An Ounce of Prevention is Worth a Pound of Cure
As many of you know, we welcomed our third son, Cairo, about 8 weeks ago. As all babies do, they come out of the womb looking simultaneously perfect (to us parents) and a little funny to the rest of the world.
Because we publish blogs every month, I frequently mine my life experiences to inspire my writing, mostly to keep writing blogs from feeling like a chore. So bear with me as I connect this life experience to what we do best here at Schroth DC.
A few short days into Cairo’s life, our trusted lactation consultant, Amber Allgaier came to visit us at home. The breadth of this woman’s services is truly remarkable: not only does she help with latching, assessing milk supply, and assessing the baby’s ability to remove milk from the breast, but she also assesses the baby’s tongue and mouth strength and the baby’s neck flexibility.
There is surprisingly a good amount of overlap with the physical therapy world, as we as PTs, are always assessing strength and mobility.
Right away, Amber noted tight mouth and neck muscles, especially on one side of the neck. Then I began to notice that when I put Cairo in his bassinet at night, he would automatically turn his head to the right, every night, every time.
If I were a first-time parent, I wouldn’t have paid much attention to this. I pride myself on not overreacting as a parent, of not creating ailments where there are none. BUT I have the benefit of this not being my first rodeo.
I am also mother to twins Nico and Rumi, who are almost 3 now. And when Nico and Rumi were infants, they also had a preferred side they turned their heads to while lying on their backs (and if you don’t know this, babies lie on their backs A LOT. It’s due to the movement coined “Back to Sleep” that was implemented in an effort to decrease SIDS – which it did.)
So let’s cut to the chase – Why is constant head rotation to one side a problem?
Babies have super soft skulls, and because the skull bones have not fully fused together, lying only on one side of the head can quickly create a flat spot on that side. This is called plagiocephaly.
If you don’t catch the flat spot quickly, you’re on the way to needing a medical helmet for your baby. Why? Because of aesthetics (the mal-alignment of the skull can subsequently distort the face) and because of things like athletic helmets in the future not fitting properly.
As I watched my beautiful twins sleeping, always with their heads rotated to the same side, doing absolutely nothing to combat this habit, their plagiocephaly became severe enough for their pediatrician to recommend we get them both medical helmets when they were 4 months old.
And sadly, these helmets are only covered by insurance if the baby has had surgery for a precipitating problem, which, luckily, my twins had not. So, out of our pocket comes $2500 per helmet.
That’s right, Eric and I shelled out $5,000 for the re-shaping of our twins’ heads. Although Nico and Rumi managed to pull off these medical helmets and still look cute (see photo), for the 4 months they wore them, it was SUMMER. IN WASHINGTON, DC! Those babies were sweatin’ every day, and those helmets got stinky quick.
Nico & Rumi donning medical helmets
The helmets did work to reshape their little heads, and that chapter now seems distant in the past, but I certainly don’t want another helmet in my future.
So, back to the present day, our 3rd baby, Cairo, and lactation consultant Amber wisely telling me, “An ounce of prevention is worth a pound of cure”, and recommending we see a physical therapist who specializes in infants to address the unilateral head rotation on the front end.
I am embarrassed to tell you all that I didn’t listen to Amber the first time she quoted Benjamin Franklin. It took her returning for a second visit a week and a half later to wake me up to the reality of the situation.
Do I want to pay $2500 in a few months and deal with sweat, stink, and not to mention Cairo not really enjoying wearing a clunky medical helmet, or do I want to hire the out-of-network (see our previous post about out-of-network medical providers) Baby PT for $150 per session for a few sessions? Even my sleep-deprived brain could figure this one out.
So into the picture comes Allison Kops, infant physical therapist extraordinaire. She assessed Cairo’s entire spine for mobility and strength. She showed me how to stretch out a baby’s neck (verrrrrry different from stretching a teen’s or an adult’s neck BTW). She taught me to put a small bolster in Cairo’s swaddle at night to delicately tip him toward his non-preferred side, putting pressure on the opposite side of his head than he’s used to – this is hugely important in re-shaping his head, I learn.
