N is still progressing beautifully.  We removed his second set of casts on Thursday night (boy, was that ever a chore!!).  On Friday, he was fitted with his new, custom leg braces. 

If you look closely at this picture, you can see the inner part of the brace that is similiar to a shoe.  That is designed to support his arch and heel properly, and stretch his toes slightly upward to prevent him from curling them down.  That assembly goes inside the main part of the brace (likes like a big boot) above. This part actually velcros very tightly around his ankles to prevent him from pointing his toes/foot.  The customizable settings you can see on the side (a short band and set of screw that attaches the upper and lower “boot” parts together) are set such that he can flex his ankle and foot into more of a bend, but not less of one.  That is also the purpose of the rubber “bump” and the thing sticking out of the back of the boot.  It allows him to flex his calf forward, but not go beyond 90 degrees to his foot.  Hope that makes sense. 

S actually had the pleasure of choosing the colors and such for the brace inner pads and velcro straps.  He chose blue since N is a boy, afterall, and he chose the horse overlay as a surprise for me!  Isn’t he sweet!

They are a bit more difficult to use than they appear.  First of all, N’s foot is so little, that we have to literally pull that bottom velcro tight enough you fear you will cut off circulation, otherwise he can wiggle his foot back into the toes-down position.  Another challenge is trying to get those braces into his shoes. 

This is not an easy task!  First of all, the adjusters on the side of the braces are very difficult to wedge into the shoe, the bottom velcro strap likes to try to fold oddly when it goes in, and one brace is cut about 1/2 shoe size longer than the other.  I have since moved him into one of A’s extra pair of shoes.  It’s about 2 shoe sizes to big for him without braces, but the braces actually fit a lot better in those shoes, and they appear a lot more comfy.   Anytime he has the braces on, he must have shoes on.  Right now, he is wearing the braces for about 3 hours in the morning, then 3 in the afternoon to get him used to them gradually and break them in.  That means a lot of on and off! 

We have been given a very nice surprise with this step of his therapy.  The braces give him a lot more confidence, and he has now done this on several occasions:

Previously, he refused to even try standing alone, but now he will stand for ever-increasing periods of time! Praise God!!

He hasn’t yet built enough confidence to try to take a step alone yet.  At this point, his hip flexors are still very weak, so his legs are actually somewhat wobbly when he walks.  I think he senses that.  He does, however, love to walk, and as long as he can hold someone’s hand, he will walk anywhere you take him!

The progress N is making is just incredible.  We are so excited that he is catching up so much faster than anyone ever imagined.  If you remember back when I first posted, if N stood up on his feet, he looked like this:

Before therapy

It was literally impossible for his leg muscles to relax and stretch enough for him to put his foot flat on the floor.  Now, after about 9 weeks of therapy, he is capable of this:

We can actually stretch and move his feet with an almost-normal range of motion and flexibility.  It is wonderful!  He still has to be reminded to “put those heels down!”  (I feel like I’m giving horseback riding lessons again!  LOL)  The fact that he CAN do it now, though, is just amazing.  There was no way just 9 weeks ago!  His calves and ankles were so incredibly tight. 

At this point, we still have a long way to go, but he is making progress weekly at this point, and I sense that he is starting to feel and even desire the new positions we are training his muscles into.  I look forward to seeing what the next month or two holds.  I would love nothing more than to see him walking this summer!!  Only time will tell.

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