I was very proud of Faith yesterday. She was so patient as she was fitted for her new SMO's. SMO stands for Supra-Malleolar Orthosis and are actually a type of AFO (Ankle-Foot Orthosis). These types of orthotics are designed to help the child maintain a vertical heel and support the arches of the foot. They are necessary for her foot because with her hypertonia her feet get pulled at a different angle than what is normal for the foot. It's sort of like trying to re-train the muscles to go in the right direction.
It took about an hour and a half for her to get fitted. The hardest part was keeping Faith relaxed so that her physical therapist (PT) could get the best fit for her foot. When Faith gets excited, her legs shoot up and out and her tone is so strong that it's hard to keep everything in place. This is exactly what happened every time someone came into the room to say hi to her.
Her PT started off by finding a plastic piece as close to the shape of Faith's foot as possible. Then, using some white, cold stuff she would fill in the plastic piece to fit her foot. Each time her PT had to add to the cast, she had to put Faith's foot in the cold white stuff to see what kind of progress she was making. She did this about a dozen times for each of Faith's feet before she finally got them perfected. Faith does not like cold things on her skin, so I knew this was a challenge for Faith every time she had to put her foot into that cold stuff.
The casting took about an hour. After this was done, someone else came in and used a special material to "tape" up Faith's feet all the way to her mid-calf. He squeezed it and held it for about five minutes and after it stiffened, he cut it away and it became a mold of what her SMO will look like. The SMO is then made with hard plastic and padding is put in over the casting part.
During the process, Faith was able to pick out what color of Velcro straps she wanted and what picture to place on the backs of her orthotics. She chose purple straps with flowers on the back. I remember the second pair of SMO's she had, her dad was in charge, and he chose to have a hockey player on the back. Her third pair had a horse, and the straps were hot pink. This new pair will be her fourth.
Faith's patience reminds me of what a good girl she is. No matter what difficulties and struggles she is having, she never fails to have a smile on her face. I am so very proud of her.
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