Guest guest Posted August 12, 2010 Report Share Posted August 12, 2010 My son who had brachy and plagi started his first Doc Band at 5 months and outgrew it in 6 weeks. We saw some great improvement but still wanted to get more length in the back of his head. He was wider at the top. We decided to go with a 2nd band even though insurance originally denied us. (After our appeal, they came back and approved it so we get a full refund from Cranial! Nice surprise for once!) has been in his 2nd band now for about 10 weeks and probably only has about 4 weeks top left. At my last adjustment appointment they mentioned a 3rd band. My husband says no and I'm on the fence. We've seen some great improvement but I don't feel like we've gotten the length we wanted from this 2nd band so whose to say a 3rd would get us there. He turned 9 months today and has been a trooper with the band on for months. I'm torn. Part of me says we've done everything and the other part says we have to do more. Any thoughts? Thanks guys! Christy polis, MD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 13, 2010 Report Share Posted August 13, 2010 Christy,Wow--that's a tough one. Perhaps, you could post 's initial measurements and his current ones and some of the parents whose babies had brachy & plagio could offer some advice?My daughter had plagio and we stopped treatment at 15 weeks after she had gotten down to less than 3mm. We could have gone another month in the helmet, but it was late June(very hot, humid where we live) and I felt like my daughter had been through enough. She had come such a long way and at the time, sleeping better and her learning to walk seemed like they mattered more than a completely perfect head shape. I am a bit of a perfectionist, so had it not been so hot, I might have gone another month, but you really have to look at all the circumstances and the big picture. In the end, I think we made the best decision for .Good luck!-AmyGood luck!From: christy.julian <christy.julian@...>Plagiocephaly Sent: Thu, August 12, 2010 2:30:28 PMSubject: When to call it quits? My son who had brachy and plagi started his first Doc Band at 5 months and outgrew it in 6 weeks. We saw some great improvement but still wanted to get more length in the back of his head. He was wider at the top. We decided to go with a 2nd band even though insurance originally denied us. (After our appeal, they came back and approved it so we get a full refund from Cranial! Nice surprise for once!) has been in his 2nd band now for about 10 weeks and probably only has about 4 weeks top left. At my last adjustment appointment they mentioned a 3rd band. My husband says no and I'm on the fence. We've seen some great improvement but I don't feel like we've gotten the length we wanted from this 2nd band so whose to say a 3rd would get us there. He turned 9 months today and has been a trooper with the band on for months. I'm torn. Part of me says we've done everything and the other part says we have to do more. Any thoughts? Thanks guys! Christy polis, MD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 13, 2010 Report Share Posted August 13, 2010 My gut instinct is that if you do not feel like the job is done you should get another band. My son was in a band for plagio and brachy for 3 months (6-9 months old). At the end I thought his head was still too wide, but everyone else said he looked great so I agreed to quit. It drove me crazy for over a year. My son is 2 now and I am used to the way his head looks, but if I could go back I would definitely have insisted on another band. On the other hand you do have 4 weeks left, so maybe will have a growth spurt and there will be a sudden improvement. In any case, good luck! > > My son who had brachy and plagi started his first Doc Band at 5 months and outgrew it in 6 weeks. We saw some great improvement but still wanted to get more length in the back of his head. He was wider at the top. We decided to go with a 2nd band even though insurance originally denied us. (After our appeal, they came back and approved it so we get a full refund from Cranial! Nice surprise for once!) has been in his 2nd band now for about 10 weeks and probably only has about 4 weeks top left. At my last adjustment appointment they mentioned a 3rd band. My husband says no and I'm on the fence. We've seen some great improvement but I don't feel like we've gotten the length we wanted from this 2nd band so whose to say a 3rd would get us there. He turned 9 months today and has been a trooper with the band on for months. I'm torn. Part of me says we've done everything and the other part says we have to do more. Any thoughts? Thanks guys! > > Christy > polis, MD > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 13, 2010 Report Share Posted August 13, 2010 { I don't usually do this, but I'm adding a note to a post... Mike is an ortho, and this is the way his practice handles exit. Please be aware that there is a lot of variety here. I don't want anyone to worry that their ortho/clinician doesn't do things exactly this way. thanks. -christine (one of the group moderators) } Hi Christy There are several factors that are used to determine when parents should decide to end treatment. 