[Untitled]

Rick Stapleton

10/1/2008

Dear List Serve,

 

In the last 6 months I have seen 3 cases, all with different pathologies
but similar symptoms. All three patients have very weak neck extensors
and cannot hold their head up for any extended period of time. They all
have to eventually hold their head up with a hand. All have been fitted
with various OTS cervical collars without success. The biggest problem
is that they cannot tolerate anything under the chin because they can't
eat, swallow, or talk without a lot of difficulty. The patient I have
been asked to fit is 62 y/o female, diagnosed with cervical stenosis and
general muscle weakness. She can hold her head up for short periods of
time without any assist, but when it comes to walking, reading, and
eating she has to have assistance. She has no muscle spasms or tone, and
does not have a cervical flexion contracture. She has had physical
therapy with no long lasting results. She can't tolerate any sternal
pressure due to open heart surgery and subsequent scarring on the
sternum. Oh yea, did I mention she is also very vain and doesn't want to
mess her hair up, but is willing to try anything, have you ever heard
that one before? :-) My previous patient had ALS and has since died, but
I tried many different devices including the non-invasive halo and I
even custom made my own orthosis trying to use a head band to no avail.
On the gentlemen with ALS the head band would begin to slip within
minutes of him donning the orthosis.

Does anyone have any experience/success with a non-standard CTO?

Thanks in advance for your help,

 

Rick Stapleton, CPO

President

Tidewater Prosthetic Center, Inc.

150 Burnett's Way, Ste. 300

Suffolk, VA 23434

Ph:757-925-4844

Fax:757-925-4973