Re: Got Ian's Out of Cast Numbers

[Guest guest]

jennifer,

okay, first a question -- the first x-ray of 43o, is that standing or

laying down? i know that dr. sanders/khoury all do laying down x-

rays during the casting process so you have to keep in mind that you

need to remember what x-rays you can compare. does this make sense?

also, in cast at 6o, is that is current 2nd cast? what was he in

cast for his first cast?

regardless, the #s do look really good. keep in mind, that mehta's

technique is to gently tell the spine how to grow straight. not

squeeze it perfectly straight. i don't think you should worry! the

#s are coming down and that is really, really positive.

also, phase II is another way to talk about rotation. it indicates

progressive infantile scoliosis. it is described in one of mehta's

earlier papers and possibly the newest. i'm inundated with papers

that i can't quite keep them straight anymore!

that's great news, jennifer! one cast has really gotten him down a

lot! i know that you were worried about the flexibility of ian's

spine, but it looks like the cobb is staying low and not just

bouncing back up to 43 again.

just my rambling (as usual) two cents,

deshea

On Feb 18, 2006, at 3:26 PM, Claflin wrote:

> I just got Ian's x-rays today. He started at 43 degrees. In cast

> he is 6 degrees, and out of cast he is 26 degrees.

>

> Questions:

>

> Is 26 degrees a good amount of correction for his first cast? I am

> not sure what to make of the number although it is certainly better

> than 43 degrees.

>

> On his original film, it says 43 degrees (cobb), 22 (RVAD), 45

> degrees rotation, Phase II. What does Phase II mean?

>

> Here is a link to the x-rays (scroll to the last 3 pics on the

> thumbnails):

>

> http://www.picturetrail.com/gallery/view?p=999 & gid=8679615 & uid=449993

>

>

>

> Noelle (12-2-01)

> Ian (8-15-04)

>

>

[Guest guest]

Okay, the 43 degrees is standing. I do not know for sure if he was laying down

or standing up for the out of cast film. Looking closely, I think I see a tube

in his mouth, so that makes me think he was sedated and laying down when they

took it. I know his curve usually looks better laying down. His first cast had

him at 7 degrees and the second one is the one that has him at 6 degrees.

Thanks for the input Deshea. Oh, and thanks for those links you sent me a while

back...I am using them to compare the rotation since there was no measurements

for the rotation subsequent to the first film.

Noelle (12-2-01)

Ian (8-15-04)

Re: Got Ian's Out of Cast Numbers

jennifer,

okay, first a question -- the first x-ray of 43o, is that standing or

laying down? i know that dr. sanders/khoury all do laying down x-

rays during the casting process so you have to keep in mind that you

need to remember what x-rays you can compare. does this make sense?

also, in cast at 6o, is that is current 2nd cast? what was he in

cast for his first cast?

regardless, the #s do look really good. keep in mind, that mehta's

technique is to gently tell the spine how to grow straight. not

squeeze it perfectly straight. i don't think you should worry! the

#s are coming down and that is really, really positive.

also, phase II is another way to talk about rotation. it indicates

progressive infantile scoliosis. it is described in one of mehta's

earlier papers and possibly the newest. i'm inundated with papers

that i can't quite keep them straight anymore!

that's great news, jennifer! one cast has really gotten him down a

lot! i know that you were worried about the flexibility of ian's

spine, but it looks like the cobb is staying low and not just

bouncing back up to 43 again.

just my rambling (as usual) two cents,

deshea

On Feb 18, 2006, at 3:26 PM, Claflin wrote:

> I just got Ian's x-rays today. He started at 43 degrees. In cast

> he is 6 degrees, and out of cast he is 26 degrees.

>

> Questions:

>

> Is 26 degrees a good amount of correction for his first cast? I am

> not sure what to make of the number although it is certainly better

> than 43 degrees.

>

> On his original film, it says 43 degrees (cobb), 22 (RVAD), 45

> degrees rotation, Phase II. What does Phase II mean?

