Things have been busy since Kate was born over a month ago. Although Kate was not large when she was born (7 pounds 12 ounces), she got stuck when trying to come out. As a result, when the doctor pulled Kate out, he stretched her neck, causing shoulder dystocia. Shoulder dystocia causes birth brachial plexus palsy.
The brachial plexus is a bundle of nerves located under your collarbone. It controls your arm movement. Fortunately, Kate's shoulder was NOT dislocated and her clavicle was NOT broken. She has had x-rays to confirm.
The brachial plexus nerve has many different branches. The C5 and C6 nerves control your shoulder and bicep. C7 controls your tricep. C8 and T1 controls the wrist and hand. Kate has been able to move her wrist and hand since birth, so the C8 and T1 branches are normal. She regained use of her tricep (C7) within a week or so. However, Kate has not been able to move her bicep or shoulder yet, so we know the C5 and C6 branches are damaged.
There are three possible options for how the C5 and C6 branches are injured. We know it isn't normal. We are hoping it has not been severed (avulsion or rupture). We also hope it is not the neuroma option (partial severe). We would really like it to be neurapraxia, which means stretched. If the C5 and C6 branches are stretched, then we don't have to do any "repairs" (i.e. surgery). In 90-95% of infants that have birth brachial plexus palsy, by the time they are 3 months old they will be able to move their shoulder and bicep if the nerve was only stretched.
At this point, we take Kate to occupational and physical therapy each week. We have seen a pediatric neurologist and a pediatric orthopedic surgeon. We saw the neurologist first, and she suggested we take Kate to St. Louis Children's Hospital as they have a brachial plexus palsy center. We then saw the pediatric orthopedic surgeon. She was very familiar with brachial plexus palsy. We felt very comfortable with her, so we have not yet decided if we are going to go to St. Louis or not. Kate has follow-up visits every month with the orthopedic surgeon. If we go to St. Louis, they will also want to see her each month. We are going to see if our insurance will cover the medical bills there or not. We are praying that Kate will bend her elbow. If she can do that, her nerve was just stretched and with therapy she should make a full recovery.
3 comments:
My heart hurts to hear about this for your daughter Kate. Our first son was born with an eyelid muscle defect that is only correctable through surgery at this point. I understand the immense love you feel for your daughter and her health. May the Lord bless her and you too.
Sorry, Sister... This has got to be so hard. Please let me know if you need anything!
Love you guys - and she is DARLING though! It was so good to "see" you at Christmas. We'll have to do it more often.
Hello, I found your blog from following UBPN on twitter. My daughter has a rt brachial plexus injury and was also 7 lb 12 oz. She is now 8 and has great movement in her arm. Although she does not have full range, her arm is functional. If you have any questions you can email me at amaysed@gmail.com. I know this can be a scary and frustrating time.
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