However, Grayson had other plans. He stayed right where he was for another three days. After a prolonged wait, Tabitha gave birth to her baby boy. It was a relief, to say the least.
Soon after her first newborn snuggle, Tabitha learned Grayson would need some extra help. He was born with Talipes equinovarus (TEV). That diagnosis is more easily recognized as clubfoot. In Grayson’s case, both feet were affected.
Clubfoot is twice as prevalent in boys than girls. In most cases, the foot is twisted inward at the ankle. Clubfoot affects one or both of a child's feet.
Tabitha’s family quickly stepped in to help, suggesting she call Shriners Children’s St. Louis.
“He was 2 months old when we were first seen at Shriners Children's. I was a little nervous. I didn’t know what to expect. All the nurses were so amazing with him, going step by step with what they were doing with him,” she explained.
Grayson’s treatment plan, outlined by Pooya Hosseinzadeh, M.D., began with four rounds of casts before surgery, otherwise known as the Ponseti method. That method uses progressive casting to correct club feet by gently manipulating muscles, ligaments and soft tissues around the foot and ankle to align the bones into a normal position in about six to eight weeks.
“When the child with clubfoot is born, there is tightness in the tissues that keeps the foot in the abnormal position,” explained Hosseinzadeh, a surgeon with Shriners Children's St. Louis.
“Most of our patients have made the diagnosis with an ultrasound in utero. The diagnosis is confirmed at birth. That being said, I would like to start casting within the first four weeks – that’s when the deformity is most flexible and responds best to casting. Starting early increases success rates and reduces the need for a more extensive surgery,” Hosseinzadeh explained.
When it was time for surgery, Tabitha didn’t take the decision lightly.
“It was hard to make the choice to do surgery. I hated to do it because I know it’s going to hurt. But, in the end, surgery was going to help him. Grayson would be able to play sports, to walk, all the things I imagined for my little boy,” she said.
Hosseinzadeh said Grayson’s surgery included cutting his Achilles tendon. This is a minor operation. In fact, more than 90% of patients with a clubfoot diagnosis will have this procedure done post-casting. The other 10% of cases require a more extensive procedure.
After surgery, Grayson spent more time in a cast and then graduated to the next step in the process: bracing, specifically a tool called “boots and bars.” First he wore his “boots and bars” for 23 hours a day. Then, it dropped to 16 hours a day, to eight hours, to just at bedtime.
“Clubfoot is a deformity. So, you can get it corrected. But, the foot really wants to go back to the clubfoot position. It’s important to keep the foot in that corrected position. So, we typically keep the braces on full-time for three months and then gradually go part-time until about age 4,” said Hosseinzadeh.
He’s going to do it, no matter what.
Today, Grayson is an active 2-year-old who loves dinosaurs and running. Clubfoot couldn’t slow him down. He crawled in his casts and now that he’s really on the move, Grayson gives his mom a run for her money.
“At this point, he keeps up with his peers. It makes me feel really happy because most people thought he wouldn’t be able to do a lot of stuff. He’s proven otherwise. He’s going to do it, no matter what,” she said.
Grayson sleeps in his casts.
A dinosaur-loving Grayson runs and plays thanks to the casting his doctors did as an infant.
Multiple rounds of casting stretched Grayson's legs and ankles to be ready for surgery
Bracing helps Grayson's body from reverting back in clubfoot position.
