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When expectant parents Kate and Troy went for their 20-week scan, they felt excited to catch the first glimpse of their baby. But the ultrasound showed something they didn’t expect: clubfoot.

Clubfoot is a condition that causes the foot to turn sharply inward. Both of their baby’s feet had the condition.

The OB-GYN told them that clubfoot was a very treatable condition. That didn’t stop the panic. “Leaving that ultrasound was just heartbreaking,” Kate says.

The doctor referred them to UPMC pediatric orthopaedic surgeon Melissa Meyer, DO. Dr. Meyer’s closest office was in Hummelstown, almost an hour from their home in York.

Kate, a self-proclaimed planner, began researching the condition right away. She quickly realized that it required several visits in the first weeks of life, so she looked around to see if there were any doctors closer to home.

There were some, but most wouldn’t even consult with Kate while she was still pregnant. “They basically said, ‘Call when he’s born.’”

In her first conversation with Dr. Meyer, Kate saw that she took the opposite approach. She wanted to answer their questions as soon as possible and get a plan in place.

Dr. Meyer even did a video call with them. She held a model of a foot beside her and explained exactly what was going on. She walked them through the entire protocol, called the Ponseti method.

The Ponseti method uses a series of casts and braces to correct the foot’s position. From her research, Kate had already learned it was the gold standard. Surprisingly, some of the other non-UPMC doctors Kate contacted didn’t follow the Ponseti method.

After that call, they knew they had made the right choice to go with UPMC Orthopaedic Care. “I really appreciated how Dr. Meyer talked with us. She gave us such peace of mind,” Kate says.

Starting the Ponseti Method at 1 Week Old

Ian was born on June 7, 2023. Dr. Meyer saw him on June 15, when he was a week old. He got his first cast that day.

He went back every week for four weeks to change out his casts. The idea is that the casts slowly correct the problem, rotating the foot further each week.

Each cast ran from his toes to his thighs. They were plaster casts, which made for a somewhat lengthy process. “Ian did not appreciate it,” Kate says.

But after the casts were on, he did OK with it. The challenge was more on Kate and Troy’s part.

Ian was their second child. They had to learn to do things differently than they had with their first, Owen.

For example, they had to hold Ian in a way that supported the casts.

That made breastfeeding challenging, though Kate eventually found positions that worked. And changing diapers was always an adventure. “We definitely got poop on the casts,” she laughs.

It helped that Ian had a good disposition. He slept well and was generally a happy baby. “His brother loved to draw on the casts,” Kate says.

Clubfoot Surgery for Ian

Once the third cast was removed, Ian needed to undergo a tenotomy, though not all children with clubfoot require it. While tenotomy is a common procedure, in many cases the nonsurgical Ponseti method is enough.

A tenotomy is a surgical procedure that cuts the Achilles tendon, releasing tightness and helping to further correct the clubfoot.

Dr. Meyer performed the tenotomy surgery at five weeks. “That was scary to have him in the OR, under anesthesia,” Kate says.

He recovered quickly. “You can barely see the scars now,” she adds.

The next step was to have Ian in casts for two more weeks.

After those came off, he progressed to the next stage of treatment: the boots and bar process. Ian wore two boots connected by a bar at the heel, which had to be worn 23 hours a day. “It looks like a mini snowboard,” Kate says.

At this point, Ian was in day care. Kate had to show them how to deal with the boots and bars. “They were very accepting and very helpful,” Kate says.

Now, at 20 months old, Ian only has to wear the boots and bars at night. “He doesn’t fight putting them on, but sometimes he thinks it’s a game,” she says.

He might start giggling, which makes his brother start to laugh. “He has the best laugh,” she adds. “It’s contagious.”

Another Diagnosis for Ian

Children with clubfoot can run a bit behind on development milestones like walking. When Ian was in boots and bars at night only, Kate thought they’d see a bigger jump.

Ian had been in physical therapy since birth. In Pennsylvania, a child with clubfoot automatically qualifies for early intervention therapy. The physical therapist noticed that Ian’s reflexes weren’t what they’d expect for a child his age.

This prompted them to get genetic testing and see a neurologist. Doctors diagnosed Ian with a rare genetic disorder that causes gross motor delays and low muscle tone.

He’s made excellent progress with his feet. Kate says that his other condition is causing his current delays. He continues to get physical, occupational, and speech therapy.

“Through it all, he is a determined little boy,” Kate says. “Now that he’s gained strength, all he wants to do is walk.” They hold him under his arms for support, and he takes off.

With his syndrome, mobility varies. “We believe we’ll get him walking, maybe with assistance, maybe without,” Kate says. “He really likes the challenge.”

What Kate appreciates most is that Dr. Meyer has researched Ian’s gross motor delay condition.

“She’s come up with an ongoing care plan that takes his syndrome into account,” Kate says. She’s always helping Kate and Troy connect with resources, even when they don’t relate to UPMC directly.

“Ian loves the pool, and we had been searching for aquatic therapy,” she says. Dr. Meyer helped them find a place close to home.

“We’ve seen a lot of doctors lately. But Dr. Meyer is special. She takes the time to understand everything and how it impacts Ian.”

Kate has one small piece of advice for parents facing a clubfoot diagnosis — or any challenging diagnosis, for that matter.

“It’s OK to feel disappointed that those first few weeks and months will be different than what you thought,” she says. “But come up with a plan to get the best care you can and then enjoy the amazing things about your child. And remember that their condition isn’t everything about them.”