second opinion #1

We went to Children's Hospital in DC to see a neurosurgeon for a second opinion on the severity of Josiah's plagiocephaly and whether he would recommend a helmet. The PA we spoke to before the doc came in did not seem like a strong advocate for the helmet. Her primary reason being that there are no scientific studies done to prove that they are more effective more than just aggressive repositioning. When the doc came in, we filled him in on Josiah's history and he took some measurements of his head. He said that Josiah's head is wider than it is long, and it should be the opposite. His right ear is also more forward and higher than the left ear. Fortunately, he was able to rule out craniosynostosis (a possible effect of plagiocephaly) and said that these issues were all pretty much cosmetic, although there's always a small chance that Josiah could potentially have other issues in the future if left untreated. (i.e. vision problems, jaw issues, etc. These are not likely though.) But it would definitely not affect his brain development.

Josiah would, in all likelihood, just have a flat head that wouldn't be as noticeable once his hair starts to grow in. But the doc's conclusion, without hesitation, is that we should try a helmet if we want to try and remedy the flatness. His reasoning was that Josiah's plagiocephaly is pretty severe. It's not severe enough that it has been causing noticeable facial asymmetry, but the flattening is pretty severe. And b/c we had told him that with doing extra tummy time over the last month and not seeing any improvement, he said his thought is that it won't improve very significantly on its own. Although even with a helmet, it probably still won't completely round out. There will still be some flattening even after the helmet, just not as severe. He said if we had told him we saw some improvement with Josiah's plagiocephaly with the increased tummy time, then he might ask us to wait another month to see if it continues to get better, but since we haven't really seen a change, he said it's not likely to get a whole lot better on its own.

We really liked this doc even though we had to randomly pick him from a list of providers with our insurance. He was very personable and honest. He said he would also write a letter to our insurance about Josiah's medical need for the helmet to see whether this could help persuade them to cover the cost of the helmet, which is around $3000. At this point, Bill and I are probably 90% sure we are going to proceed with the helmet, especially since the doc so quickly and decisively recommended the helmet. We have another appt with the actual company that makes the helmets this week (Cranial Technologies). They will be doing a free initial consultation for us and will be assessing Josiah's head shape, as well as taking measurements. They will let us know whether they think he is a good candidate for the helmet, but we're pretty sure about what their answer will be. =) Other than that, we're considering one more objective opinion from another neurosurgeon not affiliated with the helmet people... just to see what his/her thoughts are. So please continue to pray for wisdom as we are taking in all this information and processing it. We want to do what's best for Josiah and steward him as best we can. =)