I simply can not take it any more. I can not concentrate at home or work. All I think about is my back and bracing. I have so much pain whenever I am very active physically or don’t get enough rest. I am never pleased with the way any of clothes fit or look on me. I constantly yearn for the feel of a brace holding me tightly and straightening my back.
I have decided to pursue my desire and get control of my life back. Now all I have to do is start dialling the phone. The receptionist answers on the 3rd ring. I can barely talk, but I finally ask for an appointment with Dr. Phillips.
Dr. Phillips has been my orthopaedic specialist since I was 12 years old. He placed me in my first Milwaukee back brace at age 13. I wore that brace for 2 years and then had to have another larger one for 2 more years. I have been out of the brace 12 years and he has seen me for follow-up visits every 2 years since.
I hated wearing the brace the first year or so. I even quit wearing it for 3 months during that period, but the pain in my back caused me to start wearing it again with a different attitude. From that point on the brace was my friend, not something that made me different. That is why I am having such a crisis now. For the last 2 years since all I have been able to think about is wearing a brace again. For starters is makes all the pain in my back go away and I am able to do everything I want without worrying about dealing with the pain later. Additionally, I just love the way the brace feels and how wonderful my posture is in it. I think I have an addiction of sorts with the Milwaukee brace.
Whatever the reasons, I have finally decided to seek what makes me happy and complete.
2 weeks later…….Anna Romerez the nurse calls. Well its show time, now I have to follow through. The nurse takes me back to an examine room and asks all the normal questions. How is your back? Have you been having any problems? I have thought about my responses so that they are automatic. I inform the nurse that I have been having bouts with severe pain in my back and that is has been effecting my ability to function at home and at work. The nurse hands me a gown which I slip into and she asks me to follow her to the take some x-rays.
30 minutes later Dr. Phillips comes in with the x-rays and does his little examine bending me every which way asking if this or that hurts. Finally he sits and flips on the light on the x-ray viewer. Anna your kyphosis curve has increased from 38% to 46% in the last two years and you have started developing a scoliosis curve that has not been present. It is measuring 18 % in your neck, 22% in your thorax and 10% in the lumbar region. This would explain the pain you have been experiencing. I am going to prescribe some pain medication…..I interrupt before he can finish. Dr. Phillips what other options do I have besides medication? Anna your curves are not severe enough for surgery and you are too old for bracing….I interrupt again. Dr. Phillips when I wore a brace years ago it eliminated all the pain I was having then, would it not help now? It would help the pain yes, but would not correct the curves now that your are grown. Dr. Phillps I have read that bone remodelling occurs even in adults, would the brace not cause my bones to remodel. Anna there is evidence that this would occur in adults, but the length of time for such to occur is much longer than when one is actively growing and adults do not generally adjust to brace wear of that type. Dr. Phillips I understand that, but I wish to pursue the brace route. I am fully prepared to deal with the time and consequences of wearing a brace. I prefer it to any other alternatives. Anna bracing for adults is not covered by insurance and can be quite expensive. It will also restrict your lifestyle significantly. I understand that Dr. Phillps and I am prepared to deal with the expense and restrictions. Ok Anna, I will write a prescription for a hyper-extension brace for wear during the day…..Dr. Phillips do I not need a Milwaukee for full time wear? Anna that type brace would work, but it is…..Dr. Phillips I wore one for 4 years, I am used to how it feels and what it takes to wear it, if that would be the best for me then that is what I want to do. Anna you are a most persistent patient. You realize that if you wear the brace in an effort to cause bone remodelling that because you are now 28 that it is conceivable that you would be wearing the brace for 5 to maybe as long as 10 years for a complete course of treatment. Yes Dr. Phillips, I understand and I am ready to commit myself to length of time. Ok, I have never treated an adult in this manner, so I can not make any promises about the outcome. I would like to use you as a case study if you do not mind. Dr. Phillips want would that require of me. Anna I would like to see you every 2 months and take x-rays, blood samples and bone density tests. I would also like to use monitoring equipment on your brace from time to time to measure forces being exerted on your curves.
