Upper Brachial Plexus Palsy
Despite 7 years of working with infants and children with various diagnoses, before 2 months ago, I had never heard of this one. But then my sweet baby boy was given this diagnosis. I have wanted to blog about this for a while, but having a newborn and a toddler means a pretty crazy-busy life! My greatest desire in reading this blog post is for you to remember to pray for him. Especially during this very critical timeframe, before he turns 3 months old.
What happened to his arm?
Cole was a big baby considering his small mama, I guess. Three weeks early and 8 pounds 4 ounces (5 ounces smaller than his big sister, also 3 weeks early). I guess I cook 'em big and quick! The labor was pretty amazing compared to his big sis. His head was delivered after maybe 15 minutes total of pushing, but then he stopped coming. His shoulder was stuck against my pelvic bone, and his heart rate was going down sporadically. It was an emergency situation. Thankfully, the doctor got him out relatively quickly, but in the meantime, the nerves at the base of the neck that control his arm were injured. When he was born he was overall just beat up and bruised, and the doctor immediately saw that his right arm hung limp at his side.
She ordered an x-ray to rule out that anything was broken. Ruled out. We came to find out the the nerves at the base of his neck that control his arm were damaged. Cole was given the diagnosis of Upper Brachial Plexus Palsy, where the nerves that control his bicep and shoulder are damaged, but his hand and wrist seem to work okay. He is not able to "supinate" his arm, which is the movement used if you hold out your arm with palm down and then turn your palm facing up. He is not able to lift his arm or bend his elbow. We have to take care to not just let it hang there, but that it's positioned naturally, and cannot pull or tug on it. He does have pain and makes it clear to us when it hurts. We have an amazing OT friend who has helped us learn so much about nerves and has given us lots to do. We also have an OT coming out every other week to check in and make sure we are following through with stretches, stimulation, and to monitor his progress. We need to do these things to remind his brain that his arm is there, keep his joints flexible, and to stimulate the nerves. Below is a picture of Cole at his first appointment with the specialist. He is getting is neck and right arm stretched. And looking cute!This whole journey with Cole so far has been a waiting game. A time of growing in patience, perseverance, trusting in God, trusting in doctors, having hope. A quote from the United Brachial Plexus Network: "When the nerve is severely injured, it has to regrow from the neck, down the arm. Regeneration of nerves happen at a slow rate of one inch or three centimeters per month." (http://ubpn.org/index.php?option=com_content&view=article&id=120:obpi&catid=56:awareness&Itemid=101) He is now 2 months old. So, from his neck about 2 inches downward means the healing would be at about the top of the shoulder right now. In one month, healing should start to be evident in the bicep. Cole's doctor told us that most babies who are born with this injury spontaneously heal. This is our prayer for him! The doctor further explained that in many cases, if the healing happens by 3 months of age, then the lasting effects will be minimal to none. If spontaneous healing happens later but by 6 months, then he will have moderate effects. If spontaneous healing has not happened by 6 months, then he will have lasting effects that might be severe.
This is why we are praying earnestly right now, that this final month before he turns 3 months, he will one day just bend his elbow and lift his arm. If he does not, then our prayer is for healing by 6 months. If there is no significant progress by 6 months, then Cole would be looking at nerve grafting surgery, where they take extra nerves from his calves and basically plug them into his spinal column and re-route the nerve signals. But let's not think about that quite yet!!! I tell myself that everyday.
How can we pray for Cole?
- Pray that Cole will regain bicep function by 3 months of age.
- Pray that Cole would tolerate his exercises - he is a pretty fussy baby, and does not like to be messed with.
- Pray that we would be patient and trust in the Lord's plan for baby Cole's life and His plan for our family.
- Pray for wisdom - do we get a 2nd opinion, is there something wrong that none of us can see that God knows about? Is there a certain therapy style that would be best for him that no one is telling us about? We daily pray for God's guidance in these things.
- Pray that should there be no healing at the 3 month mark, his arm would heal by 6 months. We just don't want surgery for our precious little boy!!
Thank you!!


9 comments:
praying for sweet baby Cole!!!!! We love you guys!
Karyn,
This was so helpful to read everything in one sitting. It also inspires me to pray harder for your dear boy. The Lord is so good and kind! I love y'all.
Tara Koehler
We pray for baby Cole all the time! Sounds like you have a lot of great help with therapy! Just keep everything thing good and loose. Those stretches PROM exercises don't seem like much but they are so important! You are great parents! Give Cole hugs from Jadon! Jadon can give two armed hugs now!
Karyn, I had no idea. We will keep Cole and all of you in our prayers. Thank you for sharing this. We love you guys!
Thanks for posting this honest and heartfelt appeal for prayer. We had no idea that Cole (and the rest of you) was going through this, but we really appreciate the opportunity to labor alongside you in prayer. Praying for perserverance, patience, faith, peace - and of course, a healthy dose of healing. Our love to you all!
I certainly have heard of this and have even seen a case. I had no idea that you were walking this road. Thank you for sharing and explaining. We will be praying for all of you in this next month especially. Please keep us posted. So grateful that you have the background you do to understand what is going on. Just remember to live Phil. 4:8, and think only about what IS true, not about what might be true. God will give you grace for TODAY. Love you guys!
I'll be praying for Cole and the family! What a trooper!!!
-Shanda McCloskey (Audrey's cousin)
Thanks for sharing this, Karyn. We'll be praying for sweet little Cole... as well as for his sweet parents!
Karyn,
I had no idea! We will be fervently praying for you guys. I totally understand the needing wisdom part with medical stuff. God is so Sovereign and he is molding you guys to be a tremendous testimony of His grace. Cling to Him and His word which is truth and not "what if's".
<3
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