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Shoulder dyscotia...
Bub diagnosed with erbs palsy


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#1 Miss Kiwi

Posted 23 February 2012 - 01:26 PM

Our little guy arrived 2.5wks early and he was a big baby weighing 4080. Unfortunately he got stuck as was trying to come out sideways and his shoulder was stuck on my pubic bone. The relatively calm birth turned into an emergency and instantly there was a room full of people trying to get my baby out.

One MW on top of me pushing hard on my stomach and two MWs on each leg pulling them back as far as possible. With another MW using vacuum and her hand inside me trying to turn and pull him out. I have never experienced such pain and terror. It was just horrific. Thankfully they got our baby out within 4min of pushing the emergency button. I am told that is a very good result had it been 8-9min things could have been very very different.

Bub needed to be resuscitated and was taken away to special care where he quickly improved.
The next day bub continued to do well however we were told due to the shoulder dyscotia he has erbs palsy on his right arm (neuropraxia) He has had to have his arm in a sling (singlet pinned up) since. We were told physio should correct things.

Since coming home from hospital 2wks ago we have notIced some movement which is reassuring. We had an appt with the physio earlier this week which we were disappointed with. We didn't feel like we really got the answers we were looking for. We also had the PAED appt today and again we came away unhappy.

Has anyone been through this? How long did your child take to completely heal? Should we get a 2nd opinion and pay the money to see a specialist that deals with erbs palsy? (we are in Sydney if anyone can recommend). Will erbs palsy slow development I.e. learning to crawl?

The answers we have been given from the physio and paed are 'we don't have a crystal ball it is a waiting game'. We had to force out of the PAED that if we don't see improvement in 3mths then the next step is seeing a neurologist. But we had to force that out of him!! We want to understand what the game plan is and what the average rehibilation time frame is but just get blank looks and 'we will just have to see'. Very very frustrating!!!!!

I would love to hear from anyone else that has been through this as we are scared first parents and have this awful vision of our child not being able to crawl or hold a ball.

Thanks so much.

#2 Deb99x

Posted 23 February 2012 - 02:05 PM

Hi Miss Kiwi,

I have a 16 month old DD with a similar story.


Please PM me if you want to talk.

#3 Liv_DrSperm_sh

Posted 23 February 2012 - 02:07 PM

Hey!

Firstly, congratulations on the birth of your son! Second, it sounds like such a stressful end to a birth, it must have been awful!

I have no experience with Shoulder Dystocia or Erbs Palsy, but I do have personal experience with neuralpraxia. You are probably not getting much out of the medical professionals because there is actually very little they can do at the moment. The nerves need to heal and that can take a short time or a very long time!


My sciatic nerve got crushed during labour and I had complete paralysis of my lower leg for about a week followed by the most excrutiating neuropathic pain afterwards...for like 6 months, it was hell on a stick! Anyway, I couldn't get a straight answer out of any medical professional because the real answer was 'we don't know if/when your leg will get better'. Don't be afraid to ask more questions, but sometimes there just aren't satisfactory answers!

I hope you start seeing some improvements soon! Has the physio given you any exercises to do with your son?

#4 suline

Posted 23 February 2012 - 02:43 PM

How scary for you! One of my friends has a 2year old boy with Erbs' palsy from birth, he still has ongoing weakness, and his affected arm isn't growing at the same rate. I gather this is more of a worse case scenario. (she is in the UK) he had physio from about 2 months when it was apparent the arm wasn't recovering. (there was not even finger tip movement to start off with) and they still see a physio regularly now.

Personally I would pay for a private physio appointment, and find out one that specialises in paediatrics/erbs palsy.

My other concern would be A) why was a midwife using a vacuum- they aren't legally allowed to do so
B) i don't believe vacuum is the safest or recommended way of dislodging a stuck shoulder.
However I wasn't there so I don't know the details or what the correct method of delivery would be.

Maybe its something you could follow up on, just in case that down the track your baby's arm needs lots of physic, it could become quite expensive.

Best wishes.

