Questions and more questions....

[Nanette77318]

My son is 12 and during a sports physical his Pedi. noted a curve and told us to wait and watch for 4-6 months. This is where all my questions begin!

The Pedi. did not tell us to get x-rays. Nothing. Just to wait. WHO can wait?? That was more of a sarcastic question, so don't feel the need to answer that one! : )

However...I have gone over my son visually and DEFINITELY he has a rib hump. His shoulder blades are of different prominence, his hips look a little lopsided and his shoulders are as well. So, I understand that all that comes with scoliosis.

This is where my questions come in. I have searched the internet for days and I have a plethora of information, which is all fine and dandy...but should I "wait". That is the major question. "If" my son's scoliosis (which the Dr. NEVER said...he called it a "curve to his spine"...so, officially, I suppose my son doesn't even have scoliosis? or does he?) See...so many questions....

I digress..."if" my son's scoliosis is "insignificant" would I be seeing all those other signs in his body? Visually, what would an insignificant curve look like? Does that make sense?

Should I question the Pedi.? Should I trust his judgement? We've NEVER had anything major like this so, he's been wonderful up to this point! He said that since my son is in a growth spurt, to wait and watch and for him to "sit up straight" and do some exercises to strengthen his back. But, he didn't even tell us what exercises to do!!!

So, there ya go! Thanks a bunch.....

[Pooka1]

Wow you do have many questions! Welcome to the club!

I'll try to answer your questions but hopefully plenty of others will weigh in also.

My son is 12 and during a sports physical his Pedi. noted a curve and told us to wait and watch for 4-6 months. This is where all my questions begin!

(snip ped saying to wait)

This is where my questions come in. I have searched the internet for days and I have a plethora of information, which is all fine and dandy...but should I "wait". That is the major question. "If" my son's scoliosis (which the Dr. NEVER said...he called it a "curve to his spine"...so, officially, I suppose my son doesn't even have scoliosis? or does he?) See...so many questions....

If the curve is less than 10*, it is not scoliosis as I understand it.

But the problem here is there is no way the Ped could eyeball a smaller curve at all accurately. I strongly suspect most curves that are less than 10* are not obvious and only seen on radiograph.

I digress..."if" my son's scoliosis is "insignificant" would I be seeing all those other signs in his body? Visually, what would an insignificant curve look like? Does that make sense?

Yes it makes sense. I think what you are describing is a bit of rotation which is usually accompanied by a scoliotic curve (>10*). It's possible to get to a 40* curve or higher and above with little to no rotation and the curve is barely visible.

Should I question the Pedi.? Should I trust his judgement? We've NEVER had anything major like this so, he's been wonderful up to this point! He said that since my son is in a growth spurt, to wait and watch and for him to "sit up straight" and do some exercises to strengthen his back. But, he didn't even tell us what exercises to do!!!

So, there ya go! Thanks a bunch.....

If you are seeing obvious asymmetry, then you should get a referral to a pediatric orthopedic surgeon.

My guess is the pediatrician honestly thinks the curve is below the point of intervention and hopes the growth spurt can help. The conundrum with kids who have growth left is that fusion of the spine can (not if screws are used) result in complications if there is much growth.

There is no evidence that sitting up straight or exercises help scoliosis. What might help short of fusion is bracing and non-fusion surgeries like Vertebral Body Stapling (VBS), Growth Rods, and Titanium Ribs (VEPTR). Unfortunately, there is no robust evidence bracing works and the non-fusion surgical techniques are still relatively new but promising. Fusion is known to work and in certain cases is a cure with no sequelae over and above generally encountered problems in the general population. But they don't like fusing kids with lots of growth remaining.

Good luck.

[scoliboymom]

The first doctor we went to said yes he has scoliosis but it looked minor to him. He also said he didn't think they even braced anymore these days.
I insisted on x-rays and they came back showing a 58* curve well past the threshhold of surgery. He was not our regular doctor and needless to say we never went bak to him.

