The Everyday Warrior

Turning the everyday into a day of badassery through fitness, fashion & fun.

Brennen’s Medical Journey: The Scoobys / AFOs Are Here

These are Brennen’s Scoobys.

We have had them for one week now and currently we see them more often like the picture above than like this.

Right now Brennen wears them for one hour in the morning and one hour in the afternoon. Eventually he will be wearing them for most of the day, other than when he is sleeping. The arrival of the Scoobys has definitely caused some adjustments in our household. Obviously, the most affected is Brennen. The first day he got them he wore them for one hour. During that hour he pretty much cried the entire time and continuously asked me to take them off. He also refused to walk in them and just sat on the couch. As you can imagine, it was a LONG hour. I don’t think that they hurt him. I think he may experience some discomfort from his calves being stretched but I think he mostly gets upset because he doesn’t understand why he has to wear them. Luckily, as time has gone on he has become less resistant to them. The hubby has the difficult task of getting Brennen out of bed and into his Scoobys in the morning on the three days a week that Brennen goes to daycare. Brennen isn’t always very cooperative in the morning, so I give the hubby props for persevering with the Scoobys. As far as I go, I seem to be the one the gets the brunt of Brennen’s frustrations regarding the Scooby’s. He cries and resists them more often with me, but he is like that with me for most things. So I am just grinning and bearing it as I know this too shall pass.

Another challenging aspect of the Scoobys is finding shoes that can be worn with them. Because the Scoobys are made out of plastic they are very slippery on the bottom and thus have to be worn with shoes at all times. We were fortunate that Brennen already had one pair of shoes that could be worn with the Scoobys by opening the tongue up very wide and wedging them on.

 It’s quite a workout just getting the shoes on. However, we were instructed by the orthotist not to get a size bigger because they would be too long in the toe area and Brennen would have trouble walking.

We also bought Brennen a pair of slippers to wear around the house that fit over his Scoobys easily.

Who am I kidding?!?! I let him wear them out of the house too. They are way easier to put on than the shoes and he likes them better. They have a rubber bottom, so I guess they can pass as part shoe / part slipper. I think.

We are certainly seeing a difference in Brennen’s walking pattern when he is wearing the Scoobys. With them on he is forced to walk heel to toe. We are optimistic that with time, the Scoobys will correct Brennen’s toe walking by retraining his brain to walk properly. The plan is for him to wear them for three months and then remove them to see if he maintains the heel to toe stride or if he goes back to walking on his toes. If he maintains the proper stride he would be done wearing them. If he goes back to toe walking he would wear them again for another three months. In the meantime, we are just going to make the best of it and encourage Brennen to be proud of himself and his Scoobys!

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Brennen’s Medical Journey: AFO Fitting

Last week I took Brennen to get fitted for his AFOs. I was a little nervous about the appointment because I wasn’t sure how Brennen would react. However, the appointment went great! I am so thankful that we switched to the orthotist that Brennen’s neurologist recommended. It made a world of difference!

The new location we went to was way more kid friendly than the previous place we had visited. This location had a very large waiting room full of toys and a TV that was playing Madagascar. Just hanging out in the waiting room instantly put Brennen at ease. Even the individual patient rooms were kid friendly! They were painted in vibrant colors and each one had a TV, also playing Madagascar. 

But by far, the best thing about the appointment was Brennen’s new orthotist. He was amazing with Brennen. He introduced himself to Brennen, engaged Brennen in conversation and explained everything to Brennen in terms that he could understand. Brennen was comfortable with him right from the start!

Surprisingly, upon examining Brennen’s feet and legs, the orthotist immediately recognized that Brennen was a toe walker (without looking at his chart or seeing him toe walk). The orthotist pointed out that the forefront of Brennen’s feet are wider than normal due to the pressure of the toe walking and his heels are more narrow than other kids his age. This was something that we had never noticed. The orthotist also called attention to Brennen’s body builder sized calf muscles, which we were already aware of.

After the examination, the orthotist showed us a sample AFO and demonstrated how it would prevent Brennen from toe walking. The goal of the AFO is to retrain Brennen’s brain so that it knows to walk heel to toe, instead of toe to toe.  

Next the orthotist had to cast Brennen’s legs to make a mold so that the AFO could be custom shaped just for him. I wish I could have taken some pictures to show you the process, but Brennen wanted to sit on my lap while it was being done. First the orthotist put a long sock on each of Brennen’s legs. Then he wrapped wet bandages around Brennen’s legs from the knee to the tips of his toes. After the bandages hardened the casts were cut off. The last part was the fun part, Brennen got to custom design his AFO by picking from a  wide variety of colors and patterns. Brennen selected Scooby Doo as the pattern, blue straps and blue pads.

