World Clubfoot Awareness Day

Sir,

Today is Clubfoot Awareness Day. According to mayoclinic.org, clubfoot describes a range of foot abnormalities, usually present at birth, in which the baby’s foot is twisted out of shape. Clubfoot can be seen soon after birth and in some cases technology advancement has made it easier for doctors and parents to detect it during pregnancy.

Description

The front of the affected foot turns inward and the heel points down, in severe cases the foot is turned so far that the bottom faces sideways or up rather than down. The condition is also known as talipes equinovarus. The condition affects boys twice as much as it does girls. It is worth noting that clubfoot may affect one or both the child’s feet. In cases where one foot is affected, the calf muscle on the affected leg will most likely be smaller than the other. Also, the leg on the effected side is often shorter and, lastly, the affected foot may be shorter and wider.

On July 8, 2020, our family was blessed with a baby boy. As a new and young mother I was excited and nervous, coupled with all the emotions one can think of. After 10 hours of labour my life changed. I don’t know what makes women cry when the baby is placed in their arms, but I remember that I also shed a tear that moment.

As soon as the doctor took him from my arms for a routine check-up and weigh in, I guess the problem was evident. I recall the nurse calling the doctor to ‘show him something’, I became scared. After a couple of minutes, the doctor came back and he delivered the news, my baby was born with clubfoot which severely affected his right foot.

Credit to the doctor for reassuring me that it could be treated in the nicest way possible, it was as if he could see my fear and worry. After five days in hospital battling an infection, we were finally ready to go home, but the fight was not over as the longest and most painful journey in getting our son treatment had just begun for his father and I. At seven days old we took him for his first physio, not knowing what to expect. We walked in and the doctor assessed his foot and told us what we needed to know about the condition. This was the beginning of his casting journey, watching our seven-day-old baby getting a cast was not easy.

Casting

Casting is the first stage of clubfoot treatment, it is also known as the Ponseti Method. This is the most common form of treatment where a series of casts are done on the affected foot to bring it into the correct position. We watched as the doctor stretched and repositioned our son’s foot in the wet casts to try hold the foot in its new position within the cast. The processes were repeated every Wednesday for the first seven weeks of his young life.

He cried at every appointment and it did not get easy for us as his parents to watch. We noticed the change in the foot position with every week of casting.

When the casting is done, the next stage of treatment was a minor surgery which we can call Stage Two of treatment, this known as Tenotomy. This is a surgery that aims to lengthen the Achilles tendon. According to childresnhospital.org, the Achilles tendon is the cord that attaches the calf of the muscle to the heel. Our son’s surgery was short; all I remember was his father and I in the waiting room hearing our baby screaming in the other room.

When the doctor called me to come and dress him after the procedure, he was still on the bed they had operated him on walling. I couldn’t even see what they had done to him since they had already put another cast on him which he was to have for two weeks after the surgery.

Boot, bar stage

Clubfoot treatment is a journey, I mean a long and very emotional journey especially for the parents. After surgery we went on to his third stage of treatment which is the boot and bar stage.

At this point we had to buy a type of shoe which has both shoes held together by a bar. For the first three months he was to wear the shoe for at least 22 hours a day, only taking it off during bath time. Now our physio appointments had been reduced from once a week to once a month, this gave his doctor a chance to assess progress on his foot.

After the initial three months of the boot and bar treatment, the next stage was reducing the hours from 22 hours to nap time and bedtime for another three months, thereafter it was bedtime only till this day where he is 23 months.

We are to continue on this journey and now that our boy has started walking we need to buy another special shoe, the orthopedic boot, which will help keep his foot in the correct position as he learns to walk.

As we celebrate this day, which most parents wish they knew nothing about, it is important to bring awareness on the condition. There are a lot of children who are born with this condition, and without the right treatment at an early age, it affects the rest of their lives having to live with it.

This condition is very visible to the eye and makes it difficult for the child to walk normally and have a normal life. Today I would like to encourage parents whose babies were or are born with clubfoot to start treatment immediately, yes the journey is long, but it gives our babies a chance at a normal life. Parents are advised to seek treatment at their nearest hospital. To all the clubfoot warriors out there, you are powerful and special.

Nongcebo Malinga