Anyone seen a Physiatrist? - Cerebral Palsy Message Board

open_the_door · 05-08-2009, 05:03 PM

Has anyone every been treated by a physiatrist? I am thinking about taking my 4 year old boy there. He is seen by a developmental pediatrician once a year, sees a p.t., o.t., and speech therapist once a week. He was seen recently by a orthopedic surgeon, and the same day saw a neurologist. It is so hard to get therapists, and doctors on the same page about treatments. Today his physical therapist mentioned a physiatrist, and these doctors generally work very close with physical therapists. Neurologists, and orhthopedic doctors usally don't work close with physical therapists.

Yesterday when my son saw the ortho-surgeon, he mentioned so many things about my sons condition. About his hips, and foot placement. I brought the letter to the physical therapist, and another therapist there saw it too. They told me to get a second opinion, because when the doctor saw my son, it was for 15 min. and then he had an x-ray done on his hips. His left side is going out, but it is not at 50% yet. His hips actually look alot better from the last x-ray which was 6 months ago. These therapists see my child every week for an hour, so they know more of his movements. I'm sure when the doctor examined my son, my son's tone and spasticity went way up due to being scared, and stressed.

I'm very frustrated because I want to do what is best for my child. It is so hard when doctors say one thing, and therapists say another. As a parent, we only have so much knowledge, and we are not the specialists. In a way we are because we see our child everyday, but then it is difficult for us to sometimes decide what is the best therapy. Another example is the ortho-surgeon mentioned that after my son gets his botox in his hamstrings, he should have serial casting done. The physical therpists all tell me that he shouldn't because he is so ambulatory. I know my son is tight in his hamstrings that is why we do the botox, and so that he works other muscles more. The casts will only stretch the muscles but not strengthen them. It is so hard to decide what is best because ever case is different, and the surgeon just seems to think that my kid is a piece of meat, and no matter what i do with my kid as far as stretching, muscle strengthening, he will need surgery. I'm so confused......

vermontcp · 05-09-2009, 09:52 PM

Quote:

Originally Posted by open_the_door

Has anyone every been treated by a physiatrist? I am thinking about taking my 4 year old boy there. He is seen by a developmental pediatrician once a year, sees a p.t., o.t., and speech therapist once a week. He was seen recently by a orthopedic surgeon, and the same day saw a neurologist. It is so hard to get therapists, and doctors on the same page about treatments. Today his physical therapist mentioned a physiatrist, and these doctors generally work very close with physical therapists. Neurologists, and orhthopedic doctors usally don't work close with physical therapists.

Yesterday when my son saw the ortho-surgeon, he mentioned so many things about my sons condition. About his hips, and foot placement. I brought the letter to the physical therapist, and another therapist there saw it too. They told me to get a second opinion, because when the doctor saw my son, it was for 15 min. and then he had an x-ray done on his hips. His left side is going out, but it is not at 50% yet. His hips actually look alot better from the last x-ray which was 6 months ago. These therapists see my child every week for an hour, so they know more of his movements. I'm sure when the doctor examined my son, my son's tone and spasticity went way up due to being scared, and stressed.

I'm very frustrated because I want to do what is best for my child. It is so hard when doctors say one thing, and therapists say another. As a parent, we only have so much knowledge, and we are not the specialists. In a way we are because we see our child everyday, but then it is difficult for us to sometimes decide what is the best therapy. Another example is the ortho-surgeon mentioned that after my son gets his botox in his hamstrings, he should have serial casting done. The physical therpists all tell me that he shouldn't because he is so ambulatory. I know my son is tight in his hamstrings that is why we do the botox, and so that he works other muscles more. The casts will only stretch the muscles but not strengthen them. It is so hard to decide what is best because ever case is different, and the surgeon just seems to think that my kid is a piece of meat, and no matter what i do with my kid as far as stretching, muscle strengthening, he will need surgery. I'm so confused......

I certainly understand your frustration. There doesn't ever seem to be just one person who can oversee the whole picture for a child with CP. A lot of the responsibility falls to the parents, and we don't feel qualified to make some of these decisions. That being said, I strongly recommend your seeing a physiatrist. We took our son to Dr. Harry Webster at the Floating Hospital at New England Medical Center in Boston. He was absolutely amazing--kind, smart and able to see the whole kid. He did our son's Botox injections and had good advice on when he should have his hamstrings lengthened, etc. Physiatrists aren't a substitute for a physical therapist, but they are very useful for following the bigger issues. It's worth a try for your son. Ours is now 16 and is doing well. Good luck.