1. The discrepancy has corrected. Head looks great and parents are very happy. 2. Parents have elected to stop treatment. They are happy with the correction gained even though a small discrepancy might still remain. To them the remaining discrepancy is minor compared to when they first started. 3. No change in measurements for 3 consecutive follow-up visits. 4. The child is nearing 14 to 15 months of age and their hand skills have improved greatly. Parents find it a struggle to keep the helmet on. Changes are also very slow to achieve at this age. 5. Parent's frustration level – this is usually the result of one parent not really on board with the treatment and is reluctant to have the child out in public with the helmet on. This is very rare but it does happen. Since your son is only 9 months old you still have 3 to 4 months of correction available to you. In our clinic we do not treat beyond 15 months of age. Parents find that the time required to gain a few mm is not worth the time spent in the helmet and they want to get on with other stages in the child's life. I guess the fact that I find interesting is that your treatment required the use of multiple helmets. We don't treat with multiple helmets as the parents are usually ready to move along and one helmet lasts the entire treatment. Why not go back to your provider and discuss with them what they think can be realistically gained by going back into another helmet. Take care. Mike Hall Certified Orthotist Hamilton Health Sciences Chedoke Hospital Hamilton Ontario Canada > > My son who had brachy and plagi started his first Doc Band at 5 months and outgrew it in 6 weeks. We saw some great improvement but still wanted to get more length in the back of his head. He was wider at the top. We decided to go with a 2nd band even though insurance originally denied us. (After our appeal, they came back and approved it so we get a full refund from Cranial! Nice surprise for once!) has been in his 2nd band now for about 10 weeks and probably only has about 4 weeks top left. At my last adjustment appointment they mentioned a 3rd band. My husband says no and I'm on the fence. We've seen some great improvement but I don't feel like we've gotten the length we wanted from this 2nd band so whose to say a 3rd would get us there. He turned 9 months today and has been a trooper with the band on for months. I'm torn. Part of me says we've done everything and the other part says we have to do more. Any thoughts? Thanks guys! > > Christy > polis, MD > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 13, 2010 Report Share Posted August 13, 2010 Hi, I strongly disagree with necessarily stopping at 15 months. If the child does not mind or perhaps even prefers wearing the helmet, and the parents are still unhappy with the head shape, in many cases a lot can be gained by continuing. If we couldn't treat past 15 months, I would have felt devastated. This would have had enormous long term emotional consequences for our whole family! In relative terms, 's head has improved a lot since 16 months. It has improved quite a bit since 18 months, and even a tiny bit since 24 months. Although 's head is not perfect, it almost passes as normal to me and I don't feel nearly the panic about it that I felt at 16 months when I could hardly sleep fearing it wouldn't improve, but it very slowly did improve. To many people 's head is normal now. The time spent in the helmet was well worth the ~4mm gained after 15 months, which visually is substantial for a mild case. For , the improvement came off the back since his forehead asymmetry was minimal to begin with. If more forehead asymmetry had been involved, the drop in asymmetry would potentially have been much greater. Best, Kathy, mom to 26 months Mike Hall wrote: { I don't usually do this, but I'm adding a note to a post... Mike is an ortho, and this is the way his practice handles exit. Please be aware that there is a lot of variety here. I don't want anyone to worry that their ortho/clinician doesn't do things exactly this way. thanks. -christine (one of the group moderators) } Hi Christy There are several factors that are used to determine when parents should decide to end treatment. 1. The discrepancy has corrected. Head looks great and parents are very happy. 2. Parents have elected to stop treatment. They are happy with the correction gained even though a small discrepancy might still remain. To them the remaining discrepancy is minor compared to when they first started. 3. No change in measurements for 3 consecutive follow-up visits. 