>

> Here is a link to the x-rays (scroll to the last 3 pics on the

> thumbnails):

>

> http://www.picturetrail.com/gallery/view?p=999 & gid=8679615 & uid=449993

>

>

>

> Noelle (12-2-01)

> Ian (8-15-04)

>

>

[Guest guest]

That sounds pretty good, at least the numbers are coming down.

One thing I don't understand is the RVAD vs the Rotation- Evan's RVAD is 36

and no one has told us the degree of the rotation, his curve is 46 degrees.

Just wondering, b/c my husband and I try to keep tabs on Ian's numbers b/c his

scoli seems a lot like our Evan's.

Evan 8/7/05

Claflin <noellesmommy@...> wrote:

Okay, the 43 degrees is standing. I do not know for sure if he was laying

down or standing up for the out of cast film. Looking closely, I think I see a

tube in his mouth, so that makes me think he was sedated and laying down when

they took it. I know his curve usually looks better laying down. His first

cast had him at 7 degrees and the second one is the one that has him at 6

degrees.

Thanks for the input Deshea. Oh, and thanks for those links you sent me a while

back...I am using them to compare the rotation since there was no measurements

for the rotation subsequent to the first film.

Noelle (12-2-01)

Ian (8-15-04)

Re: Got Ian's Out of Cast Numbers

jennifer,

okay, first a question -- the first x-ray of 43o, is that standing or

laying down? i know that dr. sanders/khoury all do laying down x-

rays during the casting process so you have to keep in mind that you

need to remember what x-rays you can compare. does this make sense?

also, in cast at 6o, is that is current 2nd cast? what was he in

cast for his first cast?

regardless, the #s do look really good. keep in mind, that mehta's

technique is to gently tell the spine how to grow straight. not

squeeze it perfectly straight. i don't think you should worry! the

#s are coming down and that is really, really positive.

also, phase II is another way to talk about rotation. it indicates

progressive infantile scoliosis. it is described in one of mehta's

earlier papers and possibly the newest. i'm inundated with papers

that i can't quite keep them straight anymore!

that's great news, jennifer! one cast has really gotten him down a

lot! i know that you were worried about the flexibility of ian's

spine, but it looks like the cobb is staying low and not just

bouncing back up to 43 again.

just my rambling (as usual) two cents,

deshea

On Feb 18, 2006, at 3:26 PM, Claflin wrote:

> I just got Ian's x-rays today. He started at 43 degrees. In cast

> he is 6 degrees, and out of cast he is 26 degrees.

>

> Questions:

>

> Is 26 degrees a good amount of correction for his first cast? I am

> not sure what to make of the number although it is certainly better

> than 43 degrees.

>

> On his original film, it says 43 degrees (cobb), 22 (RVAD), 45

> degrees rotation, Phase II. What does Phase II mean?

>

> Here is a link to the x-rays (scroll to the last 3 pics on the

> thumbnails):

>

> http://www.picturetrail.com/gallery/view?p=999 & gid=8679615 & uid=449993

>

>

>

> Noelle (12-2-01)

> Ian (8-15-04)

>

>

[Guest guest]

RVAD is just a measurement they take to determine the likelihood of the

scoliosis progressing. I will try to find a link that shows how to measure the

rvad. To determine the rotation they look at the pedicles. This article shows

how they measure the Cobb angle and rotation. It doesn't show RVAD, but I will

find that and post it as well:

http://www.rad.washington.edu/mskbook/scoliosis.html

Here is a description of how they measure RVAD, but I am trying to find a

diagram for you....I may have a RVAD measurement on an x-ray of Ian's too...not

sure.

- Radiographs:

- rib vertebral angle:

- angle formed by perpendicular line from apical vertebral end plate

and a second line from

the mid-neck to mid-head of the adjacent rib;

- the rib vertebral angle difference is the difference between the two

RVA on the concave and

convex sides of the curve;

- a curve greater than 20 is considered progressive;

- references:

The rib vertebral angle in the early diagnosis betweeen

resolving and and progressive infantile scoliosis.

MH Mehta. JBJS Vol 55-B. 1973. p 513.

