Physical Therapy 4-week Evaluation

So today was a big day for us because it was Kellyn's 4-week evaluation at her outpatient physical therapy clinic.  Overall, it went pretty well.  Four weeks ago, Kellyn measured at about an eighteen degree tilt.  Today Kellyn was measuring at about a ten degree tilt.  So she is definitely tilting her head less.  The physical therapist also noticed improved strength in both her neck and trunk.  *Anna was also happy with how Kellyn's gross motor skills were progressing. She said that Kellyn has progressed faster than she expected in many areas.

Kellyn around the time of her four week physical therapy evaluation. 

Follow-up Helmet Appointment

About four weeks ago, we took Kellyn to get initially evaluated to see if she needed a cranial remolding orthosis. The cranial remolding orthosis is basically a helmet for children who have plagiocephaly. It helps to reshape the head into a more symmetrical shape. At that appointment, Kellyn's measurements fell within the normal range. However, she still had a flat spot on side of her head while the other side jutted out a bit more. The cranial remolding specialist did not recommend a helmet. She suggested lots of tummy time so that the head would likely fill in on its own.

This is the stockinette that goes over the head.

Rolling Belly-to-Back (towards right side)

Kellyn could easily roll from belly-to-back towards her left side.  This makes sense since her trunk favors the left side.  She had a much harder time putting weight and pressure on her right side of her trunk.  Therefore, her PT really encourage us to work with her on rolling this way.

1.  Place Kellyn on her tummy and put a toy on her left side of her body.

2.  If possible, encourage her to reach her left hand up and out towards the toy.  Her head should tilt back as she looks up at the toy.

Kellyn's got some serious bed-head going on in this picture.

Four Weeks into Physical Therapy

Here are some updated pictures of Kellyn after four weeks of physical therapy.  Her left trunk tilt is much less pronounced and her right head tilt has decreased some, as well.  Her physical therapist noticed that she tilts her head more when she is looking down.  Kellyn is more inclined to keep her head straight when she is looking straight ahead or laying down on her back.  What you won't be able to see in these pictures is how much stronger she is getting at doing her strengthening exercises.  She has also had amazing progress in her motor skill progression.  In addition, I believe her facial symmetry is improving.  I am very pleased with her progress so far.

She holds her head up much more straight when she is looking straight ahead.

Cranial Facial Appointment

Yesterday, my daughter had an appointment with a pediatric cranial facial specialist.  As I mentioned in a previous post, Kellyn has some of the classic facial asymmetries that torticollis can cause: one eye smaller, one cheek fuller, one jawline more pronounced, depression on one side of her neck, and a flat spot on the back of one side of her head.  In my opinion, they are very minor and barely noticeable unless you were looking for them.  But I wanted the doctor to take a look at her and see what he thought.

The cranial facial specialist was outstanding.  He carefully evaluated every facial feature while Kellyn made goo-goo eyes at him.  After his analysis, he confirmed that she did have some minor facial asymmetries and minor plagiocephaly that that were caused by the torticollis.  However, he said that everyone's face is asymmetrical and that her facial asymmetries were not outside the normal range.  He said that the only reason I probably noticed it is because I am her mother and that the average person wouldn't have even noticed.  Phew!  That felt great to hear, especially from a specialist who stares at faces all day long.  If anyone would be critical about that sort of thing, I am assuming it would be him. 

Kellyn's Progress in Physical Therapy

So Kellyn has been in physical therapy now for about three weeks.  Overall, I think she is making good progress.  I have noticed that her right head tilt is not as pronounced as it previously was.  Also when I tilt her to her right, she is now able to pick her head up much easier than she used to.  So her neck muscles have definitely strengthened.  Her trunk is much less inclined to tilt to the left now too.  I think the lessening of her trunk tilt is a more dramatic improvement compared to her the decrease in her head tilt.