4. The child is nearing 14 to 15 months of age and their hand skills have improved greatly. Parents find it a struggle to keep the helmet on. Changes are also very slow to achieve at this age. 5. Parent's frustration level – this is usually the result of one parent not really on board with the treatment and is reluctant to have the child out in public with the helmet on. This is very rare but it does happen. Since your son is only 9 months old you still have 3 to 4 months of correction available to you. In our clinic we do not treat beyond 15 months of age. Parents find that the time required to gain a few mm is not worth the time spent in the helmet and they want to get on with other stages in the child's life. I guess the fact that I find interesting is that your treatment required the use of multiple helmets. We don't treat with multiple helmets as the parents are usually ready to move along and one helmet lasts the entire treatment. Why not go back to your provider and discuss with them what they think can be realistically gained by going back into another helmet. Take care. Mike Hall Certified Orthotist Hamilton Health Sciences Chedoke Hospital Hamilton Ontario Canada > > My son who had brachy and plagi started his first Doc Band at 5 months and outgrew it in 6 weeks. We saw some great improvement but still wanted to get more length in the back of his head. He was wider at the top. We decided to go with a 2nd band even though insurance originally denied us. (After our appeal, they came back and approved it so we get a full refund from Cranial! Nice surprise for once!) has been in his 2nd band now for about 10 weeks and probably only has about 4 weeks top left. At my last adjustment appointment they mentioned a 3rd band. My husband says no and I'm on the fence. We've seen some great improvement but I don't feel like we've gotten the length we wanted from this 2nd band so whose to say a 3rd would get us there. He turned 9 months today and has been a trooper with the band on for months. I'm torn. Part of me says we've done everything and the other part says we have to do more. Any thoughts? Thanks guys! > > Christy > polis, MD > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 14, 2010 Report Share Posted August 14, 2010 On Aug 13, 2010, at 10:49 PM, Mike Hall wrote: > In our clinic we do not treat beyond 15 months of age. Parents find > that the time required to gain a few mm is not worth the time spent > in the helmet and they want to get on with other stages in the > child's life. I doubt a parent expressed disappointment in that way, having personally found it worthwhile to utilize even proven lousy resources for " a few mm. " For us, it seemed to make a difference with a vision problem. I would even count holding our own as a qualified success, next to letting the plagiocephaly worsen. If it were believed it to be a cosmetic issue only, still some of us would probably keep that helmet on until age 5! I'm not saying that would be reasonable; but otherwise, you probably wouldn't need to set a policy. Having found the pediatrician untrustworthy, is it any surprise if the parent who's been blown off for 15 months is disinclined to accept a negative opinion from some guy who makes artificial limbs? Thad Launderville town, VT Clara age 2, STARband '10 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 14, 2010 Report Share Posted August 14, 2010 Mike,Thanks for your post and for joining this board. I think you are an excellent source of information for parents here. I am curious if you use any measurements as guidelines for parents as well? For example, when my husband and I decided to discontinue treatment for our daughter, she had attained measurements of less than 3mm(down from 13mm in 15 weeks.) I asked the orthotist if he agreed with our decision and he said, 'Yes. If she were still measuring 5 or 6mm, I would recommend giving it another month(that's about all the room she had left in the helmet.) But, she is already well past the point at which most parents decide to call it quits.'Btw, our orthotist also mentioned much of the criteria that you listed in your post when I asked him about when we would know it's time to discontinue treatment. Thanks,AmyFrom: Mike Hall <michaelhall@...>Plagiocephaly Sent: Fri, August 13, 2010 10:49:58 PMSubject: Re: When to call it quits? { I don't usually do this, but I'm adding a note to a post... Mike is an ortho, and this is the way his practice handles exit. Please be aware that there is a lot of variety here. I don't want anyone to worry that their ortho/clinician doesn't do things exactly this way. thanks. -christine (one of the group moderators) } Hi Christy There are several factors that are used to determine when parents should decide to end treatment. 1. The discrepancy has corrected. Head looks great and parents are very happy. 2. Parents have elected to stop treatment. They are happy with the correction gained even though a small discrepancy might still remain. To them the remaining discrepancy is minor compared to when they first started. 3. No change in measurements for 3 consecutive follow-up visits. 