And guess what: just a week into doing Cairo’s baby PT program, his head is re-shaping, there’s no longer a noticeable flat spot on one side, and he’s spontaneously turning to his non-preferred side to sleep. Infant PT Allison came for 2 visits, then discharged us. Do the math. It’s a no-brainer for all of you financial people.
Prevention practices work
We live in a country where mainstream medicine is practiced reactively rather than proactively. Three-fourths of US health spending is directed at treating chronic disease¹.
Our physicians are fantastic at treating problems. I am grateful for that! But what we lack in the U.S. is prevention practices.
Our M.O. is to wait until a problem develops and then use medical devices, pharmaceutical medicines, and surgery to fix it. This was not always the way of the world. In ancient medical texts and up until the early 20th century, physicians often recommended preventative practices.
We know from present-day research that preventing disease rather than interventions interrupting the progression of established disease is more effective from the perspective of providing the greatest health benefits to the greatest number of people. Moreover, prevention has proven to be one of the most cost-effective ways to achieve improved population health².
Scoliosis Prevention
So, let’s tie this all together. We at Schroth DC treat scoliosis. Although scoliosis does not have a cure (yet!), recent developments in bracing and exercise are profoundly limiting the progression of this disease.
If we don’t brace pediatric and immature adolescent scoliosis greater than 20° Cobb Angle, we may embark on the road to spinal surgery. If we don’t brace pediatric and immature adolescent scoliosis greater than 30° Cobb Angle, we’re definitely on the road to surgery.
Surgery vs. Prevention Costs
What’s the average cost of spinal surgery to “correct” scoliosis? $120,394³.
Rate of failure of spinal surgery for scoliosis? More than 50%⁴.
Complications? There are many, and they are varied – that’s another blog post I don’t look forward to writing.
Now, let’s talk financials for prevention.
What is the cost of a brace for scoliosis? Between $6,000-$10,000, covered by insurance for most. Cost of scoliosis-specific physical therapy at Schroth DC: $220/hour; most people will need about 10 hours of this type of PT to be proficient in the exercises — that’s $2200 total to learn a set of exercises that can prevent scoliosis progression over the lifespan.
The Schroth Method
For anyone new to us, the Schroth method is a hyper-specialized form of physical therapy. All we treat at SchrothDC is scoliosis. Similar to Cairo’s neck stretches helping to re-shape his skull, we teach patients specific stretching and strengthening techniques to re-shape their scoliotic spines.
We also spend a great deal of time educating our patients on progression prevention: just like how Cairo sleeps matters (i.e. always rotating to the same side), how scoliosis patients’ sleep, stand and sit matters. For example, if you have left lumbar scoliosis and are always sitting slumped over to the left side, with the majority of the weight on your left buttcheek, your scoliosis is going to progress. I repeat, YOUR SCOLIOSIS IS GOING TO PROGRESS. This is called asymmetrical loading and is fuel to the scoliosis-progression fire. A scoliosis-specific PT will assess all positions and give you very specific tools to mitigate progression.
A few weeks ago, I asked myself, “What are you waiting for, Caroline?” The answer became so incredibly clear, and I didn’t like it. I was waiting for Cairo’s plagiocephaly to get bad enough to medically intervene in how my society has conditioned me to address a medical issue reactively.
But my next thought was about having alternative choices, choosing to be proactive, and putting in the hard work of stretching out a baby’s neck (!!) on the front end to spare my little guy from future interventions. About 2 minutes later, I picked up the phone and made an appointment for infant PT.
So what are you waiting for? Consider this an open invitation to join us at Schroth DC, where we prioritize the prevention of scoliosis progression and will teach you how to re-shape your spine and your future.
References:
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