Happy Birthday Maximus

Today is Maximus Xavier's first birthday. As I recall, he arrived a little earlier than we expected. I had just finished cooking dinner, potato soup, on January 22 last year when I woke Mel up from a nap. About that time, her water broke, so we got my aunt and uncle to come get Emma, and Mel and I left for the hospital. The next morning, Maximus was born. He has grown so much in the past year. He weighed 7 pounds 8 ounces when he was born. He now weighs over 23 pounds. And his height has increased from 20.5 inches to over 31 inches.

We have had some challenges during the year, including dealing with his torticollis and plagiocephaly, but he successfully finished physical therapy and his head was reshaped using a cranial orthosis. One thing we are still working on is getting him to sleep through the night. With the exception of a night or two, until this week Maximus has gotten up at least once every night for a bottle. The past several nights though we have not fed Max when he was up. We have been able to get him to return to sleep without one. Friday night, he went back to sleep very quickly after getting his pacifier. I think we may very soon be done waking up with him each night. It will be very nice to regularly be able to get a full night's sleep once again.

He has also begun walking recently. I am looking forward to seeing what he will begin to do next.

Finished

As of this morning, Maximus is done with the helmet to correct his plagiocephaly. He has mad a lot of progress since he started wearing it back in August. At that time, the difference between the measurements from the back left to the front right of his head and the back right to the front left of his head was 1.7 centimeters. Now the difference is just 0.4 centimeters. It will be nice not having to wash the helmet daily, and Max's head will smell a lot better now that he is not wearing the helmet twenty-three hours a day. I am glad that we decided to do this for Max though, and I think we would do it again if we needed to. Now we just need to work on getting him discharged from physical therapy.

Helmet Adjustment

Friday afternoon we noticed that Max's helmet had been rubbing quite a bit. In fact, he even started grabbing at it, making us think that it had become less comfortable. We kept the helmet off of him all weekend until I had a chance to take him in today to have adjustments made to his helmet. We were actually thinking that his head had maybe grown to the maximum size of the helmet, but the measurements indicated no change in the size of his head. The orthotist shaved out some parts of the helmet, and we put it back on Max. In three weeks we'll be back to have measurements taken again.

Max's Head

Seven weeks ago, on August 10, Maximus began wearing a helmet twenty-three hours a day to help to correct his plagiocephaly. Today we went into the orthotist's office for a follow-up appointment to see how he is progressing. When we were last there, three weeks ago, there had been absolutely no change in the size of his head since it had been previously measured. This time though, his head had grown. In the past three weeks, Max's head circumference has increased by 0.4 centimeters, which I was told was a good rate of increase. When measuring Max's head from its right anterior to left posterior, the measurement remained the same at 15.2 centimeters. The left anterior to right posterior measurement though increased from 14.2 centimeters to 14.4 centimeters. Ideally, the difference between these two measurements would be zero. The right anterior to left posterior measurement is still 1 centimeter greater than the other measurement. This is an improvement from before he started wearing the helmet though. Then the difference was 1.7 centimeters. The orthotist is estimating that Max will be done wearing the helmet in three weeks. If his head continues to grow the next three weeks as it did the last three weeks, he will reach the casting measurement of the helmet, 46.5 centimeters, and it will no longer fit. We'll see on October 19 if that is the case. It would be nice to not deal with the helmet anymore, although it does come in handy protecting his head.

Maximus's First Few Days With His Helmet

We've been breaking Max into his STARband helmet since Friday when we got it. On Friday, he alternated between one hour of the helmet on and one hour of having it off until he went to bed without the helmet. Saturday he was two hours on then an hour off, without wearing the helmet for naps or overnight. Yesterday it was on for four hours and then off for an hour, leaving it on for his naps. Finally today, Maximus was supposed to leave it on for eight hours with an hour off. However, he was napping when it was time to remove the helmet, so he actually wore it for a whole ten hours before removing it temporarily. He didn't have any difficulties napping with his helmet on, and now he is sleeping with the helmet on. The past two nights, Maximus has finally slept through the entire night without waking up to be fed. I hope he manages to do it again tonight. I am not sure if the helmet will affect his sleep though.

