Archive for July 2010

Plagiocephaly and Other Types of Malformed Infant Heads

July 25, 2010

Physical therapists who deal with children (and the MD pediatricians who send them there) believe that tummy time is going to resolve a lop sided head. No it will not.  They feel that the infant needs time off of the head so that it can grow and offset the flatness.  They are asking the wrong questions.  What causes the lopsidedness to begin with?  The birthing process and sometimes the last trimester shape and mold the head.  The head is a spherical object that is circumferentially compressed.  Do not buy into the helmut as an answer.  FYI, the helmut was devised/created by what type of professional? …believe it or not…a physical therapist.  What do they know about child development?  What medical experience with children do they have?  Insurance doesn’t pay for it, so it will cost you about $3,000 to harm your child.  One brand of helmut is called the “Cranial Band.”  How medieval and horrific does that sound? You try and put a rubber band around your head.  See how you like it.  It is a simple issue in fundamental physics that you do not resolve a compression problem with more compression; the answer is decompression (that’s where osteopaths come in).

Let’s talk about that last month first…

Things get pretty tight and difficult for pregnant moms in that last month.  Mommies, if it was uncomfortable for you,  think what the baby is going through.  Babies who are breech in that last month tend to be very colicky.  Positionally, an otherwise normally free floating and developing head  gets trapped underneath momma’s liver and a tight diaphragm; what happens is that the head gets stuck and a downward compression strain hurt these babies terribly.  They scream bloody murder because they hurt.  Whenever I hear, “Oh she laid in this spot and never moved”  my antenna picks up.  The next question is why?  Most of the time it is because there is no room.  There is always compression strain in these cases.  If there are multiples, wow, forget it, there is never enough room throughout the pregnancy, never mind the last month.  On top of that these babies need to come out early and the effects of gravity on these delicate heads will have long lasting effects, not to mention these heads are softer and are more easily (abnormally) molded.  Theses babies manifest their problems with myriad presentations.  Right off the bat, some can not latch.  Some can not nurse well [the ability to nurse, coordinate suckle and swallow is present by 33-34wks in uterol] but compression at the back of the head kinks the nerve (cranial nerve 9) that controls the muscles of the tongue and back of throat.  They tend not to gain weight too well.  Babies that are compressed may have funny looking heads, but how else can one tell.  Intuitive moms will recognize immediately these clues: the soft spot is too small, the soft spot is not soft enough, scalp veins are bulging and blue, usually on one side more than the other, red splotchy face (even when not crying), facial rash.

Lets talk about delivery…As labor starts, the infant flexes the head and presents usually the vertex, the top of the head (where the hair whorl starts).  As the infant descends, there is circumferential compression of the spherical structure that is our cranium.  In order for the infant to pass through the vaginal canal, it has to, get this, spiral the body (this is how and where the plagio starts, and also we believe, the cranial basis of a f uture back scoliosis).  Spiralling allows one shoulder to deliver before the other (otherwise, the infant would get stuck if both shoulders tried to deliver at once).   When the head crowns, it undergoes head and neck extension.  In this whole process, while it is apparently smooth, especially if the amniotic sac is intact,  may not be so.  There are over 100 bones in the head and face that are being formed in the sleeve of periosteal lining.  Anywhere along this pathway, a sleeve can get caught.  Have you ever tried to put your hand through a sleeve that is rolled or caught?  Near impossible to get it through right?  A similar situation is pulling a sweater over a long sleeved shirt when the shirt is bunched up at the shoulder or elbow.   You can still go to work, you can still function, but it isn’t comfortable is it?   Well, that is how the infant feels.  It is not pleasant for them.  They just had their brains and skull crushed down about 66% in a ardous process.  Some of them do not bounce out of it completely.   In our Most Natural State, immediately nursing on the breast helps; screaming from the pain over several months does most of the rest.  Cranial osteopathic treatment at any stage will most certainly remedy some or nearly all of  this.  Here are a couple of my favorite photos.  One day I will gather my collection of photos to educate the public.  Other interesting adult and children photos can be found on my website: www.doctorhoang.com   Oh, sorry.  These photos are a couple of my before shots.  You can go to the web site to view the great ‘after’ photos.

Oh yeah, another patient of mine just told me about this.  She decided that the helmuts are ‘evil.’  They remind her of what the Japanese do to their watermelons.   Apparently, the timing has to be perfect.  If they are off by a week because the watermelon can’t outgrow the mold, it will rot.  This is pretty much what the helmuts do to your kid’s head.  Compress the head and cause a buildup of pressure of which you, the parent are unaware; and the poor infant can not grab at it to take it off.  Please view this link:    http://news.bbc.co.uk/2/hi/asia-pacific/1390088.stm

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Whatever You Do, Don’t Do This

July 24, 2010

This foot belongs to my patient Susan P.  She and I wanted to share with the world what happens after multiple surgeries.  Do not believe that cutting into any muscle is going to relieve you of pain, especially in the foot.  The tissue scars up and the muscle, in medical lingo, contractures.  In patients who have bunion surgery, after the tissue heals, the podiatrists just look at the LOOK of the bunion.  They don’t question the function of the foot.  Please read my previous posts about feet pain.  Feet problems are never local to the foot.  Feet pain is a distal manifestation of a proximal problem.  With Susie, now that the foot is messed up, I always have to calm down the spasms.  She does not leave a session without me treating her knee, hips, back, neck and head.  The cause is always upstream and the answer is always osteopathic manipulative treatments to that cause – which is vector reduction of the distal strain.  www.doctorhoang.com  For more pictures of what the foot looks like after bunion surgery, look at my prior post