Dr. Phillips will this new brace be exactly like the one I used to wear or will it be different. The reason I ask, I want it to do its job the best that is can and I have a few requests for comfort and style. Anna, this new brace will need to fit tighter and treat both your kyphosis and scoliosis. It will also need to provide cervical traction when you are sitting to correct the curve developing in your neck. The orthotist I am sending you to will determine the detail of the brace based on your x-rays. The nurse has already called and he has an opening this afternoon at 2:00 pm.
I can barely keep from shouting with my excitement. With x-rays and prescription in hand I race to my car and my afternoon appointment. The orthotist office is an old remodelled house. The only place to park is in what used to be the driveway behind another car. I briefly wonder why he did not send me to the orthotist who made my first braces. The waiting room is what appears to have originally been a living room. The walls are covered with pictures of different types of braces and people wearing them. I can barely breath with the my heart beating with excitement. A door across the room opens and a young lady in a neat uniform asks if I am Anna Romerez.. Standing in acknowledgement, she beckons me to follow her. We walk down a hall where she asks me to wait in the last room. The room is full of tools and equipment for making braces. I recognize quite a few items from years ago when I had my first Milwaukee’s made. A few minutes later I woman around 35 or so walks in and introduces herself as Dr. Carmella. She asks for my x-rays and prescription which she reads and then invites me to sit down with her at a small desk.
Anna do you understand your condition and treatment that has been prescribed? Yes, I talked with Dr. Phillips at length about my condition and treatment options. I feel the bracing option is best for me and my situation. I have worn Milwaukee braces before and I am prepared to do so again. Anna, this Milwaukee will be much more restrictive and difficult to wear than the ones you had before. Dr. Carmella, I understand and I am eager to get the brace and start my treatment. The effects on the pain I have outweigh any restrictions and difficulties I may face from the brace.
Ok Anna, before we begin measuring and casting I want to ask a few questions. What type of work do you do? I work in department store as manager. What type of things do you do at work? I am on my feet moving stock and changing displays about half the day and the rest of the day is spent on the phone and at my computer with orders and customers. What kind of activities are you involved in your free time? I hike, swim, workout, bike, and dance and travel a lot. Do you plan on doing these activities in your brace? Yes I prefer to do them in my brace so I do not have the pain that I have been experiencing. Have you or do you currently wear braces or have retainers? Yes I have had braces and retainers, but I do not currently wear them. Are you married/dating? Single and dating. Do you have a lot of stairs at home or work? Upstairs at home. Do you shower or bath in a tub? Shower Do you normally wear your hair long as you are wearing it today? Yes I leave it long and I wear it both up and down about equally. What type of clothing do you typically wear? Work causal, jeans, t-shirts, dresses, skirts, workout clothing, everything is usually close fitting or tight, with a sexy flirty attitude.
Ok Anna, I have the information I need to get started, do you have any questions? Yes, can my brace be any colour and can it be made so it can get wet? The answer to both questions is yes. Great! Since I am no longer growing, will this one fit closer to my body? Yes, very much so. Can the brace be made so I will not need to wear anything under it? Yes it can.
Ok Dr. I am ready when you are. Ok Anna, first thing is for you to take all your clothes off and put this gown on, I will be back in a few minutes to take some measurements and then we will do your cast.