I have been out and about with Max a few times since he started wearing his helmet. I admit that I wondered how other people we would see would react to his helmet since it isn't something most people are familiar with. At Target this past weekend, I noticed that some people looked, but no one stared or asked why my baby was wearing a helmet. There was a woman who was helping an adult with a developmental disability do his shopping. She stopped to talk to Max, commenting on how pretty his big blue eyes were.

Saturday evening though, we did get a question about Max's helmet. We were eating at a restaurant. When our server initially greeted us, he said that Max's helmet was cool. Later on he asked if Max was learning to walk, assuming that was the reason for the helmet. We did explain that Max had the helmet to correct a flat spot on his head, and he found that to be interesting. Likewise, Max and I were shopping at Target today when a girl who appeared to be about nine or ten years old commented that she liked his helmet. I started talking with her mother and explained the purpose of the helmet. And of course, when I took Emma to daycare this morning, the other kids were curious about Max's helmet. I expect that Max will get second glances from people when we are out, and of course I am perfectly willing to educate them about its purpose if I am asked.

Tomorrow Maximus begins wearing the helmet for twenty-three hours every day. He still doesn't seem to mind it, so I am not anticipating any problems.

Max's Helmet

Last month, Maximus was fitted for a cranial remolding orthosis, a helmet, to correct the shape of his head. Yesterday we got the helmet from the orthotist. Max has the condition plagiocephaly, or flat head syndrome, due to his having torticollis, which causes him to turn his head predominantly to the right. Because he spent a lot of time lying on his back, and turning his head to the right while on his back, the right side of his head is flattened some. This helmet will allow the flattened parts of his head to grow out while restricting grown in the directions where his head has already grown out. After a brief break-in period, Max will be wearing his helmet for twenty-three hours a day until his head has a rounder shape. The orthotist estimated that this will take until Max is about eleven months old. So he could be wearing his helmet for about five months.

Prior to receiving the helmet yesterday, I was concerned that Max would have a problem with having the helmet on his head. However, its presence didn't seem to bother Max one bit. He does not act any differently whether it is on or off, and he hasn't tried to remove it from his head. For a couple of weeks, until he is completely adjusted to having the helmet, Max will probably have a harder time sitting up and rolling over. However, he will have the benefit of being able to fall over from a sitting position without hurting his head. Of course, when he finally gets rid of the helmet, he may be in for an unpleasant surprise when he does bump his head. We are going to have to start washing Max's hair daily now, instead of every other day as we have been doing. Otherwise, the helmet, which we will also have to wash daily, will begin to smell bad. I am really looking forward to seeing the progress that Maximus makes by wearing his helmet.

The Craniofacial Clinic

Back in June I blogged about how Maximus has torticollis, a condition which causes him to tilt his head to the left and look to the right. He has been going to physical therapy since then to work on that. We have also been doing exercises with him at home to stretch out his neck muscles to prevent this. However, despite this intervention, he still prefers to turn his head to the right when he is lying down, and as a result of this, he has developed plagiocephaly, or a flat spot on his head.

The hope was that his physical therapy would help in rounding his head out, but this has not happened. So today we went to the craniofacial clinic at a local hospital to have him evaluated. After taking some measurements, the nurse practicioner and orthotists decided that a helmet would help to correct Maximus's plagiocephaly. Maximus was fitted for a helmet. To do this, the orthotist put a cap on his head that contained reflective dots. She then scanned around his head with a laser which took information from the position of the dots. A computer then created a three-dimensional image of Maximus's head from the data it received. Maximus also needed to have a CT scan done to make sure that two of the bones of his skull had not yet fused. He actually did very well for that, especially considering how bundled up he was. Maximus hates being bundled up.

This afternoon, after we got home, we got a call from the nurse practitioner letting us know that the CT scan showed that everything was normal, and that we can proceed to order Maximus's helmet. I will call the orthotist tomorrow to set that up. She was supposed to email us a file showing the different color and pattern options, but she apparently did not get around to that yet. Hopefully she can do that when I call tomorrow so they can get to work on Maximus's helmet.