Latest / Scoliosis with Dr. Chris Gubbels / Diagnosed with Scoliosis in Denver? A Specialist's Action Plan

Transcript

Diagnosed with Scoliosis in Denver? A Specialist's Action Plan · Scoliosis with Dr. Chris Gubbels

• 0:00
  SPEAKER_00: If you or your child got diagnosed with scoliosis and the only thing that you walked out of that appointment with was a number on a piece of paper and you had no idea what to do with it, no clue if you should be worried or not worried, no plan for what to actually do next, this video is built for exactly that moment.
• 0:18
  SPEAKER_00: Whether this diagnosis is for you or your child, the window between now and your next appointment is one of the most critical structures of this entire process.
• 0:26
  SPEAKER_00: Most families spend it on Google, which can lead to contradictory information and possibly even more confusion.
• 0:32
  SPEAKER_00: What I'm going to give you is a clear breakdown of what the diagnosis actually means, what you still need to do in the next 30 days, and how to make sure the decisions that you make right now set everything up for the correct path moving forward.
• 0:45
  SPEAKER_00: I'm Dr.
• 0:45
  SPEAKER_00: Chris Goobels.
• 0:46
  SPEAKER_00: I specialize in the non-surgical treatment of scoliosis and hyperkyphosis at School A Care Denver.
• 0:51
  SPEAKER_00: I've been treating scoliosis for over 18 years in close to 6,500 cases.
• 0:56
  SPEAKER_00: I've walked hundreds of Denver families through those first 30 days.
• 0:59
  SPEAKER_00: I know where people get stuck and how to avoid it.
• 1:02
  SPEAKER_00: I'm going to walk you through what the diagnosis actually tells you, what imaging and evaluation you still need, and the one appointment that changes everything about what happens next.
• 1:12
  SPEAKER_00: Now most people leave that in this point with a cob angle or measurement of their scoliosis and instructions to monitor or to watch and wait.
• 1:20
  SPEAKER_00: What almost never gets explained is what that number actually means, whether the curve is likely to get worse, and if so, how fast and under what conditions.
• 1:28
  SPEAKER_00: What treatment options actually exist for your specific scoliosis and your situation?
• 1:35
  SPEAKER_00: And beyond that, are there treatments that actually can reduce their scoliosis without requiring surgery?
• 1:41
  SPEAKER_00: Now, your diagnosing provider likely isn't holding back on purpose.
• 1:45
  SPEAKER_00: You see, general pediatricians and orthopedic specialists see scoliosis as one item on a long list of conditions that they run across.
• 1:51
  SPEAKER_00: They're working from a basic playbook, monitor below 25 degrees, possibly bracing between 25 and 40 degrees to try and stabilize the spine and keep it from progressing, and above 40 to 45, generally surgery is recommended.
• 2:05
  SPEAKER_00: What that playbook doesn't tell you is whether your curve is likely to progress, what your gross status means for the next six months, and what kind of bracing actually works to potentially reduce scoliosis, and whether scoliosis-specific exercise or physical therapy could change the trajectory of your scoliosis.
• 2:23
  SPEAKER_00: Those are questions required from someone who actually specializes in the non-surgical treatment of scoliosis.
• 2:28
  SPEAKER_00: You see, the diagnosis told you what you have, but the next point we should tell you what you can actually do about it.
• 2:34
  SPEAKER_00: But first, you need to understand what the diagnosis does and does not cover.
• 2:38
  SPEAKER_00: Second, what imaging you might still need before anyone can give you a complete picture or the best possible treatment plan.
• 2:45
  SPEAKER_00: Scoliosis is diagnosed from x-rays, but the type of x-rays you get matters.
• 2:50
  SPEAKER_00: The standard in scoliosis specialty practice is full spine x-rays taken while weight bearing from the back or front and also from the side.
• 2:58
  SPEAKER_00: Now that imaging will show you the cob angle or the degree or severity of the scoliosis.
