Physical Medicine and Rehabilitation Doctors?

[Chris]

I was wondering how many of your kids are seen by a physical medicine and rehabilitation doctor? What do they provide that your pediatrician doesn't? Sarah already sees a opthamologist, cardiologist and ENT. I just don't want to miss anything as far as her health is concerned.

Chris

[Monique]

Hi chris,

my son has all the same specialists as sarah. I'm not familiar with a rehabilitation doctor? Is that like a physical therapist? Jameson has a speech therapist, an occupational therapist, and a physical therapist. He also had a developmental therapist at one time that helped him when he was around 2 to do more preschool type activities, like block playing, singing, puzzles etc (probably i went overboard with that but it was provided for free).

I think you have it covered though.

[marlies]

I believe it's what they call the gymnastics or yoga like exercises, no, it's mostly stretching and massages for movement stimulation. My little brother had those done. It was a yoga instructor that came to the house. Well, she was my mom's friend. My little was stretched, pulled, rolled over a big ball on his belly!!! He liked it! ;D He was made to reach out for toys, throwing a sponge ball as far as he could etc... all kinds of exercises and constant movement. I think it helped him a lot with his crawling (although it was really wiggling like a lizzard, and he was so good at it!!! hehe) and later with the walking.

Now my little brother is 21 and has no difficulty with physical activities! He enjoys dancing (he has excellent rythm) , snorkeling, etc...

[Chris]

Actually, a doctor of physical medicine and rehabilitation is called a physiatrist and they are a MD. Their patients usually have some type of disability. A physiatrist is not a physical therapist.

Chris

[wrblack]

T21 clinic at CHOP got Charlie an appointment at the CP clinic at CHOP. Charlie doesn't have CP, but that way he could get an eval/visit with physiatrist and orthopedist at same time.
They did repeat x-rays of hips, clear. Also said he has flat feet but not as flat as lots of kids with Ds. I'm still not clear on degree of flatness of feet, though chatted with PT about that just yesterday.
Physiatrist, who I think of as a PT MD, suggested trying shoe inserts, think he said might not help much but wouldn't hurt to try. We got him a pair of PattyBobs. On later visit with PT at T21 clinic, who has lots of experience and a child with Ds of her own, suggested switching from inserts to DAFO's, got him a pair of SureSteps. Glad insurance paid for them, quite a bit more expensive than the PattyBobs. The PattyBobs didn't seem to bother Charlie at all. I don't think he likes the SureSteps, sure seems happy when we take them off. But think the SureSteps have helped him a lot. Do a much better job of keeping his foot and ankle in proper position and give him support where he needs it.
We have been waiting forever for Charlie to walk. In last two weeks he has started to take several steps on his own. Enjoys walking from mom to dad and back again, like 5 to 8 steps. Last night, for reasons of his own, he turned aside, walked from family room to kitchen, where floor changes from carpet to tile, across kitchen, and out into dining room.
Just our experience. Your mileage may vary. But a visit with a physiatrist, physical and rehabilitation medicine, could be a good way to make sure you're not missing anything important and also might pick up some good ideas and insights.
Oh, and yesterday I told PT that Miracle League will be starting up again in April, asked her if Charlie would be running the bases by then. Probably not by then, but he may use his K-walker a lot less this coming season.
Cheers,
Bob

[Chris]

Bob,

It's great to hear Charlie will soon be a walker! Sarah got Sure Steps last month and I can see her walking has really improved, especially her gait. She hasn't even complained about the Sure Steps. Maybe she likes them because they are so pretty. She is all girl.

I understood that a physiatrist was basically a doctor of physical therapy plus but I wasn't sure if Sarah really needed to see one. I wish we had a Ds clinic!

Chris

[wrblack]

Chris,
Don't know where you are in Michigan. Dr. Leshin lists:

Michigan:
Pediatric Rehab. Program
Univ. of Michigan Health System
Ann Arbor, MI
Phone: [phone]
Joseph E. Hornyak, IV, MD, PhD

Developmental Assessment Clinic
North Oakland Medical Center
Pontiac, MI
Phone: [phone]

in his list of Ds clinics, www.ds-health.com/clinics.htm . There could be others. Ds clinics do come in handy, but we went for years before they started the one at CHOP. Just relied on good pediatrician who was not hesitant to make appropriate referals.
And Charlie wants to know if Sarah has a date for her senior prom yet. Little rascal, he's always on the lookout for another pretty girl.
Bob

[Chris]

Thanks, Bob. I think the clinic at U of M has just started but isn't a full blown program yet. I haven't heard of the one in Pontiac. I live south of Detroit and am about an hour away from both Ann Arbor and Pontiac.

Charlie will have to get by Sarah's daddy if he wants a prom date. Good luck! My Sarah LOVES boys. She is a rough and tumble kind of gal and thinks boys are great. I guess that's good since at least 80% of the kids in her room are males.

Chris

[laurasnowbird]

Chris,

Here's a explanation of the roles of physiatrist:

A physiatrist, pronounced fizz ee at' trist, is a physician specializing in physical medicine and rehabilitation (PM&R). PM&R or physiatry is the branch of medicine emphasizing the prevention, diagnosis, treatment, and rehabilitation of disorders, particularly those of the neuromusculoskeletal, cardiovascular, and pulmonary systems, that may produce temporary or permanent impairment. Physiatry is unique among medical fields in that its area of expertise is the functioning of the whole patient, as compared with a focus on an organ system or systems.

A physiatrist treats disorders such as:

Back Pain

Sports Injuries

Stroke Rehabilitation

Spinal Cord Injury

Chronic Pain

Traumatic Brain Injury

Arthritis

Carpal Tunnel Syndrome

In addition to management used in general medical practice, physiatrists use therapeutic exercise, heat, light, water, electricity, bracing, prosthetic and adaptive devices to treat patients of all ages. Physiatrists also attend specifically to physiologic adaptation to disability and to preventing complications or deterioration secondary to disabling conditions. The goal of the physiatrist is to provide medical care to patients with pain, weakness, numbness, and loss of function so that they can maximize their physical, psychological, social, and vocational potential.

As people survive conditions that once would have been fatal, the field of physiatry is moving to the forefront of medicine. The specialty serves all age groups and treats problems that touch upon all the major systems of the body.

Dr. Hornyak is just beginning the program at U of M, and we go every year in an effort to support that program. We just got a postcard reminding us to schedule Ethan's appointment for May.

Aside from his role as the impetus behind the Down Syndrome Clinic, Dr. Hornyak is an expert reference for issues related to orthotics and gait. We are waiting (as we speak) for Ethan's next pair of Sure Steps to arrive.

[ingei10]

Parents care more than anybody for their children which is why there is also intensive case management where you can take your kid and get to know about all the problem and its solutions there. I took my daughter there and they studied her history and advised some amazing treatments for fixing her problem.

[herdas]

Thank you for the thread here, very helpful to me. I would also like to recommend the online pharmacy called Canada drugs direct. I think you will find it helpful to you too, good luck with it