Steps You Should Take If Your Infant Has Been Diagnosed with Erb’s Palsy

First of all, congratulations on the birth of your new baby! This is such an exciting time for you and I wish you and your child all the happiness in the world.

I’m sure that an Erb’s Palsy diagnosis can be nerve-racking. I was diagnosed with this injury at birth and I can only imagine how my parents felt.  Most people have never heard of this condition and aren’t sure where to begin to help their newborn.  However, I promise that after reading this blog post, you will feel more confident about how to get the help your baby needs.  Thankfully, my parents were very proactive about getting services for me. I wouldn’t have made the progress I have today without their support from the day I was born and their continued support since then.  Your child will feel this way one day too.

Below is a list of things you must do as soon as possible.  The sooner the services are received, the more likely that there will be less permanent nerve damage.  I have compiled this list with my mom, who became an Erb’s Palsy expert, as you will too.

  1. Speak to the pediatrician at the hospital.Talk about what immediate actions should be taken.  Ask which doctors your child needs to see.  Each case can be different.  Discuss what you can do with your child at home.  For example, my parents were told to do range of motion movements with me each time I had my diaper changed.
  1. Make an appointment with a neurologist. This doctor can evaluate the baby’s injury and recommend what services would benefit him or her.  When I was an infant, the neurologist had recommended that I wear a neoprene splint intermittently throughout the day.
  1. Investigate early intervention services.Your child should be given an evaluation and, based on the results, you will be told what services he or she is entitled to.  This is a government-funded program.  The services may include physical therapy, occupational therapy, speech pathology, and/or intervention from a special education teacher.  I started receiving occupational therapy at ten days old, three times a week, 45 minutes each session. I began physical therapy within a few months.  I received these services up until three years old, when I aged out.  Then my mom contacted our school district for an evaluation to determine which services should be offered through the school. I had occupational therapy in school until eighth grade.
  1. Contact an attorney.  Most, if not all, Erb’s Palsy cases are caused by malpractice and the costs of treatment can be very expensive.  Consult a lawyer about how to open a case.
  1. Keep notes and receipts organized.  Jot down information about your baby’s evaluations and recommendations made by professionals.  These notes and medical receipts can be used for tax return purposes and also for legal proceedings.  Keep track of gas mileage to and from doctors, cost of medical visits and treatments, etc.
  1. Most importantly, treat your baby like you would treat any other child.  He or she should feel special and praised for all of his or her accomplishments. Don’t forget to give just as much attention to your other children.

 

Do you have any other recommendations from your own experiences?
Comment below to share!

Birth Injury Prevention

We know that the majority of Erb’s Palsy cases can be prevented.  Therefore, it’s important to educate ourselves about risk factors and to know what to do if these risk factors apply to your pregnancy.  There is no reason to be nervous if you keep these things in mind.

 

RISK FACTORS
  • Birth weight of infant is over 8.5 lbs.
  • Mother has diabetes
  • Breech delivery
  • Previous child delivered with shoulder dystocia1
  • Small mother
  • Long labor
  • Precipitous labor (i.e. labor that is faster than normal)
  • Fetal malposition in birth canal
  • Labor is induced or sped up by medicine
  • Use of forceps or vacuum extraction tools during delivery*** (This is super important.  These tools can be very harmful to a baby.)
PREVENTION
  • Doctor should never pull on or twist the baby’s head.
  • Have a cesarean section for babies who are too large to fit through the birth canal.  In rare cases BPI can happen during C-sections but it is much less likely.
  • Do not deliver the baby on your back. This is the worst position to be in.  Learn about different, more appropriate positions.
  • Have a calm birthing environment, so the delivery is not rushed. Your obstetrician or midwife should seem like they can handle a stressful situation like this with ease.
shoulder dystocia1: when a shoulder gets stuck in the birth canal
For more information about Erb’s Palsy causes and preventions, please watch the video below.  It includes interviews with highly educated professionals in the field who give great insight on this topic.
 
Do you know of any other risk factors or ways to prevent Erb’s Palsy at birth? 
Please comment below.
Sources:

http://www.brainandspinalcord.org/cerebral-palsy/types/erbs-palsy.html

http://www.birthinjuryguide.org/erbs-palsy/

http://www.erbpalsy.org/prevention.html

Therapy That Works

I’ve been going to therapy since I was nine days old. No, you did not misread that.  Nine. Days. Old.  For this reason, I consider myself a professional patient 🙂 and without these therapists I wouldn’t be where I am today. I am eternally grateful to them.