• 3:04
  SPEAKER_00: Additionally, it'll tell you where the apex of the curve is and whether your body is in sagittal or chronal alignment, meaning is your spine balanced when viewed from the front and when viewed from the side?
• 3:15
  SPEAKER_00: Additionally, there will be some things on their x-rays that give you clues to your level or your child's level of skeletal maturity, which is essential to determine how much remaining growth someone has, which is the key component in predicting the likelihood of the curve progressing without treatment.
• 3:30
  SPEAKER_00: Now, a lot of patients that we see are actually diagnosed from sectional x-rays, which is better than nothing, but it only gives you a part of the spine.
• 3:38
  SPEAKER_00: It doesn't give you the full scope of what's going on and how the scoliosis affects the entire spine.
• 3:44
  SPEAKER_00: It also doesn't tell you how flexible the spine is, which is one of the most important bits of information to determine how correctible the curves may be.
• 3:52
  SPEAKER_00: And it doesn't tell you if there's possible underlying pathologies that could also potentially be causing or driving the scoliosis.
• 4:00
  SPEAKER_00: So to build a proper treatment plan, we need full spinal x-rays from the front or back and the side, ideally with lateral bending x-rays and if indicated by signs of any red flags or any abnormal neurological findings and MRI of the entire spine to rule out possible underlying pathologies that could potentially be causing the scoliosis.
• 4:21
  SPEAKER_00: Now, if this video is clearing things up for you, be sure to hit that subscribe button below.
• 4:26
  SPEAKER_00: I make videos especially for people navigating scoliosis.
• 4:29
  SPEAKER_00: And if you're in those early days of figuring out what the next steps are for you or your child's scoliosis, you definitely want to see what's coming next in the remainder of this video.
• 4:37
  SPEAKER_00: So be sure to subscribe so you don't miss it.
• 4:40
  SPEAKER_00: And hit that bell icon so you're notified when we release new content specifically on scoliosis.
• 4:46
  SPEAKER_00: Now, a third point I want to make is if you've already been diagnosed with scoliosis, you likely don't want to go back to the same doctor that originally diagnosed you.
• 4:54
  SPEAKER_00: You want to go to someone that actually specializes in non-surgical treatment.
• 4:57
  SPEAKER_00: You see, general orthopedic surgeons and pediatricians or a general chiropractor is going to try to manage the curve the best they can within the framework they have.
• 5:06
  SPEAKER_00: And that framework is generally around just trying to prevent surgery.
• 5:10
  SPEAKER_00: In fact, most orthopedic centers in the local children's hospital that will tell you that you cannot reduce the size of scoliosis.
• 5:17
  SPEAKER_00: And that's because they cannot with the type of treatments that they offer.
• 5:20
  SPEAKER_00: Their bracing is only designed to try and stop or prevent or slow the scoliosis from progressing.
• 5:26
  SPEAKER_00: And they don't even offer scoliosis-specific exercises.
• 5:30
  SPEAKER_00: And although general chiropractic or general physical therapy can be good for increasing mobility, can reduce pain, those treatments have not been found effective in the scientific literature to reduce the size of scoliosis or to slow down the scoliosis progression.
• 5:43
  SPEAKER_00: Now, a scoliosis specialist or specialist in the non-surgical treatment of scoliosis works from a completely different type of framework.
• 5:51
  SPEAKER_00: The questions they ask are different.
• 5:52
  SPEAKER_00: They want to know what's the trajectory of your specific scoliosis and your specific curve.
• 5:57
  SPEAKER_00: What does the growth status mean in relates to the urgency of your treatment?
• 6:01
  SPEAKER_00: And what treatment options do you have for your specific curve pattern in your specific scoliosis?
• 6:06
  SPEAKER_00: They also want to know how likely or how reducible is your scoliosis, meaning is it possible to reduce the curves in your specific scoliosis, or is your scoliosis one that we're just trying to keep it from getting worse while we're decreasing pain and improving quality of life?
