taking a stand…

Far be it from me to offer unsolicited parenting advice to others, while somehow blindly assuming that “my way” is more effective.  Lord knows, I tend to be less than appreciative when I’m on the receiving end of those conversations.  As a self imposed professional guideline, my advice generally remains within the confines of the therapy room – unless I’m asked a direct question on a topic – and is based entirely on activities related to the visual system.  A guideline which, by the way, blossomed out of my affliction of not knowing when to keep my mouth shut. Occasionally though, personal guidelines must be set aside in the interest of those who cannot speak for themselves.  After all, rules are meant to be broken.

About four weeks ago, Ronnie started in our Vision Therapy program.  She is 9 and has Ocular Motor and Binocularity concerns.  Ronnie is a very sweet young girl, and comes from a wholesome, kind, and loving home.  Her parents are both incredible people.  During her second visit, I noticed Ronnie was constantly and violently tilting her head to one side, almost in a jerking motion, similar to the way a chiropractor would during an adjustment. When I inquired, she told me that her neck hurts and the movement “pops it” and makes it feel better.  When I asked her why her neck is sore today (thinking she slept wrong or something), she told me that she had fallen off the monkey bars at school in November and landed on her upper back and neck.  I asked if her parents knew about of this event, and she said she had told them a few times, but had never been to the doctor for it.

When Ronnie’s session concluded, I pulled her mom into the VT room and asked a few questions.  The picture mom painted was that she knew of the fall, she had noticed Ronnie trying to “pop” her neck often since that day, and was aware of it being painful – but to this point, had chosen to ignore it. She also admitted that since she didn’t think it was related, she greatly understated the event in our questionnaire before her initial exam. At that moment, my aforementioned affliction began to awake.  After all, if your child is in pain for three months, what part of your parenting instincts are failing to fire.  Out of an abundance of caution, get them checked out.

As calmly as I could, I explained to Ronnie’s mom that this behavior is not normal for a nine year old and could be at the root of her current visual issues. It also could be a warning sign, or even referred pain, from something far more severe or even life threatening.  She needs to be examined.  In addition to discussing her pediatrician as an option, I provided her mom with the name of a few local Pediatric Chiropractors who specialize in cranial manipulation, and one Pediatric Osteopath in our area. To remove any financial concerns, I offered to waive the fee of Ronnie’s next few VT sessions to allow her parents to meet whatever copays may arise in exploring her issue. Her mom thanked me, and they left. Problem solved – so I thought.

The following visit, I pulled Ronnie’s mom aside to inquire if she had made any progress in exploring Ronnie’s condition.  She informed me that she had not; she went on to say that she and her husband have decided that it wasn’t really necessary to have it checked out.  Here comes my affliction again…

After a few very strong words with mom,  I basically told her that I would be recommending to the doctor that we discontinue her daughter’s VT until she is medically cleared, out of fear that there may be something more serious occurring. We could not, in good faith, just ignore this. In retrospect, my comment was probably out of line, but in my heart was in the best interest of this little girl.  Mom reluctantly agreed to reconsider.

As of today’s visit, Ronnie’s parents have made an appointment to “have her head and neck checked”.  Stay tuned…


Posted on March 22, 2013, in From My Perspective.... Bookmark the permalink. 4 Comments.

  1. Robert –

    That’s an uncomfortable situation to find yourself in. Good for you for trusting your instincts and speaking up on Ronnie’s behalf. (Our instincts rarely fail us.) I hope she’s going to be okay, and there isn’t any permanent injury.



  2. Dear Robert
    Thank you for sticking to your guns – you knew that you must always be an advocate for your patient, even when it is awkward or uncomfortable, and you honored that responsibility. I hope that everything is OK with Ronnie, but it wouldn’t have been correct – or wise – to ignore what you observed without checking it out further.
    You are a true role model for all of us!


    • Robert Nurisio COVT

      Thank you, Linda. It got a little contentious, but I think in the end, her mom understood my concerns were genuine. This is definitely one of those times when I would love to be wrong though. Hopefully it’s nothing serious.


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