Thankfully the room was warm as I waited naked in the gown. Dr. Camella walked in with a clipboard and tape. Anna, please slip the gown off while I take some measurements. These measurements will be used to compare against measurements with you in the brace and periodically during your treatment. Since your skeleton is mature, your brace will have to exert enough pressure to completely straighten your spine for remodelling to occur. Normally the brace provides a guide with correction for the spine to grow straight, but since your not growing anymore, correction from the brace will need to be 100%. Please slip into this stocking and we will begin your cast. Dr. Camella then fastened a pelvic halter around my waist and hips and a halter around my head. Then she lead me into the next room to a table frame for casting. She had me lay on my back and placed a padded bar under my kyphosis curve and under my knees. The bar under my back hurt as my curve arched back and straightened under my body weight. Next she attached weights to the head and pelvic halters to lengthen and straighten my spine and scoliosis curve. Since my spine needed to be corrected 100% Dr. Camella attached slings to my neck, side and waist to further straighten the “S” curve and then slings to my shoulders pulling them down and back and my waist pulling my stomach downward onto the frame. This effect further straightened my kyphosis lordosis curves. Dr. Carmella left me strapped down this way for an hour. After returning to check on me she tightened all the straps and added more weights to the traction. This time her goal was to over correct the curves in the opposite direction by several degrees so that when I was in the finished brace the curves would be 100% straight. The body always has a little room to curve in a brace after it is made, so the over correction was to solve this problem. I was left in this position for another hour. When Dr. C, as I started calling her, came back she had really warm water for the plaster. She wrapped plaster from my neck to basically the top of my thighs. She wrapped it really tight around my waist and pressed in my stomach from the just below my breasts to the top of my public bone as the plaster dried. She also wrapped the plaster very thickly around my breasts making a sort of plaster bra. I had had my breasts enlarged a few years ago from a 34C to 34DD. My back felt so straight as the warm plaster set on my body. When the plaster had set enough she released me from the table and took more measurements while I was in the cast. Then she had me do several stretching exercises in the cast while she made notes on her clipboard. She then asks me what colour I wanted the plastic and metal parts to be. I had thought about this a lot and had decided on the plastic girdle being blue and the lining being black. My Latin heritage left me with a deep natural tan and I thought the blue and black would blend with my natural skin and hair colour (my hair is jet black).
The plaster was ready to be removed, but I was dreading my release for the cast. It as so warm, tight and my back felt so good held straight in the cast. I could not get my brace unless it came off, so I turned as the Dr. C started the saw and shivered as the saw tickled its way through the cast.
As soon as the cast was off Dr. C again made measurements as she had before for comparisons. She then asks me to put on a pair of stocking shorts. Then she had me sit in box of foamy think liquid that quickly formed to my contours forming a mould of my backside. While the foam was setting she had me bit down on a mould for my teeth. I ask what these mould where for and she just told me that they were to make part for the overall brace.
After I had dressed she came back into the first room we had met in an told me that she would have my brace ready for the first fitting in 5 days. We made an appointment for 9:00 am and she told me to have the whole day available for the fitting.
All the way home, I could only think of the brace and how wonderful my life would be in 5 days.
After I arrived at home, I called my supervisor and told him of my situation. He was very supportive and asked if I would need any special accommodations. I told him that I did not believe it would require any special changes and that I would be able to return to work the day after I received the brace.
For the next few days I had some shopping and preparations at home to make. Not to mention telling all my family and friends about the brace. They where all used to me talking about my back and the brace I used to wear so there where no surprises for anyone. I did not currently have a boyfriend to deal with and I lived alone.
I don’t think the next 5 days will pass fast enough. The house is in order, I have new clothes for work, and I have told everyone I could think of that needs to know. To help with the time passing I unpacked my old braces from storage and dug up all my old pictures and video tapes from when I was younger. My last Milwaukee was when I as 15 and 16. My body is more mature now then back then but I could not resist trying it on. It is a little short, the neck ring rests a little low around my neck and it really too tight around my neck. The pelvic girdle lacks about 5 inches being big enough around my hips. In high school my hips where around 35 inches now they are 40 inches. My waist is still 28 inches. I’m not fat at all, my stomach is still flat and my hips and legs are muscular. I just bigger now, guess I grew some more after wearing the brace. Despite the size changes I managed to get in the brace and fasten it. It feels so good, even though its too small. I will wear it until I go see Dr. C. It’s a get used to wearing it again period I tell myself.
