Tuesday, March 3, 2015

Initial Evaluation, PT, and Chiropractor, Oh My!

We met with Dr. Staci yesterday at Hanger Clinic for 8-weeks follow up to evaluate whether the PT, along with head growth, has been helping with cranial abnormality, or not. Thankfully, the appointment went so much better this time with C interpreting for us. Dr. Staci measured Frankie's head to discover any improvements, or decline with his head growth. 

Good news was that Frankie's cranial vault was beginning to even itself out! 

Here's a picture of what cranial vault is: 

Anyway, a cranial vault is the topmost part of our skull. You may notice with your newborn, especially if you've had a vaginal birth, that your newborn's head may look like a cone head! It is a result of being squeezed through a relatively small hole during child birth, and the skull is very soft so it can be contorted in order for a baby to be born. The cone-head appearance usually evens itself out as the baby grows.  
You can see the slight bulge on the forehead, and the unevenness on top of the skull. 

However, with Frankie, the front part of his cranial vault, on the left part of Frankie's forehead, is slightly bulged out, and this will be remedied with helmet therapy. The back part of his head on the top, not on the back of the head--hope this is making sense, is slightly pointed. Now with this, you want to see the measurement to go down, because this cannot be remedied with a helmet therapy. The helmet does not have a cover, and even if it does, then it can't quite "compress" the cranial vault. There needs to be a certain amount of pressure applied in order to fix the cranial vault from top, and the bottom. It is just not doable with a helmet.

*On a side note, several parents do choose to take their infants for Osteopathic Manipulative Therapy. This is a doctor that squeezes, and massages the skull of an infant in order to manually shape the head. This is a bit controversial, and is not proven on a piece of paper that it is successful, even though there are many people that have benefited from it. There is one OMT doctor here in Green Bay area, but the waiting list is really, really, really ridiculously long, and the doctor is booked until kingdom come! So it is just not feasible for us. Besides, we don't feel that OMT is right for Frankie, and want to go with a helmet therapy instead.* 

So, anyway, back to our appointment...

This time, Frankie's head was measured between 12 mm in width across, and 14.5 mm diagonally, which was slightly better than how the measurements were at 8 weeks ago. However, Dr. Staci explained to us that this could have been attributed to a human error; the measurements could have been the same as the last time, or worse, or better. We don't know for exactly sure, since we had to include a human error of measurements. It made sense. Since Frankie's head measurements were still above 10 mm, he was still qualified, and recommended for a helmet therapy.

As pictured, the flatness is apparent on the left side...never mind my tribal leggings sticking out like an eyesore!

From what I was explained, we will obtain a "one-size fits all" helmet for Frankie, and inside the helmet, there is a layer of foam that ranges in thickness all around in order to mold with Frankie's head, and over the time, the foam will be shaved off as Frankie's head grow. Neat, huh.

Currently, all the information from our initial visit yesterday is being submitted to our insurance by Hanger Clinic. I am really nervous about the approval process. It is hard to predict what will come from this being submitted to our insurance. From what I have heard from parents of children that needs helmets, sometimes their insurance can be a butthead, and cause such a hassle. Sometimes, the insurance is awesome, and cover or partially cover the helmet. I'm hoping that our insurance will either cover the helmet completely, or at least pay half of it. We are informed that if we hear nothing from Hanger, then it is a good news, because it means the helmet is covered by our insurance. I'm keeping my fingers crossed that we hear nothing until the 18th! Come on, and cross your fingers, along with toes, for us, as well! 

We are going back on the 18th to obtain a several head scans of Frankie's head, and start an official paperwork in the file to monitor the process over time. The measurements will be taken once again to be sent in to the manufacturer to build Frankie a helmet!

On the 31st, Frankie will be fitted with a helmet, and we will be given a regime of treatment for his helmet therapy. On that very same day, we are going to ship Frankie's helmet via FedEX to be sent all way to Washington state! There, Paula will be painting the helmet for us, and once she's done (this usually takes only a day..two days max), she will ship it back to us. We should get it within 2-3 days of shipping it to her. The design is top secret, and we will reveal the design once we get it back! 

On April 6th, Frankie has a follow up appointment to see how the helmet therapy is going, and to take measurements along with head scan. Then again, on the 20th. We may have more appointments after that. I don't know what to expect after the appointment on the 20th. 

Frankie's PT is going well. He is beginning to be able to turn his head to the right with a lot of vocal, and visual prompting. Sometimes, I need to guide Frankie manually with my hand to get his head turn to the right first time. It depends on how the day is, and how Frankie is feeling. Usually, he is able to turn by himself. It is quite an amazing feat! He still greatly favors his left, especially when he is leaning back, or laying on the back as you can see in this picture. This is why he has such severe flatness on the left side of his head.

We are taking Frankie to a chiropractor on this Thursday on the 4th of March. Hopefully, we will see a result from combined therapies of using PT, and chiropractor work on Frankie's wry neck. The wry neck can be seen in the picture below:

Yeah, I know he has a mean mullet action going on back there! I don't have a heart to trim, or cut it off just quite yet. I will probably have to trim his hair before he gets fitted with a helmet to prevent tangles, dirt, and sweat from getting into his hair.

Stay tuned with us in the next few weeks, and you will be updated with how our appointments are going with Frankie!