I can't find a diagram on the internet. Let me see if I can find it on one of

Ian's x-rays.

I think with the rotation, they more or less can tell you the degree by

eye-balling it. Some give it to you in degrees or in stages 0, +1, +2, +3,or

+4. I am not surprised no one has given you a number for the rotation. Dr. K

only gave me the measurement because Mehta was so surprised at how significant

Ian's rotation was for his degree of curve. She said she'd never seen that much

rotation in a curve like his. I plan to ask Khoury to measure his rotation the

next time I am there.

Noelle (12-2-01)

Ian (8-15-04)

Re: Got Ian's Out of Cast Numbers

jennifer,

okay, first a question -- the first x-ray of 43o, is that standing or

laying down? i know that dr. sanders/khoury all do laying down x-

rays during the casting process so you have to keep in mind that you

need to remember what x-rays you can compare. does this make sense?

also, in cast at 6o, is that is current 2nd cast? what was he in

cast for his first cast?

regardless, the #s do look really good. keep in mind, that mehta's

technique is to gently tell the spine how to grow straight. not

squeeze it perfectly straight. i don't think you should worry! the

#s are coming down and that is really, really positive.

also, phase II is another way to talk about rotation. it indicates

progressive infantile scoliosis. it is described in one of mehta's

earlier papers and possibly the newest. i'm inundated with papers

that i can't quite keep them straight anymore!

that's great news, jennifer! one cast has really gotten him down a

lot! i know that you were worried about the flexibility of ian's

spine, but it looks like the cobb is staying low and not just

bouncing back up to 43 again.

just my rambling (as usual) two cents,

deshea

On Feb 18, 2006, at 3:26 PM, Claflin wrote:

> I just got Ian's x-rays today. He started at 43 degrees. In cast

> he is 6 degrees, and out of cast he is 26 degrees.

>

> Questions:

>

> Is 26 degrees a good amount of correction for his first cast? I am

> not sure what to make of the number although it is certainly better

> than 43 degrees.

>

> On his original film, it says 43 degrees (cobb), 22 (RVAD), 45

> degrees rotation, Phase II. What does Phase II mean?

>

> Here is a link to the x-rays (scroll to the last 3 pics on the

> thumbnails):

>

> http://www.picturetrail.com/gallery/view?p=999 & gid=8679615 & uid=449993

>

>

>

> Noelle (12-2-01)

> Ian (8-15-04)

>

>

[Guest guest]

That was a really good article- I think that makes a whole lot more sense now. I

hope they'll tell me his rotation- I would think it's pretty bad, his ribs look

horrible and I truly see a bad difference from week to week as his scoli

progresses. I just hate that he is so little and it's getting worse by the day.

I wish we could go ahead and cast him-

Sorry for the rambling- it's just that my husband and I are getting so worried

about the way he seems to be progressing and worry about his correction- From a

lot of our research, we haven't seen a lot of infants with such a major degree

and RVAD as he has- it seems the kids are a little older than he and that

worries me, but I guess it shouldn't as we see such good results from all of you

all with the casts!

So, are you pleased with the numbers now that you have them? Were you

expecting a lower number for his out of cast measurement? I'd be pleased with

that number, especially since you say Ian's curve is so flexible. Do you all get

to see Dr. Mehta again for the Early Intervention Treatment thing? I wish we had

had Evan's diagnosed earlier and then maybe he could've participated-that would

have been so wonderful. Oh well---- I think I've rambled long enough- sorry =)

Thanks again for the article / explanation!.

Evan 8/7/05

Claflin <noellesmommy@...> wrote:

RVAD is just a measurement they take to determine the likelihood of the

scoliosis progressing. I will try to find a link that shows how to measure the

rvad. To determine the rotation they look at the pedicles. This article shows

how they measure the Cobb angle and rotation. It doesn't show RVAD, but I will

find that and post it as well:

http://www.rad.washington.edu/mskbook/scoliosis.html

Here is a description of how they measure RVAD, but I am trying to find a

diagram for you....I may have a RVAD measurement on an x-ray of Ian's too...not

sure.

