Serial Casting

This evening Levi gets his first of many casts in a treatment program called "Serial Casting".  Serial casting involves the use of plaster and/or fiberglass casts to restore or improve range of motion. Muscles are placed in a lengthened position (i.e. stretched) and a cast is applied. The cast is then removed after one week and his legs will be measured to track the improved range of motion and position; a new cast is then applied. The average gain is 5 degrees per cast.  This process continues until the desired range of motion is obtained and the entire process may take from 12 to 16 weeks depending on how his muscles are responding to the stretching and if his skin has negative reactions.  Some patients have the casts removed and re-applied back to back, others have a "holiday weekend" approach of removing the casts on a Friday and getting new casts the next Monday.  We will see how he responds and decide as we go. 

If you'd like to learn more watch this video that follows a 4-yr old with CP that undergoes serial casting.

Levi is currently measuring -40 degrees and he needs to be at 0 (or "neutral").  Once he is at neutral and can stand flat-footed he will be casted for two more weeks in that position.  Then he will be molded for braces the very same day his last cast comes off.   He will need to wear the braces for 12 months and sleep in splints at night, all the while doing lots and lots of therapy.  After all of this our confident hope is that he will be able to walk unassisted. 

This is how Levi stands now... 

The first half of his PT appointments are spent stretching him after they use heating pads to warm up his muscles so they are loosened a bit... and he gets to catch up on his morning reading :)

And the rest of the session he works on standing flat-footed with a wedged platform under his feet while his legs are straight...

He does great and we see that his body can do most of these tasks but when therapy is over his muscles tighten up and he immediately regresses. 

We have to find a long-term solution and we are trying real hard to avoid surgery.  We also don't want to take the Botox approach that has been given to us because that will just trick his muscles into relaxing and once it wears off in a few months his body will go right back to the tight tone.  The other option is medicating him with muscle relaxers and that is not ideal either. 

With the serial casting his muscles are very slowly stretched and real gains are made.  His range of motion will improve steadily and it will be a natural, non-invasive, non-medicated way to permanently lengthen his muscles. 

We know this will be a hard road and a little tough on us all but we believe the rewards will far outweigh the short-term discomfort and inconvenience. 

He doesn't really understand what's coming so please keep him in your thoughts and prayers.  Thank you!