We should be able to pick up the AFOs (or Brennen’s Scooby’s as we have started to call them) in about 2-3 weeks. In the meantime, I have been searching for special AFO socks for Brennen to wear. They are a tad expensive, $8-$12 a pair, but if they make Brennen more comfortable they will be worth it. Brennen will also have to get new shoes once he gets his AFOs as his old shoes are not roomy enough to accommodate the AFOs.

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Brennen’s Medical Journey: Appointment Update

As I previously mentioned, this week was jam-packed with appointments for Brennen.

We started the week by getting him fitted for shoe inserts that are meant to discourage toe walking. The inserts are made of metal and are designed to make the soles of his shoes less bendable. I think Brennen saw the inserts as a challenge. Similar to when I tell him to stop jumping on the couch. The more I tell him to stop jumping, the more he jumps. In this case, Brennen realized the shoes made toe walking more difficult, which made him even more determined to do it. And like every determined  three year old, he figured out a way to get what he wanted.

A few days after the appointment with the Orthotist, we paid a visit to Brennen’s physical therapist to evaluate how the inserts were working and discuss other options. Immediately, the therapist recognized that he was toe walking despite the shoe inserts and asked if we had made a decision in regards to casting or bracing his legs. I was prepared for this conversation as the hubby and I spent a lot of time researching and talking about our decision. I explained to her that we were not on board with either option. We would understand the need for it if he exclusively walked on his tippy toes. However, Brennen can and does walk flat-footed at times. In addition, his range of motion in his legs and ankles has not been limited due to his toe walking. I told her we would prefer to keep any eye on him and if anything changed for the worse, look into those options at that time. And guess what? She agreed! She said she would release Brennen from PT as long as we agreed to do the exercises and stretches that she taught us and get back in touch with her if anything changed. Yay!

Later in the day after the PT appointment, we had a follow-up appointment with Brennen’s neurologist. I had prepared myself for this appointment by putting together a small folder that included our family medical history in regards to toe walking and scoliosis,  notes about anything out of the ordinary in regards to Brennen from conception till now and a list of questions. The folder helps me feel more in control of a situation that I have very little control over.

The neurologist first reviewed the results of Brennen’s x-ray. He confirmed that it indicated 13 degree scoliosis but also agreed with us that it was possible that Brennen was not standing appropriately for the x-ray. (Picture squirming & uncooperative 3 year old in front of a x-ray machine.) Moving forward, Brennen will get an x-ray every 6 months to monitor the scoliosis. As of now, no treatment is required. The MRI was reviewed again and the doctor reiterated that a mild version of CP can not be ruled out. In regards to toe walking, the neurologist agreed that the shoe inserts were not beneficial and wholeheartedly recommended braces. Also known as ankle foot orthoses or an AFO. So much for my victory dance earlier in the day. :( His argument was that Brennen’s foot could become deformed due to amount of pressure being placed on his toes and the tendons in his legs may not grow as long as they should due to the amount of time Brennen is on his toes. Although, this was not what we wanted to hear, we recognized that it was better to do the bracing sooner than later as the average time in an AFO is 3-12 months. We decided to try bracing now so that Brennen would be out of them before he started pre-school next year. So next week Brennen will be seeing a new Orthotist (his doc didn’t like the previous one the pt person sent us to) to get fitted for an AFO. I also inquired about the possibility of Brennen having some sort of sensory disorder. Here is a little background as to why I suspected a sensory disorder. It took Brennen until he was about 2 years of age before he would walk on grass, he still will not walk on sand, he has very sensitive hearing and is easily overwhelmed in crowded places. After some discussion, the doctor agreed with me and recognized that part of his toe walking may be due to sensory issues. However, insurance companies do not recognize sensory disorders as a medical issue, so any professional treatment would be out-of-pocket. In all reality, we have been treating Brennen’s sensory disorder on our own. We gradually expose him to things that make him uncomfortable until he becomes desensitized to it. We will continue to do this and we will research some ideas on the internet as well.

Although this week did not turn out exactly as we would have liked, we recognize that these things are do-able. The good news is that once the AFO is on, we will greatly reduce the number of appointments we need to go to. :) We will only have to do a x-ray every 6 months and visit the neurologists’ office every 3 months to see how the AFO is working. I am looking forward to a time in the future when all of this is just a vague memory, but in the meantime we are going to make the best of it and recognize that despite our challenges we are still very lucky to have so much happiness!

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