Yes I think your son probably should be x-rayed now, just to establish a baseline to know 6 months down the road if it's progressing.
I have to say that Patrick's xrays always looked more impressive then his real life back (and he is very thin). I think the skin and muscles can hide a lot. At the same time I think one can have a lot of rotation without a high curve so that could account for the ribhump.

Ramona

[laurieg6]

I agree with what's been said so far. It sounds like you need to bring your son to a pediatric orthopedic surgeon for an x-ray to get a baseline measurement. Your son is probably at least starting an adolescent growth spurt now and a lot can change in 4-6 months. Plenty of people end up "waiting and watching" in 4-6 month increments but you have to know where your starting point is. The sooner you start treatment, the more effective it can be and the more treatment options you have. With some treatments, the child's growth is utilized to help straighten the curves.

[Nanette77318]

I so appreciate you moms!

Would it shock any of you if I said that I feel like I am hearing "Greek"?

It's like a battle in my head, where I don't want to be motivated out of fear but I want to be wise at the same time...My husband thinks nothing of this latest news but every time I see my son, I find myself constantly looking at his back! When I see him across the room, my mind is thinking..."are his shoulders crooked?" Ya know???

And then another part of me thinks, oh, in 4 months we'll go back and he'll be fine. All this will be gone and it's just a quirk of growing up....is that thought, me...being in denial???

And then I think, well if I get x-rays now, and it "really" is nothing significant, I wait anyway!

It's a viscous circle!

[Pooka1]

Fear itself

I so appreciate you moms!

Would it shock any of you if I said that I feel like I am hearing "Greek"?

Don't worry about that now. Once you get to a pediatric orthopedic surgeon, everything will be explained hopefully.

And I really think you need to see a surgeon for a baseline soon. The measured angle is one thing; The rate of curvature, if any, is another important piece in deciding what, if any, course of action is required. You need at least two points to calculate a rate.

It's like a battle in my head, where I don't want to be motivated out of fear but I want to be wise at the same time...My husband thinks nothing of this latest news but every time I see my son, I find myself constantly looking at his back! When I see him across the room, my mind is thinking..."are his shoulders crooked?" Ya know???

No need to be motivated out of fear. Be motivated by trying to figure out what, if anything, is required for your son NOW. Some non-fusion treatments have an optimal time window. You don't want to miss any window that you wish you went through. We are talking one or two radiographs. This is not a big deal to get a baseline.

And then another part of me thinks, oh, in 4 months we'll go back and he'll be fine. All this will be gone and it's just a quirk of growing up....is that thought, me...being in denial???

Some curves spontaneously correct completely. But I have to tell you, if the curve is large enough to produce a visible asymmetry to the unschooled eye, then it is not likely to spontaneously correct but rather stay where it is or get worse.

And then I think, well if I get x-rays now, and it "really" is nothing significant, I wait anyway!

It's a viscous circle!

There is no down side to getting radiographs now and there are several upsides (like not missing time windows).

Good luck.

[Nanette77318]

to produce a visible asymmetry to the unschooled eye,

I have taken pictures, to help me down the road, to gauge for myself if anything significant is happening.....but they are too large to post on this and I have no computer skills to shrink em. I'm questioning if I am just being a neurotic mother. Maybe I'm seeing things that aren't there? Maybe?

[Pooka1]

I have taken pictures, to help me down the road, to gauge for myself if anything significant is happening.....but they are too large to post on this and I have no computer skills to shrink em. I'm questioning if I am just being a neurotic mother. Maybe I'm seeing things that aren't there? Maybe?

That approach is likely not reliable. Nobody can eyeball things accurately that way.

Have your son bend forward at the waist and see if there is a hump on one side of his back. If there is, I suggest you get radiographs.

[Snoopy]

Nanette,

At the very least, convince your son's ped. to order an x-ray.

Our family doctor diagnosised my daughter with obvious Scoliosis--I could see it with my untrained eye as soon as he had her bend forward--but told me he didn't think it was too bad. He said we'd probably just watch her for now but wanted an x-ray to be sure.