- Radiographs:

- rib vertebral angle:

- angle formed by perpendicular line from apical vertebral end plate

and a second line from

the mid-neck to mid-head of the adjacent rib;

- the rib vertebral angle difference is the difference between the two

RVA on the concave and

convex sides of the curve;

- a curve greater than 20 is considered progressive;

- references:

The rib vertebral angle in the early diagnosis betweeen

resolving and and progressive infantile scoliosis.

MH Mehta. JBJS Vol 55-B. 1973. p 513.

I can't find a diagram on the internet. Let me see if I can find it on one of

Ian's x-rays.

I think with the rotation, they more or less can tell you the degree by

eye-balling it. Some give it to you in degrees or in stages 0, +1, +2, +3,or

+4. I am not surprised no one has given you a number for the rotation. Dr. K

only gave me the measurement because Mehta was so surprised at how significant

Ian's rotation was for his degree of curve. She said she'd never seen that much

rotation in a curve like his. I plan to ask Khoury to measure his rotation the

next time I am there.

Noelle (12-2-01)

Ian (8-15-04)

Re: Got Ian's Out of Cast Numbers

jennifer,

okay, first a question -- the first x-ray of 43o, is that standing or

laying down? i know that dr. sanders/khoury all do laying down x-

rays during the casting process so you have to keep in mind that you

need to remember what x-rays you can compare. does this make sense?

also, in cast at 6o, is that is current 2nd cast? what was he in

cast for his first cast?

regardless, the #s do look really good. keep in mind, that mehta's

technique is to gently tell the spine how to grow straight. not

squeeze it perfectly straight. i don't think you should worry! the

#s are coming down and that is really, really positive.

also, phase II is another way to talk about rotation. it indicates

progressive infantile scoliosis. it is described in one of mehta's

earlier papers and possibly the newest. i'm inundated with papers

that i can't quite keep them straight anymore!

that's great news, jennifer! one cast has really gotten him down a

lot! i know that you were worried about the flexibility of ian's

spine, but it looks like the cobb is staying low and not just

bouncing back up to 43 again.

just my rambling (as usual) two cents,

deshea

On Feb 18, 2006, at 3:26 PM, Claflin wrote:

> I just got Ian's x-rays today. He started at 43 degrees. In cast

> he is 6 degrees, and out of cast he is 26 degrees.

>

> Questions:

>

> Is 26 degrees a good amount of correction for his first cast? I am

> not sure what to make of the number although it is certainly better

> than 43 degrees.

>

> On his original film, it says 43 degrees (cobb), 22 (RVAD), 45

> degrees rotation, Phase II. What does Phase II mean?

>

> Here is a link to the x-rays (scroll to the last 3 pics on the

> thumbnails):

>

> http://www.picturetrail.com/gallery/view?p=999 & gid=8679615 & uid=449993

>

>

>

> Noelle (12-2-01)

> Ian (8-15-04)

>

>

[Guest guest]

Congratulations on the out of cast #s! I think that's super especially since

Dr.K was so worried about the flexibility of his spine!

Best wishes for continued success,

mom to and Jake

P.S. Jake's shirt get grungier (if that's even a word) by the day!!!

Claflin <noellesmommy@...> wrote:

I just got Ian's x-rays today. He started at 43 degrees. In cast he is 6

degrees, and out of cast he is 26 degrees.

Questions:

Is 26 degrees a good amount of correction for his first cast? I am not sure what

to make of the number although it is certainly better than 43 degrees.

On his original film, it says 43 degrees (cobb), 22 (RVAD), 45 degrees rotation,

Phase II. What does Phase II mean?

Here is a link to the x-rays (scroll to the last 3 pics on the thumbnails):

http://www.picturetrail.com/gallery/view?p=999 & gid=8679615 & uid=449993

Noelle (12-2-01)

Ian (8-15-04)

[Guest guest]

I can understand you worrying about waiting . I am sure time seems to be

passing so slowly. It's too bad he's sick, but I guess they have to be super

careful with lung issues and the anesthesia. Once he has his cast, you are

going to feel so much more relieved...at least that is how it has been for me.

