Guest guest Posted February 10, 2012 Report Share Posted February 10, 2012 Thanks a bunch, Sherry. This is a good email for me to elaborate on the importance of proper & necessary terminology for future families faced with PIS…As most of us already know, the principle factor in “casting,” infants effectively is Early Treatment (ET). Properly applied EDF (elongation, derotation, flexion) casts with Mehtas modifications have the ability to harness the childs rapid phase of growth to train the spine to grow straight, gently & permanently. Over the last decade, I have heard many stories where the parents go to the ortho to request “casting,” and their child receives a cast, but it may not be an EDF and it may not be applied Early. Im hoping we can all add “Early Treatment” to the terminology so everyone involved (docs, staff & parents) are sure of exactly what treatment is being requested. Just my two cents…Thanks Sherry and everyone. This is not a correction to anything Sherry said, just a recommendation that I am sure will help others in the long run.Thanks!HRH From: infantile scoliosis treatment [mailto:infantile scoliosis treatment ] On Behalf Of SR ClancySent: Thursday, February 09, 2012 8:45 AMinfantile scoliosis treatment Subject: RE: New here. 6 month old just diagnosed. Casting questions! Hi ,Welcome to the group. Despite your son’s diagnosis and your worry, I am happy that you see an orthopedic doctor that knows about casting and recommends it. I live in PA. Casting is done at Philadelphia and Erie Shriners by the same doctors. My daughter is treated by one of them, and I’m very satisfied. However, she was 29 months when first casted so I have no experience with treating a 6 mo old. Best wishes! You have found a supportive group!Sherry -----Original Message-----From: infantile scoliosis treatment [mailto:infantile scoliosis treatment ] On Behalf Of lindsayrineerSent: Thursday, February 09, 2012 10:10 AMinfantile scoliosis treatment Subject: New here. 6 month old just diagnosed. Casting questions! Hello everyone. My 6 month old was just diagnosed with Idiopathic Scoliosis. His curve is measuring 48-50 degrees. Our orthopedic Dr. said his recommendation is casting, but he does not have any first hand experience with this, nor did he know of anyone in our area that does. He is meeting with two co-workers next week to discuss my son's case and is then getting back to us. He said he'd like us to have him casted locally so that he can monitor, but this doesn't exactly appeal to me if there aren't any Dr's in the area with a lot of experience casting young babies.I, personally, have been doing as much research online as I can regarding where he can be casted. It's extremely overhwelming (as I'm sure everyone says when they are first faced with this!) I'm so glad that I found this site because there seems to be an abundance of information here.My question is this: Does anyone know of any Doctors that are known for casting in my area? We live in , MS. I searched this site and found that someone had said awhile back that the only Dr. in the south/southeast that was trained in casting was in Birmingham, AL. We are definitely willing to travel if it means getting the best possible treatment.I also have family in PA, so traveling to PA is also a possibility. (I've heard Shriners in PA casts?)I would really just like some information from someone that has been down this road...first hand. Any and all information is greatly appreciated! Thank you, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 13, 2012 Report Share Posted February 13, 2012 Absolutely right, , and thank you for commenting! Our original ortho did not recommend “casting” for my 27mo old daughter because he only knew about RISSER casting. [Aside: Instead he was recommending growth rods (to be fair, he never said how long he’d wait or how bad her 49 deg curve would get before he’d put them in). And the whole time he was touting his time at Shriners (which was evidently a while ago and his knowledge of what they were doing hadn’t been kept up-to-date) and proudly demonstrated his expertise on scoliosis by showing me his contributions to one of the premiere national scoliosis physicians’ group’s websites. Again to be fair, he recommended we go to CHOP and Shriners next, and then refused to talk to us any further and practically kicked us out of the exam room. No irritation here! J] So, what is the specific term that should be used? How’s this: Early Treatment-Casting applied with Elongation, Derotation, and Flexion with Mehta modifications? And a shortened version: ET-casts with EDF & Mehta modifications? Oh, and since Eden was first casted at 29 months, is that considered Early Treatment? Sherry New here. 6 month old just diagnosed. Casting questions! Hello everyone. My 6 month old was just diagnosed with Idiopathic Scoliosis. His curve is measuring 48-50 degrees. Our orthopedic Dr. said his recommendation is casting, but he does not have any first hand experience with this, nor did he know of anyone in our area that does. He is meeting with two co-workers next week to discuss my son's case and is then getting back to us. He said he'd like us to have him casted locally so that he can monitor, but this doesn't exactly appeal to me if there aren't any Dr's in the area with a lot of experience casting young babies. I, personally, have been doing as much research online as I can regarding where he can be casted. It's extremely overhwelming (as I'm sure everyone says when they are first faced with this!) I'm so glad that I found this site because there seems to be an abundance of information here. My question is this: Does anyone know of any Doctors that are known for casting in my area? We live in , MS. I searched this site and found that someone had said awhile back that the only Dr. in the south/southeast that was trained in casting was in Birmingham, AL. We are definitely willing to travel if it means getting the best possible treatment. I also have family in PA, so traveling to PA is also a possibility. (I've heard Shriners in PA casts?)I would really just like some information from someone that has been down this road...first hand. Any and all information is greatly appreciated! Thank you, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2012 Report Share Posted February 16, 2012 , It is clear! J Eden was diagnosed at 27 months. However, the rib hump was visible the previous year. Maybe earlier…I can’t remember. We kept thinking it was due to her Erb’s Palsy, which is not just arm muscle paralysis, but chest and back muscles too. I am wondering about the “Early Treatment” descriptor as it applies to the child’s age. So many of the children I