a blog about raising a daughter with cerebral palsy and learning unexpected lessons along the way

Friday, July 2, 2010

Serial Casting

Oia had an appointment today with Dr. R; her ortho doctor so we could discuss some options to hopefully combat the tone in her lower legs. Both Rob and I as well as Oia's PT have noticed that in recent months her tone has become more tight; meaning it is more difficult to stretch her right foot/ankle into a 90 degree position. In simple terms, her right calf muscles and heel cords are becoming tighter because she is growing so quickly. Bone growth shortens the calf muscles by contracting them, thus having to walk on her toes. Right side is strongly affected, left side minimally but still an obvious concern.

Since growth doesn't play nicely with CP kids and that's what Oia has done a lot of these days, we are at a point in the road where an intervention is necessary. Our options are Botox injections, night splinting, or serial casting. Surgery may be a future option.

After this mornings discussion with Dr. R, he feels the best intervention for Oia is serial casting. And the kicker: both feet at once. Serial casting will provide Oia's calf muscles a prolonged stretch for a two week period. After two weeks, both casts will be removed and legs and tone re-examined. Depending on the results, Oia may be recasted again for another set amount of time; as many times over as necessary. I am unsure yet of how long the effects of serial casting last but the idea is to keep Oia as flexible as possible while she continues to grow so quickly. The more we can utilize a less-invasive approach now, the better our outcome will be of improving Oia's quality of mobility in 5, 10, 20 years down the road. There are no guarantees but we have to try and do whatever it takes.

Dr. R assured me that Oia will be able to walk while wearing the casts. We'll see about that.

Overall, this should be a good thing and we're happy to have resources and options available to us that will help our girl grow into the person she is supposed to be. However, I'd be lying if I said I wasn't dreading this process. I feel sorry that Oia has to go through the challenges she does and must rise to the occasion every single day. I don't want others who see her to feel sorry but as her mother, I reserve the right to feel sorry from time to time. It's hard to watch your child go through these things but as Rob has told me long ago, "These things build character" and that's certainly all little Miss is full of.

Oia will be casted Tuesday morning, July 6th.


  1. Oh man, Mo! Been there done that, hated every minute of it! Poor Oia, ICK, in the summer no less! BOOOOO! will be praying for ya!

  2. Is their anything we can do to help? We will be praying for the time to pass quickly and the perfect outcome to occur during the first casting.

  3. Well crap, Mo. My PT warned me how this could happen, that you'd be tooling along thinking your child's progress was wonderful then a growth spurt comes along and she looks like you've never done any work with her. I kinda hate it when he tells me stuff like that. Besides the long term gains for her, even though it will be painful to get there, the only good thing I can see in you guys going through this is that with your gentle wisdom and can do attitude, you girls will be helping those of us who are behind you in age to handle it when our turn comes around. I'm so sorry for all this stress. Please let us know if we could do something to cheer sweet Oia, like a little present or some such thing?

  4. Good luck tomorrow, I'll be thinking about you guys. Sweet Oia will be a good sport through all of it, and you're right...it builds character.
    Love the new picture up, by the way.

  5. Thinking of you all and hope the casting went well. The new picture at the top is priceless! The most infectious smile! Love it.