Tuesday, January 7, 2014

Serial Casting- #1

Yesterday we slipped and slid our way downtown for Flower's first appointment in her serial casting program.  She is a toe-walker, and for a variety of reasons, it is time to get it corrected.  Her achilles tendon and the surrounding muscles are too short for her to walk flat-footed right now, so each week she will have her feet casted in a progressively more flexed position, allowing those muscles to grow and stretch.  After she has gained the length and range of motion needed, she will then have AFOs (ankle foot orthotics...aka braces) for the next few years- starting off 24 hours a day and eventually weaning down to just at night until she stops growing.  It is going to be a l.o.n.g. road, but we are determined to see it through.

I could go into detail, but instead, if you are curious about serial casting you can read about it here.  Those are her orthotist, tech and physical therapist in the picture and everything.  We are lucky to live so close to a hospital with a great program (serial casting techniques have really been pioneered here for the last 20 years or so).  Getting the casts on was pretty easy.  They watched her walk and measured her foot angles, and then they put on the cotton sock and wrapping and casted her legs while she laid on her tummy and colored pictures.  She has cast boots she wears over the casts so that she doesn't slip too much when she walks.  It is very much like walking in ski boots.  The trick is that they must stay dry.  I made some cute waterproof covers to wear in the snow, but most likely I will be carrying her in and out of places until the snow and slush disappear.  This is why we will be getting our handicapped parking placard tomorrow- between carrying her and Little Bee, who is still not too good at walking in the snow, I quite literally now have my hands full!

We have been warned over and over that it is not the casting that is the hard part, but the 60 minutes of physical therapy we are responsible for doing with her every single day until she is weaned off the daytime AFOs.  If I count up how many minutes that comes out to in a year my eyes cross...convincing a four year old to spend an hour (split into three smaller sessions) doing exercises that are difficult for her is requiring a lot of patience and creativity.  The exercises are basic- lifting her left leg up and down, taking baby steps, passing things between her knees like a football hike...so we are trying to find ways to make them fun.  We put puzzle pieces on one side of the room and the puzzle on the other and she baby steps back and forth to complete the puzzle.  We exercise to princess music.  We let her walk back and forth to get markers from me to color a picture.  There is a sticker chart and rewards.  But at the end of the day, fun or not, it has to get done.  I will be gratefully accepting any and all creative ideas for how to keep this fun for her!!

Anyways, thought this might be interesting to some of you.  I have gleaned a bunch of advice from the few blog friends I have who have been through casting and AFOs with their kids, so I feel like I should share the love a bit and write about our experience.  I'll add a few pictures below.  Next week I'll let you know how it goes getting the first casts cut off.  I broke my leg as a four year old and to this day I remember screaming my head off absolutely CONVINCED they were about to cut off my leg with the saw.  The casting tech told Flower that next week he promised her would make her giggle...so I am guessing they are used to dealing with this fear and have ways to make it fun for the kids.  This week they sent her home with her own rolls of cotton and moleskin and cast socks so she could put casts on her dolls or siblings.  There is a reason these angels work at a children's hospital!

Snoozing on her "casty bear" who also has pink casts that Great Gramma made for her!


  1. Thanks for writing this I have been having a hard time finding personal experiences with serial casting. We will be starting this journey with my 6 yr old son in 2 weeks and I'm pretty nervous about it. Toe walking sucks!

  2. I've been looking for a blog like this. And then I recognized the "cast man", as Isaac, our cast man! We just started 1/11/16. I started a fb page documenting our adventure!