read about here are being diagnosed before 12 months. With Eden being over 24 months, according to the one article, her chances of complete correction are not as good as those who start casting earlier. The value and practice of casting “older” kids, specifically 4 years and up, has been discussed here too. Would this also be considered “Early Treatment”? Is it a matter of when the casting starts or through what age it continues? I know it’s all evolving, so if that’s the answer or if it’s just a grey area, I’ll accept that too. Just wondering what your thoughts are. Thanks, Sherry New here. 6 month old just diagnosed. > Casting > questions! > > > > > > Hello everyone. My 6 month old was just diagnosed with Idiopathic > Scoliosis. > His curve is measuring 48-50 degrees. Our orthopedic Dr. said his > recommendation is casting, but he does not have any first hand experience > with this, nor did he know of anyone in our area that does. He is meeting > with two co-workers next week to discuss my son's case and is then getting > back to us. He said he'd like us to have him casted locally so that he can > monitor, but this doesn't exactly appeal to me if there aren't any Dr's in > the area with a lot of experience casting young babies. > > I, personally, have been doing as much research online as I can regarding > where he can be casted. It's extremely overhwelming (as I'm sure everyone > says when they are first faced with this!) I'm so glad that I found this > site because there seems to be an abundance of information here. > > My question is this: Does anyone know of any Doctors that are known for > casting in my area? We live in , MS. I searched this site and found > that someone had said awhile back that the only Dr. in the south/southeast > that was trained in casting was in Birmingham, AL. We are definitely > willing > to travel if it means getting the best possible treatment. > > I also have family in PA, so traveling to PA is also a possibility. (I've > heard Shriners in PA casts?)I would really just like some information from > someone that has been down this road...first hand. Any and all information > is greatly appreciated! Thank you, > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2012 Report Share Posted February 16, 2012 Hi Sherry,The pioneer of Early Treatment(ET) w/ Mehtas specialized EDF casting and many other experienced ET docs feel that the best case scenario to attain complete curve resolution is to diagnose and treat children with PIS in their rapid phase of growth(24 cm’s), which is under 2 yrs old. The key principle here is to harness the childs rapid rate of growth to train the young spine to grow straight, gently & permanently. Unfortunately, a childs rapid rate of growth slows down after age 2 and the next big growth spurt isn’t until adolescence (only 14 cm’s)..The value and practice of casting “older” kids, specifically 4 years and up, has been discussed here too. Would this also be considered “Early Treatment”? Is it a matter of when the casting starts or through what age it continues? **If the childs scoli didn’t develop until 4yrs old (juvenile stage) and the child was edf casted straight away, then it would be considered ET. If the child was diagnosed at 1yr. of age with a progressive case and is not casted until age 2.5, its not considered ET. My thoughts on all of this is that all docs (peds & orthos) must be made aware of the significance of PIS in an infant and the necessity of ET, so they can properly refer their young patients to centers that apply ET properly and less children will fall through the cracks. I believe ET must be an available option to every child on the planet affected by PIS and know that its parents that will help the forward momentum of the ET movement, as the more they are made aware, the more ET will demanded for young patients all over the world.HTH’sHRHFrom: infantile scoliosis treatment [mailto:infantile scoliosis treatment ] On Behalf Of SR ClancySent: Wednesday, February 15, 2012 6:55 PMinfantile scoliosis treatment Subject: RE: ET/Mehta terminology ,It is clear! J Eden was diagnosed at 27 months. However, the rib hump was visible the previous year. Maybe earlier…I can’t remember. We kept thinking it was due to her Erb’s Palsy, which is not just arm muscle paralysis, but chest and back muscles too. I am wondering about the “Early Treatment” descriptor as it applies to the child’s age. So many of the children I read about here are being diagnosed before 12 months. With Eden being over 24 months, according to the one article, her chances of complete correction are not as good as those who start casting earlier. The value and practice of casting “older” kids, specifically 4 years and up, has been discussed here too. Would this also be considered “Early Treatment”? Is it a matter of when the casting starts or through what age it continues? I know it’s all evolving, so if that’s the answer or if it’s just a grey area, I’ll accept that too. Just wondering what your thoughts are. Thanks,Sherry New here. 6 month old just diagnosed.> Casting> questions!>>>>>> Hello everyone. My 6 month old was just diagnosed with Idiopathic> Scoliosis.> His curve is measuring 48-50 degrees. Our orthopedic Dr. said his> recommendation is casting, but he does not have any first hand experience> with this, nor did he know of anyone in our area that does. He is meeting> with two co-workers next week to discuss my son's case and is then getting> back to us. He said he'd like us to have him casted locally so that he can> monitor, but this doesn't exactly appeal to me if there aren't any Dr's in> the area with a lot of experience casting young babies.>> I, personally, have been doing as much research online as I can regarding> where he can be casted. It's extremely overhwelming (as I'm sure everyone> says when they are first faced with this!) I'm so glad that I found this> site because there seems to be an abundance of information here.>> My question is this: Does anyone know of any Doctors that are known for> casting in my area? We live in , MS. I searched this site and found> that someone had said awhile back that the only Dr. in the south/southeast> that was trained in casting was in Birmingham, AL. We are definitely> willing> to travel if it means getting the best possible treatment.>> I also have family in PA, so traveling to PA is also a possibility. (I've> heard Shriners in PA casts?)I would really just like some information from> someone that has been down this road...first hand. Any and all information> is greatly appreciated! Thank you,>> >>>> Quote Link to comment Share on other sites More sharing options...
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