• 6:22
  SPEAKER_00: Once we have the answers to all those questions, then we can formulate a specific treatment plan for you or your child.
• 6:29
  SPEAKER_00: Now, in Denver, there are general providers who see scoliosis cases and providers who exclusively specialize in scoliosis treatment.
• 6:37
  SPEAKER_00: The difference in what they notice, what they recommend, and what tools they have is quite massive.
• 6:43
  SPEAKER_00: Now, for the first 30 days after that initial diagnosis, one of the most valuable appointments you can make is with someone who actually specializes exclusively in the non-surgical treatment of scoliosis.
• 6:55
  SPEAKER_00: Now, knowing where to go is one part, but the fourth piece is knowing exactly what to bring with you or what information to bring so you get the most out of that next appointment.
• 7:04
  SPEAKER_00: So point number four is be sure to bring these four things to your next specialty appointment.
• 7:10
  SPEAKER_00: This will allow that appointment to be a lot smoother and it'll help your provider give you the best information possible.
• 7:16
  SPEAKER_00: So the first thing you want to do is bring any prior x-rays that you have had with you or contact the office so they can reach out and they can get all your possible records.
• 7:25
  SPEAKER_00: We don't even want just the most recent ones, but we also want to know if you've had any ones previously, because this can show a history of curb progression, which is one of the best predictors of future curb progression.
• 7:37
  SPEAKER_00: Also, if you've had any MRIs or CT scans, those are also things that you want to bring to your provider on that specialty appointment.
• 7:44
  SPEAKER_00: At that appointment, there are four questions that you want to make sure you get answered.
• 7:48
  SPEAKER_00: The first thing is what's the full measurement beyond the cob angle, including how much rotation do I have at my apex and what's my current level or my child's current level of skeletal maturity.
• 8:00
  SPEAKER_00: You see, an important piece of information, when we look at the size of the curve in ratio to the amount of rotation in the spine, that's a big predictor of curve progression.
• 8:10
  SPEAKER_00: For example, if there's a lot more rotation in the spine than we would expect compared to the size of the curve, that's a curve that's going to be more aggressive and more challenging to treat.
• 8:20
  SPEAKER_00: If there's a curve that has less rotation than we would expect based on the size of the curve, that's generally someone that's more reducible and will respond better to conservative treatment when we're looking at reducing the size of the scoliosis.
• 8:33
  SPEAKER_00: The second thing you definitely want to know is what's the trajectory of the scoliosis, meaning how likely is the curve to progress without conservative treatment.
• 8:41
  SPEAKER_00: Now, when we look at adolescents or juveniles and growing, or basically anyone that's still growing, the things we look for there are different than adults.
• 8:49
  SPEAKER_00: Because what causes scoliosis to progress in a growing child or teenager is completely different than what causes scoliosis to progress in someone that's done growing.
• 8:57
  SPEAKER_00: So for each case, there's very specific things we look for.
• 9:00
  SPEAKER_00: These are signs or predictors of curve progression.
• 9:03
  SPEAKER_00: But you want to make sure that you walk away fully understanding is how likely is this curve to progress without treatment.
• 9:10
  SPEAKER_00: The third thing you want to know is what is the goal of treatment?
• 9:13
  SPEAKER_00: Is the goal just to stabilize or is the goal to try and reduce the size of the curve?
• 9:18
  SPEAKER_00: Now, just so you know, overall the number one goal is always to prevent surgery when possible.
• 9:23
  SPEAKER_00: But there are times, especially when we have growing children or teenagers, where we are actively trying to reduce the size of the curve.
• 9:31
  SPEAKER_00: For example, I had an eight-year-old child yesterday who had a smaller curve, but the goal of that is to greatly reduce or almost completely eliminate the scoliosis compared to maybe uh someone that's almost done growing that has a very large curve.
