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Thursday, April 28, 2011

Brachial Plexus Injury

When I was in labor with our older son, he became stuck in the birth canal and required forceps in order to be delivered. That was no fun. In the final moments before he was born, I had a rare moment of clarity...and counted nineteen people in the room behind the attending physician and his staff.

This hospital was what they call a "teaching hospital." Having medical students and young residents gain practical experience was part of the deal. It also was the largest hospital with the best pediatric care in the area. We were told that we could opt to not have people observing our birth, but that it would place the doctor in a very uncomfortable position with the hospital and his peers. As new parents-to-be, we took the gamble that we wouldn't be faced with the decision--what are the chances that I'd give birth when a class was around, anyway?

Ugh.

I'm just now realizing how many people have seen me with my pants down. (Taking another swig of coffee)

With our second son, we vowed to do everything differently. Amidst the stress of caring for a demanding toddler who was already receiving services for developmental delays, I found a new obstetritian. We chose a different hospital. We were deliberate.

Flaccid. That's the word I kept hearing the nurses and new doctor say after our younger son was born. The nurses were caring for him in the corner while the doctor cared for me. I recall the doctor looking over her shoulder to the corner a couple times. She was not smiling.

Our son's left arm was flaccid, paralyzed. They were whispering it to themselves, but not talking to us about it. We were oblivious parents, happy that the process was so much easier than it was with our older son.

At some point over the next couple of hours, we were told that nerves had been stretched in his neck and that they should heal by three months of age. No big deal. The pediatrician came the next day and told us that our son had a brachial plexus injury, but that it was no big deal.

I wonder, if members of the medical community that have ever called this condition no big deal would feel the same if their child had it?

"No big deal" is an archaic approach to these injuries. If the nerves are torn from the spinal cord, as some of our son's were, use to that area of the arm will never happen. If the nerves are stretched, they heal very slowly. During the healing process, muscles can atrophy.

In the end, our son's condition was considered mild, and yet his arm did not start to move for the better part of a year. He started physical therapy at one month of age. And, while our older son was receiving 30 hours of in home therapy for his newly diagnosed autism, our younger son started receiving in home therapy also.

Four years of his life are a blur of specialized vests, braces, taping methods, all intended to correct the condition that we were told was no big deal. And, in the end, after fighting the red tape of insurance companies for a year, we were blessed to take that no big deal to Texas for corrective surgery.

There are few jokes for me to find in this situation. My husband had to stay at home with our older son who was too developmentally disabled to handle the trip. My parents, both heavily supportive in this endeavor, came to Houston with our son and me. They took charge. They lead the team. I could not have done this alone. There are no words that express my gratitude.

They gave him the gift of a life without disability.

Without the surgery, our son couldn't put his left hand to his mouth. He couldn't hold a plate with two hands. He wouldn't be able to tie his shoes--the list is endless. And, yet, medicine considers this no big deal.

WITHOUT A DOUBT, when I first found out we were to become parents, I sure didn't think that it was going to be the challenge that it has been for the past decade. However, I can also say, without a doubt, meeting the challenge of our son's brachial plexus injury will remain one of my greatest rewards.

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