Our Natural State

July 18, 2010

Hello world.  Hey!  Thanks for reading my blog people – all three of you.  Ha- Ha.  You have inspired me (people are actually reading) and I want to resume entering new posts on my blogs on pediatrics and chronic pain.  Before I renew these efforts more consistently, I want to provide context for my posts.   My whole medical philosophy and practice, whether it is for children or adults, always originates with Our Most Natural State.  What is Our Most Natural State?  Out there in the great wide natural world, how do we survive if we had to avoid and fend off predators?   This is why I continue to stress over my little girl.  [I had the good fortune of speaking with 2 people this week who allowed me to cry and absolve me of some of my guilt for dropping her].  Her inability to sleep is concerning.  Sleep is natural and it is necessary – we need to reboot on a daily basis.  If a child (or adult) cannot initiate, maintain sleep and wake up rested then there is trauma, pressure and strain within the closed tissue space that is our head.  In our most natural state, she would be sluggish and prey to any big cat and lunch meat.  She even would have been lunch meat earlier on with all that crying.  When I treat patients for sleep disorders, they stop sleep walking, they snore, they sleep longer, they wake up more rested and for however many hours they sleep, they are more rested.  I dare not touch my little girl.  I have to wait.

Progress and civilization has removed us so far off from our most natural state, I believe that a good portion of chronic disease would be eliminated if we attempted the return.  Just remember this as we venture off into new discussions and posts. thanks.

There is Something Wrong with My Baby – update #2

July 6, 2010

My baby continues with her sleep issues.  My husband and I continue to be grateful for her significant progress with Dr. Miller’s help.  This weekend I realized that I would have to be the one to help her and watch her.  I had made an appointment to see another doctor colleague in San Diego, but then cancelled.  In talking to this doctor I had told him of her sleep issues.  What I wanted to hear was, “Children that have sleep issues, when I treat them, they usually get better.”  I did not hear that.  I was told that I should just make an appointment. 

This weekend, I decided that because of the great work that Dr. Miller did, she should only need, little by little incremental work as her brain grew and stretched out the plates of her skull.  And so I did very little, so fearful of hurting her.  Her worst times to getting to sleep are at about 7 to 8 pm.  She needs a boob in her mouth and even then she kicks and hits with her right arm.  All this activity or inability to wind down actually startles her awake.  I would settle her and leave.  Within 30minutes, she would cry for me.  This happens pretty much nightly. 

This weekend, however, with much grief and guilt for having to touch her, we were pleasantly suprised.  We put the other one down to bed, no problems.  Then I nursed the little one and left her on our bed.  We started watching Avatar and as expected, she startled herself up within an hour.  Our current life is just about that every night.  This time however, instead of stopping the movie and running in every 30minutes, it was about one hour apart.  My husband was very grateful that we managed to complete Avatar in 4 hours; he thought it would take us 2 days to finish it.  The following night, more relief…she was so tired, we wore both girls out at the park, nursing her to sleep was easy.  It did not take long and several times when she startled herself awake, she was able to soothe herself back to sleep.  It was wonderful.  Dare I hope?  Has she turned another corner?  We will have to wait and see…

Embarassing Questions

July 3, 2010

All right ladies and gentlemen, come one, come all.  You are invited to ask your most embarassing questions.  Why this invitation?  This is a safe forum.  In my interactions with patients and parents sometimes, after the fact and much, much later, I find out things that had questions been asked earlier on, we could have addressed and resolved issues.  Why suffer unnecessarily?

As a pediatrician, I am talking about pooping and peeing (the kids giggle here) all the time.  I usually don’t give those words a second thought.  But then in adult company, I throw them around and then I am shocked and suprised at my own editing failures.  I know there are tens of hundreds of thousands who suffer but don’t know how to ask for help.  Should I bring them up in future posts?

OK.  Here are some sample topics that people would want addressed.

chronic constipation. hemorrhoids. bad breath.  lopsided boobies.  painful sex.  body odor. chronic farting (flatulence).  am i crazy?  does my baby’s penis look funny? people with a ‘lazy eye’  that were supposed to be ‘corrected’ but are not – how do you talk to them and where do you look?  stuff like that other doctors may or may not have touched and with my own brand of osteopathic perspective.

www.doctorhoang.com

The Depleted Mother Syndrome

July 3, 2010

After having one baby most women recover nicely.  By the second one, however, something happens to the mother’s body.  Without rest, exercise and a varied diet to replenish, despite supplementing, some women find that they continue to lose hair, can not lose the weight and generally feel blah.  I find that theses moms tend to have pre-existing medical conditions that make  it difficult for the woman to mechanically return to their previously unstrained prepregnancy body.  Are you a depleted mother?  How do you know?  A simple question to ask yourself is if you feel that after the second baby if things have never been the same.  

There are even some of you mommies out there who have done all the right things, rested, exercised and still can not lose the weight.  The problem is that if the physics of the body is distorted it will affect the biochemistry of the body.  Have no fear, I have found the answer.  Unfortunately, biochemically replenishing yourself with supplements will not remedy the situation.  First, you need osteopathic manipulative treatment to mechanically correct the body.  Alas, I can not reveal the what I do for my mommies.  You have to call and make an appointment.  www.doctorhoang.com