Some Frequently Asked Questions....Page 3
21. What is the importance of checking for hip dysplasia?
Checking for hip dysplasia should be routine in all pediatric examinations.  In clubfoot it is particularly necessary because hip dysplasia is slightly more common in babies with clubfoot than in those who are otherwise normal.
22. What is the importance of checking for jaundice before leg casts are applied?
Heel pricks are commonly used to check a newborn baby's blood during treatment for jaundice.  If a jaundiced baby has casts on both legs, it makes it more difficult to get blood samples.
Plaster is used because the cast can be easily molded into the correct form needed to hold the foot in specific positions.  Fiberglass, while easier to remove and lighter, is not conducive to molding the foot into position.
23. Why is plaster used instead of fiberglass during casting? 
24. How does one contact Angel Flights?
25. How does one contact the Ronald McDonald house?
29. How does one know if the foot is positioned in the DBB/FAB shoes correctly?
Some parents have punched a hole or a window in the back of the shoe to make sure that the heel is properly seated in the shoe.  I have heard that shoes can be ordered with the window in them, though I haven't seen them.  Sometimes a line is drawn on the shoe so you can see where the child's toes line up.  Make sure you keep possible swelling, curling of the toes, normal growth and thickness of socks in mind if the toes don't meet the line every time.  Draw a new line as needed until you don't need it as a reference any more.
Background by:
26. Are hospital discounts available at the Iowa City hotels?
Yes.  Almost all hotels in the area have hospital discounts.  Some also have shuttles to the hospital.  Make sure you ask for the discount rate when you make reservations.  Most of the hotels are actually in Coralville (right next to Iowa City) and are less than a 10 minute drive from the hospital.
27. Where does one find out about things to do in Iowa City?
28. What should one bring when traveling to Iowa City for treatment?
Nationally
Iowa City, Iowa RMD House
Warm clothes if it is late fall, winter or early spring.  A stroller (one may be borrowed from the Ronald McDonald House also).  Make arrangements for a carseat if you'll be renting a car.  If your child will be getting casts applied, bring small blankets or towels for putting under the casts (see hints section). 
30. Can a child move while wearing the DBB/FAB?
Yes, children learn to kick, roll, crawl and pull up to a stand while wearing the brace.
31. What is a plastizode insert?
It is an orthotic foam piece with a sticky backing that is placed in the heel of the shoe to discourage the child's heel from lifting up inside the shoe.  It looks similar to an upside-down horseshoe and will be thicker on top.  Sometimes a piece of foam is also placed in the tongue of the shoe.
32. What is the normal adjustment period to a cast or DBB/FAB?
There is no answer for this question.  Some children have no problems adjusting to casts or braces, others will not tolerate them well at all.  A general rule of thumb is the older the child, the more difficult the transition.  Some children have a hard time sleeping in a cast or brace, but they should become accustomed to it within one to two weeks. 
33. Are there organizations that accept used braces?  How does one donate? 
Doctor John Herzenberg travels to Central or South America to treat clubfoot children about once per year.  He accepts used shoes and braces to help treat these children who cannot afford them.  Shoes and bars can be mailed to:        
John Herzenberg, MD
Kernan Hospital
2200 Kernan Drive
Baltimore, MD 21207
Tel: 410-448-3394

Doctor Shafique Pirani has developed a clubfoot treatment program in Uganda that has been instrumental in spreading the Ponseti method through most of eastern Africa.  Dr. Pirani is from the Royal Children's Hospital in Vancouver.  He can be contacted at:

Shafique Pirani, MD
205-245 East Columbia Street
New Westminster
British Columbia
Canada V3L 3W4
Tel: (604) 522-2332
Fax: (604) 522-7686

34. What are typical costs for Ponseti Method treatment? 
The costs of the Ponseti method in Iowa from start to finish are probably between about $1,000 to maybe as much as $4,000 depending on if both feet are involved, number of casts (4-7) and whether a tenotomy is needed on both feet.  The cost for a brace with shoes was $211 (American) as of August, 2000 in Iowa.
35. Insurance advice?
Since there are so many different insurance companies and policies, there isn't an easy way to help everyone with their insurance questions.  One thing I can note is that the Ponseti method is not considered "experimental".  If you are seeking treatment in Iowa, here is the number for the University of Iowa Hospital's Customer Service office (319) 356-2211, they've been able to help me with all my insurance questions thus far.  Dr. Ponseti is also listed as a Preferred Provider for Blue Cross/Blue Shield.