Thursday, January 26, 2012

Orthotics Lessons

We went to see the Orthotist today for Carter's Plagiocephaly. I just have to say that I am a nerd, and I found the entire thing utterly fascinating!! :) I'm also extremely thankful for the clinic we chose to go to. The people are wonderful and the CPO (Certified Prosthetist Orthotist) was amazing. She was fun, very personable, very knowledgeable, and explained herself clearly. She was wonderful in her interactions with Carter, and that's always important to a mama!

She explained that when an area of the skull is malformed (the flat side of the back of his head) then the brain has to find another area to grow. This is what is causing the beginnings of a bulge on his forehead-his brain doesn't have any room in the back so it's growing where it has room. The wonderful thing about the way God created babies? His brain does have room to grow!!!! Even if it's making his skull misshapen, there is absolutely nothing wrong with his brain!!! (We already knew this, but I was just struck by God's awesomeness of creation as she explained how the skull and brain work at this point in development). The helmet is considered a passive intervention. It is not actually pushing on his head. It will basically only allow his skull to grow in certain directions. So, the area that is flat right now won't actually be touching the inside of the helmet. The helmet will put pressure in other areas so that as his brain grows the flatter areas will have to grow. This is the reason why this intervention only works before 18 months of age--their skull plates have to still be unfused (if that's a word) so that everything can easily move without creating any issues for brain development. Carter is still in a perfect timeframe for intervention.

She took several measurements of Carter's head. Two of the measurements she said that if he had a perfectly round head there would be a 0 mm difference. Carter has a 17 mm difference between these two measurements. Then she told us about a ratio on a different set of measurements. The ratio should be 80%. Carter's was at 93%. (I know I'm not being very technical. I'd have to actually show you on his head where these measurements are, but I think you still get an idea). She classified Carter's Plagiocephaly as severe. She said that if we did nothing that over the next 10 months some change would naturally occur. The flat part of his head would round out some, but that it will not naturally completely correct itself because of the level of severity. She did affirm that it is still a decision up to us. It won't hurt anything to not put a helmet on him. His brain will still grow and develop just fine continuing to make room for itself as it needs to. She commented that if we did nothing the Plagiocephaly could impact how a hat fits in the future as well as glasses if he should need those. She said that women can more easily disguise this issue because of long hair, but that men usually have shorter hair and can go bald so his head shape can potentially be easily noticeable throughout his life. Anyway, all that to say that we in no way have to correct the problem, but it could still impact things in his future. All of this confirmed our decision to go forward with a helmet.

She took some really cool 3D images of Carter's head to send off to the company that makes the helmets. We go in a week to have it fitted and bring it home. We will spend a week breaking it in and working him up to 23 hours a day. She compared this to wearing a new pair of shoes. If he immediately went to 23 hours a day, he could get pressure sores on his head. They will send us with specific instructions for this next week.

We felt very good about today's appointment. We loved her, and feel very comfortable and confident in working with her and her clinic for the next 3-4 months. We are thankful for the Lord's guidance in this process and thankful for an easy going baby that thought today's appointment was just another fun thing in his life. :) We are praying for a smooth transition into the helmet and that he won't even know it's there!

I'll update again next week with how his first fitting went and post pictures as well! I'm sure he will still be the most adorable little boy that exists!