4. The child is nearing 14 to 15 months of age and their hand skills have improved greatly. Parents find it a struggle to keep the helmet on. Changes are also very slow to achieve at this age. 5. Parent's frustration level – this is usually the result of one parent not really on board with the treatment and is reluctant to have the child out in public with the helmet on. This is very rare but it does happen. Since your son is only 9 months old you still have 3 to 4 months of correction available to you. In our clinic we do not treat beyond 15 months of age. Parents find that the time required to gain a few mm is not worth the time spent in the helmet and they want to get on with other stages in the child's life. I guess the fact that I find interesting is that your treatment required the use of multiple helmets. We don't treat with multiple helmets as the parents are usually ready to move along and one helmet lasts the entire treatment. Why not go back to your provider and discuss with them what they think can be realistically gained by going back into another helmet. Take care. Mike Hall Certified Orthotist Hamilton Health Sciences Chedoke Hospital Hamilton Ontario Canada > > My son who had brachy and plagi started his first Doc Band at 5 months and outgrew it in 6 weeks. We saw some great improvement but still wanted to get more length in the back of his head. He was wider at the top. We decided to go with a 2nd band even though insurance originally denied us. (After our appeal, they came back and approved it so we get a full refund from Cranial! Nice surprise for once!) has been in his 2nd band now for about 10 weeks and probably only has about 4 weeks top left. At my last adjustment appointment they mentioned a 3rd band. My husband says no and I'm on the fence. We've seen some great improvement but I don't feel like we've gotten the length we wanted from this 2nd band so whose to say a 3rd would get us there. He turned 9 months today and has been a trooper with the band on for months. I'm torn. Part of me says we've done everything and the other part says we have to do more. Any thoughts? Thanks guys! > > Christy > polis, MD > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 14, 2010 Report Share Posted August 14, 2010 I'd probably take the same approach as Amy and go by the measurements. Are they in the typical range? If they haven't taken measurements, why not ask them to take some soon so you have an idea of whether or not you will need to have a 3rd helmet made. > > Christy, > > Wow--that's a tough one. Perhaps, you could post 's initial measurements and > his current ones and some of the parents whose babies had brachy & plagio could > offer some advice? > > My daughter had plagio and we stopped treatment at 15 weeks after she had gotten > down to less than 3mm. We could have gone another month in the helmet, but it > was late June(very hot, humid where we live) and I felt like my daughter had > been through enough. She had come such a long way and at the time, sleeping > better and her learning to walk seemed like they mattered more than a completely > perfect head shape. I am a bit of a perfectionist, so had it not been so hot, I > might have gone another month, but you really have to look at all the > circumstances and the big picture. In the end, I think we made the best decision > for . > > Good luck! > -Amy > > > > Good luck! > > > > > ________________________________ > From: christy.julian <christy.julian@...> > Plagiocephaly > Sent: Thu, August 12, 2010 2:30:28 PM > Subject: When to call it quits? > > > My son who had brachy and plagi started his first Doc Band at 5 months and > outgrew it in 6 weeks. We saw some great improvement but still wanted to get > more length in the back of his head. He was wider at the top. We decided to go > with a 2nd band even though insurance originally denied us. (After our appeal, > they came back and approved it so we get a full refund from Cranial! Nice > surprise for once!) has been in his 2nd band now for about 10 weeks and > probably only has about 4 weeks top left. At my last adjustment appointment they > mentioned a 3rd band. My husband says no and I'm on the fence. We've seen some > great improvement but I don't feel like we've gotten the length we wanted from > this 2nd band so whose to say a 3rd would get us there. He turned 9 months today > and has been a trooper with the band on for months. I'm torn. Part of me says > we've done everything and the other part says we have to do more. Any thoughts? > Thanks guys! > > Christy > polis, MD > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 15, 2010 Report Share Posted August 15, 2010 Thad,Mike was simply stating his clinic's treatment cut off for treatment and recounting what his experiences have been like with parents on a professional level. Don't get me wrong. I understand exactly where you are coming from. Every single mm mattered to me when was undergoing treatment.However, attacking an orthotist who has been kind enough to add his insights to the board doesn't encourage open dialogue. It's also inappropriate to insult others for making "artificial limbs." Making prosthetics is a very admirable profession. It helps those who have been born without arms or legs lead more normal lives. It also allows military service members who have lost parts of themselves while serving the country a chance to feel more normal again and begin to piece their lives back together. In addition, making "artificial limbs" can be a highly technical and complicated process. Many would argue, much more complicated than orthotic cranioplasty.-Amy From: Thad Launderville <p38thadl@...