Re: When to call it quits?

[Guest guest]

Hello Amy

Thanks very much for the welcome to the forum; it was very kind of you.

As much as I would like to have a scanning system we are still using calipers

and a tape measure to collect our data. We measure at the initial assessment

and it is at this time we explain to the parents what the child's dimensions are

and how large the discrepancy is regardless of whether they are plagio, brachy,

or a combination of both. This is usually when parents ask the most questions

and once they understand what their options are they may then elect to continue

repositioning, cast, or `sleep on it' and let us know their decision in the next

day or so.

If they elect to continue re-positioning then we would re-measure again in 4

weeks time and see how the discrepancy has changed. If they wish to proceed

with treatment then a cast is taken and they would be fitted 2 weeks later. At

the fitting we measure again and these are the most important measurements for

our clinic as it establishes the base line numbers from which we then evaluate

how the correction of the head is affected strictly based on the use of the

helmet. After the fitting, the child would be re-measured at each follow-up

visit.

So in our clinic our children are measured every time we follow-up and sometimes

again during in between follow-ups should they return over a concern of redness.

It's pretty much the only way we have of assessing progression of the correction

and the parents are always interested in knowing how their child is progressing.

Since we have 3 orthotists providing helmet therapy there is always a risk of

there being measurement error if the child is seen by a different orthotist

every time. To reduce this error risk the same orthotist would follow that same

child throughout their full treatment.

As far as which severity scale we follow we use the one that was posted on this

forum. As always our goal is to get to Zero but parents are always pleased if we

can get close to the 0 to 3mm mark. Your orthotist seems reasonable in

continuing had there still been another 4 to 6 mm to gain.

Thanks for asking.

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 and thanks again for the welcome.

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

> >

>