#5 Miss Kiwi

Posted 23 February 2012 - 03:11 PM

QUOTE (suline @ 23/02/2012, 03:43 PM) <{POST_SNAPBACK}>
How scary for you! One of my friends has a 2year old boy with Erbs' palsy from birth, he still has ongoing weakness, and his affected arm isn't growing at the same rate. I gather this is more of a worse case scenario. (she is in the UK) he had physio from about 2 months when it was apparent the arm wasn't recovering. (there was not even finger tip movement to start off with) and they still see a physio regularly now.

Personally I would pay for a private physio appointment, and find out one that specialises in paediatrics/erbs palsy.

My other concern would be A) why was a midwife using a vacuum- they aren't legally allowed to do so
B) i don't believe vacuum is the safest or recommended way of dislodging a stuck shoulder.
However I wasn't there so I don't know the details or what the correct method of delivery would be.

Maybe its something you could follow up on, just in case that down the track your baby's arm needs lots of physic, it could become quite expensive.

Best wishes.


Thank you for your post.

DS has finger movement and is starting to have movement in his shoulder and elbow. Both arms are the same length. Physio has given us exercises to do at home and we see her again in two weeks.

I just spoke to my DH re the use of vacuum he thinks she stopped using vacuum and was only using her hands to turn him and pull him out. But to be honest this is not my concern, they did what they had to do in order to get him out as fast as possible.

#6 suline

Posted 23 February 2012 - 03:27 PM

QUOTE
DS has finger movement and is starting to have movement in his shoulder and elbow. Both arms are the same length. Physio has given us exercises to do at home and we see her again in two weeks.


I believe that is a really positive sign, my friends son had nothing at all at 2 months.

#7 Miss Kiwi

Posted 23 February 2012 - 07:23 PM

Bump

Really keen to hear from mums that have had a child with erbs palsy.

#8 MaggieL79

Posted 23 February 2012 - 07:31 PM

There is a clinic at Westmead Children's Hospital for children with brachial plexus injuries, there you will have access to specialists from physiotherapy occupational therapy and paeds.

#9 Miss Kiwi

Posted 23 February 2012 - 07:34 PM

QUOTE (MaggieL79 @ 23/02/2012, 08:31 PM) <{POST_SNAPBACK}>
There is a clinic at Westmead Children's Hospital for children with brachial plexus injuries, there you will have access to specialists from physiotherapy occupational therapy and paeds.


Thanks so much for that we will look into that.

#10 Deb99x

Posted 23 February 2012 - 08:15 PM

After trying (and failing !) to send you a PM, I thought I'd just put our story up here.


My DD was pulled out by suction cup as she was too big at 4kg.
At birth she had no left arm function and very limited hand function.
We were given a referral by our paed to Westmead Children's to the arm/hand clinic (PM your email address and I will give you Dr names) and have been seeing them monthly since.

Now, at 16 months she has pretty much full function of her hand, but about 60% use of her arm. She can use it, but is unable to lift it above shoulder height.

This meant that she didn't crawl, she shuffled along on her bum...which was hell on her clothes :-)

This also meant that walking was probably a little delayed as her balance is not the best, and she also probably falls over a little more due to not having 2 arms to use for balance.

The doctors have just in the last month decided to operate on her arm to give her more function, so we're still at the wait and see stage for how this will affect her.



I understand from talking to her doctors that they see someone at the level maybe one a year, so I hope that your DS is not anywhere near this injured.


And if you end up at Westmead don't be too surprised to find yourself hugging your DS and being very very grateful that he is alive and not any more injured. I find myself doing it every time I'm out there....

#11 MammaP

Posted 23 February 2012 - 08:36 PM

Royal Children's link


So sorry to hear that you are having troubles. The Royal Children's in Melbourne also have a clinic for this type of injury and this is their parent info booklet.

Good luck getting the help you need.

#12 Vellichor

Posted 23 February 2012 - 09:30 PM

I'm sorry to hear you had a scary experience.
I also had shoulder dystocia with my DS (he was 4.5kg).
He had a brachial plexus injury, which resulted in limited movement in his left arm. By the time he was a month old he was able to raise his arm and soon after he could put it over his head. Now at 19 months you would never guess he had an injury at birth.
Just wanted to add a positive story, I think it is really hard to tell with these type of things. I hope you can get some answers soon.