>Plagiocephaly Sent: Sat, August 14, 2010 3:18:46 AMSubject: Re: Re: When to call it quits? On Aug 13, 2010, at 10:49 PM, Mike Hall wrote: > In our clinic we do not treat beyond 15 months of age. Parents find > that the time required to gain a few mm is not worth the time spent > in the helmet and they want to get on with other stages in the > child's life. I doubt a parent expressed disappointment in that way, having personally found it worthwhile to utilize even proven lousy resources for "a few mm." For us, it seemed to make a difference with a vision problem. I would even count holding our own as a qualified success, next to letting the plagiocephaly worsen. If it were believed it to be a cosmetic issue only, still some of us would probably keep that helmet on until age 5! I'm not saying that would be reasonable; but otherwise, you probably wouldn't need to set a policy. Having found the pediatrician untrustworthy, is it any surprise if the parent who's been blown off for 15 months is disinclined to accept a negative opinion from some guy who makes artificial limbs? Thad Launderville town, VT Clara age 2, STARband '10 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 16, 2010 Report Share Posted August 16, 2010 I think you're missing the self-mocking aspect of my meaning. A mild rebuke of apparent patronization was my intent, not personal attack. I have a lot of friends with disabilities, myself. -- Thad On Aug 15, 2010, at 7:11 PM, Amy McGinnis wrote: > > > Thad, > > Mike was simply stating his clinic's treatment cut off for > treatment and recounting what his experiences have been like with > parents on a professional level. Don't get me wrong. I understand > exactly where you are coming from. Every single mm mattered to me > when was undergoing treatment. > > However, attacking an orthotist who has been kind enough to add his > insights to the board doesn't encourage open dialogue. It's also > inappropriate to insult others for making " artificial limbs. " > Making prosthetics is a very admirable profession. It helps those > who have been born without arms or legs lead more normal lives. It > also allows military service members who have lost parts of > themselves while serving the country a chance to feel more normal > again and begin to piece their lives back together. In addition, > making " artificial limbs " can be a highly technical and complicated > process. Many would argue, much more complicated than orthotic > cranioplasty. > > -Amy > > From: Thad Launderville <p38thadl@...> > Plagiocephaly > Sent: Sat, August 14, 2010 3:18:46 AM > Subject: Re: Re: When to call it quits? > > > On Aug 13, 2010, at 10:49 PM, Mike Hall wrote: > > > In our clinic we do not treat beyond 15 months of age. Parents find > > that the time required to gain a few mm is not worth the time spent > > in the helmet and they want to get on with other stages in the > > child's life. > > I doubt a parent expressed disappointment in that way, having > personally found it worthwhile to utilize even proven lousy resources > for " a few mm. " For us, it seemed to make a difference with a vision > problem. I would even count holding our own as a qualified success, > next to letting the plagiocephaly worsen. > > If it were believed it to be a cosmetic issue only, still some of us > would probably keep that helmet on until age 5! I'm not saying that > would be reasonable; but otherwise, you probably wouldn't need to set > a policy. Having found the pediatrician untrustworthy, is it any > surprise if the parent who's been blown off for 15 months is > disinclined to accept a negative opinion from some guy who makes > artificial limbs? > > Thad Launderville > town, VT > Clara age 2, STARband '10 > > > > <!-- #ygrp-mkp { border: 1px solid #d8d8d8; font-family: Arial; > margin: 10px 0; padding: 0 10px; } #ygrp-mkp hr { border: 1px solid > #d8d8d8; } #ygrp-mkp #hd { color: #628c2a; font-size: 85%; font- > weight: 700; line-height: 122%; margin: 10px 0; } #ygrp-mkp #ads > { margin-bottom: 10px; } #ygrp-mkp .ad { padding: 0 0; } #ygrp- > mkp .ad p { margin: 0; } #ygrp-mkp .ad a { color: #0000ff; text- > decoration: none; } #ygrp-sponsor #ygrp-lc { font-family: Arial; } > #ygrp-sponsor #ygrp-lc #hd { margin: 10px 0px; font-weight: 700; > font-size: 78%; line-height: 122%; } #ygrp-sponsor #ygrp-lc .ad > { margin-bottom: 10px; padding: 0 0; } a { color: #1e66ae; } > #actions { font-family: Verdana; font-size: 11px; padding: 10px > 0; } #activity { background-color: #e0ecee; float: left; font- > family: Verdana; font-size: 10px; padding: 10px; } #activity span > { font-weight: 700; } #activity span:first-child { text-transform: > uppercase; } #activity span a { color: #5085b6; text-decoration: > none; } #activity span span { color: #ff7900; } #activity > span .underline { text-decoration: underline; } .attach { clear: > both; display: table; font-family: Arial; font-size: 12px; padding: > 10px 0; width: 400px; } .attach div a { text-decoration: > none; } .attach img { border: none; padding-right: 5px; } .attach > label { display: block; margin-bottom: 5px; } .attach label a > { text-decoration: none; } blockquote { margin: 0 0 0 4px; } .bold > { font-family: Arial; font-size: 13px; font-weight: 700; } .bold a > { text-decoration: none; } dd.last p a { font-family: Verdana; font- > weight: 700; } dd.last p span { margin-right: 10px; font-family: > Verdana; font-weight: 700; } dd.last p span.yshortcuts { margin- > right: 0; } div.attach-table div div a { text-decoration: