Mosca again said it had excellent flexibility and it was just fat. I tried to send pictures to Dr Ponseti, but the quality of them was too bad for Dr Ponseti to tell anything.

In June Dr Mosca released Kai from 23/7 brace wear. Again we brought up the strange look of the foot and again were told that flexibility was great. I tried again to contact Dr Ponseti about it, but without photos he could only say that Dr Mosca was an excellent, highly qualified doctor.

Finally in July I got a digital camera for my birthday.  I sent Dr Ponseti photos in August and he then told me that Kai's foot was an unusual foot and that it was definitely not corrected.  We were devestated!  We spent a few days talking to both doctors, both by e-mail and phone.  When I began to discuss it with my husband - how Dr Mosca was closer, but didn't seem familiar with the problem, but could be coached by Dr Ponseti, so on, my husband looked at me and said "Why don't you have plane tickets yet?  As far as I am concerned you are going to Iowa and that is it."  Within three weeks Kai and I were in Iowa.

Dr Ponseti then told me that Kai had plantaris - an unusual form of clubfoot that involves the midfoot in an abnormal way. He put two casts on Kai and sent us home with new angles on our brace. If we had stayed another week, we would have been able to get the then-new Mitchell Brace.

One In A Million

Most cases of complex clubfeet stabilize sometime between 12 and 24 months.  All, of them, in fact, except two.  Guess what?  It is lonely at the top.  Yeah, we have a one-in-a-million kind of guy.  Kai turned three in December 2005.  To date, his foot has had a relapse of cavus every six months or less since we left Iowa.  He has had 6 sets of casts with a total of around 16 casts.  The Mitchell shoes helped some, but we have gone back to the Markells for the time being and at this point they are working as well as anything or nothing.