Below I have included an overview of different forms of therapy, in the order that I began them, that have been really beneficial to me:

Occupational Therapy: I had occupational therapy from nine days old until the age of fourteen.  At first, I received therapy at my house.  Eventually I received it in school as part of a 504 Plan1.  My mom fought tooth and nail to get these services.  She had to justify why occupational therapy was necessary for me to receive and, because I write with my other hand, it was often difficult to make this justification because it had to affect your progress in school.

  • Occupational therapy helps with daily living activities, including fine motor activities, such as writing, buttoning, zippering, etc.

 

Physical Therapy (Structural and Functional): I began physical therapy at the age of two in Connecticut. My parents drove me up to Hartford at Regional Physical Therapy because it had been recommended by my occupational therapist at the time.  At the age of six, I met a physical therapist named Steve Moran, at another one of Regional Physical Therapy’s offices, who I still visit to this day at Crossroads Physical Therapy in Columbia, Connecticut.  (He opened his own office soon after I met him.)

  • This type of physical therapy is actually considered manual physical therapy, which means that the therapists use techniques, such as craniosacral therapy, myofascial release, joint mobilization, and others.

 

Aquatic Physical Therapy: I began aquatic physical therapy at six years old at Hope Physical and Aquatic Therapy in Plainview, New York.  My parents had been searching for a physical therapist that was nearer to our home and thought that aquatic therapy would be really beneficial.

  • Aquatic therapy is great because the water makes exercises easier to do and more fluid. Additionally, having an injury to your arm affects your ability to swim, so this type of exercise is essential.

 

Physical Therapy (Traditional): After about seven or eight years of aquatic physical therapy, my neurologist suggested that I start traditional physical therapy to gain more muscle strength and range of motion.  I received this type of therapy up until a few years ago and only go if I’m having severe pain.

  • This type of therapy involves electric stimulation, massage, light weightlifting, stretching, and machine exercises.

 

Massage Therapy: As I’ve gotten older, I’ve had many stiff necks and pain in both shoulders, which are definitely related to my injury.  These things especially spring up when I’ve been reading for an extended period of time or I am stressed at work. Three years ago, I had a stiff neck for the whole summer and sought out massage therapy.  I found an amazing woman named Sharon Klein in Bellmore, New York and since seeing her, I have had significantly less pain.

  • Sharon does therapeutic deep tissue massage with acupressure and cervical traction.

 

 

1504 Plan: Accommodations made for children in primary and secondary who have disabilities that affect their function in school.

 

What is BPI?

Brachial Plexus Injury (BPI) is a nerve injury, normally caused at birth by constrictions during natural delivery called shoulder dystocia. The brachial plexus is simply a group of nerves that work together to move your shoulder, arm and hand, and can affect your neck as well. This may occur when the infant’s arm or neck is pulled out forcefully in an attempt to get him or her out as quickly as possible.   Usually, the nerves are separated from the spinal cord (avulsion) or overstretched (neuropraxia).

In my case, this was exactly what happened.  Forceps were illegally used twice in order to pull me out; at the time, in 1989, they could only legally be used once.  In turn, the nerves C5-8 and T1 were overstretched and the only part of my upper left extremity that I could move was my thumb.  I was quickly diagnosed with Erb’s Palsy1 and Klumpke’s Palsy2, which can be generally referred to as BPI, due to neuropraxia.

Thankfully, my parents were very proactive and, at nine days old, I began physical therapy.  It was important that my arm was moved many times throughout the day in order to “reteach” the nerves.  Within the first two years of a baby’s life, it’s possible that the nerves can fully recover.  However, for most of us, this is a life-long process of improving and maintaining function.

*This injury can be caused by other situations as well.  Car or motorcycle accidents can be causes, for example.

626d5-brachial2bplexus-42b252832529

To learn more in-depth, scientific information about BPI, please see these links:

1Erb’s Palsy: upper part of the brachial plexus has been affected (nerves C5-C6)

2Klumpke’s Palsy: lower part of the brachial plexus has been affected (nerves C8-T1)