none; } > div.attach-table { width: 400px; } div.file-title a, div.file-title > a:active, div.file-title a:hover, div.file-title a:visited { text- > decoration: none; } div.photo-title a, div.photo-title a:active, > div.photo-title a:hover, div.photo-title a:visited { text- > decoration: none; } div#ygrp-mlmsg #ygrp-msg p a span.yshortcuts > { font-family: Verdana; font-size: 10px; font-weight: > normal; } .green { color: #628c2a; } .MsoNormal { margin: 0 0 0 > 0; } o { font-size: 0; } #photos div { float: left; width: > 72px; } #photos div div { border: 1px solid #666666; height: > 62px; overflow: hidden; width: 62px; } #photos div label { color: > #666666; font-size: 10px; overflow: hidden; text-align: center; > white-space: nowrap; width: 64px; } #reco-category { font-size: > 77%; } #reco-desc { font-size: 77%; } .replbq { margin: 4px; } > #ygrp-actbar div a:first-child { /* border-right: 0px solid #000;*/ > margin-right: 2px; padding-right: 5px; } #ygrp-mlmsg { font-size: > 13px; font-family: Arial, helvetica,clean, sans-serif; *font-size: > small; *font: x-small; } #ygrp-mlmsg table { font-size: inherit; > font: 100%; } #ygrp-mlmsg select, input, textarea { font: 99% > Arial, Helvetica, clean, sans-serif; } #ygrp-mlmsg pre, code { font: > 115% monospace; *font-size:100%; } #ygrp-mlmsg * { line-height: > 1.22em; } #ygrp-mlmsg #logo { padding-bottom: 10px; } #ygrp-mlmsg > a { color: #1E66AE; } #ygrp-msg p a { font-family: Verdana; } #ygrp- > msg p#attach-count span { color: #1E66AE; font-weight: 700; } #ygrp- > reco #reco-head { color: #ff7900; font-weight: 700; } #ygrp-reco > { margin-bottom: 20px; padding: 0px; } #ygrp-sponsor #ov li a > { font-size: 130%; text-decoration: none; } #ygrp-sponsor #ov li > { font-size: 77%; list-style-type: square; padding: 6px 0; } #ygrp- > sponsor #ov ul { margin: 0; padding: 0 0 0 8px; } #ygrp-text { font- > family: Georgia; } #ygrp-text p { margin: 0 0 1em 0; } #ygrp-text > tt { font-size: 120%; } #ygrp-vital ul li:last-child { border- > right: none !important; } --> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2010 Report Share Posted August 18, 2010 Hi Mike,Thanks for clarifying! I'm glad 15 months is not necessarily where you believe treatment should end. Unfortunately, some parents were not given the option of a helmet until late, and they are very grateful for the opportunity of a helmet. I find it very disappointing when parents are turned down for helmet treatment before closer to age 2. It was close to age 2 before we noticed a slowdown in 's improvement. We started the helmet at age 12 months, and we had slow improvement before age 15 months, but our improvement remained fairly steady for almost a year. Thanks for taking your time to provide us with information.KathyOn Mon, Aug 16, 2010 at 8:47 PM, Mike Hall <michaelhall@...> wrote: Hello Kathy In your post you said that…. " Although 's head is not perfect, it almost passes as normal to me and I don't feel nearly the panic about it that I felt at 16 months when I could hardly sleep fearing it wouldn't improve, but it very slowly did improve. " And this is exactly what it is all about. Your experience at wearing the helmet beyond the 15 months and gaining the addition 4 mm is great. As always, the decision to decide when to finish treatment is always left with the parents. In the 9 years that we have been providing this service I have had parents continue beyond the 15 month mark and they have been happy with the results, much like yourself. At one point in your treatment plan you would have had a discussion with your clinician around when to complete treatment. In some cases parents say to us that they are ready to stop and that's fine. In other cases parents also elect to continue into the older months. What is important in all of this is that parents do need to review the child's progress to date along with the treating clinician and determine if further treatment will benefit the child. Every child develops/responds at a different rates and every parent has different expectations as to what they feel they want to gain from having their child in treatment. That's what makes it so difficult to put a precise number on when treatment should finish. When I said that we don't treat beyond 15 months, it's not because we think that is when treatment should end. It's because we seldom have parents requesting to continue beyond that time frame. My apologies if this is the way it came across and I hope that this helps clarifie my original comment. In Christy's original post she presents a very typical treatment outcome. Early intervention, great correction, and then the question, do we continue? She indicated that " My husband says no and I'm on the fence. " And again this is typical for some parents and this is the time when parents need to discuss what their future options are for their child with their clinician. Christy also mentioned that her child was now 9 months old and too me her child still had more corrective time available. I suggested that she should return to her clinician and discuss what their options are not that she has outgrown her current helmet. Disclaimer – The above comments are representative of experiences we that have seen within