Keir’s Story – Baby Boy with Bilateral Talipes

Ours is an everyday story or a boy with Talipes. I say ‘everyday’ because in the almost two years that Talipes has been part of our lives, we’ve come to realise many people go through exactly the same experience as us. Thanks to dedicated health professionals and charities like STEPS, we’ve learned that clubfoot is an entirely treatable and manageable condition.Rewind to April 2009 and it was a different story, however. Our son Keir was diagnosed with bilateral Talipes at my 20-week scan at the Royal Free Hospital in North London. My husband and I already have a five-year-old daughter and were delighted to be providing her with a sibling. The radiographer took her time and finally told us she suspected ‘bilateral Talipes’, which she translated to ‘clubfeet’ when she saw our blank faces. She provided no information about treatment, then tried and failed to find a colleague to offer a second opinion (she was a locum and unfamiliar with the hospital). So we were sent home with a promise that someone would be in touch with some information ‘soon’.

We sat in the car – weeping hormonal Mum and white-faced Dad – trying to absorb the shock. We knew absolutely nothing about clubfoot. Would our child ever walk? Thank heavens for the Internet. Within an hour we knew about STEPS, the Ponseti technique and had a list of Ponseti clinics in London.

Before giving birth I visited three London hospitals with Ponseti clinics to find out about how the technique was applied – Chelsea & Westminster, Great Ormond Street and The Royal Free. Each place told us almost exactly the same thing. This helped reassure us that we were making the right decision in choosing the Ponseti method. We chose the clinic at the Royal Free – closest to us in London – run by an amazing physiotherapist, Nikki. If I’d only known she existed back on the day of the scan, only a floor below us in the same hospital, a lot of upset could have been avoided! We met when I was at the ‘London bus’ stage of pregnancy and she generously spent nearly two hours with us, explaining each step of the treatment to come and showing photos of previous patients’ development. Since then, she has guided us gently through the process, which has progressed exactly as she first told us it would.

Keir was born on August 17th 2009, a gorgeous boy with a fuzzy black Mohican of hair. We barely noticed his tiny wonky feet, which bent right up in towards his anklebones, because we were so busy making sure the rest of him was okay! Yes, they looked odd, but knowing about them in advance meant we felt pretty calm and just delighted to have a healthy baby.

Three weeks later – just after dropping my daughter off for her first-ever day at school – we took Keir for his first set of plasters. We had been provided with a list of things to bring to help the session go smoothly, such as a bath support, extra nappies and dummies. I brought along some expressed milk and Keir calmly took his first-ever bottle while his feet were plastered into position.keir-mccallum7834-7-wks-old-after-treatment

Keir had weekly plasters from the age of three to eight weeks, with each set turning his feet slightly further out. He never seemed too bothered by them. But – as any parent of a child with Talipes would probably tell you – why would he be? He’d never known any different. He did love to smash his feet down a lot, once resulting in a speedy visit to hospital to patch over a caved-in heel.

His feet responded well to the treatment and at nine weeks old his consultant performed a tenotomy under local anaesthetic, in which he made a tiny incision in each heel to sever the Achilles tendon. Despite now turning outwards, Keir’s feet were still pointing downwards, so this procedure ‘released’ the foot upwards, enabling it to be plastered at a 90-degree angle to the leg and allowing future flexibility. I had a little sob over a Starbucks during this (we weren’t allowed in) but it’s amazing how quickly a baby’s body heals, because three weeks later the tendons had grown and re-connected. And it was a relief to get those last plasters off… Three weeks of full-on baby action had left them dirty, stained (don’t ask) and covered in little doodles generously drawn on by his sister.

Now it was time for the bar and boots. We’ve been lucky enough to be provided with the type in which the boots can be easily unclipped from the bar, making nappy-changing and dressing easier.

keir-maccallum-boots-and-bar-7834Ooh, the pressure of the day his boots first went on…! All the hard work of our physiotherapist and her team had got Keir to this point, now it was over to us. What if we messed up?? It takes time at first – we kept laughing at ourselves sweating over this tiny boy’s feet, trying to keep the heel down, straps tight enough, socks smooth – but we soon honed our technique. We did of course make the classic beginners’ mistake of boots on the wrong feet, OOPS, but he forgave us.

To begin with we did wonder if he was a little confused. He’d had heavy legs which he could kick as he liked. Now he suddenly had light legs, but they were somehow stuck together. But he got used to them quickly enough, wearing them 23 hours a day for the first three months, with an hour off for bath-time and a bit of play before bed. If anyone ever stared I thought (like any proud Mum) it was down to his being cute rather than his unusual footwear.

When Keir was six months old, the wearing time went down from at 23 to 16 hours a day – 14 hours at night (7pm–9am) and two during his daytime nap. This is more or less how things will be until he is about five years old, though the nap will probably go. We’ve been advised to stick to the routine as much as possible to give the technique the best chance of working.

There are some tough times of course – but that’s par for the course with young babies. Each time he moves up a boot size there’s a short period during which the straps seem to be too tight or loose. Until they stretch and soften we wonder if they might be hurting him. When he does get the occasional sore patch, a combination of new socks, miraculous Aveeno moisturiser and careful padding provided by Nikki help him heal quickly. But it could also be his teeth, wind, hunger or chatty sister that sometimes wake him at night! Perhaps he’ll be able to tell us how it all feels once he’s a bit older. Or perhaps, even better, he won’t remember much about it.

With some boot-free time during the day, we entered a great new stage. Keir began rolling, then sitting up, and finally started to crawl a few days before his first birthday. He’s now a high-speed crawler, both in and out of his boots, and pulls up to grab things he shouldn’t have off the table. His joints are also hyper-mobile so perhaps he’ll be using his ridiculously flexible feet as a future party trick. He has check-ups every three months and each time Nikki says to him “What beautiful feet!”.

Hopefully walking is not far off; although friends of mine who have boys tell me they often walk later than girls. Call me sentimental, but when I do see him take his first steps unaided, it may be a dribble or it may be a flood, but there will be happy tears.