• Atom was born in 2010, and despite 12 ultrasounds and even a 3-D ultrasound, his clubfoot was missed. All the ultrasound images seemed to focus on his face, which is what every parent wants to see, but his foot was missed. In some ways, this was a blessing -- my wife did not worry during the pregnancy. But it also did not afford us the luxury of researching the problem in advance and seeking the right doctor. 

    We asked the doctor about Atom's bent foot when he was born. The doctor replied she'd talk to us about it later. So we started researching, and it was evident that Atom had unilateral clubfoot. We read other problems like spina bifida could sometimes be associated with clubfoot, and we were very concerned at this point that what our son had was the tip of an iceberg. All the online reading we did on our own got us so worried; I guess it's why it's far better to discuss with a doctor than do your research. 

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    Our pediatrician referred us to a prominent orthopedic doctor who placed Atom's foot in a cast, like when you have a broken leg. This doctor was supposedly following the accepted Ponseti method, but we later realized it was a variant. Atom's foot was then placed in a locally made splint.

     

    My wife was not happy with Atom's foot. I, on the other hand, felt we should trust the doctor. After all, he had an excellent reputation and was recommended by our pediatrician. I didn't want to question his methodology. In hindsight, however, I realized that all doctors have their particular areas of expertise. Whenever possible, a second opinion is always good. 

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    My wife was insistent that we meet with another doctor that she had found online. I reluctantly agreed, but it turned out to be a very important choice.

    Atom met with Dr. Julyn Aguilar of St Lukes Hospital in Quezon City. At this point, we realized Atom had, in fact, not been receiving the correct treatment. Under Dr. Aguilar, Atom started the treatment again from scratch, this time using her expertise, the Ponseti method, known to be the widely practiced method for initial treatment of infants born with clubfeet. We followed the treatment to the letter because if it became successful, there would be no need for major surgery (although minor surgery to the tendon is common). 

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    We saw improvement in Atom's foot immediately. After a month of casting, Atom started to wear a Ponseti brace. He would wear this for five years, but by the end, he would wear it only at night.



    Clubfoot is a common ailment, occurring in 1 in 1,000 births, although in Asia it is slightly more common. My wife and I had no family history of clubfoot. It is an ailment that I had never seen before. In developed countries, all children are treated, but we saw many children with untreated clubfoot in Manila. It was heartbreaking because we knew it could be treated to avoid a lifetime of disability. 

    You should read up about the Ponseti method. You should go online and chat with other parents and seek recommendations. When Atom was born, there were email forums. These days, you've got Facebook and others. 
    If the doctor isn't following the Ponseti method precisely (such as not using full leg casts or not recommending Ponseti braces), then seek another doctor.  

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    The biggest lesson I have learned though is to get treatment as soon as possible. The longer the child is left untreated, the more it will cost to correct and the more difficult it will be for the older child to deal with the bracing.

    We had heard about an orphan, Sonny (not his real name), who had bilateral clubfoot in my wife's hometown in Mindanao. We flew him to Manila, and he underwent the same treatment that my son received. But he was 5 and a half years old, and it made a huge difference. While a baby would need four or five casts, this older boy required 25 casts. The change was dramatic though as you can see in the photos below. (Read more about Sonny's treatment here.) 



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    Sonny's case stresses the importance of treating a child who is born with clubfoot immediately. The longer it is left, the more expensive and time-consuming it becomes to manage. 

    Once the casting phase is over, a child needs to wear a Ponseti brace for some years. These are imported from America and can be costly. However, there is a culture of donating old braces to developing countries and others in need. 

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    For the determined mother who plans, there will always be donations of these very special shoes. All of Atom's Ponseti braces were passed on and likely used many times.

    During the bracing, you'd be surprised to know that Atom loved his brace. He wasn't happy when he no longer had to wear it. In time though, Atom declared that he no longer had clubfoot. It was reinforced by the fact that he was paid twice to model shoes! You've probably seen his photos modeling in the mall --  and when Atoms sees them he will declare that he was famous! 




    Atom does sport, plays and runs like all the other children. Most people will not notice he has clubfoot, but in truth, he will always have slightly missized feet and a thinner calf muscle. 

    Recently, we've learned that, at nearly 7 years old, Atom has relapsed so that it will be back to casting and more therapy. If there's anything we've learned about this journey, though, it is we'll get through it, and he'll be just fine. He's lucky to have an amazing doctor here in the Philippines. He will normally walk again soon. The disadvantage presented by his foot is made up a million-fold in everything else about him. 

    As for our initial worries that Atom might be somehow abnormal or have other problems, these were unfounded: the only abnormal thing about him is his love of books, and his wish to be a scientist when grows up!

    To read more about Atom's treatment, click here.  

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