C-Section's & RBPI W/ Horner's Syndrome

[Yolanda827]

Hi Everyone,

I am new to the message board, I have been reading some of the messages posted for the last couple of days, and I am amazed at the number of people who have this injury. I am the grandmother to a 2mon. old babygirl who was born on my birthday, what a great gift to get, huh! Well, my daughter had to get a c-section because she only stands 4'7'', so we knew she would have to get one, but her doctor never told her about this kind of complication. I noticed the baby's right arm right away wasn't moving, and her right eye would not open, the nurse told us it was from the trauma of the birth and some babies take a couple of hours to get used to being out of the womb. The doctor's never did say anything to my daughter about the babies injury's and when she questioned them they told her it was nothing to WORRY ABOUT! We found out about 3 weeks later that it was ERP's Palsy, it was all through her medical files, she had breathing problems, no one informed us of that either! So, now she is getting some movement back in her right arm, she can now lift her hand to her mouth, but she keeps her fist balled tightly with her thumb stuck inside, she is getting OT at a hospital and at home from Childlink, but when I ask question's everyone seems to shy away from the conversation and since no one told us about this injury in the first place, I feel that they knew that they made a mistake and was trying to hide it all along. My daughter just turned 19 yro. she would have never known what to do if I was not here to pursue things for her and get the information for her. I am so grateful for this and all the websites that I have came across, because I'm learning so much about this injury and to know that I'm not alone in my fight for my PRECIOUSE BIRTHDAY GIFT...MY GRAND-DAUGHTER. I just want people to know that this injury does not only happen's with a vaginal delivery, but with c-sections as well.

Thank you ladies for being here and I wish all of us the best in getting the word out about this Injury!

Yolanda827

[PeggyUBPN]

Congratulations on the birth of your grand-daughter (and happy beleated birthday!!)!

Have your daughter make an apt. with a pediatric neurologist to follow your grandchild and I would start contacting BPI specialists to have them follow her, as well.

All the best to your new addition to the family and to all of you!

Peggy

[Kath]

Happy Birthday and what a great gift a grandchild.

I am sorry to hear she was injured. I am happy that you are there to support your young daughter and help her.

I am also a grandmother I have 5 grandchildren and three children. I am ROBPI I was also birth injured. I know this must be so hard on you and I am so glad you found us.

Please keep us posted and see a bpi specialist as soon as possible. I assume that the PT has you doing range of motion daily and if not please get the instructions to do ROM.

Kath

[Joni]

Hi Yolanda,

I am sorry to hear about your grandchild's injury. I am curious to know if your daughters C-section was planned early or if she went into labor first? Thanks.

[admin]

A friend of mine had a baby that was recently injured during a "planned" c-section. I am so very upset about this because she has already been through a bpi injury from her first child's birth.

[admin]

Yolanda, I am SO sorry to hear about your granddaughter's injury. I HATE how hospital staff don't give the information you need to help the poor little babies right away. That is so hurtful. I am just now understanding that brachial plexus injuries can happen in a C-section. I have not seen much literature on this, and it's never really talked about. People usually talk about C-sections being the "safe" way to deliver the baby. This drives me crazy!!! It sounds like your granddaughter is experiencing some good recovery, which is great - but it also sounds like she has some very serious symptoms - limitations with her hand, difficulty breathing, and involvement of her eye. I definitely support all of the people writing above who suggested you see brachial plexus specialists for your granddaughter. I am so glad she is already involved in therapy - I know therapy can work wonders, but this injury is so complex, it needs to be fought on every front possible!! I, too, am curious whether it was a planned C-section prior to labor or an emergency C-section. My second child's collarbone was broken at birth (a planned C-section), and a recent visit to an upper extremity orthopedic surgeon informed us that there may be some underlying nerve damage to the brachial plexus as well, because they don't see "normal" movement returning to his shoulder area as they think they should be now. I wish I had more information about injuries with C-sections.

[admin]

