Friday, January 11, 2008

Ella's Follow-Up Appointment

We Scottish Rite!

We went to Dallas yesterday for Ella's follow-up appointment with Scottish Rite. We received 2 thumbs up on all of her therapy and they were all VERY pleased with her improvement.

Chad and I knew that she was doing so much better then when we were there in November but it is so nice to hear the hand specialist teams reaffirm that to me. She has great movement and her range of motion is great. She is experiencing no atrophy and all of the joints, etc. seem to be moving just the way that they are supposed to. We had been told no "tummy-time" until Dr. Ezaki felt that her arm/shoulder were strong enough to to controlled. Ella Grace has now been taken off of probation and tummy-time is a GO! She has a great grasp and good control of her arm, hand and fingers. We are so thankful to our doctors and great therapist at Scottish Rite for their encouragement, wisdom and wonderful attitudes. I am forever grateful to these doctors for the guidance on reversing this condition and for the grace that they do it with!

Ella being checked by Dr. Ezaki

Our wonderful team of Doctors and our Therapist

For a brief update she has Brachial Plexus Palsy; an injury that she received during birth. Being such a big girl she was hung up in my pelvis and the nerves in her neck were "stretched" (See picture below)
Shoulder Dystocia describes a situation where the fetal head has been delivered, but the shoulders are stuck behind the mother’s pelvic bone and cannot be freed. This often results in causing brachial plexus injuries. These injuries damage the bundle (plexus) of nerves that control the shoulder, arm, wrist and hand muscles.

There are 3 types of Brachial Plexus injuries: (The first of which Ella has had)

1.Stretch - which vary in degrees of intensity, however nerves in plexus are often compressed due to swelling or bruising from birth trauma of shoulder getting caught on the pelvic bone. Stretch injuries will spontaneously recover in 1-2 years of age with 90-100% return of function. neuroma which is scar tissue that compresses the nerves may occur also and surgical intervention is needed to remove it.

2.Rupture - nerves are torn at either one or several places in the plexus requiring surgery for the nerves to recover.

3.Avulsion (most severe injury) - nerves are pulled from the spinal cord as evidenced by a totally flaccid extremity, which requires surgery and possibly muscle transfer to gain function. Horner's syndrome may be present if this is involved.

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