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thefuturemrskudla
member
Physiatrist or Orthopedic surgeon?
thefuturemrskudla
member
Hi,
This is related to my post about casting. DS toe walks, although he can come down to flat feet, and can also dorsiflex, and I have gotten different opinions about treatments from his physiatrist and the orthopedist. The physiatrist said DS has some spasticity in his lower limbs, and suggested a wait and se approach (although she would not be against trying botox). The orthopedist disagrees that DS is spastic and feels his achilles heels are just too short. He suggests casting (says botox would be useless).
I plan on talking to our pedi and neurologist, but can anyone suggest where I may turn for another opinion, or possible course of action?
Thanks.
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Re: Physiatrist or Orthopedic surgeon?
Are the two differing opinions from the same hospital or clinic? Is there any way they could meet with you together and hash out what is really going on? Is there a test to prove spasticity or a test to prove a short achilles?
It sucks being in this position! I am not sure what your pedi or neuro can bring to the table. Are you in a position to get opinions from both another ortho and physiatrist? Ugh. I am no help. If I were in this position I think I would looking for second opinions or at least try and figure out what the timing is on both treatments. If timing is not an issue maybe try the least invasive first.
Of course, they are at different hospitals and in fact, the physiatrist is the only one in this area. The casting is noninvasive, and the ortho said he wouldn't recommend surgery until Owen went through his first major growth spurt at age 5. I wanted to speak to our neuro to get her take on spasticity; I assumed this would be an easy call.
Once I get the ortho's report, I will look for some second opinions. I know there is something off w/how Owen walks, and this isn't improving. Even though he is steady on his feet, can climb up stairs (not so good coming down, tends to slide off the edges with both feet), I see he doesn't have the same kind of gait or rythym as other kiddos. The thing is, I am somewhat suspicious of the physiatrist b/c when we first saw her, she thought Owen had "drop foot," which he doesn't.
Argh! So frustrating! Now I know why doctors "practice" the "art" of medicine.
, a or e a bi am going to find out whether there is a test for it
Could the coming down the stairs be more a CC issue than a gait issue? Maybe he cannot judge the spatial distance of the steps and his sensory timing is off. He's pointing his feet to touch the next step and then when he touches it the signal isn't moving fast enough around his brain to tell his foot to flatten out.
Are you part of the ACC list-serve? Another place to ask this is on the ACC or HCC facebook groups. Both groups are private....I see people talking about stair problems a lot. I think most kids have a perception issue but I am sure there is someone there who has dealt with this or could give you some insight....