#13 Miss Kiwi

Posted 23 February 2012 - 09:32 PM

QUOTE (Deb99x @ 23/02/2012, 09:15 PM) <{POST_SNAPBACK}>
After trying (and failing !) to send you a PM, I thought I'd just put our story up here.


My DD was pulled out by suction cup as she was too big at 4kg.
At birth she had no left arm function and very limited hand function.
We were given a referral by our paed to Westmead Children's to the arm/hand clinic (PM your email address and I will give you Dr names) and have been seeing them monthly since.

Now, at 16 months she has pretty much full function of her hand, but about 60% use of her arm. She can use it, but is unable to lift it above shoulder height.

This meant that she didn't crawl, she shuffled along on her bum...which was hell on her clothes :-)

This also meant that walking was probably a little delayed as her balance is not the best, and she also probably falls over a little more due to not having 2 arms to use for balance.

The doctors have just in the last month decided to operate on her arm to give her more function, so we're still at the wait and see stage for how this will affect her.



I understand from talking to her doctors that they see someone at the level maybe one a year, so I hope that your DS is not anywhere near this injured.


And if you end up at Westmead don't be too surprised to find yourself hugging your DS and being very very grateful that he is alive and not any more injured. I find myself doing it every time I'm out there....


Thank you very much for sharing your story I really appreciate it. I hope your DD improves once she has her surgery.
I will PM you as would be interested to get the names of the Doctors at Westmead.

Thanks.

QUOTE (Deb99x @ 23/02/2012, 09:15 PM) <{POST_SNAPBACK}>
After trying (and failing !) to send you a PM, I thought I'd just put our story up here.


My DD was pulled out by suction cup as she was too big at 4kg.
At birth she had no left arm function and very limited hand function.
We were given a referral by our paed to Westmead Children's to the arm/hand clinic (PM your email address and I will give you Dr names) and have been seeing them monthly since.

Now, at 16 months she has pretty much full function of her hand, but about 60% use of her arm. She can use it, but is unable to lift it above shoulder height.

This meant that she didn't crawl, she shuffled along on her bum...which was hell on her clothes :-)

This also meant that walking was probably a little delayed as her balance is not the best, and she also probably falls over a little more due to not having 2 arms to use for balance.

The doctors have just in the last month decided to operate on her arm to give her more function, so we're still at the wait and see stage for how this will affect her.



I understand from talking to her doctors that they see someone at the level maybe one a year, so I hope that your DS is not anywhere near this injured.


And if you end up at Westmead don't be too surprised to find yourself hugging your DS and being very very grateful that he is alive and not any more injured. I find myself doing it every time I'm out there....


Thank you very much for sharing your story I really appreciate it. I hope your DD improves once she has her surgery.
I will PM you as would be interested to get the names of the Doctors at Westmead.

Thanks.

#14 Miss Kiwi

Posted 23 February 2012 - 09:33 PM

QUOTE (MammaP @ 23/02/2012, 09:36 PM) <{POST_SNAPBACK}>
Royal Children's link


So sorry to hear that you are having troubles. The Royal Children's in Melbourne also have a clinic for this type of injury and this is their parent info booklet.

Good luck getting the help you need.


Thank you this is most helpful!!

#15 Miss Kiwi

Posted 23 February 2012 - 09:38 PM

QUOTE (gracie.m.dreamer @ 23/02/2012, 10:30 PM) <{POST_SNAPBACK}>
I'm sorry to hear you had a scary experience.
I also had shoulder dystocia with my DS (he was 4.5kg).
He had a brachial plexus injury, which resulted in limited movement in his left arm. By the time he was a month old he was able to raise his arm and soon after he could put it over his head. Now at 19 months you would never guess he had an injury at birth.
Just wanted to add a positive story, I think it is really hard to tell with these type of things. I hope you can get some answers soon.


Thanks so mUch for sharing!
I am pleased to hear your DS has recovered well. Did he have any finger movement at birth? Did he experience delayed development I.e. crawling?
My DS has has finger movement at birth and now at two weeks can move his shoulder up and down. When he was born his arm hung like a dead weight. But now after two weeks resting in sling he does move it. We are hoping that his case is not too severe and he will recover fully. Your story gives us hope.

