For Starters

I had scoliosis, I did not know until the school nurse sent me home with a note asking my parents to take me to my doctor for a follow up thorough examination to determine if indeed I have scoliosis and start with a course of treatment. I did not notice it, but the doctor treating me said I could not stand straight which was obvious.

I was only eleven when I was diagnosis with scoliosis. It was to my surprise, what it was since all this happen as a result a note from the school nurse. This prompted my parents to take me to the doctor (my regular doctor) to confirm what the nurse had indicated. The paediatrician was alarm by the note from the school nurse. She referred us to an orthopaedic surgeon.

On the day of the appointment with the orthopaedic surgeon, I was a bit restless and concern. I knew the doctor was a guy doctor from the business card my paediatrician had handed to my parents. I was very conscientious that a male doctor was going to examine me to confirm whether I have scoliosis or not. However, I did not have much choice.

I was already in an exam room waiting for the doctor to come in. The room was decorated with spine posters and paraphernalia; there were knee knockers and various measuring instruments, but no needles, which was a comfort to me. I took a seat on the exam table, which was covered by crisp white paper that wrinkles instantly upon contact after I changed into a backless paper exam shirt. It was light blue and I was allowed to keep my cotton printed underwear on, for me, no bra yet cause my breasts were nowhere near maturity.

There was a knock on the door and the doctor came in. He was a young and handsome looking guy for a doctor. That made me more embarrass since I have to let him look at me naked. He had his white overcoat over some blue surgical scrubs. He may have been in surgery prior to my appointment. He greeted my mom who was with me in the exam room. He went down to business by inquiring about my medical and family history. He asked if there was a history of various underlying medical condition that might be causing the scoliosis and if there were any family history of the disease or other attributing medical disorders especially the spine were noted. He asked my mom if my birth was normal, was I carry to term. He asked an embarrassing question, if I had started to menstruate, but he explained the importance of these questions in determining my growth spurt. He mentioned that girls’ growth spurts happen after she develops her breasts and starts her menstrual cycle. He confirmed that I was eleven, at the onset of puberty, in order to determine the number of years remaining until I reach adulthood, at which time curve progression may cease.

Next he informed me that he would like to do a thorough physical examination to determine my health and general fitness condition. The exam will also serve as his baseline to measure my progress during treatment if that becomes necessary.

After that short conversation, I was asked to get off the table and stand as straight as I can in front of the doctor. He looked at my front and my back. He observed for any asymmetric abnormalities in the shoulders, rib cage, waist, and pelvis. Then he asked me to take off the paper exam shirt to see if my developing breasts were symmetrical or not. I turned red, but he told me it was okay, he is only going to look at it. I removed the shirt to let him examine me.

After I put the shirt back on, I was asked to bend forward at the waist. Next I felt this metal object on my back. He told me it is a scoliometer, which is used to measure the degrees of a rib hump. He drew a line down my back with his finger. Next he recorded my motion ranges based on observing my flexion, extension, lateral bending, and spinal rotation. Asymmetry was also noted.

Then I was told to get back on the table and lie down and do leg stretches and sit up and stretch over to reach my toes. He trace my back again as I bend over reaching my toes. He had me sit up on the table to measure my leg length and compared to determine discrepancy. Then he checked my reflexes and my neck movements.

I lay back down on the table as he did a palpation exam to help determine spinal abnormalities by getting a feel where my ribs and lumbar muscles may be more prominent on one side than the other due to the curvature of my spine.

Next the doctor was at the end of the table. He asked me to slide down toward him with my knees bent. I was asked to take off my panty. I had my hands on each side of my panty, making sure it was not going to get remove and I burst into tears. I think I caught the doctor by surprise. He tried to calm me down and said he was not going to hurt me. My mother asked why was it necessary that I need a gynecological examination. He explained that he is only getting a visual assessment to determine which stage of puberty I was at. He was not going to cause penetration. My mother accepted his explanation, but I was still sobbing that I don’t want to get the examination. He left the room to get a nurse into the exam room. He kept reminding me that he was not going to hurt me. My refusal to let the doctor examine me prompted the nurse to forceful held my hands away from my body as the doctor lowered my panty to my ankles and did his examination as I continued to cry. When he was done, the nurse let go of my hands and I quickly pulled my panty back up to where it belong.

He explained to my mother that he needs some x-rays done to determine if my scoliotic curves were structural (major) or non-structural (minor). He said he would like to have four baseline x-rays taken for now, a front, back, side and a side bending one. Now my tears have dry off and it was time to take a walk down the hallway to the radiology department. I walked down with the doctor cooperatively.

The doctor introduced me to the radiologist. He greeted me and told me that they were going to take some pictures of my spine and it is not a painful test, just stand still against a board that was part of the machine as instructed. I stood face front for the first shoot as I took a deep breath and held onto it, the same thing as I turned to have my back facing the machine. Then I was reposition to stand sideways and held on to a deep breath. Next I had to bend over on my back for the next one. I stood there waiting until the doctor came over to inform me that they would like to do some of my back with me lying on my tummy. I got on to the table. They slid a rather large plate under the table. I gather that was the film. They took one and next the doctors told me the next x-ray will involve apply traction on my spine. My ankles were strap on to the table and my chin was stretch out by this support. That was kind of painful. I whined that they were hurting me when they adjusted the chin support. After that x-ray, they remove the traction and allowed me to go back to the exam room down the hallway and wait for his return.

