Jacen and I went to his big physiatry appointment today. The NICU doctors scheduled the appointment for us the day Jace was discharged. A physiatrist is a “rehabilitation physician”, but as far as I’m concerned it’s just arrogant physical therapist. I wasn’t thrilled with our “physiatrist”.
The first question the evil physiatrist asked was about Jacen’s head control. I smiled and told her that he has great head control and that the pediatrician was really impressed. The physiatrist examined Jace, looked at me, and explained that he doesn’t have good head control and that developmentally Jace is not where a 2.5 month old should be. I told her that he was 7 weeks early and had he been born on his due date, he would be one month old today. She went on a rant about how she doesn’t believe in “adjusted ages” – that it sets a kid up for failure by teaching him that it’s okay to lag behind his peers.
Next, she held toys in front of Jace’s eyes to get him to focus and track objects. I told her that he was good at focusing and was starting to be able to track. She told me I’m wrong – that his focus is marginal and that he isn’t tracking.
After that, she rolled Jace onto his side and explained that he seems to favor looking to the right. I told her we thought he favored looking to his left. She moved on, then circled back to explain that Jace clearly favors looking to his left.
She proceeded to talk down to me with phrases like “it’s a really fancy word, but you don’t have to worry about remembering it” or explaining something in technical terms and then saying “but for the average person like you, that just means….” Irritating.
Then she told me I needed to be doing cross-stroking with Jace because he was not aware of his right side and that would cause serious problems later if it wasn’t corrected. I told her we’d been doing cross-stroking like they taught us in the NICU. She had me demonstrate and asked who taught me to cross-stroke. I told her and she said “Oh, she’s just a physical therapist. I’ll have a talk with her, because that isn’t proper technique at all.” The evil physiatrist has a very different style of cross-stroking.
Alright – I just deleted the next four paragraphs I’d written, because they were just more of the same. In summary, Jace has to go to a different hospital sometime next week to be fitted for thumb braces which he will wear 3 times a day for 1+ hour each time. We’re supposed to do the new method of cross-stroking 3 times a session, 12 sessions a day. We need substantially more tummy time to work on head control and “side time” to develop awareness of his other side. We have a follow up in two months. After the physiatrist rolled him from side to side, put him on his tummy, and upset him (and me), Jace spit up all over the table. I didn’t even apologize.
For the record, our pediatrician, March of Dimes, the American Academy of Pediatrics, and a zillion other sources (healthychildren.org, the What to Expect books, the NICU, the preemie boards I read) all recognize actual and adjusted ages and base development on adjusted age for the first 24 months (more, in some cases). So here’s a photo comparison.
Happy in the Glider
After the appointment, we came home and hung out in the glider.
Anyways, I understand that (SOME OF) the issues the physiatrist noted are important and need to be addressed. He does tuck his thumbs in, but it’s worse when he’s stress and she stressed him out! And he does still go to the fencer pose quite a bit. But she didn’t have to be so condescending or judgmental about it. We will step up our cross-stroking, work more on tummy and side time, and follow up with the thumbs…. But look at this face – he’s perfect!