our own clinic and are not to be considered as the standard of care that all facilities should follow. As always consult with your clinician regarding your specific concerns with your child's care. Take care. Mike Hall Certified Orthotist Hamilton Health Sciences Chedoke Hospital Hamilton Ontario Canada > > > > > > My son who had brachy and plagi started his first Doc Band at 5 > > months and outgrew it in 6 weeks. We saw some great improvement but > > still wanted to get more length in the back of his head. He was wider > > at the top. We decided to go with a 2nd band even though insurance > > originally denied us. (After our appeal, they came back and approved > > it so we get a full refund from Cranial! Nice surprise for once!) > > has been in his 2nd band now for about 10 weeks and probably only has > > about 4 weeks top left. At my last adjustment appointment they > > mentioned a 3rd band. My husband says no and I'm on the fence. We've > > seen some great improvement but I don't feel like we've gotten the > > length we wanted from this 2nd band so whose to say a 3rd would get us > > there. He turned 9 months today and has been a trooper with the band > > on for months. I'm torn. Part of me says we've done everything and the > > other part says we have to do more. Any thoughts? Thanks guys! > > > > > > Christy > > > polis, MD > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2010 Report Share Posted August 18, 2010 Thank you all for your feedback/comments. Such a difficult decision here! I took my son to see his pediatrician for something else this morning and he thought his head looked good, said it was a little asymetrical but he doesn't think he would go for the 3rd helmet. I just can't decide! I'm not 100% happy with the results from the 2nd doc band so why do I think the 3rd would give me better results? We have an appointment tomorrow and I'll be sure to have her do measurements. Thanks again everyone! Christy n 410.984.2962 From: Amy McGinnis <mcg_woo@...>Plagiocephaly Sent: Sun, August 15, 2010 7:11:52 PMSubject: Re: Re: When to call it quits? Thad,Mike was simply stating his clinic's treatment cut off for treatment and recounting what his experiences have been like with parents on a professional level. Don't get me wrong. I understand exactly where you are coming from. Every single mm mattered to me when was undergoing treatment.However, attacking an orthotist who has been kind enough to add his insights to the board doesn't encourage open dialogue. It's also inappropriate to insult others for making "artificial limbs." Making prosthetics is a very admirable profession. It helps those who have been born without arms or legs lead more normal lives. It also allows military service members who have lost parts of themselves while serving the country a chance to feel more normal again and begin to piece their lives back together. In addition, making "artificial limbs" can be a highly technical and complicated process. Many would argue, much more complicated than orthotic cranioplasty.-Amy From: Thad Launderville <p38thadl@...>Plagiocephaly Sent: Sat, August 14, 2010 3:18:46 AMSubject: Re: Re: When to call it quits? On Aug 13, 2010, at 10:49 PM, Mike Hall wrote:> In our clinic we do not treat beyond 15 months of age. Parents find > that the time required to gain a few mm is not worth the time spent > in the helmet and they want to get on with other stages in the > child's life.I doubt a parent expressed disappointment in that way, having personally found it worthwhile to utilize even proven lousy resources for "a few mm." For us, it seemed to make a difference with a vision problem. I would even count holding our own as a qualified success, next to letting the plagiocephaly worsen.If it were believed it to be a cosmetic issue only, still some of us would probably keep that helmet on until age 5! I'm not saying that would be reasonable; but otherwise, you probably wouldn't need to set a policy. Having found the pediatrician untrustworthy, is it any surprise if the parent who's been blown off for 15 months is disinclined to accept a negative opinion from some guy who makes artificial limbs?Thad Laundervilletown, VTClara age 2, STARband '10 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2010 Report Share Posted August 19, 2010 Hi Thank you for the welcome. I look forward to helping out in areas where I can. Just like the parents that post here, I am interested in learning more also. I just thought that parents might be interested in how some things are approached from the clinical side. Take care Mike Hall Certified Orthotist Hamilton Health Sciences Chedoke Hospital Hamilton Ontario Canada > > > > > > > > My son who had brachy and plagi started his first Doc Band at 5 months and > > > >outgrew it in 6 weeks. We saw some great improvement but still wanted to get > > > >more length in the back of his head. He was wider at the top. We decided to go > > > >with a 2nd band even though insurance originally denied us. (After our appeal, > > > >they came back and approved it so we get a full refund from Cranial! Nice > > > >surprise for once!) has been in his 2nd band now for about 10 weeks and > > > >probably only has about 4 weeks top