#16 Vellichor

Posted 23 February 2012 - 09:54 PM

I'm glad I could give you some reassurance original.gif it is a worrying thing to go through.
Our DS has finger and hand movement at birth, he could move his hand to his chest but that was all, his arm also hung. He didn't have a sling.
His development was all normal, he army crawled for a longer time than my daughter before getting up on all fours, but it wasnt delayed.
I think the fact that he is moving his shoulder up and down is a great sign original.gif I remember clearly when our DS put his arm above his head, we took a photo and cheered!
I wish you all the best for a full recovery for your little one too original.gif
P.s make sure you take care of yourself as well. Going through shoulder dystocia is scary, I thought my baby might die at the time and had flashbacks for a while. Talking about it with friends and going thrugh my birth with the ob helped.

#17 Mumsyto2

Posted 23 February 2012 - 10:09 PM

QUOTE (Deb99x @ 23/02/2012, 08:15 PM) <{POST_SNAPBACK}>
And if you end up at Westmead don't be too surprised to find yourself hugging your DS and being very very grateful that he is alive and not any more injured. I find myself doing it every time I'm out there....

Ditto. It really puts everything in perspective. Whenever wethought we were having a rough trot with DD with her issues it really makes you sooooo greatful that it's "all" you have to worry about if that makes sense. I both love and hate the place for this reason.

#18 !momo!

Posted 23 February 2012 - 10:25 PM

QUOTE (suline @ 23/02/2012, 03:43 PM) <{POST_SNAPBACK}>
B) i don't believe vacuum is the safest or recommended way of dislodging a stuck shoulder.
However I wasn't there so I don't know the details or what the correct method of delivery would be.


I had a shoulder dystocia with my DD she was also a vacuum extraction. Just to address this concern i'm not 100% sure but I believe the vacuum is only used up until the head is delivered. A shoulder dystocia only becomes apparent when the head is born but the shoulders don't follow. Like the OP I had the Mc Roberts manouver performed ( legs pulled to my chest and MW pushing on my stomach). My daughter also had to be resuscitated and spent 2 days in the special care nursery but fortunately no injury. So I doubt the use of the vacuum caused any issues.

I hope your little one recovers quickly OP looks like a few people have some good places to start and it sounds like he is starting off strong. I don't know if it has anything to do with her rocky start but my DD is one tough cookie when she falls or has a bump she tends to pick herself up and get on with it when other kids are a blubbering mess!

#19 MyAngelsWatching

Posted 23 February 2012 - 11:20 PM

Don't have any real advice except as deb99x said

And if you end up at Westmead don't be too surprised to find yourself hugging your DS and being very very grateful that he is alive and not any more injured. .

My Dd1 had shoulder distocia at birth and unfortunately never made it. You may have a tough road ahead and in the difficult times just hug him close and remember how precious life really is, a couple of minutes difference and it could have been devastating.  Good luck hope he recovers quickly.

#20 Deb99x

Posted 24 February 2012 - 08:36 AM

MyAngelsWatching, please accept my utmost sympathy on your loss. I am very aware that I was minutes away from being in your shoes.

Hopefully MissKiwi's DS recovers full movement and doesn't need to even go to Westmead. It's not been that hard, compared to what could have happened, but it hasn't been a picnic either.

However, I am available if you need to talk to someone who has been there/is there now.

#21 Miss Kiwi

Posted 24 February 2012 - 10:33 AM

QUOTE (MyAngelsWatching @ 24/02/2012, 12:20 AM) <{POST_SNAPBACK}>
Don't have any real advice except as deb99x said

And if you end up at Westmead don't be too surprised to find yourself hugging your DS and being very very grateful that he is alive and not any more injured. .

My Dd1 had shoulder distocia at birth and unfortunately never made it. You may have a tough road ahead and in the difficult times just hug him close and remember how precious life really is, a couple of minutes difference and it could have been devastating.  Good luck hope he recovers quickly.


I am so sorry for your loss and I thank you for sharing your story. Thank you for helping me put things in perspective, I know that things could have been much worse but hearing of your heartbreak makes me realise again how lucky we are. Take care.

