Erb's Palsy (Brachial Plexus)

Erb's Palsy - A Mother's Story.

I thought I'd like to share my experience with you especially for those of you who may find yourself in the same situation as myself. I hope it might help knowing that there are other people out there going through what you're experiencing and that, no matter how rotten you feel, you're not alone. I'd never heard of Erb's Palsy until 2 days after my little girl was born. I'd had a normal labour (although I'd been induced 11 days before my due date as I'm a diabetic), but just as they'd told me it would probably be about another half hour before I could start pushing, I was sick. The baby went into distress so they decided to try and get her out.

They went in first with the ventouse cap - it slipped off the first time and so they tried again - but no luck. So then they tried with forceps - her head came out but she didn't turn - her shoulders got stuck on my pelvis. Thankfully the Head Midwife, Roz, came in and talked the doctor through what to do and thankfully little Sophie came out on the next push. She was okay although it took a couple of minutes to get her breathing and so, because of that and the fact that I'm diabetic and her sugar levels had to be monitored, she was taken away to the Special Care unit.

I'd had an epidural (it took 10 hours to wear off!) and, when I eventually managed to wobble into the Unit at 5am, there was my little girl all wired up in an incubator. Thankfully there was a lovely nurse there to explain everything to me and reassure me that she was okay, even though we'd had one of the worst types of births possible - but she had the most enormous, purple, inverted triangular bruise covering her eyes, nose and mouth and her little head seemed to be somewhat misshapen and swollen. Thankfully all of these things slowly disappeared over the course of the next few days.

I spent most of that first day sitting beside her incubator watching her and stroking her little hand - she mewed like a little kitten and just kept looking at me - her eyes seemed to say "Please take this pain away, Mummy". I felt so helpless but I knew she was in excellent hands. She had drips in both feet and a pulse monitor strapped to her left hand and I became aware as the day went on that she wasn't actually moving her left arm. Her right arm was free and moved about a great deal. By the end of the day I mentioned it to one of the nurses and they alerted a doctor who came and examined Sophie. They decided to x-ray her overnight. Apparently it can be quite common with the sort of birth we'd had for the collar bone to break - but there was no break.

The Paediatrician came and saw me the following morning to inform me that she had signs of Erb's Palsy, but that she thought it was only very slight. Needless to say, hearing the word "Palsy" sent me reeling. I'd never heard of Erb's Palsy and although I was given an explanation of it at the time, it wasn't until I got home several days later and was able to look it up in my anatomy and physiology books (I'm a Therapeutic Massage Therapist) that I was able to understand it fully. Basically, where they were trying to get Sophie out quickly using the ventouse cap and forceps, the constant pulling of her head when her shoulders were stuck on my pelvis caused the nerves that originate from the vertabrae in her neck to become stretched and bruised. Thankfully they had not been severed.

We were in hospital for six days and during that time I was told to make sure I always supported her arm, not to let it fall backwards, especially while I was feeding her. Before we left we saw Elaine, a brilliant physiotherapist who taught me some exercises to do with Sophie to begin to get her to use her arm and, being a massage therapist, I was also able to help stimulate the nerves through gentle massage.

As time progressed, with visits to physio eventually getting further and further apart, the use of her arm came back and 2 years down the line she thankfully has complete use of it. We were the lucky ones. The last time we visited the Royal National Children's Orthopaedic Hospital I met two mothers whose children had been badly affected by this problem and, at the age of two, had had to have operations to re-attach the nerves. Both children happened to be about four years old when I met them. They were travelling all the way into London for physio and still seemed to have a 'long way to go'. They couldn't get their elbows behind them so, when pulling their knickers up, could only get them so far and then had to use their other hand to pull them up the rest of the way.

Classic signs are the hand turning outwards away from the body (in a "waiter's tip" position); not being able to stretch or straighten the arm upwards as much as the unaffected one; and not being able to push the elbow backwards. I hadn't realised, nor appreciated until then, just how badly Sophie could have been affected. Thankfully her nerves were just bruised and a bit stretched and now you'd never know she'd had a problem - except I get paranoid when she doesn't use her left arm as much as her right during swimming lessons - but that's the only time I get reminded of it these days. She has no other signs and uses both arms equally - even down to holding a spoon or pencil and loves swinging like a monkey from the rails in the local Post Office!!

I thank God and all the wonderful staff at Wexham Park Hospital, especially those in the Special Care Baby Unit, the Royal National Children's Orthopaedic Hospital in London and my own GP for their help and support during these last two years. For more information, you can call the Erb's Palsy Support Group on 024 76452321.

Hilary


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