You are currently browsing the category archive for the ‘toe walking’ category.
.
I’m assuming that was the general theme in Bean’s head when she left with her “Da-duh” Thursday evening. She and I had a rough 11 days, with highlights that included her running away screaming “no!” any time she didn’t want to do something, coming back at me swinging after I ‘chased’ her down (really just walked after her until she was cornered), connecting on some of the swings, including one solid punch in the gut, numerous time-outs in her room and mommy reaching deep into reserves she did not know she had to avoid saying or doing anything I would truly regret.
Needless to say, mommy was on the receiving end of a LOT of “I’m not talking to you ever again!”, “I’m NOT your friend!” and “I don’t love you!” shouts. Many of them in public, where most innocent observers met my eyes with an empathetic smile. I’m sure more than a few folks walked away in silent judgment of how I chose to handle these situations, including Bean’s dropping to the floor and screaming “I’m NOT coming with you” in stores, and me walking away and saying “okay, bye”. I know that, before Bean, I would have been judgmental. Now I find myself incredibly empathetic and understanding of a lot of parental choices, as long as they aren’t demeaning or hitting their children. It’s very much a “walk a mile in my shoes” type of situation – folks who have never been challenged with a ‘difficult’ child really can’t understand or appreciate just how much it takes to be a good-enough parent to these kids.
The differences between Bean and Miss O are like night and day, already. Nature or nurture? Probably a little of both. But being a good-enough parent to Miss O is a walk in the park … of course, she’s also 14 months old, which is vastly different than 3.5 years old.
Speaking of Miss O, she’ll be spending the night at Dave’s again tonight. We’re going to really work on once-a-week overnights, and build to two-night overnights. I think it’s good for her, good for Dave, good for me and especially good for Bean. My sweet Bean who, less than 24 hours after her joyful reunion with Dave, informed me in the car that she wanted to stay with me for all the days, even D days.
Bean had an appointment with the podiatrist yesterday, as she needs orthotic inserts to correct her foot structure. They took x-rays of her feet and on both feet, her calcaneus bone, instead of pointing straight down at her toes, is pointing away at an angle. In her left foot, it’s a really large angle. You can see how it’s supposed to be a linear structure, with the calcaneus going straight into the cuboid, which feeds straight to the tarsals. Her calcaneus is angling out about 30 degrees in her left foot, and about 15-20 in her right.
She’ll likely be wearing orthotics for a LONG time.
As an aside, the doctor said Stride-Rite shoes are the very best shoes out there for kids, and suggested getting Miss O in them to ensure she doesn’t develop similar problems, and also buying them exclusively for Bean. Just wanted to share this with other parents. I’ve found Stride-Rite on clearance at Marshall’s for $10 a pair, and they also make a ‘knock-off’ brand I’ve found at Kohl’s called Munchkin.
.
.
For those who haven’t heard, with a few extra details I got from Kelli (her PT) yesterday:
She was supposed to be re-cast Friday, but had developed a small, minor pressure sore on one foot, so they are re-casting tomorrow (Wed). The casting did give her some small increase in her range of motion, but Kelli wants to see her with 5-10 degrees of flex in both ankles; right now Bean’s at about 2 degrees. So she may be in casts longer than two weeks. The whole point of serial casting is to gradually increase the range of motion, I know, but I was really hoping for a fast gradual increase …
She’s going to be fitted for splints when the casting is done – they may just need to be worn at night, but Kelli is going to talk to the orthotist about making the splints in such a way that they *could* be worn during the day if we need the extra support. My understanding on this is that night splints would be rigid, allowing no ankle movement, whereas day splints would maintain the stretch and allow Bean to flex her foot upward, just not downward, preventing her from toe-walking.
Bean will likely wear a small ‘brace’ inside her shoes for years, possibly even as an adult. This will hold her arch (she’s tending toward flat-footedness now) and correct her pronation. She’ll be fitted for those next week.
There’s a large habitual/sensory component to the toe-walking that needs to be addressed by Dave, myself and PT/OT, where we’re all working to give her input into her heel and her whole foot. That means rubbing the soles of her feet with hands/washcloths, basically *forcing* her down on her heels if she toe-walks, having her jump off things and land on her whole foot, etc.
For example, her current “jump” usually has her land either on her knees, or lightly on her toes and then down on all fours. It’s not ideal, but I have her spend time every night jumping off my bed onto Miss O’s bed but only if she’ll land on her whole foot. If she starts slacking, the game is over.
Miss O and I also firmly ‘pat’ Bean’s heels. O loves smacking things, and Bean laughs hysterically when O does it, so I usually let them just kind of mess around and do the work 
They also love to ‘roughhouse’ together, and since it’s something that Kelli thinks Bean needs, I let them play around and roll around for awhile at night. It’s kind of nice having Miss O play the “heavy” on some of this stuff, as Bean is usually pretty resistant to me doing more ‘formal’ OT stuff with her.
