I don't think I've ever mentioned this before, but Bat Girl has a flat head.
To be precise, she has mild positional plagiocephaly
--the rear right quadrant of her skull is flattened and the rear left quadrant pushes out very slightly. We first noticed the flat spot when she was around three months old, but in retrospect it's likely she came out of the womb that way, given the cramped conditions and her breech positioning. (Her right ear was also smushed and folded almost double for the first few weeks of her life.) She has always favored turning her head to the right, so it's also possible that she had very mild torticollis,
especially in light of her resistance to nursing on my right boob (i.e. turning her head to the left). If she did, it was very mild, as she has no problems with range of motion now.
At her four-month well baby visit, we pointed out the flat spot to the pediatrician. She was unconcerned and recommended that we do some repositioning (bolstering Bat Girl when she slept so she turned to the left, etc.), which we had already already doing, and we left it at that. However, by this point Bat Girl was already rolling over and mostly slept on her tummy or side. Everything I read about plagio said that mild cases usually resolved themselves once the child started rolling and crawling, so I wasn't worried and pretty much forgot about it. We made an effort to keep her off the flat spot when we remembered, but it wasn't an obsession or anything.
By the time Bat Girl was 9 months old, the plagio was definitely no better, and in fact I worried that it was getting worse. Was her head bulging out to the left? Were her ears still misaligned? (Earlier, her right ear was visibly set further forward on her head than the left.) I brought it up to the pediatrician again, who took another good look at Bat Girl and said, essentially, yes, she has a flat spot, but it's not that bad, she doesn't need a helmet, and once she grows some hair you won't even notice it.
But I kept obsessing about it, on and off. I'd go through periods where I thought, oh, it's not so bad, you can't even tell. Then I'd catch sight of the top of her head in a mirror and think, holy crap, and then spend two or three days googling pictures of pre-banded plagio babies' heads until I worked myself into a panic. But I thought it was probably too late to do anything about it, and to be honest, I really did not want Bat Girl to wear a helmet. I just didn't. So I stuck my head in the sand.
Over the last month or two, though, I've read about Statia's
battle to get the Mini banded, and have emailed with her about her experience, and I started to think, why not just see a neurologist and get it checked out, just for peace of mind? So last week I prepared myself for battle and called the pediatrician. Who, of course, gave me no hassles at all about it and gave me the names of 4 pediatric neurologists. Only one of them accepts our insurance, so I called the office to make an appointment. Here is how it went:Me:
I'd like to make an appointment with Dr. Fancypants.Bitchy Receptionist:
What's the diagnosis?Me:
And how old is the infant?Me:
Actually, she's a year old.BR:
Oh, Dr. Fancypants doesn't see plagio patients older than 10 months. Why are you just calling now?Me:
Our pediatrician felt it might get better on its own, but it hasn't really improved, so--BR:
Well, it's never
going to improve. It's too late, her skull has hardened.
AARGH! Setting aside the fact that YOU, BITCHY RECEPTIONIST, ARE NOT A DOCTOR, AND IN FACT HAVE NO MEDICAL TRAINING WHATSOEVER, I have read of plenty of cases where children have been banded as late as 18 months and shown improvement--not as much as if they were banded before 9 months, true, but it's not totally unheard of. Also, WTF?!?!?!?!? Why not just tell me, "I'm sorry, Dr. Fancypants doesn't see plagio patients older than 10 months"? You could even add, "He feels that after 10 months is too late for treatment." There is no need for you, bitchy receptionist with no medical training, to editorialize and diagnose MY child over the phone. Ugh.
Unfortunately, my default reaction in cases such as these is to fall apart and start to cry, rather than opening up a can of whoop-ass as this woman so richly deserved. So instead of ripping BR a new one, I hung up and felt like the worst mother in the world. Why hadn't I pushed for a referral sooner? Was Bat Girl's head going to be fucked up for the rest of her life, and would she resent us forever for not fixing it?
I'm still debating whether to call around and see if one of the other neurologists our ped recommended will see Bat Girl. It will probably cost around $350 for the appointment (that's average for a non-insurance-covered office visit around here) and it seems likely that another doctor will tell us there isn't much they can do, given that BG has passed the optimal banding age. The money is definitely a factor--obviously if it would help BG, there's no amount of money I wouldn't spend, but if it's just to be told "Sorry," I don't know if it's worth it. The head shape looks bad from some angles, but other times it seems fine, and honestly I've been looking at it so much, I don't know what to think anymore. Her ears have definitely evened out, so maybe it's getting better.
My main concern is that it not cause other problems for her down the road, and it seems like long-term effects are usually in severe cases where there's facial asymmetry. BG doesn't have any facial asymmetry due to the plagio--back in September she was diagnosed with mild ptosis
, but after the Bitchy Receptionist encounter I called the pediatric opthalmologist we saw back then (whom I LOVE, btw, if anyone needs a ped. opthalmologist in the Big City area) and he assured me that the ptosis was "100%" not caused by any head shape irregularities. (And I believe him, because I also have a slight asymmetry between my eyes, as does my dad.)
In the end, it comes down to the guilt, as always. Guilt for not noticing sooner, guilt for not being more aggressive with repositioning--we turned her so her head faced the other way when she was lying down, sure, but we could have also changed the way we held her during feedings, etc. etc. On the other hand...we did tons of tummy time, she spent no time in a car seat and very little in a bouncy seat or swing (was in-arms practically constantly her first three months of life), she rolled over and crawled early, so what else could we have done? Other than call a doctor and get her banded, of course.
At the very least, this is another fun thing we can blame on my stupid uterus. (Intrauterine crowding due to twinning, uterine anomalies, and/or breech positioning can lead to plagiocephaly. Too bad our pediatrician didn't know that, or didn't mention it when BG was two weeks old and I told her I had a UU and asked if there was anything we should watch out for in BG as a result--she said, "Nope, nothing!") And we like blaming things on my stupid uterus.
I don't know...forgive all the rambling. What would you do?
Labels: Bat Girl, mama drama, unicornuate uterus, WTF?