#22 ~carmen~

Posted 29 February 2012 - 01:52 PM

WOW! I didn't realise that shoulder distocia was so serious. Thank you to everyone for sharing your stories and my heart goes out to those of you who lost your angels.

I had my DD#2 3 weeks ago and we had planned a natural waterbirth at the hospitals birth centre (as we had with my DS 4 years ago) and everything was going fine until she crowned and I realised she was stuck on the next contraction so I told my midwife we had to get out of the water as i thought she was stuck and all of a sudden there were at least 8 more people in the room and my poor hubby freaked out cause I had to climb out of the bath with our baby's head half out and they got me onto the bed to continue to push her out. Was quite painful but they managed to turn her on the next contraction with my legs held right back and I really didn't quite know what was going on until they said she wasn't breathing and had only gasped so they took her to the resuss cart to give her oxygen and she was fine after that. My poor hubby was so freaked out and this all happened in a matter of minutes no one had time to tell him what was going on, he was in shock for quite a while afterwards so once she was okay I let him hold her first.

It seems we were very lucky to have things turn out the way they did, she was a very healthy 4.1kg which I was not quite prepared for as my other 2 children were not nearly as big. I had no idea until now just how close we were to things possibly being so much worse. I hope everything works out for your son and his condition improves. x

Edited by ~carmen~, 29 February 2012 - 01:52 PM.


#23 mummy26

Posted 01 March 2012 - 12:00 AM

I don't have a child with Erbs Palsy but my husband and my SIL both have it from a traumatic birth.  My hubby has limited movement in the affected arm and it is smaller/shorter than his other. His arm hangs and is bent at about 110 degrees. He is 46 now. 20 years ago he had an operation called a tendon transfer which did restore movement in his fingers.  He has no movement through his elbow or wrist. He can't lift his arm out or up.  He has lived like that for his entire life so it doesn't bother him.  I guess there is a lot they can do for the condition now and its great to hear your bubs is showing improvement.

#24 mmk

Posted 28 April 2012 - 09:21 PM

I've only just come across this, so hopefully your DS is much better by now!

DS was 4.6kg and ended up with erb's palsy.  I know how lucky we were that the ob managed to get him out and 'all' he suffered was a the loss of use of his arm for a few months...  If he was 200g bigger I don't think he would've fitted...  I'm forever grateful to the ob that delivered him (forceps)...

I think he may have had finger use, but I really can't remember.  We were told to keep his arm wrapped tightly beside him.  

He was lying there one day at 6 weeks old unwrapped, when all of a sudden he swung his arm across his body so hard that he rolled onto his side.  We'd previously not seen it even twitch, so this was a huge surprise!  This ended up being his new party trick and that was the end of him lying on his back! He also managed to roll over the other way so he was rolling quite early, but he couldn't roll himself back over (leading to many frustrated tears!)

He hated tummy time because his arm was too weak to support him, so he needed to build up his strength.  We were told to put a rolled up towel under his chest to help support him, but I'm assuming you would've been told that.

He crawled earlier than other babies, maybe because he was rolling earlier than them?  It didn't affect him walking at all.  Because it was his right arm he's ended up left handed because that's what he favoured early on.  I'm also left handed, so that may have had something to do with it, however when he's done grip strength tests at Scienceworks he's actually stronger with his right.

He's seen the chiro since he was a baby, and she can tell that there's a slight difference.  When he was younger his reflexes weren't as good on his right arm, but now they're ok.  She can notice that he seems a bit tighter on the right shoulder though, but that may too disappear as he gets older.

When he gets tired at swimming his left arm goes straight back when he's doing backstroke but his right arm goes back bent.  I'm assuming that's residual, but it may just be coincidental.

He's at the stage now that a 'normal' person can't tell, and he's been like that for ages.  It's only the chiro that can tell and his swimming teacher made mention how his right arm seems lazy when he's tired and he finds it easier to breathe from one side.  It might be coincidental, or it might be the erbs palsy.  Even if it is, we're very lucky that he's recovered so well.

We were also given no indication how long things would take or what they'd consider doing etc.  it was basically just make an appointment and wait.

A friend from mother's group DH has erb's palsy, but his arm is shorter and has limited use.  He's at the other end of the scale, so it's a reminder of how lucky DS is...

