Mister Shapen

Alrighty. So. Yes. Amos has a funky head. If he were a lady, I'd call him Miss Shapen. As it stands, he must be Mister Shapen.

We visited the second orthotist, a division of Hanger Orthotics, on Friday. She gave us a great deal of information about plagiocephaly and brachycephaly. She examined Amos' head, measured him, and declared him to be mildly to moderately plagiocephalic and brachycephalic. Meaning, he has a flat spot toward the right side of his head (plagiocephaly) but also a flattening of the back of the head (brachycephaly). We already knew that, but she had an even better diagnostic tool than just a measuring stick.

Hanger Orthotics uses a computerized scanner that digitalizes the head in 3D. Yup. We had the chance to see Amos' head on the computer and in person. She placed a stocking cap over his noggin, which made him look like the most adorable burglar ever. A receiver was placed inside the cap, and then she waved a wand all over his head in order to get the 3D image. It was pretty darn cool to watch.

Here is Amos' head.

As you can see, the red line indicates the middle of his forehead dissected through to the middle of the back of his head. For the most part, the left side of his head is forming well (that would be on the right side of the pic for you). The right side of his head, however, is troubling. That is where the original flatspot formed. It has shaped out better over the past few months of repositioning, but it isn't completely normal yet. The back of the head is flattenened and slopes to the right (the left side of the pic for you), but it is starting to round out. That is a very good sign.

Actually, the more I look at it, I think the red line should be moved over a few notches to indicate the true middle of his forehead, but it doesn't really matter. You can clearly see that Amos' head is misshapen.

So, measurements of Amos' head show that his width is almost the same as the length. Normal heads are longer than they are wide. It is possible that Amos' head will improve even more with continued repositional therapy. That means we keep him off of the back of his head. We encourage him to sit up as often as possible. When he sleeps at night or takes naps, we position him on his left or right side. For now, I will be concentrating mostly on positioning him on his right side in order to flatten out that bulge. I had been positioning him on his left quite a bit more, and it's clear from the scan that we've been successful in helping to round out that part of his skull.

It was agreed that we will continue to reposition Amos for another 5 weeks. We'll go back for another scan. They can superimpose the new scan over the old one to see how things have improved. If we're happy with the improvement, then all we may need to do is keep repositioning. If it's not clear that anything is changing, then we may consider a helmet.

I'm feeling good about this decision. It's sort of a happy medium between the two options. We've clearly seen that since Amos has learned to sit up, it is helping to reshape his head. I almost think it's helping faster than any of the repositioning I've done. Maybe. But, within a week of him sitting up, we saw the back of his head start to round out. That brings me much joy, people. Much joy.

He may still need a helmet. We'll see in 5 weeks. If he does, he'll probably wear it for 4 - 6 months. He'll need to keep it on for 23 hours a day. One hour off to bath him and to clean the helmet.

The downside for me, because the inner selfish lady is whining about it, is that this decision means at least 5 more weeks of losing sleep. Amos sleeps next to my side of the bed, and despite my efforts to wrap him up tight and to position him just so, he still manages to wriggle his way onto his back on occasion. I've gotten used to it, but gosh darn, I really miss sleeping.

Here is Amos' head just before he turned 6 months, and just before he started to sit up on a regular basis. You can kinda see that it is not as improved as the scan shows, which was taken a few weeks after he turned 6 months (and was a pro sitter).

Phil was trying to indicate where the middle of Amos' forehead was, but Amos keep flailing around.

So, that's the story. We'll keep on a keepin' on with our current methods. Then we'll see what we see.

Oh, and one of the more fun therapies we're using is to rub Amos' head with our hands. I will shape him into something great, like a bowling pin or an ashtray. Heheh.

Kim, if you are reading this, the second orthotist also said that neurosurgeons are notorious for being anti-helmet. I'd suggest that you do what we did: get a prescription for the helmet from your pediatrician or family doc that normally sees your little girl. Then, get a referral to an orthotist. We really like Hanger Helmets because of the scanning to get the head shape. The scan is used to create the helmet. Other helmets are created by taking a plaster cast of the baby's head, which can be a bit traumatic to the baby and the parents. The other helmets work just as well, but Hanger just has a friendlier approach to creating it.


For anyone dealing with plagiocephaly, there is a Yahoo group you can join.

I'll update as things progress. Send Amos' head some good vibes and thoughts!