Yes, his curve is pretty high, but he is also really young so you may get even

better correction and faster results than what we are getting since Ian is a bit

older. In hindsight, I wish we had gotten him casted at our first trip to Erie,

but back then it looked like he was going to resolve.

Well, I am happy that there is an improvement as far as his numbers go. But,

since he was 7 degrees in that first cast, and because I couldn't physically see

a big curve out of cast, I assumed we got lucky and that maybe he was only at

something like 12 or 15 degrees. But, Deshea is right, they try to gently

correct the curve. Dr. K told me he isn't being as aggressive in his

manipulations since talking to Mehta and learning how important it was to not be

too aggressive. So, I am trying to keep that in mind. I was just wondering if

his correction was " average " to what most other kids got after their first cast.

Noelle (12-2-01)

Ian (8-15-04)

Re: Got Ian's Out of Cast Numbers

jennifer,

okay, first a question -- the first x-ray of 43o, is that standing or

laying down? i know that dr. sanders/khoury all do laying down x-

rays during the casting process so you have to keep in mind that you

need to remember what x-rays you can compare. does this make sense?

also, in cast at 6o, is that is current 2nd cast? what was he in

cast for his first cast?

regardless, the #s do look really good. keep in mind, that mehta's

technique is to gently tell the spine how to grow straight. not

squeeze it perfectly straight. i don't think you should worry! the

#s are coming down and that is really, really positive.

also, phase II is another way to talk about rotation. it indicates

progressive infantile scoliosis. it is described in one of mehta's

earlier papers and possibly the newest. i'm inundated with papers

that i can't quite keep them straight anymore!

that's great news, jennifer! one cast has really gotten him down a

lot! i know that you were worried about the flexibility of ian's

spine, but it looks like the cobb is staying low and not just

bouncing back up to 43 again.

just my rambling (as usual) two cents,

deshea

On Feb 18, 2006, at 3:26 PM, Claflin wrote:

> I just got Ian's x-rays today. He started at 43 degrees. In cast

> he is 6 degrees, and out of cast he is 26 degrees.

>

> Questions:

>

> Is 26 degrees a good amount of correction for his first cast? I am

> not sure what to make of the number although it is certainly better

> than 43 degrees.

>

> On his original film, it says 43 degrees (cobb), 22 (RVAD), 45

> degrees rotation, Phase II. What does Phase II mean?

>

> Here is a link to the x-rays (scroll to the last 3 pics on the

> thumbnails):

>

> http://www.picturetrail.com/gallery/view?p=999 & gid=8679615 & uid=449993

>

>

>

> Noelle (12-2-01)

> Ian (8-15-04)

>

>

[Guest guest]

,

I am almost going to be embarrassed when they see how dirty his shirt is

especially because I know there is dog hair stuck to it....ewwww!

Noelle (12-2-01)

Ian (8-15-04)

Re: Got Ian's Out of Cast Numbers

Congratulations on the out of cast #s! I think that's super especially since

Dr.K was so worried about the flexibility of his spine!

Best wishes for continued success,

mom to and Jake

P.S. Jake's shirt get grungier (if that's even a word) by the day!!!

Claflin <noellesmommy@...> wrote:

I just got Ian's x-rays today. He started at 43 degrees. In cast he is 6

degrees, and out of cast he is 26 degrees.

Questions:

Is 26 degrees a good amount of correction for his first cast? I am not sure

what to make of the number although it is certainly better than 43 degrees.

On his original film, it says 43 degrees (cobb), 22 (RVAD), 45 degrees

rotation, Phase II. What does Phase II mean?

Here is a link to the x-rays (scroll to the last 3 pics on the thumbnails):

http://www.picturetrail.com/gallery/view?p=999 & gid=8679615 & uid=449993

Noelle (12-2-01)

Ian (8-15-04)

[Guest guest]

Ditto. And can you believe how far that shirt stretches? I think we've tested

it to its limits. Gross!

Claflin <noellesmommy@...> wrote: ,

I am almost going to be embarrassed when they see how dirty his shirt is

especially because I know there is dog hair stuck to it....ewwww!