I everyone, thank you for your responses. When my daughter Laurin started going for her pre-natal appts., the doctor figured that she may have to have a c-section because of her height and also, because I had three c-sections, and my oldest daughter had a c-section. Most doctors say, that if the mother have one, usually your daughter my follow suit. Also, we have seen a pediatric neurogolist, and an orthopedic surgeon at Children's Hosp. of Phila., Dr. Cornwall, but he has only been doing this for a year, so I'm not quite sure, if I trust his judgements right now, I'm thinking about getting a second opinion. But most people, including doctors, when I start to ask a lot of questions, they don't wont to come out and say it was the doctors fault for this injury, especially, when I tell them she has a Brachial Plexus injury. Dr. Cornwall, even told me to watch out for the different websites I visit, because some of them are sponsered by lawyers and only out for the money. He did'nt even know if I wanted to sue or not, I have been going to the sites, because I need further information on this injury, I need to research the information that they are giving me, to decide if they are telling everything that I need to know about this Erb's Palsy, which will affect my grand-child for the rest of her life. But, I have been to all the doctors that you ladies mention, she is in therepy, she has seen an eye doctor last week, who told me he did not see signs of the Horner's Syndrome in her right eye, I asked him is that something that can go away on it's own and he a sured me that sometimes it does, but every time I look into her tiny face I can still see the symptoms, I don't know if he even knows what the syndrome is suppose to look like, but I will be asking more questions about it when I see the neurologist on wednesday, she has seen a ear doctor, because to little lumps on both sides of her ears, but it turned out to be nothing, she had an MRI, back in October, that is why we had to go see an Orthopedic Surg. because the Neurologist found her injury to be more severe then she first suspected, but she did not explain that to me either. From what information that I have gathered on my own, my grand-daughter has the Erb's Palsy and the Klump's Palsy. The nerves that were found to be damaged were C-5, C-6, T-1, & T-2, but other nerves like C-7, & C-8 must also be damaged for her hand to stay fisted so tightly, and a nerve in her face had to be damaged also. But, Dr. Cornwall, said that the Horner's Syndrome came from when she was still inside my daughter, probably pressing up against the wall of the uterus. That is why I'm writing to the board too, to see if anybody else child have the Horner's Syndrome and did they see any changes the child's appreance. I know most doctors that I'm encountering right now, will only tell me what I need to know and only answer the questions that I pose to them, because I know that they are thinking that I must be asking a lot of questions because they figure that we are going to sue, which may not be the case, I just want the best possible treatment for my grand-child and I don't think that these doctor's, nurses, or other people in this field, realize the emotions, the worrying, the frustation, the fear of the unknown, because it is not them going this process.

I would like to think you all who responded, and I look forward to keep an open dialogue with you all and will keep you posted and will contiue to read the board and pray for all of you and your families.

Yolanda827

[Yolanda827]

I forgot to mention, that the c-section was not really planned. My daughter had started dilating on 8/23, she was 2 or 31/2 centimeters. The dr. examined her that day, took us in his office and said to us, how do you feel about having a baby today? My daughter & I looked at each other and said fine, by that time my daughter was having leakage and back pain the weekend that had past, but everytime we called the hosp., they said, if the pain wasn't 3-5 min. apart or if her water hadn't broke don't come in. After the dr. asked us if we were ready to have the baby that day, he called the hospital, but couldn't get her a bed, until 8/27, which was her due date anyway, so we waited until then, but my daughter did want to try and have a natural birth, but by the 27th. she was just ready to get the baby here and for the pain to go away. And I want to thank everyone for wishing me a belated birthday.

Yolanda827

[Joni]

Yolanda,

Thanks for the response regarding whether the C-section was planned. I'm sure many of us have our theories on how these injuries happen, but I have always suspected a few reasons as to why the injuries can happen in C-sections, however I am not in the medical field and they are only my opinions. I believe the head can be engaged and the shoulder may already be stuck as the baby starts to descend downwards in the early stages of labor so maybe as the baby is being pulled out from the stomach during the C-section, the shoulder/head are already stuck in the birth canal. Another one of my suspicions would be that the 3 inch cut made to pull the baby out of the stomach may not be wide enough and if the babys shoulders are too broad injury may also occur through the pulling and tugging to get the baby out of the stomach. I've had a vaginal and a C-section delivery and the baby didn't just come right out of my stomach when it was cut open. There was a great deal of pulling to get my child out, and I asked them to make a much larger cut because I didn't care about scarring. Luckily, through my C-section my second child was fine, however my first vaginally delivered child was not so lucky and ended up with a ROBPI and spinal cord injury also with Horner's Syndrome. I may be wrong about my assumptions but I can't understand how these injuries can occur without some form of traction or very strong impaction. I wish your family the best and I'm glad you've found UBPN so you will have more information to try and get the best care available for your child, and receive support as well.

[katep]

Yolanda,

There is an "in-utero" theory that hypothesizes that the injury actually occurred in the womb. This theory, however, can be tested with a very early EMG and examination of muscle mass that can tell how "old" the injury is and thus determine if it really happened before birth (if the muscles and nerves show signs of degeneration that would have taken longer than the time since the birth, for instance). Unfortunately, these tests need to be performed very early in life, and unfortunately the doctors who go by this theory don't seem to bother to do the tests early enough to be definitive.

What are the symptoms that you are thinking you see that may be Horner's syndrome? There are other effects from this injury, torticollis being one, that can cause assymetry in the face that aren't Horner's. Our child also had a droopy eyelid for the first month or so that went away. My understanding is that the full Horner's is easily detectible by examining how the pupils react to light - it causes the pupils to dilate differently - which is the easiest part of the syndrom to test for.

If they saw anything on the MRI, it is likely that it is very severe injury with avulsions; you can't really see anything but that on an MRI.

I would definitely recommend a second opinion from a doctor who performs primary nerve grafting surgery.

Kate