I went back to the exam room where mom was. She asked me how many x-rays were taken and did it hurt. I told her what happened.

Shortly the doctor returns with the x-rays. He explained to my mother that there were some difficulties in getting a good x-ray of my back so they had to do more than he had expected. He propped my x-rays on these lighted fixture mounted on the wall, which lit up the dark films showing my spine. I was surprised that was how my spine looked. He had marked the x-rays to determine my curvatures. He explained what each mark meant and confirmed that I had a double major curve 29 and 33 degrees, which warranted for bracing treatments and that I should started as soon as possible. He said he would monitor my progress through the course of the non-invasive treatment, which was bracing my back to stop it from curving any further and hopes to correct the existing curve since I was still growing. He mentioned what kind of brace I would be fitted into. He called it the cervico-thoraco-lumbo-sacral orthosis, (CTLSO) or the Milwaukee brace for the layman, this is the best noninvasive treatment for scoliosis because the mobility restriction and confining the back, neck and head movement have proven to be effective in correcting scoliosis. He explained that my curve was in the thoracic and lumbar region of my back so I would have to wear a brace 23 hours a day… Before he could finish, I cried that I am not wearing a brace to school or wherever I have to go. He had to stop and explain to me why it is important that I have to wear a brace. He finished up with monitoring my progress and I would get tapered off of it as I reach close to the peak of puberty. He also mentioned that I would need a follow up neurological evaluation with a neurologist to get assessment whether I had any underlying neurological problems that may have cause the scoliosis. He said they would be looking for painful/numbness symptoms and tingling sensations in my extremities, motor function, muscle spasm, weakness, and bowel/bladder dysfunctions. He handed my mother a business card of the other doctor for my mother to make the appointment and a sealed envelope to be given to the neurologist who will be examining me.

Next he spoke about getting me measured for my brace. He explained that I would be temporarily in a body cast until they have a custom fitted brace manufactured for me. I whined that I don’t need to be brace and why I have to wear a brace and that I was fine and I think it was a mistake that everyone thinks I have scoliosis.

Mom inquired on how long the treatment would last and the doctor said I had a lot of growing time left so I would have to wear this until I stop growing and he thinks I have to stay in a brace full time until I am 16 or 17 and possibly be in a brace part time there after. To me it was like great, I have to be in a brace for at least 5 or 6 years – that is a long time. I would have to come back every three month for check up during the first year of bracing and as we progress in the years the office visit intervals will be further apart. He also mention that I would probably go through several braces as it accomodates my corrected body and growth. It felt this was all too much for me.

I asked the doctor if I really have to be in a brace because I will look ugly and everyone at my school will laugh at me. I don’t want to be confined to a brace. My body would be limited to what I can do. Doctor says in time you will get use to a brace, it is better than surgery and be in a cast, but you will have to be in a cast temporarily until your custom made brace is ready. Doctor asked us to wait in the room and he would check to see if the orthodist had time to measure me for my brace. Shortly, the doctor came back and told us the orthodist had time. All that was running in my mind was that I had to wear a body cast that I could not take off and that it would cover my entire body from the neck down. Doctor reassure me that the cast is only for about two weeks and the brace would not be as restraining as a cast and it would help me improve my posture. That did not make me feel any better, but I would have been happier if he said I did not have to wear a brace.

The orthodist was just down the hallway. I was asked to take off all my clothes – even my cotton printed underwear. I had to put on four body stockings, one over the other. When I was done putting the stockings on, the orthodist came up and shove a long thin piece of leather-like material down the middle of my back, inside the stocking. I had no idea why. I was asked to hold onto these two triangular rings strung from the ceiling, they were like these holding handles for standing riders on a subway. My chin was resting on this horizontal holder that was a challenge to reach, this kept my back as straight as possible in the ideal position they wanted me to be in. It was beginning to hurt when I had to stay still for a period of time. I wanted to slouch, but the other man that was helping to get this mold done held me in the correct standing position as the orthodist wrapped this gauze that was dipped in this paste like gray liquid and it was tightly wrapped around me several times. I got plaster all over where the stocking were. I had to stay in that position until the gauze got hot, turned into plaster and dry and I was stiff. Two men in white outfits came over and carried me to a table. I lay there as I watch them cut off the cast cafefully. This one was a molding to my brace. They let me sit up and told me I need to put on some more stockings and get on that standing traction to get plaster again. After this one dried off and I was carried back to the same table. I lay there as they trim it down to a form fitting to my body. But clearly, this was not how I hold my body up, it was already securing my body to the way it was supposed to be if I did not have a bent back. I have to wear that until I get my brace, they anticipate two weeks or ten working day from today.

However, my brace was ready 6 days later. They took cast off the same day they put me on my brace.