BOB体育

Marissa and Jon Yeatman gave birth to a healthy baby boy named Nathaniel on Feb. 9, 2018, in Tallahassee, Florida. He was their second child and made their daughter a big sister, a position she was eager to take on.

Three days after his birth, Marissa and Jon took their baby to the pediatrician for his newborn checkup, and the doctor noticed an abnormality in the shape of Nathaniel鈥檚 skull.

鈥淭he pediatrician took pretty much one look at him and said, 鈥楲et鈥檚 take some X-rays,鈥欌€� Marissa said.

Though Nathaniel鈥檚 head only had a mildly pinched appearance, his abnormal head shape foreshadowed a much more serious problem. Nathaniel was diagnosed with sagittal craniosynostosis, a birth defect in which one of the fibrous joints between the bones of Nathaniel鈥檚 skull closed prematurely before his brain was fully formed.

鈥淯sually when you look at a newborn鈥檚 head on an X-ray, it looks like the skull is kind of shattered, but part of his looked like it was already formed and closed like an adult,鈥� Marissa said.

Their pediatrician recommended Lance S. Governale, M.D., BOB体育鈥檚 chief of pediatric neurosurgery who has a focus in craniosynostosis. The Yeatmans contacted him immediately, hoping to resolve the issue as quickly as possible.

Dr. Governale knew he needed to treat the problem early, so he scheduled the Yeatmans for an appointment close to their home at the BOB体育 Pediatric Specialties practice in Tallahassee.

鈥淎t that point, he was like new, new to the world,鈥� Marissa said. 鈥淗e was only about a month old. So, our options were kind of broadened, because we caught it so young.鈥�

To gather more information, Dr. Governale obtained a special CT scan. CT scans involve some amount of radiation exposure, but at BOB体育鈥檚 Gainesville and Tallahassee locations, Dr. Governale introduced ultra- low-dose CT scanning. These scans provide 3D views of the skull at a radiation dose similar to a few X-rays and much lower than standard CT scans. After Nathaniel鈥檚 CT scan confirmed the condition, Dr. Governale laid out three different treatment options.

鈥淭he skull is made up of multiple different bones with sutures in between them,鈥� Governale said. 鈥淪utures allow the skull to grow. If they close early, it alters the head shape. In addition, suture closure can restrict skull growth while the brain is trying to grow leading to increased pressure.鈥�

Craniosynostosis is typically treated surgically, due to the need to unlock the bones and reshape the skull. The traditional surgery, larger and more invasive, would probably require a blood transfusion and a longer hospital stay, but Dr. Governale was committed to offering minimally invasive options.

鈥淥ne minimally invasive option consists of unlocking the bones through one or two small incisions with the assistance of an endoscope, and then using a helmet afterward to reshape the skull,鈥� Governale said. 鈥淭he downside is that the helmet has to be worn for 23 hours per day for upwards of nine months. It also requires regular visits to a helmet orthotist, who may not be located in the family鈥檚 region, like Tallahassee.鈥�

Because of these issues, Dr. Governale and his pediatric craniofacial plastic surgery partner, Jessica A. Ching, M.D., introduced a second minimally invasive option to BOB体育 鈥� cranial expander springs. With springs, a helmet is not required. BOB体育 Shands Children鈥檚 Hospital in Gainesville is the only site in Florida offering this newest treatment option.

Though she trusted the physician鈥檚 expertise, Marissa was relieved to feel as if she wasn鈥檛 forced into one specific treatment option for her baby boy. She felt that Dr. Governale let her have the final say.

鈥淗e was really good about not pushing one option over the others,鈥� Marissa said. 鈥淗e said if there was one option that was better than the other two, he wouldn鈥檛 offer the other two.鈥�

That third, minimally invasive option for Nathaniel was the one that the nervous parents eventually chose.

In May of 2018, Nathaniel underwent craniosynostosis surgery with cranial expander spring implantation. Drs. Governale and Ching made one incision, used an endoscope to help open the sealed suture and then put in two cranial expander springs to reshape the skull. Three and a half months later, they went back in and took out the springs, completing the process 鈥� no helmet required.

A team approach is essential for treating craniosynostosis. The physicians work side-by-side to tailor the treatment to the patient and involve other specialists if needed, including ENT, oral surgery, dentistry, genetics, speech therapy, audiology, psychology and social work. Although Nathaniel did not need those additional specialists, he did have one more added benefit of Dr. Ching鈥檚 participation in the surgery 鈥� a beautiful closure with minimal scarring, something Marissa and Sean are very thankful for.

鈥淪he did an amazing job with all of his stitches and everything,鈥� Marissa said. 鈥淭he scar was actually, originally, a pretty odd U-shape. As his head is growing, it has started to stretch and look straighter. Already, you can鈥檛 see the incision that much.鈥�

Today, Nathaniel is a healthy 1-year-old, and you can鈥檛 tell there was ever anything wrong with his skull.

鈥淗e had an excellent reshaping. His head looks normal now and is allowing his brain to grow,鈥� Governale said. 鈥淲e鈥檒l be watching him, but hopefully, because he鈥檚 otherwise healthy, he won鈥檛 encounter additional issues.鈥�

Nathaniel鈥檚 more focused on doing his favorite things, now that he doesn鈥檛 have to worry about surgeries or doctors鈥� visits. His big sister is his greatest source of entertainment.

鈥淗e loves his sister. Hands down, she鈥檚 the one that can make him smile the most,鈥� Marissa said. 鈥淎ny time she gives him attention and plays with him, he鈥檚 just so happy. They鈥檙e cute together.鈥�

Nathaniel started walking recently and is very mobile. He loves eating and playing with a little lion rattle. The lion has been with him from the day he was born through every surgery after that.

Like that little rattle, Marissa and Jon have been there the whole way, too, and have learned a lot through their hardest moments with Nathaniel. Marissa offers advice to other parents who are about to undertake their own harrowing journey with craniosynostosis.

鈥淚 would say don鈥檛 panic,鈥� Marissa said. 鈥淵ou鈥檒l get through this. Honestly, the doctors know exactly what they鈥檙e doing. Trust them.鈥�

She also encourages parents to trust their gut when it comes to health care decisions for their children.

鈥淚t鈥檚 very, very scary seeing your newborn baby go into surgery,鈥� Marissa said. 鈥淚t鈥檚 just very difficult. When Nate was waking up after his first surgery, he was very fussy. That whole day he was fussy: upset, disoriented, crying. I was second guessing our decision while trying to comfort him. Then, the next day, he woke up and smiled and was suddenly completely himself again. Don鈥檛 second guess yourself. You know what鈥檚 right for your family and your child. It鈥檚 crazy how resilient children are.鈥