Exotic feet

Today Krassi was casted for his AFOs (ankle/foot orthotics) and the seasoned professional who our PTs recommended for the job was duly impressed. He kept saying that he wished he had a resident around to watch/learn from this case!

Krassi's feet are in really tough shape. He spent so many years with his legs crossed and tightly wrapped around each other that his feet have formed to each other and prefer to point downward rather than sit flat. But, because walking is still on the horizon for this boy as far as everyone who's seen him is concerned (both in his orphanage and here in the States), it's worth working with those feet to give him something stable to work with. Another challenge for making his AFOs is that because he is so underweight, there is very little natural cushion (ie, fat) between the skin and the misaligned bones. This will need to be taken into account so he can add artificial cushion to prevent excessive chafing.

This was Krassi's most difficult medical appointment so far. He did very well considering the circumstances, and considering that he's had some pretty notable emotionally challenging times pretty much every day for the last week. He showed he was nervous by laughing very loudly during some parts of our visit, and mild distress by whimpering and trying to force his way out of the position I was holding him in on my lap during more hands-on parts of the visit. I think the toughest thing for me to see was a particular pull of his lip that I've seen in some of the referral photos we have of him, but haven't seen in real life since he's been home.

Tiny little boy, very uncomfortable in this photo! I think this was taken when he was eight years old. You can see the tension in his upper lip - this is what I saw today. :( This also happens to be a photo where you can see pretty clearly the challenges he faces with his feet.

It was so good to be able to hold him through the casting, and then put his coat on and put him back into the van and drive him back home. He loves going out, largely, I think, because he loves coming back home.

The orthotist (I think that's the right word??) we saw appears very confident about the work he's going to do, and commented a number of times that these were going to be a pair of AFOs that he was going to do himself and not just send out to a lab. He's putting Krassi in the top 5% of most challenging feet that he's seen, and he's a man with lots of experience under his belt. He scheduled the actual fitting of the AFOs for a three-hour time slot, and scheduled an assistant because, in his words, he's doing something "exotic" with these feet!