Our Thursday clinic attached to the West Bengal Nodal Office is usually our busiest day of the week. We see the most number of children on this day, and the team of doctors, plaster technicians and post graduate trainees can range from 4 – 8 in number. Every week, an average of 25 children are given casts, most of which are bilateral cases. One of these bilateral cases was Ayush. Ayush, his mother, and his grandmother visited our clinic for the first time in November, 2016. The trio arrived just as the casting was being completed for the last two patients of the day. While his file was being made, one of the doctors came in, and said that the treatment for this child would begin next week as he arrived too late. With the help of one of the plaster technicians, we managed to convince the doctor that delaying treatment was only going to delay the correction process and it wouldn’t take too much time to do just one more child.
The grandmother told us that Ayush was more than 5 months old, and that she was aware of the fact that early treatment for clubfoot was key to fast correction, but was unable to bring him for treatment earlier due to complications. When asked to elaborate, she said that the toes on both feet were either badly formed, or not present, and that he had stubs on his right hand, instead of fingers, while the left hand was normal. They had been going for regular check-ups but the doctor concluded that they would operate on his hands and feet when he was older, but to get the foot corrected in the meantime.
One thing which struck us while we were counselling the mother-daughter pair and telling them about the treatment process, was that they were never worried about the treatment. They were optimistic that we would be able to correct Ayush’s feet, and over time, he would be completely cured. Once the treatment started, they were amongst the first to arrive every week. The grandmother took it upon herself to talk to all the parents, and share the snacks she would bring with everyone present. She also chided the younger mothers for not taking better care of the casts, and gave advice on how keep it clean and prevent it from breaking.
Ayush was a friendly baby, who always smiled, but would start wailing the minute he was taken near the casting room. He had 9 plasters and a tenotomy over a period of 4 months. The reason it took so long was that he would occasionally break out in rashes due to the friction between his thighs and the cast, and the rashes would take about 2 weeks to heal each time, or he would get a fever- in which case they would call us and tell us that they would not be attending the clinic that week.
We finally gave him the FAB in mid March, he was initially extremely scared, and wouldn’t stop crying. However, as soon as he was given the CURE pens which are used in the clinic, he stopped crying and played with the pen instead. His foot has now been corrected, he is wearing the shoe as directed, and the treatment for his hands will start in a few months.