Why?

"Mama Bear, why do they want me to walk flat footed?"

I took a deep breath. I said a quick prayer. This was the question I'd been waiting for since we had our first appointment with the orthopedic surgeon. This was the question I was dreading. Because I knew the question that lingered behind it. "What is wrong with me?" Why do I know this? Because, I too, walked on my toes as a child. I too, wondered why everyone wouldn't just let me be and walk any old way I wanted.

But now, I was the Mama Bear. I was in charge of the one who just wanted me to "let him be". I'll admit, there was a part of me that wanted to just pick that bear cub up and run to the woods where we could start a toe walking commune, but I didn't. I had to be the Mama Bear.

I took another deep breath, and gently explained it to him. I told him that while his body prefers to walk on his toes, that it wasn't good for his muscles to walk on his toes forever. That, if he continued, he would risk losing use of some muscles and then wouldn't be able to do every activity he wanted. I explained that walking with your whole foot (not just your toes) is how a human being is intended to walk. He seemed fine with that explanation and, as kindergartners are apt to do, moved quickly on to another question.

But I didn't.

This is a question Papa Bear and I have dealt with as parents since Brother Bear began his journey into the upright world. He began walking on his toes as soon as he started walking. We were hoping (as the pediatrician suggested) that it would go away. But we also knew that 70% of toe walkers had a parent who walked on their toes.

At the age of three, we were referred to an orthopedic surgeon at a local Orthopedic Hospital. He told us that most kids "grow out of this" and that he would see us in a year. In a year, at age 4, he said that Brother Bear didn't seem to be growing out of it like we had hoped. He broached the idea of a surgical solution, and wanted to see us again in 9 months. Nine months later, he confirmed no positive changes in Brother Bear's gait and told us that surgery was the best option. We asked for more time. He gave us 3 months.

We began to search in earnest for alternate solutions. We were divinely connected with a Physical Therapist who, with twice weekly visits and night braces (molded twice a month), helped Brother Bear gain enough range of motion to actually put his heels on the ground with ease (and without pain), but we were unable to get enough range of motion for him to be able to walk flat footed. The therapist, who was very connected with the Orthopedic Hospital, noticed some odd things about Brother Bear's reflexes. She suggested that these things might suggest a neurological component to our problem.

At our next checkup, our orthopedic surgeon agreed to a neurological work up. The neurologist became our close friend over the next year. He said that we needed to "retrain his brain." We put Brother Bear in cast for 4 weeks. He gained some elasticity, but the neurological symptoms only increased. The neurologist suggested more testing. We had an MRI that found "a spot" on his brain. It might explain the problem. We continued our effort to "retrain the brain" by having AFO Braces made for Brother Bear, and having him wear them six hours every day.

Another MRI, a genetic test, and 9 months later, we are back where we started. Brother Bear (when he's out of his braces) still walks on his toes, and we still don't know why. They call it "Idiopathic Toe Walking". (Funny - My Daddy Bear {a retired physician} asked me if I knew what "idiopathic" meant. He said "idio" means, "I don't know" and "pathic" means "why the hell" Ha!).

Basically, Brother Bear walks on his toes and no one has a text book reason why. Unfortunately, we just can't keep letting him walk like this.

So, Tuesday morning, we will check him into the Orthopedic Hospital where a very seasoned, very capable Doctor Bear will perform a Bilateral Sliding Heel Cord Lengthening Surgery. Basically, the Doctor Bear will make small incisions in 3 places in both of Brother Bear's Achilles heels. Doing so will allow the muscle to "give" enough to stretch Brother Bear's feet into dorsiflexion (toes to shins). The Doctor Bear will then put hard "walking casts" on Brother Bear's feet while in dorsiflexion. He will be in these casts for 4-6 weeks. The theory is, that this "extra length" (and time in casts) will allow Brother Bear the ability to walk flat footed.

As you see from my writing, we didn't come to this decision lightly (quickly, or easily!!). Papa Bear and I did not want this surgery. It's painful and the entire recovery is about 6 months. Neither of us wanted to inflict this on Brother Bear. But, after many consultations, and many prayers, we feel confident that we are making the right decision for our cub.

So, tomorrow, I send my my cub into surgery. A piece of his innocence will be lost in this process and, as his Mama Bear, I mourn that. I will be brave. But he will be braver.

Until then, we sent him to school for the first time in over a year without his braces. He was ecstatic! Papa Bear and I both figured that one day without braces wouldn't hurt.

Plus, we gave him one last day to just "let him be". To let him know that nothing, absolutely nothing is wrong with him.