Noelle (12-2-01)

Ian (8-15-04)

Re: Got Ian's Out of Cast Numbers

Congratulations on the out of cast #s! I think that's super especially since

Dr.K was so worried about the flexibility of his spine!

Best wishes for continued success,

mom to and Jake

P.S. Jake's shirt get grungier (if that's even a word) by the day!!!

Claflin wrote:

I just got Ian's x-rays today. He started at 43 degrees. In cast he is 6

degrees, and out of cast he is 26 degrees.

Questions:

Is 26 degrees a good amount of correction for his first cast? I am not sure what

to make of the number although it is certainly better than 43 degrees.

On his original film, it says 43 degrees (cobb), 22 (RVAD), 45 degrees rotation,

Phase II. What does Phase II mean?

Here is a link to the x-rays (scroll to the last 3 pics on the thumbnails):

http://www.picturetrail.com/gallery/view?p=999 & gid=8679615 & uid=449993

Noelle (12-2-01)

Ian (8-15-04)

[Guest guest]

Well, I haven't even tried to clean his! How bad am I? I just taped it up to

his cast and have been done with it. This time around I am thinking of having

them tape it with the water proof tape at the bottom, although, doesn't that

defeat the whole purpose? I simply cannot diaper him unless it is taped to the

cast. I am wondering if I should email Dr. K about it...I seriously hate not

being able to see down in the cast.

Noelle (12-2-01)

Ian (8-15-04)

Re: Got Ian's Out of Cast Numbers

Congratulations on the out of cast #s! I think that's super especially since

Dr.K was so worried about the flexibility of his spine!

Best wishes for continued success,

mom to and Jake

P.S. Jake's shirt get grungier (if that's even a word) by the day!!!

Claflin wrote:

I just got Ian's x-rays today. He started at 43 degrees. In cast he is 6

degrees, and out of cast he is 26 degrees.

Questions:

Is 26 degrees a good amount of correction for his first cast? I am not sure

what to make of the number although it is certainly better than 43 degrees.

On his original film, it says 43 degrees (cobb), 22 (RVAD), 45 degrees

rotation, Phase II. What does Phase II mean?

Here is a link to the x-rays (scroll to the last 3 pics on the thumbnails):

http://www.picturetrail.com/gallery/view?p=999 & gid=8679615 & uid=449993

Noelle (12-2-01)

Ian (8-15-04)

[Guest guest]

Yes, I definitely find diapering a challenge to say the least. I almost wish he

was potty trained already! He likes to sit on the toilet but does nothing once

there. Just a game at this point. Oh, well...

mom to and Jake

Claflin <noellesmommy@...> wrote:

Well, I haven't even tried to clean his! How bad am I? I just taped it up to

his cast and have been done with it. This time around I am thinking of having

them tape it with the water proof tape at the bottom, although, doesn't that

defeat the whole purpose? I simply cannot diaper him unless it is taped to the

cast. I am wondering if I should email Dr. K about it...I seriously hate not

being able to see down in the cast.

Noelle (12-2-01)

Ian (8-15-04)

Re: Got Ian's Out of Cast Numbers

Congratulations on the out of cast #s! I think that's super especially since

Dr.K was so worried about the flexibility of his spine!

Best wishes for continued success,

mom to and Jake

P.S. Jake's shirt get grungier (if that's even a word) by the day!!!

Claflin wrote:

I just got Ian's x-rays today. He started at 43 degrees. In cast he is 6

degrees, and out of cast he is 26 degrees.

Questions:

Is 26 degrees a good amount of correction for his first cast? I am not sure what

to make of the number although it is certainly better than 43 degrees.

On his original film, it says 43 degrees (cobb), 22 (RVAD), 45 degrees rotation,

Phase II. What does Phase II mean?

Here is a link to the x-rays (scroll to the last 3 pics on the thumbnails):

http://www.picturetrail.com/gallery/view?p=999 & gid=8679615 & uid=449993

Noelle (12-2-01)

Ian (8-15-04)