Monday, August 8, 2011

Deenie

For years, whenever I heard anything about scoliosis, I thought about Deenie. Deenie is a book by Judy Blume about a beautiful 13 year old girl who is trying for a modeling career until it's discovered that she has scoliosis. As a result of this curvature of her spine, she must wear a Milwaukee brace going down from her neck to her hips for the rest of high school. This pretty much kills her modeling aspirations. Suddenly, she goes from being the prettiest girl in school to being given permission to take the bus for disabled kids.

This book definitely served to fill me with fear as a child. Every time the pediatrician told me to bend down and touch my toes, I knew what they were looking for. It was terrifying. I didn't want to end up like Deenie. Luckily, I did not have scoliosis and my modeling aspirations were realized. (Not really.)

Anyway, when I was rotating in pediatric orthopedics, we had a 13 year old female patient in our clinic who was absolutely gorgeous. She was so beautiful that the attending felt a need to comment on her looks no less than three times while we were in the room, and once straddled her in a way that was borderline inappropriate to demonstrate her scoliosis to her parents. And she knew she was hot. I could tell by the way she flipped her hair back after she stood up from touching her toes.

You couldn't tell from a few feet away, but she had a 35 degree scoliosis, which is pretty significant. It calls for bracing, especially in a female, where the curve is likely to progress.

But instead of being offered the life-ruining Milwaukee brace, she was given two different options. One was a Boston brace which she could wear 20 hours per day, taking it off only for some sports activities. The other was a Charleston brace, which she could wear just at night, while she slept. The attending said that most girls opted for the night brace.

Both the Boston and the Charleston braces are TLSO's, which only go up to the thoracic spine. The Milwaukee brace is a CTLSO, which goes all the way up to the cervical spine (neck). I had read that the Milwaukee is indicated for curvature at above the T8 level, which our patient's scoliosis most certainly was. So why wasn't she prescribed the Milwaukee?

My attending's answer: "Have you SEEN the Milwaukee brace??"

So apparently, in this day and age, they don't force hot teenager girls to wear cumbersome, life-ruining braces. Too bad Deenie wasn't 13 in the 21st century.

4 comments:

  1. Makes me think of how Driver's Ed colored the idea of getting in a car accident for me..
    There was a woman trying to scare us off of drunk driving, so she told us that if you got in a car accident, the EMTs would cut all your clothes off and then just leave you there strapped to a board in the freezing cold until an ambulance showed up. I remember being surprised at what assholes she was describing the EMTs to be. I do believe remember her repeating quite a few times, that they don't care how you feel. I would think the EMTs wouldn't be pleased with the description.

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  2. My neurologist, whom I love because she is completely and totally evil and a brat, once threatened me with a Milwaukee brace for my (significant) kyphosis. She pushed, shoved, and twisted me into the position the brace would enforce. I pointed out that I could not breathe in that position. She said, airily, that breathing was not her specialty and I'd have to consult someone else for that.

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    1. That's totally my goal. I'm going to be an evil, snarky, bratty neurologist and people will love me because I'll be so damn good at it.

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  3. I was diagnosed with scoliosis back when I was 10. Fortunately, I had a very mild case (about 20 degrees or so, if memory serves) and we never had to do any interventions. However, in a misguided effort to reassure me, my parents printed out a bunch of stuff on the internet about scoliosis and how some kids had to wear the aforementioned Milwaukee brace or get surgery and were bedridden for months - complete with photos. Not the most reassuring thing to show a scared 10 year old :p

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