Leg Length Discrepancy(LLD) and external heel lift

 Leg length discrepancy  or LLD is a condition where one leg is shorter than the other. It could be classified as true or functional. True LLD is when the femur or tibia is short and functional is when the pelvis is not properly aligned.

 Working in the Pacific Island of CNMI is a challenge due to its location. We are limited in almost all resources, nonetheless, we do the best we can with what we have.

After evaluating a baby with LLD and finding out it is true LLD, I can't wait for June or December for a team from Shriners Hospital to come and evaluate him.Furthermore, baby is already walking using a posterior walker.  LLD can cause scoliosis and back pain.Thorough evaluation reveals Left leg is shorter by 2.2 cm. I ask baby's parents  for his shoe so I can add an external heel lift.They gladly gave it to me and brought it to the office. I told them I will be bringing it on my next visit.
Since it is just temporary pending the Shriners team evaluation, I made use of  cardboard  to make external heel lift. I traced the heel of shoe onto the cardboard and made a lot until it was already 2.2cm when stacked together.

 I traced and made cut outs of cardboard and stacked them together using a paper tape.

Side view of the shoe with the lift. I used paper tape to hold together the cut out card board heels and scotch tape to hold it onto the shoe. Dad and mom were informed to reinforce tape if it loosens up.

Bottom view of both shoes

After the baby wore the modified shoe, he was walking with very minimal limp to none.

Parents are happy while waiting for Shriners this June 2012.

The Importance of Tummy Time

Tummy Time! You can do it Jaela, lift your head some more!

Supported  tummy time using log pillow.

Tummy time is very important in a baby's development. It is the position where you place baby on their tummy.It can begin as soon as after birth however, my personal opinion is to start when belly button is fully healed..However due to SIDS,babies nowadays rarely been given this opportunity to be on their tummy.

Tummy time must be supervised and should be encouraged. It must be done only when the baby is awake and during play.Babies tolerance to it should be increased. With my baby Jaela, we started tummy time when she was a month old, Right after birth,she had infection on her belly button requiring hospitalization thus delaying tummy time.

Tummy time encourages the baby to lift his head,push up on his arms as well as lift up upper back thus strengthening the muscles on these areas.These skills are needed later on for rolling,crawling,sitting,etc.

I would initially use supported tummy time with small log pillows or towel roll place under the chest and as the baby is able to develop more strength,I would then remove the pillow.

Easter Monday in Tinian Island!

It was Easter Monday,I woke up late and had to rush to the airport. A few minutes in the air and I was back on the island of Tinian for an evaluation.  It's been months since I've been on the island.  Our team includes Teacher Robin,Service Coordinator Doris and me.
The evaluation went well and we didn't qualify the baby for early intervention but was placed on monitoring every 3 months. Baby is back on track with development despite some setbacks weeks earlier and a traumatic incident.  Truly God has His ways!

Teacher Robin at the Check In Counter

Teacher Robin and me.Do I really want to fly in this plane!

Cockpit of Cherokee 6

After a 15 minute flight, we arrived in Tinian.

Tesa,our contact in Tinian.

Following a snail pace tractor.

We flew back to Saipan right after. My wife fetched me at the airport and a big hug from the kids when we  got home.That was my Easter Monday.

True Meaning of Easter!

Our little Bunny sitting on her own!

Come and get me! Jaela trying to reach a bunny cookie.

 My family did a lot of  spring cleaning last Saturday. Everyone took turns in carrying Jaela or playing/entertaining her during tummy time. On Sunday, a day of rest, we went to Church and the message was on the Resurrection, it was Easter Sunday. We need to remember that almost two thousand years ago, God sent his only begotten Son Jesus Christ to die for you and me that we would be saved from condemnation and have eternal life. Have a Blessed Easter!

Overview of Developmental Milestones

Jaela independently sitting at 6 months.

Developmental milestones are a series of events occurring at predictable age of a child. These events refers to the areas of  child development.These milestones are used by professionals in order to determine if our children have delays in one or more areas.. We must consider though that every child is unique and therefore, they vary.