Technology Helps Fix “Pigeon Chest” In US Patient

In an exam room at East Tennessee Children’s Hospital, all eyes were on 14-year-old Tinsley Allen as he became first patient in Tennessee and one of first in nation to be fitted with a South American medical device. 

But Tinsley’s eyes were on his future: eight months to a year from w, when he should be able to take off his shirt to swim without people staring at him. 

Since he was about 2 years old, Tinsley has h pectus carinatum, more commonly kwn as “pigeon chest.” His rib and breastbone stick out from his chest wall, giving him a pointy protrusion, like a bird’s. 

A two-year attempt to correct it with an older metal brace showed little progress toward making his chest look “rmal” — and besides that, Tinsley said, it was painful. 

“It wasn’t pded ... and metal clips dug into my ribs,” Tinsley said. He wore it 12 hours a day — anytime he wasn’t in school — and was responsible for manually tightening pressure himself, in hopes that brace could grually force his chest to a more typical shape. 

“It hurt him so b that he didn’t want to wear it a lot of time,” said his mor, Debra Allen. “It was a struggle.” 

And at end of two years, re was very little difference, she said: “It was very discouraging.” 

But surgeon Dr. Glaze Vaughan and physician’s assistant Matt Greiner, of East Tennessee Children’s Hospital’s newly opened chest wall clinic, hope for a much better outcome with newer device, FMF Dynamic Compression System developed in Argentina. 

Vaughan compared it to “going from a T-Model to a Ferrari.” newer device is fitted over Tinsley’s protrusion, and he wears it an increasing number of hours a day, beginning with four to six. 

A digital mechanism on brace automatically justs pressure, so all Tinsley has to do is wear it for recommended time, along with some breathing exercises to make his chest more flexible. Vaughan expects within a year to reach ir goal, “complete correction, a totally rmal chest wall” — before end of teen’s freshman year of high school. 

Children’s Hospital launched monthly clinic for children with chest wall deformities a few weeks ago, after ting hospital treated nearly 70 children last year for two most common conditions: pectus carinatum, which Tinsley has, and pectus excavatum, or “funnel chest,” when ribs and breastbone grow inward. 

Pectus excavtum patients once h option but to have a metal rod surgically implanted to help reshape chest, but a newer treatment suitable for some uses a vacuum bell device that looks like a suction cup attached to child’s chest. It creates a vacuum seal that grually lifts sternum over time. 

Vaughan said chest wall deformities are t that uncommon, affecting about one in 5,000 children, with males four times more likely to have m. Most are congenital, and while some are part of larger diagsed syndromes, he said, many occur on ir own with or health issues, and ir cause isn’t clear. Periods of rapid growth — as during puberty — can change position of sternum, making chest wall condition even more prounced, he said. 

While abrmally shaped chest walls can cause difficulty breathing, chest pain, respiratory infections and heart palpitations, Vaughan said, for many children ir appearance is biggest issue. A primary reason to treat conditions, he said, is that children can develop “distorted body ims” that can cause problems with confidence and self-esteem “right when y’re going through olescence and trying to figure out who y are,” and can even le to children being bullied. 

“We recognize se chest wall disorders are t just cosmetic,” Vaughan said. y can cause “a complete disruption of what a rmal teen’s life should be.” 

That’s why patients at clinic will see a multidisciplinary team of surgeons, nurse practitioners, subspecialists like pulmologists and orthopedists, and psychologists and social workers who can help children deal with body im and psychological issues. 

Social workers and care coordinators on team can help identify resources to help un- or under-insured families afford treatments, Vaughan said: “We don’t want any child to go untreated because of an inability to pay.” 

Though FMF brace is new and manufactured in a different country, Vaughan said insurance appears to be paying for it — although it can still be pricey for families with high deductibles or co-pays. 

Debra Allen said her family’s employee-sponsored BlueCross Blue Shield policy paid all but about $725 of roughly $3,500 brace; she put $230 down and financed rest. It’s a little more than three times cost of Tinsley’s older brace, but “it’s worth every penny,” she said. 

Tinsley said he hasn’t been bullied for his appearance, but he enjoys swimming and basketball and has been self-conscious when he removes his shirt in public. While people aren’t ugly, he said, y still stare: “y’re curious.” 

Though he tices it’s re, new brace isn’t uncomfortable, he said, and shouldn’t impede him from his summer activities: farming soybeans, wheat, corn and hay with his far and grandfar, and visiting railros, an interest instilled by his late grandmor, who took him to railro tracks when he was a child. He hopes as an ult that he’ll farm and work for rfolk Sourn. By n, brace — and condition it corrected — should be a distant memory. 

“This way, I won’t have to worry about it when I’m older,” Tinsley said. 

Also Re: Does Augmented Reality Indulgence Affect Peoples' Behaviour