Monday, January 14, 2008

All done!

This morning Eli's DOC Band® came off for good! What am I talking about? I know, I kept putting off posting about Eli's positional plagiocephaly and the orthotic device that we got for him to treat it. So, here's the (long) story...

Eli was born with a condition called torticollis, where the neck muscle is tight or shortened on one side. This caused him to be much more comfortable looking to the right than to the left. We noticed this preference when he was a newborn and didn't think much about it. After he was about two months old we started to realize this could be a problem. Grandma Janis showed us some information about plagiocephaly, and one of Ann's friends had a son almost 4 months older than Eli who was being diagnosed with the same condition at the time. When we looked carefully at Eli's head, we noticed the characteristic asymmetry and misalignment of his ears. So we went to the pediatrician and they recommended we start doing some gentle neck stretches and reposition his head when we put him to sleep. Sometimes the flattening will round out as the baby gets older and spends more time sitting up, on his tummy, or in other positions that don't put pressure on the back of the head. But it is less likely to "work itself out" when the baby also has torticollis.

We did the stretches, which did help improve his range of motion looking to the left. We also did the repositioning, which involved sneaking into his room repeatedly during the night and trying to turn his head from the right back to the left without waking him up. As you can imagine, this was tiring work. We also started taking him in for physical therapy to help his range of motion and midline. (Babies with torticollis also usually have a tendency to tilt their head to one side.)

After he got to be 4 months old, there was not any noticeable improvement in his head shape, so we decided to look into the "helmet" options. Several companies make orthotic devices which gently reshape the head over time. We chose Cranial Tech because they are the leaders in this field, their "Dynamic Orthotic Cranioplasty Band®" is FDA-approved, and they claim shorter treatment periods.

The only problem was, we would have to go to Cleveland or Chicago to get a DOC Band. We chose Chicago for several reasons. The main reason was because the clinic in Cleveland was not in our insurance network (it is a privately owned clinic licensed by Cranial Tech to provide the DOC band, while the clinic in Chicago is actually a Cranial Tech facility). The secondary reason was that we had good friends in Chicago who were willing to let us crash with them on a weekly basis for a few months. (Thanks, Ryan and Angie!) Thirdly, c'mon, we're talking about Cleveland versus Chicago. Which one would you rather visit 10 weekends in a row?

Besides, from where we live on the north-northwest side of Cincinnati, our drive time to Chicago is actually only 30 minutes more than to Cleveland. (The 70 MPH speed limit in Indiana is helpful in this regard.)

So in November we headed up to Chicago and Cranial Tech made a plaster cast of Eli's head. He did not enjoy this procedure, but it was fairly quick and he made it through okay. The anticipation of it was probably worse for Ann than the actual procedure was for Eli.

We went back for the initial fitting of his DOC Band® ten days later in mid November. He did a great job with it from day one! I guess some kids have a lot of trouble adjusting to it and sleeping with it. I don't know if it is because he was young when he started treatment, or because he's a pretty easy-going child, but he didn't really mind wearing it. It's probably a combination of both.

So earlier I mentioned weekly trips to Chicago. The inside of the DOC Band® is made of a kind of plastic foam that must be shaved out in certain places periodically as the child grows. Because Eli started at just under 5 months of age, we had to go back every week until the very end of treatment. (Babies can be treated with the DOC band up to 24 months of age, but the younger they are, the faster they are growing. This also means the treatment is typically shorter than for an older baby.) So there were about 7 weekly trips, then the last two were spaced out a little more.

So now you know why Eli is wearing that sweet camouflage helmet with his trademark "ELI*JOE" logo, even though you'll not see him wearing it in person anymore.

Last Monday when we were at Cranial Tech they did a final adjustment to the band so he could wear it one more week. Then they re-did all his measurements and took photos of him from all angles just like they did in the initial consultation. They also usually do an "exit mold" (another plaster cast) of the head. This is so they have a record of his head shape post-treatment, for comparison if there is ever a question of him regressing in the future. However, Cranial Tech has finally come out with a digital laser scanner that allows them to scan the babies heads and make a mold without putting the child through the plaster casting process. The Chicago clinic is getting theirs in mid-January, so we decided to wait a couple weeks and go back one more time for the scan. Besides not putting Eli through another casting, we get to visit Chicago and our friends one more time and sample another fine Chicagoland restaurant. Plus, as my friend Ryan pointed out, "Lasers are kewl. Who knows, maybe Eli will even pick up a super power."

Here's hoping! ;-)


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