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Shoulder dyscotia...
Bub diagnosed with erbs palsy


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#26 smithsholidayroad

Posted 25 May 2012 - 05:13 PM

Kiwi mum, I realise this thread is from a few months back and I hope your child has recovered well from his SD and Erbs palsy.

my son was born 7 years ago and in addition to a severe brain injury at birth resulting in quad cp, he also had right erbs palsy which actually resolved itself by about 6 months of age. he has no affects from the erbs palsy now but maybe that also has to do with the fact that his CP is very pronounced.

hope things have settled down xx

Bron

#27 Miss Kiwi

Posted 21 July 2012 - 07:09 PM

QUOTE (mmk @ 28/04/2012, 10:21 PM) <{POST_SNAPBACK}>
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

Thank you for sharing your story. I am so pleased to hear your DS has recovered so well.

It looks like we could be the lucky one's also. At 3mths our DS started slightly moving his arm, small movements but they were movements! He is now 5mths old and has done so so well, he has brilliant range of this arm and if you didn't know he had erbs you would certainly not guess.  As his Mother I can barely tell, although he does still favour his other arm.  We are still seeing the physio regularly but our next big check up is when he is 6mths with our Paed.  We are hoping that given his progress he won't see the need to refer us to the surgeon.  It was a tough 3mths not knowing if our son will ever gain full use of his arm but each week has improved and we are hoping that improvement will continue.  He is reaching his milestones which was one of our concerns, is rolling and is even trying to crawl!
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QUOTE (niksia @ 13/05/2012, 12:02 PM) <{POST_SNAPBACK}>
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.


Thank you for your sharing. I am sorry for the struggle your daughter has had with her erb's, what a rollercoaster you have been on and seem to still be on. I wish you and your daughter good health for the future.

You are right about the US jumping on the suing the doctors! I came across that as well and couldnt believe it. Like you I am just thankful they got my son out and erb's palsy was his only health issue. As you said it could have been so much worse.

I too will seriously be considering a CS next time, even IF they think it won't happen again I think my fear will be too great to take the risk.

I have updated above original.gif
QUOTE (TheSmithFamily @ 25/05/2012, 06:13 PM) <{POST_SNAPBACK}>
Kiwi mum, I realise this thread is from a few months back and I hope your child has recovered well from his SD and Erbs palsy.

my son was born 7 years ago and in addition to a severe brain injury at birth resulting in quad cp, he also had right erbs palsy which actually resolved itself by about 6 months of age. he has no affects from the erbs palsy now but maybe that also has to do with the fact that his CP is very pronounced.

hope things have settled down xx

Bron

Thank you for sharing also. I am so sorry that your DS suffered such a severe injury at birth. I wish you and your family well x

#28 Miss Kiwi

Posted 21 July 2012 - 07:26 PM

I forgot to say in my update that we changed Paed's the first one was an IDIOT (appointed public from hospital)!!!!!!!! When in our first consultaton when our DS was 4wks old he proceeded to take a phone call from his wife, didn't say excuse me I need to take this call, just answered and proceeded to have a trivial conversation about nothing! This was all while we were asking him questions about the concern we had for our son's health and his injury.  

When my husband started asking hard questions, the Paed turned to his computer and typed into google 'erbs palsy', clicked on wiki pedia and then turned around the computer so that we could read about it.  Ahhhh you think we haven't already DONE THAT?!!!

Needless to say we walked out of there and immediately found a new private Paed, who saw us the next day and finally answered our concerns with compassion and care.  We have been with him ever since and he has been amazing.

#29 samshine

Posted 21 July 2012 - 08:41 PM

I couldn't read this and not reply.

Miss Kiwi, I am so glad you are seeing progress and your little boy has good function in his arm.

Our DD1 was a shoulder dystocia bub.  It was one of many complications during her birth and she was born using similar techniques to your son, McRoberts procedure (legs in stirrups and a midwife on my stomach) and ventouse.  We were incredibly lucky, she needed resus for a few minutes but escaped without a permanent legacy.  I never stop thinking how lucky we are.  

QUOTE
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.


This is another reason I feel so lucky.  Our second next child was nearly a kg bigger and they (the public hosp we birthed at with both) had decided I was fine to trial a VB.  Thankfully, when he we got to 10cm and second stage didn't proceed, we had a CS when suddenly the attending ob became very concerned about history repeating itself.  We may not have been so lucky the second time, with an even bigger baby.  Then, when we discussed birth options for our 3rd with our private ob, she was horrified they even considered trialling a VB for our and also thought we were very lucky not to get further into the VB.  So, our 3rd was an elective, and ended up the same size as our 2nd.  