I have just been out riding my bike (in my old brace), and as I open the door, the phone rings. Its Dr. C, she wants me to come in in the next 30 minutes if I can. She has finished my brace and she has the afternoon open for the fitting. Well, it would take me 25 minutes to drive there and I need to take the old brace off and take a shower, which I explain to Dr. C. She tells me to just wear the brace in and I can shower there after the fitting.
Without hesitation, I grab my keys and off I go in my old brace and biking shorts and sports top.
30 minutes later I am sitting in the fitting room and Dr. C walks in to greet me. Anna, thank you for coming in on such short notice. I finished the brace last night an when my appointment for this afternoon cancelled, I thought it would be good to get you into your brace as soon as possible. I see you have your old brace on. Its way to small for you now, this new brace will fit much better.
Let me go get it while you undress and take off you old brace.
A few minutes later she knocks before entering carrying my new brace in one hand and tray full of what looks like extra parts. Anna please remove your underwear also. This new brace is designed to be worn next to the skin. Anna before we try this on, I want you to remember that I will take several days to get adjusted to this brace and not to panic. Your body will have to have time to reshape itself to the restrictions of the brace. The brace is stunning. The pelvic girdle is a shiny blue and the lining is a dull black. The metal parts are all shiny metal which I ask about and she tells me that after she has adjusted it she will cover them. I watch as she unlatches the pelvic girdle and neck ring. The new brace does not have any straps. Anna since you are not growing anymore once the brace is fitted you will not have need of adjustable straps. Plus the appearance under your clothing will be smoother and have less wear on your clothing. I have used a waterproof neoprene material for the lining of the brace and as padding on the chin pad and occipital pads. This way you may wear it while swimming and bathing. Lets try it shall we Anna. Dr. C opens the brace and holds it open for me to step up to an place my arms through. Then she guides the pelvic girdle into place in front and at the waist. Anna you will have to stand tall to get the neck ring in place. I try to stretch, but can not stretch enough for the neck ring to slip in place. Dr I think the neck ring needs to be lower. No Anna, it is set for the measurements we took while you where in the cast. The cast made you 3 inches taller. I want you to place your hips against this table and lean forward. I did and the neck ring almost slipped into place. Anna place your arms on the table to balance yourself and resist me from pushing you onto the table. I want you to stretch as I push against the curve in your back. Wow, I have no idea how I will get into and out of this by myself. As she pushed and I stretched my chin cleared the chin pad and the brace closed around behind me. Anna don’t move while I tighten the brace. I felt the pelvic girdle pull tight around my waist and hips and the catches in back locking into place. As this happened my pelvis was forced to tilt forward eliminating my lordosis and my stomach was pushed in from just under my sternum all the way to my pubic bone. Wow, I was so tight and firm in its grip. Next she push against my kyphosis curve some more to pull the back uprights together which she used a similar latch like on the pelvic girdle to keep together. Then I felt her fasten the neck ring closed. The chin pad was now just below my chin, barely touching me. The kypho pads in the back where about 1 inch thick and the about the size of my hand in an oval shape. They where attached to two stainless steel bars inch wide by ¼ inch thick. They where a solid piece unlike my old brace which where made in two pieces for adjustment. Dr. C told me this was for strength for the extra forces being placed on my body and if any adjustments needed to be made in height, then she would simple reattach the bars higher on the pelvic girdle. The front bar was 2 ½ inches wide and 5/8 inches thick. There was a sternal pad attached to the front upright at the top of my sternum pushing my upper chest back in the brace to counter and assist the effects to the kypho pads in back. The front and back uprights approximately ¼ inch from by body except around the force pads and perfectly followed the contours of my body. Since I have quite a large chest and the front bar had to be so wide and thick for strength, Dr. C told me that she had rounded and smoothed the edges of the front bar between my breasts for comfort and that after she had coated the bars with neoprene they would be even more comfortable.