Kyle Lowry was a freshman in high school when he first noticed something might be wrong with his chest.
A soft mound of cartilage protruded outward, and oftentimes Kyle would find himself pushing down on it, reflexively. It was different and worrisome. But it wasn’t painful.
“My chest just looked weird. I was concerned,” said Kyle, 17.
His mother, Margo, sharing Kyle’s concern, began researching chest wall conditions online.
“I didn’t even know any of this was a thing – pectus carinatum. We googled it and learned it can be a lot worse – especially if it’s untreated. We knew we had to get on it pretty quickly,” she said. “And then, lo and behold, I found there is a Chest Wall Center at Cincinnati Children’s.”
Already familiar with Cincinnati Children’s (her daughter Keilah is a frequently seen patient who is treated for cerebral palsy and other medical conditions), Margo knew Kyle was going to be in good hands.
So in January 2019 Kyle and his family met with staff in the Chest Wall Center, and he was diagnosed with pectus carinatum (pigeon chest), a common condition in which the breastbone and ribs are pushed outward.
“They were very knowledgeable,” said Margo. “It didn’t surprise me that they were so good because that’s what we’ve always run into at Cincinnati Children’s. They knew what they were doing for sure.”
Fortunately, Kyle – like most patients with pectus carinatum – didn’t require surgery. The chest wall in children and adolescents is very soft and flexible, so the condition is usually corrected with bracing.
During his initial visit, Kyle was scanned for the Pampamed FMF brace. His measurements were collected and sent to a team in Argentina to begin making the custom fit brace.
Three months later the custom brace was ready and Kyle returned to the clinic to be fitted.
“This brace is superior to the prior brace we were using because the Pampamed brace is adjustable and can be configured to each patient’s body,” explained Emily McKenna, a nurse practitioner in the Chest Wall Center.
Once fitted, Kyle returned to the clinic every four to six weeks so the team could make adjustments (tighten, loosen the brace) as needed.
“At each visit we measure how much pressure is required to correct the carinatum, the pressure the brace is exerting on the chest and how pliable their chest is. Based on these numbers we adjust the patient’s brace to make it fit better,” said McKenna.
Based upon the severity of their condition, patients are placed in one of four groups, with the most severe cases (stiffer, less pliable chests) in Group 4. As patients wear the brace they will typically drop to lower groups over time until the chest is corrected or a “neutral” position is attained. Once neutral, the patient is gradually weaned off the brace, usually over several months.
Kyle was placed in Group 1, and his chest corrected faster than expected. At his first clinic follow-up visit a month after his initial fitting, Kyle’s chest was already neutral.
“He was very diligent [in wearing the brace]. I was very proud of him,” said Margo. “Doctors were impressed too. Sometimes kids don’t want to mess with it, but he did what was needed.”
Kyle wore the brace from April and into the summer before it was removed in August.
“I was hoping to be done by the time I went back to school,” said Kyle. “It wasn’t too noticeable. I’m just happy that we got it done when we did.”
It was a little uncomfortable at first, he added, but gradually he got accustomed to carrying around the extra weight.
“It didn’t hurt. It might’ve been a little more difficult to breath but I got used to it,” said Kyle. “There was just a lot of cartilage. Straps over your shoulder were kind of annoying and it’s kind of a weight on your chest. Eventually I didn’t really notice the straps anymore.”
Now a junior at Lebanon High School, Kyle is a year removed from wearing the brace. He is taking online classes at Sinclair Community College and is already thinking of a career in the movie industry.
“My dream is to go into film,” said Kyle, citing The Godfather as one of his favorite films.
Excited about his future, Kyle still thinks back occasionally on his past and the clinic visits during the four months of wearing the brace.
“I’m very grateful for the treatment,” he said, noting that many people in the world are born with this condition but are unable to get the help they need in a timely manner only to have it worsen over time.
“I was just excited to get my chest fixed and they knew what they were doing. It was pretty easy and fast,” said Kyle. “The doctors and nurse practitioners, they made me feel very comfortable. I wasn’t made to feel pressured or nervous.”
His advice to other patients is to listen to the doctors and “trust the process.”
“If you notice anything, say something to your parents,” said Kyle. “And whenever you first get the brace, yeah, it can be a little uncomfortable, but it’s nothing to be nervous about or scared of because it’s gonna form around [your chest]. You just have to trust the process.”
(Published February 2021)
Kyle (lower right) with his siblings Caden, 14; Ian, 16; Nate, 18; and Keilah, 4.
Over the past 3 years, the Chest Wall Center has seen a total of 365 patients for pectus carinatum since implementing the FMF Dynamic Compression brace. Currently:
For patients in Group 1 the Chest Wall team recommends they wear the brace 24 hours/day except for showers.
When initially fit for their brace, patients gradually work their way up to 24 hours.