Braces

#1 Andrew at 11.5 months *First* braces AFO's (Ankle Foot Orthoses)
#2 Andrew in July 97 at 27 months and bears is wearing the old ones (his *first* braces)
Andrew is wearing the second pair (still AFO's)

Here are 4 pictures of the hinged braces (AFO'S)
DEC 1999 Andrew was 4 yrs old
They look a lot like regular AFO's and go up until just below his knees.
P.s Andrew's feet DO NOT turn out like this to the side-
I just placed his feet like this to show the hinges better :)

Notice how the back of these braces are not solid as the AFO's from above.
These give him LESS support, yes LESS support to work his legs better.

In the first picture the right brace is with out the straps to show you the *cut*.
The second is Andrew wearing them, they come up to 6 in from his ankle bone.
Notice these are not hinged as the last ones were,
I think they look less *bulky* And fit MUCH better in regular shoes & sneakers!!
2003

Andrew's hamstrings have almost always been tight but they were tighter than usual and his range of motion was not as good as it had been. We noticed that Andrew would walk (with braces and no crutches) with his knees bent due to his tight hamstrings. Walking in this way was tiring for him. We had problems keeping Andrew's hamstrings stretched, even though he was getting stretched out each morning before he wore his braces and before bed. Stretching the muscles created a lot of discomfort for Andrew. Our Ortho wanted us to see a Dr that did Botox for kids up at Children's Hospital and she thought she could help Andrew's walking.

The protocol for using Botox requires stretching of the muscle that is weakened by the Botulism toxin (Botox). The muscle is not fully affected until about a week after these injection have been given. Long leg stretching is started a week after the injections. Twice a week PT sessions need to be started, where his therapist will do a lot of stretching. Immediately, this looseness his leg muscles and the lack of pain in stretching lead to improvement in his range after a few weeks. He also seemed taller after about two-four weeks, since his knees were no longer kept bent while standing. But they don't stay like this for very long b/c he grows so fast that the muscles get tight again. These injections will be re-done until he has stopped growing in order to keep him from being overly tight and bending his knees which tier him rather quickly when walking.

This is the knee immobilizer Andrew wore at night for a few months before the first Botox injections were started.
This brace is made out of the same plastic that most AFO's are made from, and it's
padded he wore it over thin P.J. bottoms so he wouldn't get any pressure sores.

This brace was ONLY worn at night on his right leg

Casting after the first round of shots

Cast #1 was soccer balls and worn for 1 week
Cast #2 was red and worn for 1 week
Cast #3 was Dark-blue and also worn for 1 week

AND yes Andrew could still walk with these casts on lol they gave him a cast shoe to wear with it.

A total of 3 weeks the casts were worn then the blue cast was turned into a night splint that he wore for 8 months at night only, instead of the knee immobilizer. We did go back to the immobilizer for a while after the 8 months time was up. But he shortly grew out of it.

See how well Botox has helped his ankle?
SORRY camera was messed up (got a new camera for my b-day lol)

In the first picture right heal did not hit the floor flat.
Second picture after Botox right foot is NOW FLAT!!!!

Andrew will get Botox again Feb 04 this time to his hamstrings because he grew so fast that they are tight.

Andrew got more Botox 02/10/04, as I stated above, he did well with them again and will be seen back in 4 weeks. He also starts PT 2 times a week for 45 mins to get the best out of the Botox injections. We are all very excited and hope they help his walking as much as they did the first time.

Andrew was seen by Dr Nimec, she was pleased with how the Botox was working. She wanted him casted for a new night brace to be worn for about 6 months after Botox and new SMO's to replace his old ones.

Andrew got his new braces they still called them SMO's but they are MUCH lower then his last SMO's. He's having a bit of a balance problem with these but I'm told it's b/c they keep his knees straight.

Andrew is getting stronger and walking better with the new braces. Now we want to make sure he keeps that right knee straight so he will be wearing the knee brace (picture above) at night every other night to maintain this straight leg. Working like a charm!

Andrew will have MORE Botox done on May 3rd, 2005. Andrew's foot is still flat to the ground but his right ankle is tight again as is his hamstrings, he had a growth spurt. He has grow so quickly his size 7 pants got short and he's almost out of his size 8 pants too. So I know this is one reason for his tight ankle and hamstrings. I'll keep you posted here after surgery.

Andrew got Botox May 3rd, and is now receive private PT 2 times a week, I'll keep you posted on how he is doing.

June 05

Andrew started out a bit weak but PT is helping! The Dr felt Andrew would do better with a longer AFO on his left foot so we just picked it up. He has a short SMO on right and a longer AFO on the left. His walking has improved A LOT!

Sept 05

WOW Andrew has grown 4 inches since Feb, Dr is pleased at how well Andrew is doing (with new afo), but feels this right hamstring didn't get enough Botox in May (or it wore off too fast) so he will have Botox re-done on his right hamstring on Oct 27th, 05. He is now in size 10 pants and starting to out grow these! I will post how he did.

Andrew got Botox re-done Oct 27th, she decided to do both hamstrings and he started PT 2 times a week for 45 mins. I'll keep you updated on how these work this time around.