So that’s the latest. Woe be to Miss O if she ever walks on her tip-toes …
.
.
Jen, Bean’s casts are to correct her toe-walking. It’s something she’s always done, and we’re not sure why. It may have been a sensory thing to begin with, or it may have been physical – that her Achilles tendon was too short. Whatever the initial cause, she has done it for long enough to limit the degrees of flexion in her ankle, so much so that it is probably impossible for her to walk on her ‘whole foot’ for long periods of time because it’s such a tight stretch. So they will flex her foot and stretch the tendons and muscles a little, then cast it while it’s flexed and stretched. This will help lengthen the tendons and muscles a smidge, hopefully allowing her the ability to use her whole foot all the time.
It’s going to be a tough adjustment, I’m sure, between the weight/awkwardness of the casts and the fact that it will probably be a little painful. She’s excited by the prospect of being able to draw/paint on her casts, though, and I’ve been stocking up on $1 books at Goodwill so each day she can have a surprise to help mitigate the suck factor.
When she’s done with the casts, she’ll still have to wear splints at night for awhile to maintain the stretch overnight. But hopefully between casts/splints, PT and home exercise she’ll be better about walking on her whole foot within a few months. At PT, her therapist has discovered that Bean responds better to therapy if there’s a bit of ‘sensory’ stuff worked in, so they do a lot of swinging and ‘crashing’ play and then her therapist does the heel-toe walking stuff. Bean’s really resistant to any prolonged whole foot walking, though, hence the casts.
~~~***~~~
I need to take the van in to Honda today for an oil change and inspection. It’s due for a 30K mile service, too, so we’ll see what they say. I hate the idea of spending tons of money on a tune-up, but I know that preventative maintenance is cheaper than repair work. Hopefully I won’t be stuck there for-evah, because my laptop battery usually only gives me about an hour before dying.
.
.
Day two of laryngitis, but thankfully it’s a ‘daddy weekend’, so I don’t have to attempt to whisper Bean into submission. I had a scratchy voice for most of the day, but by the time I got home from Bean’s holiday party at school and the park afterward, I was back to whispering.
Miss O loves going to the park now. She climbs up the steps of the playscapes, crawls over to things and crawls through the tubes. She even gets herself set up to slide on her own, either in the sitting position or feet-first on her tummy, like she’s sliding off the couch. I got some great pictures of her playing today.
And some great pictures of Bean at her school party. It was a cute little sugar-fest for the kiddies, with a visit from Santa and lots of parents/grandparents in attendance.
Bean’s going to get casts on both ankles/legs on the 31st. Yes, real plaster casts. She’ll have them for at least two weeks, possibly up to six weeks, depending on how much improvement the casting yields. I feel terrible for her, because I know it’s going to be rough for her, but I also accept that it needs to happen.
She was due to move up to the next class level at her school, but after I told her teacher about the casting, they offered the option of letting Bean stay in her current class as she adjusts to the casts. I asked her what she wanted, and she wants to stay in her current class, so that’s what we’ll do.
.
.
Thanks mom and dad for the bath time yesterday! I got to cook myself in my bathtub and even got in a short (way too short) nap with Miss O afterward. My folks got to play with Miss O for a few hours without Bean interfering, and I think they enjoyed it
I’m still feeling kinda crappy, but I broke down and took some Tylenol yesterday evening to help with the aches and the sore throat. I hate knocking out the fever, but oh well.
Julia, S and Jen, thanks for your comments on my last post. Julia, I probably was wading a bit farther into the scary side of the pool than I needed to, so thanks for the reality check! (She tiptoes even in hard-soled shoes, believe it or not.) And S, thanks so much for your perspective on the casting. I’m even more hesitant about it now …
I just don’t want to jump that far ahead if it’s not absolutely necessary. She doesn’t need to deal with that if there are options. If you ask her to walk on her whole foot, she will, but it’s a flat-footed kind of thing. And she reverts to tiptoes really quickly. But she *can* walk on her whole foot, so I can’t believe she would need something so drastic, ya know? It’s not like we have to do the casting now for it to be effective, so my low-intervention, conservative self is saying “not yet!”
I’m really leaning toward Bean having some sensory issues … if my friend L is reading this, she’s smiling and saying “no duh!”, as she’s been concerned about that for a while. Knowing the cause doesn’t really change the situation, but I’d like to be able to understand what’s going on. But she has a lot of the signs of Proprioceptive Dysfunction, as well as some Vestibular Dysfunction indicators – and her PT used both terms in her initial assessment.
Bean drew me a picture of a “Bick” the other day, and it’s hanging up in my office. For the uninitiated, a Bick is a “scary monster!” It’s usually represented by a bunch of lines scribbled in a clump, but I asked her to draw a face for the Bick, and I ended up the proud owner of a Bick with 5 eyes, a scribbly nose, a smile (because all scary monsters smile), arms coming out of the head at ear-level and legs. I love it!
