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Joe's Mom
04-20-2005, 08:39 PM
Joe went for his 6 month check up today. Over the past 6-12 months he has experienced greater difficulty in remaining comfortably seated for longer time periods. His performance on the PSAT was uncharacteristically scattered and when I met with school, it became evident that remaining seated for that lenght of time (3 hours with few breaks) was a factor.

Long story, short . . . Scoliosis curve (which had been stable for about 3 years at 26 degrees) had progressed in past 6 months to 35 degrees.

Kyphosis curve (Which had been progressing at 5 degrees every six months for the past 18 months) showed no change this time.

School has a 504 plan in place now which will allow him adaptations during lenthy seating periods (SAT/ACT testing next year).

He will be fit with a brace now and will see a PT for an exercise program to try to help postural issues during sitting and they will also look at sitting issues.

A ??? I have is . . .Can kyphosis curves and scoliosis curves progress simultaneously . . . can two different planes torque simultaneously or will they simply take turns.

Another ??? I have is . . . Risser Signs indicate that his growth is almost complete BUT he started really late and this is really the first/only growth spurt we have seen and his feet are continuing to grow 1/2 to 1 size each six months so doctor wasn't totally convinced the Risser signs were going to be absolute indicators for him. Any thoughts out there about growth patterns - we were told earlier that once his feet stop growing he has about 2 more years of growth to go and that doesn't really correlate to what is being seen with Risser signs.

If his scoli curves progress to high 40's doctor says surgery is in order.

Thanks in advance for any/all input here.

Joe's Mom

Mary Lou
04-21-2005, 08:18 AM
Hi Joes' Mom,

I'm sorry to hear that Joe's Scoliosis has gotten worse. What is he saying about wearing a brace? I sometimes think it is easier for boys to wear their brace than it is for girls.

As for your question about curves progressing simultaneously...my daughter's curves have had different patterns of changes. Sometimes just the Scoliosis had increased...sometimes just the Kyphosis...and other times both have changed. All of Jamie's Kyphoscoliosis issues have taken place over a period of about 1 1/2 years (diagnosed 8/03 and surgery 12/04) and during that time, she was in a major growth spurt for part of that time, so that might explain the changes.

Mary Lou

Joe's Mom
04-21-2005, 11:14 AM
Joe isn't thrilled with the idea of the brace, but he understands the reasoning behind it. Actually, boys are WORSE at wearing braces than girls for a host of reasons I am told. He has already said he won't wear it on gym days as he doesn't want ANYONE to see it on him, so I think he is terrified of being teased or seeming different.

Carmell
04-21-2005, 01:40 PM
Sorry to hear things aren't going well for Joe. Did the doc say anything about giving him medication to help with the discomfort? Did he suggest ibuprofen or Tylenol? Maybe if he took something like that just before a big test, his concentration would be better. I know when you don't feel well, concentrating on a test like that is that LAST thing you want to be doing. I'm very happy to hear the school is helping you with a 504 plan. Be sure to list ANYTHING you think may help him - things like allowing him to have a set of books at home so he doesn't have to carry a heavy backpack, allowing him to go to the bathroom as needed, no questions asked, allowing him to have a pillow on the back of his chair, allowing him to be the last one in the classroom so he doesn't get pushed from behind as much, etc.

I agree with you about the growth thing and the Risser score. I'm finding the Risser thing to be a bit more accurate with girls than boys. My daughter didn't grow in height anymore after her Risser score was complete (5) but she did some more "filling out". I have a 14yr old son who's feet stopped growing for about a year, then suddenly in the past couple of months, his feet have grown a full shoe size. He is only about 1 inch taller than he was this time last year. He's hoping he'll grow taller soon (he's 5'7" - no spine problems with him, so I don't know his Risser score). My point is that I know many boys who grow in height in their early 20s. Very interesting, IMHO.

I agree with Mary Lou about your question re: kyphosis and scoliosis. I would imagine you may see differing degrees at various times, if you took xrays each month. There are so many variables.

If Joe is having this much discomfort in his back, he may benefit from some physical therapy or more strenghening exercises. Does he like to swim? Does he like to do exercises/sports that will help improve the strength of his abs and back muscles?

Good luck and keep us posted.

Mary Lou
04-21-2005, 03:45 PM
I'm not sure who would have less problems with wearing a brace-boys or girls-but I was just looking at it from the mom of a girl's point of view. I would think girls tend to have more clothing issues with a brace than boys. If your son is like the boys in our schools, their pants and shirts are already baggy so that would help to hide the brace where as the girls' clothes are more form fitting and also the brace tends to show if for example they wear a belly shirt.

I do know that it was very hard for my daughter to start wearing her brace at the age of 12. Like your son, she didn't want ANYONE to know she wore a brace. She too refused to wear it on gym days and refused to go to the nurses office to take the brace off before gym. She was not interested in an alternative gym class either. She found many, many excuses to not wear the brace--I'm going to a sleep-over so I can't wear it; I want to go to the dance, so I can't wear it; and I don't think that is just a girl thing. I think it is just a teenager/pre-teen thing. I'm sure your son will try to get out of wearing the brace for sports, etc.

keep us posted on how things are going.