TOT Collar Review

I am the type of person who wants to feel like I have exhausted EVERY avenue possible to fix a problem.  So when I heard about the TOT collar on a torticollis forum, I immediately started researching it.  Basically the TOT collar is a device to help correct torticollis.  It is is made out of soft tubing that goes around the child's neck.  The TOT collar has two vertical nylon tubes positioned on the torticollis side that discourage the child from tilting his head to that particular side.  Please note that it is very important to always be supervising your child when he/she is wearing the TOT collar.  It also should not be used while sleeping or riding in a car seat.  As far as the reviews I read about the TOT collar, they were mixed.  Some parents liked it and thought it helped, while others said it did not help as much.  But for the price, I thought it was worth it if there was a possibility of it helping our daughter.

In this picture, the TOT collar was working quite well for her.

First PT Appointment with Early Intervention

Today was Kellyn's first physical therapy appointment with our state's early intervention program.  Her assigned physical therapist came to our home to work with Kellyn.  I am so excited how quickly we were able to get started with this program.  After having such a great experience with Luke in this program, I feel very confident that we will have great success with Kellyn in it as well.

Ayelet © 123RF.com | yeletkeshet

Before Pictures

Here are some pictures of Kellyn before or at the beginning of physical therapy.  Her physical therapist suggested we take pictures of Kellyn regularly.  That way, I can track her progress since its hard to notice the changes since I'm with her all the time.  I'm trying to see if her neck and trunk straighten up and her slight facial asymmetries resulting from the torticollis resolve themselves over time.

 This is the back view of her head tilt at approximately 1 week into physical therapy.    

Ophthalmologist Appointment & Scoliosis Evaluation

Today is one of those appointment filled days for Kellyn. After this morning's evaluation with the early intervention program, we had an ophthalmologist and pediatrician appointment scheduled for the afternoon. As I had mentioned previously, children with torticollis occasionally have vision issues that cause them to tilt their head in a certain direction. Just to be on the safe side, we wanted to have her vision tested. At the ophthalmologist appointment, they discovered that she was about twice as farsighted as the average seven month old. The doctor shared that her vision both near and far was not great. Immediately, I started to freak out in my head. "Is she going blind?," I asked with with alarm written across my face. He shook his head no and said that she may need to wear glasses down the line. He did not recommend glasses at this time because he said babies' vision could naturally improve in time. Compared to my initial concern with her going blind, the prospect of her possibly having to wear glasses in the future seemed totally tolerable.

hermione13 © 123RF.com | hermione13

Torticollis Diagnosis

On Friday, Kellyn had her two big appointments with her pediatrician and her physical therapist.  Her pediatrician officially diagnosed her with torticollis.  Later that day, Kellyn had an initial evaluation with an outpatient physical therapist.  She confirmed the diagnosis, did some initial physical therapy exercises with Kellyn, and gave us a helpful flyer to take home that outlined her exercises with detailed descriptions and pictures.  I was so nervous about her initial physical therapy appointment that I brought along two sources of moral support: my husband and my mother :)  I felt less anxious with them by my side.

Feeling Scared

So it seemed like an eternity between the three days of waiting for her pediatrician and physical therapy appointment to get an official diagnosis of torticollis (which at this point, I was almost 100% that she had).  In the meantime, I started researching torticollis on the internet.  I learned about the condition of torticollis and various treatment options.  I scoured torticollis forums on BabyCenter to see what other parents' experiences were.

The one thing that stood out to me was that many babies were diagnosed with this as infants and had started physical therapy early on.  Now my daughter was almost seven months and that almost seemed late to be officially diagnosed and treated in the "torticollis world".  The more I learned about this condition, the more fear and guilt crept into my mommy conscience.  My poor daughter likely started showing signs of this condition around one or two months of age.   That means that I could have spent the last four or five months working with her to correct this problem.

Torticollis Suspected

So for the past few months, I've been noticing my daughter Kellyn has been tilting her head to her right side and tilting her trunk to the left side.  I also noticed that her left eye is open slightly more than her right side.  I mentioned her tilts and her eyes to her doctors when she was about six months old, but no one seemed to be too concerned.  I was given general advice of stretching her and encouraging her to look to her right side.  I was also told that if it doesn't correct itself over time, than she may need physical therapy in the future.