Wednesday, March 25, 2015

FDR is FOUR Months Old

Dear Frankie,

You are FOUR months old!

This letter may be the last one with a picture of you without a helmet.

Since you are in your fourth month, this means you're out of the fourth trimester. You still have a startle reflex that wakes you up, which is becoming less, and less these days, and because of this, you are still being swaddled. However, you are in the process of being transitioned out of the swaddling. You are beginning to prefer to have your arms out of the swaddle. You're already napping without needing to be swaddled. It is bedtime that you are being worked on to be transitioned out of. Mama is hoping that you will be able to forego needing to be swaddled once for when you are fitted with a helmet, because she is told that you will be quite hot at the night with it on. It will be an adventure to figure out what is the best for your night wear when you go to bed.

You're beginning to look like a baby with your own features that is being enhanced by your personality. It is so wonderful in getting know who you are; you love to flirt, and soak in attention while being cuddled by people. There is something about you that just asks to be kissed, and held. Your sunny disposition is always shining through. It is not very often when you are grumpy. This grumpiness occurs when you are going through growth spurts, and it makes you feel not exactly the best. When it does happen, you love to be put in the wrap, and fall asleep against your Mama's chest. 

You are outgrowing your bassinet. There is pretty much almost no room left for your long legs.  Due to this, Mama is starting to transition you to sleeping in crib for naps in order for you to get used to sleeping in the crib, and hopefully, you'll be used to sleeping in it by the time you get your helmet. It is more reasonable to have you sleep in the crib, because it has more space to accommodate you, and provide more comfort for once when you are required to wear your helmet 23/7. Mama has recently fixed up your bedroom to make it more roomy, and more livable. It is hard to believe that time has come for you to start sleeping in your own bedroom just like your big brother. Mama is a bit sad to let you go, but it is time. 

Daddy, and Mama are looking into getting you a new car seat, because once you are fitted in your helmet, then you may not be able to fit in your infant car seat carrier comfortably anymore. It will be a bit of adventure in trying to figure out how to carry you around since you yet have begun to sit up, and can't sit up in shopping cart. It is a good thing that babywearing will come in very handy, and even better that warmer weather is just around the corner, which makes babywearing you a lot easier! Wearing you may be a solution until you are able to sit up, and support yourself without toppling over. It is possible that you will be delayed in sitting up on your own, because of Torticillis.

Your visits to chiropractor is doing a wonder for your back, and neck. As it turns out, your back is so tight that even with physical therapy, it cannot be loosened up, and it is a good thing that you ended up seeing Dr. Katie. Once your back has been tweaked, you are able to lift yourself more freely without struggling so hard! As for your neck, the muscle on your right side also had to be tweaked.

This is where tons of tummy time comes in, since it is strongly encouraged that you are on your tummy a lot in order to make PT more successful, and this means you are on your tummy quite a lot. It is a pretty good thing that you are able to tolerate tummy time a lot more now. Mama puts you on tummy time exercise in intervals, and it is more successful that way rather than forcing you to be on your tummy for long period of time each time. You are beginning to tolerate tummy time better. Matter of fact, you are actually laying on Mama's lap right now! Mama has found different ideas with incorporating tummy time for you, because it is so important for you to strength your upper body in order to be able to overcome Torticillis.

You are able to hold your head steadily more, and more these days rather than tilting. Based on research Mama has done (yes, that's how Mama is), it is possible that you regress, and tilt your head during growth spurts, illness, and teething. It is good to know this so Mama won't panic, and think you are regressing permanently. Fortunately, these brief regressions are not permanent, and will go away once whatever ails you goes away.

Dave is impressed with how well you are doing. You have come from being in 30-40 degrees of head range to 70 degrees. He said that between 80 to 90 degrees is considered to be normal. You are almost there, little man!! He likes what he is seeing from you with how you lift yourself up, move your head, and the fact that all the hard work you've been dong is paying off. Dave did give a caution that you may regress a bit in the beginning when you start wearing your helmet. Nonetheless, he is confident that you will bounce back from the regression without much trouble. Mama thinks that you are probably going to be released from PT in a couple months if you are able to continue this with helmet therapy.

You met with Dr. Staci, and it was shown that your head had progressively gotten worse by 4 MM. It was most likely caused by your growth spurts. Unfortunately, due to your head abnormality, your head continued to grow into a wrong direction, and because of this, your flat spot had gotten worse. It was not anything you, or anybody else had done wrong. It was just what it was. You had your head scanned, which was really cool, because Dr. Staci had a hand device that reminded Mama of Star Trek phaser. The scan showed that your skull was shaped almost like an egg! It was kind of crazy to see how much plagiocephaly was affecting you. It really did confirm Mama's, and Daddy's decision to go with a helmet therapy to correct your head shape.

Since your head was growing so fast with each follow-up visit, Dr. Staci felt it was for the best for you to have a helmet immediately after your fitting on March 31st, and advised against having your helmet to be painted at this time. It was somewhat a disappointing news. However, it did work out for the best, because your health came first over fashion. Mama, and Daddy chose to go with solid yellow helmet for you to have in the next two months. It had not been decided if Mama was going to put stickers on your helmet, because it seemed like a huge hassle to remove the stickers off your helmet for the painting.

Nonetheless, Paula has been really awesome about having to reschedule for your helmet painting. Mama, and Paula agreed on June 2nd for your helmet painting. By that point, you will be six months old, and by then, your head growth will be a lot more stable. Then you can afford to lose at least up to two days of not wearing your helmet to have it painted. Dr. Staci even supports this.

A good news is that our insurance will be covering your helmet completely! What a blessing, and especially so, a relief!

You met with Dr. Karbon for your 4-months wellness check. You were said to be in a great health. Mama brought up about your bowl-legged shaped legs to Dr. Karbon, and learned it was quite normal for babies to have bowl legs for first year of their lives, especially breech babies. Your height clocked at 25 inches long, and that put you in 67% among of your peers. That meant you were one tall boy! As for your weight, you were weighed at 14 and half pounds, which put you at 25% of your peers, and that pretty much said you were tall, and thin! You received a second round of vaccinations, and that made you super sleepy (and a tad fussy, but that was okay). Dr. Karbon ordered a follow-up ultrasound for your hips to further make sure that everything was growing well. It was scheduled for April 1st! Mama was confident that you would pass the ultrasound with flying colors. 

Forrest is still ambivalent toward you. However, he continues to give you kisses, and pats you on your head. He always want to join you if Mama is taking pictures of you. It seems as when you get bigger, the more interested Forrest becomes, and wants to develop a rapport with you. It will be interesting to see how you both interact when you get to the point of being able to scoot everywhere! 

Mama is so blessed to have you, and Forrest in her life. Here is the secret though... Mama is glad to have you second. 

Here is why: You needed a seasoned, calm, experienced, and a "veteran"mother. If Mama had you first, then she would have been overwhelmed by all the issues that came with you, remembering how to do PT exercises, finding ways to make tummy time fun for you, and scheduling all the appointments in order to help you get better. Forrest was an easy baby, which was perfect for a mama that had no idea what the hell she was doing, and that meant he got a lot of bunt of mistakes! In this, Mama learned from her mistakes, gained tips how to raise a baby, gathered resources that was filed away in her mind to be used for subsequent children, and most importantly, the lessons to become a better mother. While Forrest made Mama a mother for the first time, Forrest did set up a path for Mama to become exact type of a mother that you needed, and you got exactly this with you coming into the world as a second child. So you were incredibly blessed to have come at a wonderful timing.


Mama, Daddy, & Forrest

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!