Mary Lou

LindaRacine
04-21-2005, 04:01 PM
Hi...

I think that boys may have more difficulty with the brace because it's so rare in boys. They rarely, if ever, get to see another boy wearing a brace. Even if girls don't have friends in school that wear a brace, they probably know others, or at least get to see them at the doctor's office.

For either gender, it's often a very difficult situation.

Regards,
Linda

Joe's Mom
04-24-2005, 11:34 AM
Thanks for all the replies! We are going to the orthotist tomorrow morning at 8:00 am to get the brace fit. For the past 4 years I have asked each of the two orthopaedists we have seen if PT would help . . if muscular tone might play a role. NO . . I was told by both . . the issues here are skeletal and PT or Exercises would not be needed or helpful. Well, now the BIG turnaround. Now all of a sudden a PT exercise program is just what the doctor ordered. We saw the PT on Friday afternoon. My son is very active . . he swims water polo (a very good water polo player) and has always been a swimmer . .he plays basketball and loves to be physically active, so overall he is active and fit. The PT was able to find particular muscle groups (lower abdominals and back muscles) that are weak and in need of strengthening. Further, his ankles are tight which she attributed to compensatory due to the weaknesses elsewhere. She felt confident that by strengthening these weaknesses, his ankles would be less tight/fixed and his back muscles would be in a better position to support his spine and hopefully hold it in position so that the progression may be less.

Of course, my son asked me all weekend WHY on earth we didn't do this earlier.

Hind sight is alwasy 20/20, but I will say that I ASKED and was FLAT OUT TOLD by two doctors from the start that the issues were skeletal and not muscular. If I had it to do over again, I would have insisted upon a COMPLETE evaluation of MUSCLES and SKELETON at the outset and have both addressed from the get go.

As to the issue of boys and braces . . .compliance was reported to be less with boys than girls and Linda is right . . the numbers of boys are so low that they have no knowledge of any other boy out there who is wearing a brace. But I do think that girls may be somewhat more compliant than boys . . .also, boys grow for longer/later ages and that may be a factor . . . a 12 year old may be more compliant about a brace than a 16 year old.

Marc H
05-17-2005, 05:26 PM
Joes mom

Sorry to hear that the curve has worsened, I was told that on a number of occassions, whereby the next stage is brace fitting. After a while he should get used to it, I did, and after I went to check-ups the curve improved. I was told that a certain excercise would also help along the way when the brace is not being worn, which is as follows:
1) Sit on a chair upright.
2) If the curve is too the left then the left leg, bent at the knee needs to go under the right (vice versa if curve goes to the right).
3) Then you need to curve your torso the opposite direction to the curve, whereby the spine needs to move the other way.
4) I did this for 10minutes twice a day every day for 6 months, while my brace was not on and it helped greatly in strainghtening my curve out.

This is a very good exercise and it kinda speeds things along and assists the brace.

Hope the brace works out

Central
05-17-2005, 11:53 PM
" Then you need to curve your torso the opposite direction to the curve, whereby the spine needs to move the other way."

You mean in the same direction as the curve? I would think that if you turn the torso towards the right for a right curve, it would straighten?

Marc H
05-18-2005, 04:11 PM
Yes, you need to curve your torso to the opposite side of the curve, so if your spine curves to the right you need to curve your torso to the left. My spine curves right so i curve my torso to the left.

susannajon
05-23-2005, 08:50 PM
Hi Joe's mom. Stick with the PT, as it can only help.

On the Risser score issue, our original doc told us when our daughter's curve was at 47 degrees that her Risser was a 4 and her curve would likely not progress very much more, may 1 or 2 degrees a year, and it was OK to wait a year for surgery. That was in June of last year. In September we got her x-rayed, and over the summer her curve had progressed to 53 degrees. By December it was 60 degrees, and by March when she had surgery it was 70 degrees. I think Risser scores can give you a false sense of security. I would keep a close eye on him.

Joe's Mom
06-17-2005, 09:22 PM
We returned to see the Orthopaedist today for a recheck after the brace was in place. We saw the doctor in the hallway on the way to the exam room . . he recognized Joe right away, said HI and commented that he appeared to have gotten taller since April.

When we got to the room, they took Joe to Xray since there seemed to be some significant growth.

Scoli curve stayed stable at 44 degrees since April; Kyphosis curve had reduced by 3-5 degrees in that time.

Joe has been wearing the brace at night and that is all they want him to do. Also getting PT twice a week and the PTs thought there would be a change in the Kyphosis too (and they were correct!)

PT will continue twice a week and Joe will wear the brace each night too. Return in December.

Doctor did comment that bracing with boys is different and stated that there is some thought that the curvature in boys (active curving process) may in fact be different that what happens in girls.