I just wanted to share DS's story with you as he's one of the lucky ones.  And also so you're prepared the day he works out how to move his arm!  I hated leaving him in his cot after that because he kept rolling over!

With this baby they're testing me early and also later for GD.  I didn't have it with DS, so just in case it was undiagnosed.  They're also going to do growth scans later on to check on her because they know how worried I am about her also being huge.  At this stage she's measuring 4 days behind, so I'm hoping she stays there!

Are you able to update how he's going?  Just because I'm interested...  blush.gif

#25 niksia

Posted 13 May 2012 - 11:02 AM

Hopefully by now bub is doing well and there is no adverse affects left.

DD12 developed shoulder dystocia and had to be resuscitate but with no adverse affects. DD7 wasn's so lucky she had a fractured collar bone and did not move her arm until she was 4mths old, when she managed to bend her elbow for the 1st time. That started more problems as then she could not fully straighten her arm and developed contractures in the elbow. She also developed a waiters tip where the hand turns the wrong way. We have been in physio since she was 2 wks old.

At 9mth her arm could not be straightened beyond 90 degrees. She could not crawl and the public health told us to get used to it, that is how it is. Luckily we had a private physio that they did not know about and with intensive physio we got the contracture down to 10 degrees. She started crawling at 14 mths and we rearranged the house to prevent her from walking as much as we could to try to keep her weight bearing on the arm.

At two she could finally supinate (turn her palm up) most of the way. No Dr, of public health wanted to deal with her as it was not a significant injury. But our fantastic physio sees us every 3 months. Even her teacher does not notice any issues except in sports. She has learnt to use her right hand for everything which has created another basket of issues.

Over the past year we notices that her scapula started winging (instead of sitting flat against her back), she has shoulder droop and cannot dress/undress herself in tight clothes. She cannot use a knife and fork as she doesn't use her left hand. As she grows the contractures start again so we have to keep working on them. The only muscle from the shoulder down that works properly is the deltoid. We are noticing ossification (wasting) of her forearm. She has full use of her hand (thankfully) but she does not feel heat, cold or sharp pain in half of her arm. Even at 4 degrees she did not feel cold and we had to demand she put a jacket on.

I have just started an occupational therapy degree so I am seeing so much more of what she cannot do. Most people to look at her wouldn't even notice. So I booked her into our GP (we changed about 2 yrs ago) and he has referred us straight to an OT. The OT doesn't have the facilities she needs so we are going back to the public system this week - I am dreading it. We also have to work on her bilateral skills (using both hand) and her usual physio that addresses whatever issues arise. I am also pushing for a neurologist referral to get her nerve function tested so we can see how bad it is.

The most important thing, public or private is that you have professionals that you trust and will listen to you. If they don't find new ones. You know your own child even if they know the injury better. Don't let them fob you off. My new GP could not believe that they didn't test her when she was a baby and if we had that we could see what recovery she has made.

I know there is a brachial plexus clinic at the public hospitals in both Brisbane and Melbourne so I would definitely seek this out if this is available in your area. Even if bub appears to make a full recovery, there could be a little weakness in some muscle areas or reduced feeling. It is just keeping on top of it if there is issues.

The only other thing I can suggest is be carefully reading american sites. They are so oriented on suing the doctors for malpractice and in some cases this may be appropriate but in a lot, the Dr has just done the best they could with a really bad situation. Also if you are looking to have further children in the future please do research on the risk of subsequent shoulder dystocia even in small babies. My 3rd child was 9'1 after DD who was 8'8, there was no way he would have come out naturally in one piece (and more than likely brain damaged or dead) and I am very thankful I listened to my OB over my pride to have a CS. The determining factor for me was I could not guarantee that it would not happen again, but I could guarantee that I could not live with myself if I broke or killed my baby as a result of my pride. This made the decision for me a simple one.

Everyday I look at my daughter and it kills me to see how much she struggles to do simple task, even though she is a trooper and pushes herself so much. She has even started doing her own stretches throughout the day so she can straighten her arm one day. I will be pushing for splinting again at the next OT appointment which hopefully will improve it.

Sorry for the war and piece, but the sign of recovery at an early age is really good and hopefully this doomsday post will be irrelevant to you.






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