Another Doctor's Opinion

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Tagged brad, medical, update : Update on brad

BC!:

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We went to see Dr. Haber at the University Medical Center today. He is a pediatric orthopedic specialist who appeared to be in his late 30's or early 40's. I personally was encouraged by the visit, but Rhonda and Brad have different views.

Because of Brad's build, pain in his back, Rhonda's mitral valve prolapse, my family's history of heart disease, and Brad's spine curvature, he wants to rule out something called Marfan Syndrome. That's the problem that causes young athletes to drop dead suddenly. People with this problem tend to be tall, thin, and lanky, so basketball players are the ones who frequently make the news for dropping dead. Brad's "wingspan" is wider than he is tall by about 4 inches, but he's not particularly tall. Dr. Haber is no expert in this area, but he wants to rule it out by having a series of interviews and tests done next week by geneticists at UMC. There is no blood test or scan that will diagnose this. The doctors will "score" each syndrome and figure out if he has enough symptoms to be diagnosed with this. To me, this seems like a long shot. However, I would never say to not have the tests. This website includes information on the treatment of people with this problem.

More about the original problems: his pain comes from kyphosis (humpback), not the scoliosis (curved spine). The scoliosis is not the main problem. There are two reasons to have surgery:

The brace would help in any event and has no "down side", but it's very painful to wear. A possiblity is accept the "deformity", do therapy for the pain, and avoid surgery. That's an option.

If we elect surgery, we would choose Dr. Haber to do it. He would fuse the vertebrae from L1 or L2 up to the thorasic spine. Screws would be inserted and tied into titanium rods placed along his spine and his spine would be straightened at the conclusion of the surgery. So immediately, he would be "corrected". He would still have a good range of motion and some people are able to play sports after this. Loss of mobility would be minimal and not noticable in everyday life. The surgery would take 4-5 hours, then he would spend about 6 days in hospital. After three weeks, he would be back in school.

Dr. Barrett (the original orthopedic surgeon) was worried about operating on his spine with the bar implanted in his chest. The "normal" way is to go in from the front, so the bar would be a barrier. Dr. Haber said that he would go in from the back on someone Brad's age and would anticipate no problems. When we began to discuss appointment times for the surgery, Brad said he didn't want to miss any more school. Christmas holiday is generally booked up, but he thought there might be one slot open. However, he would be leaving town afterwards and would not operate unless he could provide post-operative care. "Normal" times are booked all the way out to February or March. Rhonda objected that she didn't want him getting worse while waiting for surgery, but Dr. Haber assured us that he would keep regular visits going and act before Brad got too much worse.

After all that, Dr. Haber said he wanted to see Brad in his brace. Brad strapped it on and really looked pretty good. It's still not comfortable, but he wasn't screaming and crying with pain. Dr. Haber took a look at it and decided that we should give the brace an honest try for a month before any surgery is decided upon. He pointed out that the neurological risk with surgery to correct kyphosis (as opposed to scoliosis) is high and that it's not a matter of deciding on two equal treatments. Straightening with the brace is much preferable from a risk standpoint. He asked Brad to ease into the brace with 6 hours per day for 3 days, then 10 hours for 3 days, then 14 hours for 3 days, etc., up to the 22 hours per day originally recommended.

We then made the future appointment with the geneticists and with Dr. Haber. Brad seemed okay while we were there, but I think the gravity of the situation hit him on the way home. He's pretty depressed at this point about the cards life has dealt him. Rhonda's right there with him. And...it's homecoming night for Beth's senior year.