left. At my last adjustment appointment they > > > >mentioned a 3rd band. My husband says no and I'm on the fence. We've seen some > > > >great improvement but I don't feel like we've gotten the length we wanted from > > > >this 2nd band so whose to say a 3rd would get us there. He turned 9 months today > > > >and has been a trooper with the band on for months. I'm torn. Part of me says > > > >we've done everything and the other part says we have to do more. Any thoughts? > > > >Thanks guys! > > > > > > > > Christy > > > > polis, MD > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2010 Report Share Posted August 20, 2010 Thanks again all. I really do appreciate your feedback!!! We had our appointment with CT yesterday and we have decided we won't go forward with the 3rd doc band. I feel very good about my decision and after speaking with my pediatrician, he completely agrees. Knowing he is the one who sent me immediately to CT, I know he is very proactive and I value his opinion. So, 2 more weeks and will be a doc band graduate! Can't wait! Christy n 410.984.2962 From: Mike Hall <michaelhall@...>Plagiocephaly Sent: Thu, August 19, 2010 9:47:04 PMSubject: Re: When to call it quits? Hi Thank you for the welcome. I look forward to helping out in areas where I can. Just like the parents that post here, I am interested in learning more also. I just thought that parents might be interested in how some things are approached from the clinical side.Take careMike HallCertified OrthotistHamilton Health SciencesChedoke HospitalHamilton OntarioCanada> > > >> > > > My son who had brachy and plagi started his first Doc Band at 5 months and > > > >outgrew it in 6 weeks. We saw some great improvement but still wanted to get > > > >more length in the back of his head. He was wider at the top. We decided to go > > > >with a 2nd band even though insurance originally denied us. (After our appeal, > > > >they came back and approved it so we get a full refund from Cranial! Nice > > > >surprise for once!) has been in his 2nd band now for about 10 weeks and > > > >probably only has about 4 weeks top left. At my last adjustment appointment they > > > >mentioned a 3rd band. My husband says no and I'm on the fence. We've seen some > > > >great improvement but I don't feel like we've gotten the length we wanted from > > > >this 2nd band so whose to say a 3rd would get us there. He turned 9 months today > > > >and has been a trooper with the band on for months. I'm torn. Part of me says > > > >we've done everything and the other part says we have to do more. Any thoughts? > > > >Thanks guys!> > > > > > > > Christy> > > > polis, MD> > > >> > >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 23, 2010 Report Share Posted August 23, 2010 Mike, I realize that this is the way your clinic handles things, but I'd like to present a parent's point of view regarding banding past 15 months. My daughter was banded one week prior to turning 15 months and we found no problem with using the band. The 6 months in her band was well worth the cost and the time in the band for us. While in the band, she improved from 95 percent to 92.2 percent and got improvements that are not measured at level 3. In fact, if my ortho would have allowed it, I would have kept her in it for longer, even just for the chance at a 1 percent improvement. Four months for one percentage point would have been worth it for us. In fact, it would have been easy because she loved her band and cried every time we took it off. She was so attached to it. It was her special helmet. In fact, she refused to take it off at the exit appointment and so she wore it home. You might want to ask the parent whether they would feel it was worth it before denying them.. There have been several parents here who have had their toddlers banded and most are quite happy with whatever results that they managed to get. I haven't heard any say that they wished that they hadn't spent the money or the effort (other than perhaps Thad because of a bad helmet). , mom to , almost 3 years STARband grad May 2009 (from 14.5 to 20.5 months) Chiro and CST land > > > > My son who had brachy and plagi started his first Doc Band at 5 months and outgrew it in 6 weeks. We saw some great improvement but still wanted to get more length in the back of his head. He was wider at the top. We decided to go with a 2nd band even though insurance originally denied us. (After our appeal, they came back and approved it so we get a full refund from Cranial! Nice surprise for once!) has been in his 2nd band now for about 10 weeks and probably only has about 4 weeks top left. At my last adjustment appointment they mentioned a 3rd band. My husband says no and I'm on the fence. We've seen some great improvement but I don't feel like we've gotten the length we wanted from this 2nd band so whose to say a 3rd would get us there. He turned 9 months today and has been a trooper with the band on for months. I'm torn. Part of me says we've done everything and the other part says we have to do more. Any thoughts? Thanks guys! > > > > Christy > > polis, MD > > > Quote Link to comment Share on other sites More sharing options...
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