We finally got some decent rain yesterday, after days of threatening rain, and knowing everyone to the north, south, east and west of my general area was getting plenty of rain. Yesterday wasn’t one of the big rain event days that the previous days were supposed to be, but we got a nice little thunderstorm in mid-afternoon, including a 15-20 minute downpour. I figure everyone can thank me for that, as I ran my sprinklers that morning and watered my plants, having given up on Mother Nature. You’re all welcome.
I’m trying to decide what kind of classes to enroll Miss O in. At this age, Bean was doing Gymboree, so I’d like to get Miss O into either a music class or a gym class soon. I think she’d get a real kick out of it, as she loves seeing other kids. And it would be fun to have a just me-and-O activity. I really need to start getting paid to do something so I can afford some little extras for the girls …
Bastardized lyrics from Meredith Brooks’ “B*tch” … kinda makes you wonder if Bean’s Bick, is, in fact, a hybridization of Vick and b*tch … hmmm …
.
I’m feeling a little crappy – sore throat and a fever, plus congestion. Not sure if it’s something viral or just some fun allergies, but the sore throat really blows. I’d kill for a long, hot bath to just soak some of the aches away, and to jack up my body temp a bit to help the fever do it’s thing. I tried doing that in the girls’ tub last night after Miss O was asleep, but it just isn’t very comfy, nor is it deep enough for that good, full-body soak. I don’t want to take anything like Tylenol to help with the aches or the sore throat, because I don’t want to knock out the fever, ya know?
And to add to the crappy feeling, I got a call from Bean’s PT yesterday, after Dave and Bean left. She wanted to tell me what she told Dave, and that was that her initial assessment that Bean’s toe walking was fixable with just PT and some stretching had changed, and after consulting with another PT, they felt the best course of action was serial casting.
I’m a bit taken aback, as her both ortho doc and the original PT assessment left us thinking she wasn’t as tight, muscle/tendon-wise, as she could have been for her degree of toe-walking. I also hate, hate, hate the idea of her having to go through something this involved. She’s just a little girl, and the notion of her having big, plaster casts on her feet for a few weeks is a bit hard to accept. They’re going to be heavy, and hugely obvious and she won’t be able to do any water play or take baths for weeks.
I’ve only spent a little time Googling it, but it doesn’t sound like there’s any guarantee that casting will resolve the problem, or that it’s the best course of action. There are some who say that *no* treatment is needed, I think even no PT, because you don’t see any adults walking on their tip-toes by choice I think I’m somewhere in the middle – I’d like to look at orthotics before we go to something as extreme as casting …
I’d like to take her back to the ortho surgeon for a re-eval, and see what he has to say. I’m pretty sure Dave will be leaning to the more conservative side of ‘treatment’, as well, but I’ll give him a few days to do his own research and then we can discuss.
What’s bothersome is that toe-walking can be associated with cerebral palsy (it’s unlikely that she would have this as the only symptom, and at her age, it’s unlikely that we wouldn’t have gotten some indication of CP in some other way, so I’m not really concerned about this. It’s also an early indicator of autism. There’s also a chance it’s “just” sensory in nature.
When I Google toe walking autism, I find some interesting anecdotes – like here, references to giftedness and digestive issues and toe-walking. Now, her family knows that Bean is one of the two most brilliant children around (insert bragging mommy smile here), but I’ve never wanted to label her as anything. However, one mom’s words: “The area of the brain responsible for language also tends to dictate toe walking and many kids with unusual language patterns walk on their toes.” interested me, as Bean is highly verbal.
Info like that doesn’t really give me a lot to go on in the “to cast or not to cast” debate, but it’s interesting. And the link between toe walking and autism makes me super glad I have not vaccinated her, based on the recent government concession that – in one case at least – vaccines aggravated a “a pre-existing mitochondrial disorder … which ultimately resulted in an ASD (autsim spectrum disorder) diagnosis.”
Argh. Too much to think about.
She’s going to Schlitterbahn today with Dave on a company outing. As long as I have dibs on Disney World, I’m willing to surrender the first water park trip I hope she has a blast, and I can’t wait to talk to her about it. I’m wondering how much she’ll actually do, since she doesn’t like to dunk, but it looks like she’ll have a lot to choose from and will be able to find a couple things she truly enjoys.
She spent the night at Dave’s last night, so I’m getting a small break – she’ll be home after school tomorrow. I started taking my Zoloft in the morning … I’d been taking it later in the afternoon, since the peak blood concentration occurs 8-10 hours after you take it, and if any was going to make it into my milk, that would be the prime time. So I was trying to time the 8-10 hour window for the 8-11 pm window when Miss O rarely nurses. However, I don’t need to be at my most Zen when they’re fast asleep – I need it in the afternoons
Lyrics from the amazing Bob Marley’s “Three Little Birds“
.
