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Routine Days… Could Not Be So “Routine”

The Determination To Overcome

Routine Days… Could Not Be So “Routine”

There are certain days when we wake up in the morning and feel stiff. We could be sore from exercising too much the day before, or maybe we just slept too long and our body is protesting. Opening our eyes we swing our legs out of the bed and the most of us make our way to the bathroom for a refreshing shower. We brush our teeth and comb our hair, then head back to the bedroom to get dressed and start the day. Whether it be getting the children ready for school or heading off to the office we are on the way to starting the day. But do we take this daily routine for granted?

Imagine if you or your child where to have suffered a birth injury or other harm that left them with a permanent impairment? Would the morning routine, be as “routine” as it is now?

Six to Eight of every 1,000 births in the United States involve some form of birth injury. Between 1970 and 1985 the number of birth injuries from trauma fell by 88 percent. These amazing decreases can be attributed to advances in technology, methodology, and the attention placed on these injuries by both the medical and legal communities.

In our law practice, a substantial number of clients have suffered permanent injury to their Brachial Plexus Nerves, due to mismanagement in the delivery process. As a result, at birth, these babies have had little or no movement of the affected arm, shoulder and/or hand. The treatment for this injury depends upon the severity of the injury; whether the nerves are stretched, torn or pulled from the spinal column, an avulsion. If the baby experienced a stretch injury, often aggressive therapy with qualified physical or occupational therapist can help improve function of the limb, though the child may never recover full mobility and strength in the arm, shoulder and/or hand.

When the injury is more severe, resulting in a tear of the affected nerves, an aggressive course of therapy along with surgery may be indicated. Babies with these most severe injuries where the nerves are torn or avulsed from the spinal column may obtain some benefit surgery by specialists who have extensive experience and success with this specific type of injury. Even with the best surgeon in the world, the success of surgery on a severe avulsion may result in some improvement of function, but will not result in a “normal” arm. These types of injuries can also impact the child’s balance and coordination.

Although children with permanent Brachial Plexus Injuries (BPI) will experience limitations for the rest of their lives, with strong and encouraging parenting, often they are able to adapt to their limitations and participate and excel in activities that may surprise us.

Some of our former clients have engaged in and enjoyed success in some surprising activities. For example, Kennedy. Kennedy came to us with a severe avulsion injury, despite multiple surgeries; Kennedy’s right arm has very limited function. She is unable to lift it without using her left hand and strength to do so. She cannot actively bend her elbow, use her fingers or otherwise move the arm without use of gravity (by swinging it) or moving it by grasping it with the hand of her uninjured arm. These limitations, however, have not stopped Kennedy from being a very active little girl. At a very young age, Kennedy’s parents, after numerous interviews, signed Kennedy up for cheerleading and dance classes. Now seven years old, Kennedy recently rocked the stage in her spring dance recital. Although she was not able to perform all of the hand/arm motions choreographed into the routine, Kennedy mastered the routine and lit up the stage with her performance.

Another great example is Starr, a shy, but active eleven year old, who wants to be a basketball player. Starr’s brachial plexus injury resulted from excessive stretching of the Brachial Plexus during her delivery. Like a rubber band stretched beyond its capacity to the point where it loses its elasticity, Starr’s BPI resulted in limits to her range of motion and strength of her left arm and shoulder. Starr accommodates her injury by using her left arm as a “helper arm” for most tasks and has learned to play basketball by focusing on the use of her right arm, with her left serving as a balance or helper for swishing the basket. Starr also enjoys music performance. Her father is an accomplished pianist, and although Starr has limited use of her left hand as a result of her BPI, she is able to play piano duets with her father by using her right hand.

Finally, Abrianna, who is a little ball of fun. She too has a permanent BPI resulting from excessive stretch of the nerves during delivery. Abrianna’s injury affects her right arm which she uses as a “helper arm” for her many activities. One of the effects of a permanent BPI can be the impact of the injury on balance. The injury does not usually impact the child’s leg strength, and like most uninjured children, even children with a BPI want to master the two-wheeled bicycle. Abrianna learned to ride her bike and is able to navigate a two-wheeler well. However, due to her range of motion and strength limitations, when she hits a bump in the road, her ability to maintain control is compromised, as is her ability to catch herself during a fall to her right side. The result was a fractured shoulder; however Abrianna remains determined to make the most out of life.

While the challenges placed before a child with a birth-related shoulder injury can be daunting, there is hope. One need only look to the 2011 first round draft pick of the Tampa Bay Buccaneers to see what hard work and dedication can achieve. Adrian Clayborn, the star defensive end from the University of Iowa, was born with Erb’s Palsy. Clayborn suffered nerve damage that caused loss of movement and weakness in his right arm. As with many who suffer brachial plexus injuries, his doctors told him he would never be “normal” or play sports. Fortunately, his mother made sure he received the physical therapy he needed, beginning just a few months after his birth. Ultimately, ten years of physical therapy and intense weightlifting helped Clayborn to shine as a high school athlete. Through hard work and immense talent, Clayborn made his way into the NFL and beyond what his doctors said was possible.

It is also worth noting that Alexander the Great suffered from Erb’s Palsy. Yet, his injury did not stop him from creating one of the largest empires the world has ever seen. Under his reign, the Macedonian empire stretched from the Mediterranean to the Himalaya. Having never lost a battle, Alexander the Great is considered one of history’s most successful commanders.

Of course, not all of us are blessed with a 6 foot 3 inch, 287-pound physique or the mind of a military genius. Also, the severity of the injury will largely determine whether the child will be able to play sports with his friends, let alone in the pros. But the example set by Clayborn shows why it is so important that children with similar injuries doggedly adhere to their physical therapy regimen. It is important for a child not to give up, not to lose hope. Hard work and physical therapy will improve the child’s disability. Adversity can be overcome and should be measured by the level of improvement.

While pro athletics and the Olympics remain a long-shot even the most dedicated competitor, the Paralympic Games provide another opportunity for competition. The name literally means “alongside the Olympics.” Every four years, highly-trained athletes compete in summer and winter games, immediately following their respective Olympic Games. So while the 2012 London Olympics have just come to a close, the Paralympic Games are just getting started. The first competition occurred in 1948. It was primarily a gathering of World War II veterans. Now, it is one of the largest international sporting events. Competitors suffering from brachial plexus injuries include Paralympic rower Emma Preuschl, sailor Stephen Churm, cyclist Michael Gallagher, and table tennis star Melissa Tapper.

Life is a blessing that is often taken for granted, but the stories above show the core of the human spirit. Each of us has the ability to put on a smile and make the best out of any situation for ourselves or someone else. With the proper treatment, whether it be a kind word or a medical procedure and therapy, it is possible.

Tonight as we put our heads on the pillow and think of the day gone by let us not forget the many blessings that we have. Let us not forget the many people that cannot do our same routine in the morning when we wake. Let us not forget that those with disabilities could be us, and if we provide the proper care and treatment all people can grow to overcome those disadvantages

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