Once the x-rays were done, we waited a long time, which I knew couldn't be good. The x-ray tech finally comes out and of course says she "can't" tell me anything. (I pleaded and begged until finally I guess she felt sorry for me and wrote down a number) The number she wrote down shocked me! She then proceeds to tell me that my family doctor is on the phone and wants to speak to me. Not good. Anyway, Jamie's "not too bad" Scoliosis was already at 36*! Yikes!

Trust your instincts. You'll find that you will have to speak up on behalf of your son often. Push for an x-ray and an appointment with a pediatric orthopedic who specializes in Scoli. Start searching for a doctor now and get at least a second opinion. Oh, and please know that you are NOT alone in this!

Mary Lou

[Nanette77318]

That approach is likely not reliable. Nobody can eyeball things accurately that way.

Have your son bend forward at the waist and see if there is a hump on one side of his back. If there is, I suggest you get radiographs.

Yeppers! That's how I took the pictures, ..and to me, there is an obvious hump on his right side.

[Pooka1]

Yeppers! That's how I took the pictures, ..and to me, there is an obvious hump on his right side.

Okay good work.

If there is an obvious hump, you don't need us yahoos to give you any further advice.

I think you have enough now to justify a visit to a pediatric orthopedic surgeon to get radiographs sooner rather than later. It's not an emergency but you don't want to miss any potential treatment opportunities.

[Nanette77318]

you don't need us yahoos to give you any further advice.

You all are the BEST bunch of yahoos that I have ever come across!!!!! Seriously, I felt like I was having this conversation with coffee and friends today....I think I'll call his Pedi. tomorrow.....

[mariaf]

I don't have much to add - you've gotten great advice so far but I wanted to welcome you.

I think you should trust your instincts - if you are seeing something then there probably IS something (although you won't know the extent until you get an x-ray).

Under these circumstances, I see it as you have nothing to lose by seeing a specialist. So, after your pediatrician orders an x-ray, if it shows that in fact your son does have scoliosis (of 10+ degrees), he should definitely see a specialist, in this case a pediatric orthopedic surgeon.

When my son was very young, I thought his son's back look "off", but initially my pediatrician brushed it off. My point is that general practitioners and pediatricians often know relatively little about scoliosis treatment.

Best of luck and please keep us posted.

[jillw]

Hi Nanette, Welcome to the boards.

Not to beat a dead dog since others have already said it, but you need to get your son Xrayed NOW and not later. As Pooka/Sharon pointed out, a VERY important piece of information in determining what strategy or treatment to follow is getting a sense of the trend so you must get an xray now to see the starting point/baseline. Depending the size of the curve, they might choose to do nothing at this time. However, when your son goes back for the 4-6 month followup, they will be able to see if his curve was stable or if it's increased which is an important piece of information.

My daughter's curve was barely visible when she did the Adam's bending test (and therefore I am very thankful that our pediatrician did pick it up and did tell us to go to an orthopedist to get xrays). Yet her curve was almost 20 degrees. Maybe you'll be pleasantly surprised and hear that its only a minor assymetry of less than 10 degrees, but you need to have that information soon. Your son is lucky to have you as his advocate instead of blindly accepting the ped's advice!

By the way, I can relate to your feelings about seeing the "crookedness" of your son's shoulders when you look at him. I had never noticed it in my daughter and even when the pediatrician brought it up I didn't noticed (I didn't specificially look because the pediatrician downplayed it given how minor it seemed and my daughter's long hair covered her shoulder blades). However a couple weeks later...the day she was scheduled to go the orthopedist...she had a bathing suit on and her hair up and I saw the hump and had a visceral reaction. From that point on I couldn't not see the curve- it seemed so obvious, how had I missed it?

Anyway, good luck.

[Nanette77318]

teensy update....

We are going for x-rays this afternoon.....
I feel good just saying that! We are going for x-rays.....woo hoo!

Okay, done.

Now, we wait..probably won't hear until Monday.....

Okay, so this morning (Friday) his Pedi called back! Cameron's curves are 10* thoracic and 9* lumbar. So..THAT is a good report. I am relieved and thankful that the x-rays happened! We will follow-up in 6 months or sooner if I notice any changes.

Thanks a MILLION times over for all the help in your replies!