I am so sorry to those of you that have lost your beautiful babies.



#30 mmk

Posted 21 July 2012 - 08:44 PM

Thanks for your update!  I was wondering how you guys got on!

QUOTE (Miss Kiwi @ 21/07/2012, 07:09 PM) <{POST_SNAPBACK}>
You are right about the US jumping on the suing the doctors! I came across that as well and couldnt believe it. Like you I am just thankful they got my son out and erb's palsy was his only health issue. As you said it could have been so much worse.

I too will seriously be considering a CS next time, even IF they think it won't happen again I think my fear will be too great to take the risk.

A guy from work was basically saying the same thing - that it was the ob's fault for injuring my boy.  I don't see it that way at all!  I'm forever grateful that he managed to get him out, as it could've ended up much worse than a bung arm.  It's the same ob that's making the decisions for this baby and I trust him 100%.

As far as you considering CS goes, I've suffered a lot of anxiety this pregnancy over the same thing happening again.  It's been brought up at various appointments, and the midwives and obs have been great.  I've also seen a social worker to talk things through, and I'm at the stage now that I'm not overly scared.  I've had a scan at 36w1d, and she was measuring at 59th percentile (2.937kg on the day).  I know they can be 10% out, but that's much less than DS would've been given he was 4.6kg.  We had a meeting after the scan and the ob said that it's up to me, but I asked him what weight he'd be happy with.  He said 4kg, which is the size I had in mind too.  I'm having another scan at 39w4d, and an appointment the next day to discuss what will be happening.  If she looks like being too big then it will be CS, and if she comes before then then she will be small enough.  I'm happy with how things have been handled, and whilst I'm still obviously scared of it happening again, I feel much better about it than I did 8 months ago.

My advice would be to mention it at your first appointment to make sure that the staff understand your concerns, and if you're still not over his birth then to speak to someone about it and deal with it preferably before you're pregnant again.  I also had an early and a late GD test to make sure that I didn't have it (clear again), so maybe insist on that too.  

Given that he was early I'd be asking for a sizing scan from 34w in case the next one is bigger, and if you're not confident then I would just go CS.  As much as my ob said he prefers to go natural, a few weeks of pain and risk of infection etc is nothing compared to living with yourself because pride got in the way of wanting a CS.  If you make the decision to have a CS, then stay strong and know that you've done the right thing.  I wouldn't be trying for another 4kg baby if this one got stuck.  I'd probably only be comfortable with 3.5kg.

Good luck!  I hope you get the same support with the next baby that I've had with this one - then you'll be fine  wink.gif

Oh, and the first paed sounds useless!  At least you got onto a good one quickly and didn't waste time with the other guy.  Our public paed was great too, but I would've been worried if he started googling in front of me...

#31 Miss Kiwi

Posted 21 July 2012 - 08:51 PM

QUOTE (samshine @ 21/07/2012, 09:41 PM) <{POST_SNAPBACK}>
I couldn't read this and not reply.

Miss Kiwi, I am so glad you are seeing progress and your little boy has good function in his arm.

Our DD1 was a shoulder dystocia bub.  It was one of many complications during her birth and she was born using similar techniques to your son, McRoberts procedure (legs in stirrups and a midwife on my stomach) and ventouse.  We were incredibly lucky, she needed resus for a few minutes but escaped without a permanent legacy.  I never stop thinking how lucky we are.  



This is another reason I feel so lucky.  Our second next child was nearly a kg bigger and they (the public hosp we birthed at with both) had decided I was fine to trial a VB.  Thankfully, when he we got to 10cm and second stage didn't proceed, we had a CS when suddenly the attending ob became very concerned about history repeating itself.  We may not have been so lucky the second time, with an even bigger baby.  Then, when we discussed birth options for our 3rd with our private ob, she was horrified they even considered trialling a VB for our and also thought we were very lucky not to get further into the VB.  So, our 3rd was an elective, and ended up the same size as our 2nd.  

I am so sorry to those of you that have lost your beautiful babies.


Thank you for sharing your story I am so pleased your baby was fine after i know what would have been a trumatic birthing experience for yourself and partner. Hearing your story has just reaffirmed in my mind that I will go for an elective CS next time. I intend on going public again but if they don't support me in that decision then I won't hesitate to go private.

#32 Poppylove3

Posted 13 November 2015 - 12:01 PM

Hello. Is anyone still using this thread? I have a 9 month old with erbs palsy. Very traumatic birth and am looking for people in a similar boat as me. Anyone in Melbourne? I would love to raise awareness of shoulder dystocia but don't know how to go about it




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