Something we've never seen - a little arm lift!

You might not be able to tell why we are so excited, but around 37 seconds into this video, we think we see a new shoulder movement!  He very often rolls his right arm inward with his shoulder, with his arm against his body, as you can see in the first part of the video.  When he's really mad, we've seen it be pushed inward by that muscle so hard that his arm ends up on his chest.  But here, if you go really slow-mo, you can see it slightly go outward and then up - a different shoulder muscle!!  Well, so it appears to us - any OT or PT friends want to give us their opinion? :0)  Maybe it's just the same muscle getting stronger or his back muscles, but we never see him go outward with his arm, so even slight is great!!  Another thing he's been doing lately that is new is leaving his arm on his chest after we have put it there.  Cole's OT says that this shows that he isn't just sporadically tightening his tricep to pull his arm down like he used to, and he isn't just letting it flop to his side, but somehow is helping it to stay in place.  This video is taken the day after my last post.  Thank you for your prayers!!

Please pray for baby Cole!

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!

What are we waiting for?

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!!