Plug in the Saw, Lucille

Ashley was cast today. Not for a play or a movie, but for those plastic orthotic things you see on the feet and ankles of many kids with physical disabilities. This was the third attempt at casting and finally, success was achieved.

The casting process is almost exactly like getting a cast when an arm or leg is broken. There is a stockinette, something like a sock with the toes cut out, that fits over the foot and leg, a pan of water, something that looks like rolled up gauze but is actually rolled up fiberglass, some scissors, and a saw. The person doing the casting has to get the stockinette on the foot of the child, put a long blue piece of plastic down into the stockinette and next to the foot and leg, wet the fiberglass gauze stuff, wrap it snugly around the child’s foot and leg, and then hold it still and in the same position until it dries. Wiggling the toes, lifting the foot, or trying to turn the ankle can sabotage the process and take things back to square one. Once the cast is dry, it must be cut off with a little saw. The saw blade is run down the blue piece of plastic previously placed next to the child’s skin, and if all goes well, off pops a fiberglass replica of the child’s foot and leg. The entire process must then be repeated for the other leg and foot.

Sounds fairly simple, eh? Well, let’s throw into this picture a child with deafblindness. Ashley gets anxious in unfamiliar settings and around unfamiliar people. She doesn’t like to wait more than a few minutes. Strange smells and sounds set her on edge. And she especially doesn’t like when someone grabs a part of her body and starts doing things she wasn’t told were going to happen. Time of day, how well-rested she is, how she feels, and whether or not she is hungry can all play a role in how well Ashley handles an unfamiliar situation. So, on the first two unsuccessful attempts at casting, the fact that the owner of the company made Ashley wait an hour after her appointment time started things down a slippery slope. Add to that all the unfamiliar smells and textures, the fact that the owner never spoke a word but just kept grabbing at her foot, and lots more waiting, and the gig was up. The meltdown happened but the casting didn’t. Finally, the Wicked Witch of the West End, affectionately know as Mom to Ashley, had to step in and insist on some changes.

Ashley’s therapist and a new caster, a person with better bedside manner and distinctly better time management skills than the owner of the company, agreed to attempt the third casting at Children’s Hospital, the place where Ashley goes every week for therapy. Now that she was back on familiar ground and the people around her were not strangers, Ashley was more relaxed. It was early morning and she was well rested and well fed. She had some of her own toys with her, and she was being told through sign language exactly what was going to be done at every step of the process. The cast for the first leg was applied, dried and cut off with nary a whimper from Ash. The casting of the second leg went just as well.

Doctors, therapists, nurses, and all other professionals usually know their craft extremely well. But, they don’t always know their patients equally as well, especially if the patient has rare, unusual, or low-incidence disabilities. The professionals that I consider the best are the ones who are not afraid to admit that they might need some help on that patient piece. No one knows my child better than I do, and if a professional is willing to admit that and to accept helpful suggestions, everyone’s life would be so much easier, especially Ashley’s.