• 9:44
  SPEAKER_00: Also, when we look at scoliosis, someone that's a senior citizen that has a more severe degenerative scolaris and chronic pain, the goal of that will be different than a young adult that's still pretty flexible.
• 9:55
  SPEAKER_00: So you want to make sure you walk away with a clear understanding of what the goals and expectations of your treatment are.
• 10:01
  SPEAKER_00: And the fourth thing is what is actually included in the treatment plan, how long will treatment last?
• 10:07
  SPEAKER_00: And what does treatment look like for you on a long-term basis?
• 10:10
  SPEAKER_00: With most treatments, we have things that we're trying to accomplish immediately.
• 10:14
  SPEAKER_00: We also have things we're trying to accomplish over the next few months.
• 10:17
  SPEAKER_00: And then you also want to notice what does this look like throughout my entire life?
• 10:21
  SPEAKER_00: Because in general, scoliosis is not curable, but if we take care of it properly, the long-term treatment can be dramatically different compared to if we don't take care of it properly.
• 10:30
  SPEAKER_00: Now, the answers to those four questions are gonna tell you whether or not the provider you're seeing is working from a current scoliosis-specific framework or just a general one.
• 10:40
  SPEAKER_00: It should also give you a complete picture of what your next six months should look like before you ever commit to any treatments.
• 10:46
  SPEAKER_00: Now, at Scholar Care Denver, we actually offer a free discovery call, which is an initial 15-minute call that you can have with the provider in our office so you fully understand your case and what your treatment options are before ever coming to the office and spending any time, energy, or money.
• 11:04
  SPEAKER_00: So look, I get it.
• 11:05
  SPEAKER_00: That first 30 days after an initial scoliosis diagnosis feels really uncertain.
• 11:10
  SPEAKER_00: The uncertainty isn't because the situation is hopeless.
• 11:13
  SPEAKER_00: Most of us just haven't had access to the full picture yet.
• 11:16
  SPEAKER_00: But now you know what to ask for and what treatments to seek out in the Denver area.
• 11:20
  SPEAKER_00: So four things I want you to do tonight.
• 11:22
  SPEAKER_00: One, write down the date of your last diagnosis and what the cobangle was or what the severity of your scoliosis was at that appointment.
• 11:30
  SPEAKER_00: Two, look at your x-rays.
• 11:32
  SPEAKER_00: Were they full spine?
• 11:33
  SPEAKER_00: Do you have or just a sectional?
• 11:35
  SPEAKER_00: Were they from the full spine from the front and the side, or just one view?
• 11:39
  SPEAKER_00: Also, did you have any lateral bending x-rays or were they just static?
• 11:42
  SPEAKER_00: Also, make sure to write down who the provider was you went to and what facility they're from, and where you had your imaging done, because a lot of times imaging is done at external facilities.
• 11:52
  SPEAKER_00: And then search for a scoliosis specialist in the Denver who actually offers an initial evaluation and book it before the end of the week.
• 12:00
  SPEAKER_00: Take action.
• 12:01
  SPEAKER_00: You get rewarded for taking action, and nothing is more true when it comes to your health.
• 12:05
  SPEAKER_00: These four steps alone put you on the path for everything else that needs to happen.
• 12:09
  SPEAKER_00: Now, sometimes people are told that their child may have scoliosis or they may suspect their child has scoliosis or that they have scoliosis, but they actually haven't had an official diagnosis yet.
• 12:19
  SPEAKER_00: And they're frequently wondering what are the most prominent or obvious signs of scoliosis.
• 12:25
  SPEAKER_00: So in the next video, I go over the warning signs of scoliosis.
• 12:29
  SPEAKER_00: I cover all of them in detail and tell you exactly what to look for and what to do if you find any signs of scoliosis.
• 12:37
  SPEAKER_00: The link is on the end screen and in the description below.
• 12:40
  SPEAKER_00: I'll see you there.