Questions about post mod quad/caps surgery & startingtherapy.

[Karrie -- Md.]

Kyle had the mod quad/caps surgery Feb. 12, 2002. He is 6 weeks into his 24 hr splint. I was curious about what is the best way to go about weaning him out of the splint after his 8 weeks. I know warm water pool therapy is good and we have that lined up, but what exactly do you do in the pool? Kyle has been in the airplane splint, straight out to the side at 90 degrees. He cannot even hold his arm up so what do we do with it when we take him out of the splint? He can't go around trying to hold it up all day with his other hand. Also what is the general treatment plan for after surgery in terms of how often going to therapy. TCH told me after the first 8 weeks he would start back up with therapy two times a week for PT/OT and two times a week for pool therapy. That is so much therapy compared to the once a week we were going before surgery. And I know every child is different, but how about the length of time it takes to get the arm loosened back up. Kyle is getting so stiff in his elbow from being in the splint. I cannot even get good stretches in anymore cause he says it hurts all the time. Lisa @ TCH said to not push it and wait until he gets back into therapy after the 8 weeks, but I'm afraid of him getting an elbow contracture if I don't try to stretch it some. What about his shoulder....if his elbow is that sore I can't even imagine what his shoulder is going to feel like. Any advice or ideas would be greatly appreciated. I am trying to prepare myself for what is to come in two weeks. Yikes!!!!
Karrie

[admin]

Hi Karrie,

I am glad you posted this! This has been on my mind as well as we are both now approaching the 8 week mark with our little ones. Have you been doing any therapy with Kyle? Dr. Nath told us not to do anything at all until the 8 week mark. Alyssa is only doing 8 weeks total with the splint (nothing at night after that) and I am curious too as to how this is going to work out. Only 2 more weeks!!! YEAH!

[francine]

Hi Karrie - wow time flies!

The best advice I can give you is take one day at a time and let Kyle lead the way. I thought Maia's elbow would be more contracted and it seemed that way - but now it's the opposite - it's fine...and we only have one week left to nighttime only splinting. Kyle's arm is going to seem tight and stiff and it will be for a while and then in time it will all relax again.

The warm water is really great because if he's in the water and has as floatie on - his arm will be at 90 degrees just resting (floating on the water all by itself)... this is great all in itself. You'll be able to accomplish a lot in the water that you won't be able to accomplish on land - especially early on.

So.... the best advice is not to panic - just relax and give Kyle's body a chance to adapt and transition back to what's normal for him and allow him the time. You'll be able to massage his elbow and stretch it more when the splint is off.

Breathe my friend

francine

[francine]

by the way - there's no weight bearing for another 8 weeks - so even the therapy itself can't just go booming right into it all.

[francine]

weight bearing or resistance exercises....

[blakesmom]

Blake was in an airplane splint for caps/bicep lengthening and just came out yesterday. He holds his arm out to the side when he isn't in his splint. He lets it down when he isn't thinking about it. Wouldn't it be hard to hold your arm out like that all day? He lasted 6 1/2hours without splint this morning and then another 5hours tonight after his nap. The warm water is wearing him out and he moves very well in the water. I just make sure I give him Motrin before the splint is off. Good luck!

[blakesmom]

since Blake had bicep lengthening, I haven't even begun to start ROMs yet, I will give it a couple of more days, he won't bend his elbow at all. He has his 8weeks of night time splinting now, then will wear an extension splint at bedtime for his elbow. He says his shoulder hurts a little, but his elbow a lot, he gets mad if we even touch it. Starting on scar massage again tomorrow if tolerable, we gave up for a couple of days.

[Tessie258]

The only sdvice I can give to add to all the others is to not panic when you see how weak his arm looks...It will get stronger. They are very weak right after coming out.
Keep your head up!
T.

[Jodi]

We were really afraid Bailey's shoulder was going to be really stiff. But it actually loosened up pretty quick. Within two weeks. Her elbow is still stiff. She didn't have the bicept lenghtening. I have a strong feeling she probably should have. Dr. Nath decided right before surgery that he wanted to give her a little more time. It has been about 17 weeks since her caps surgery and she still can't bend her elbow to touch her mouth. She can straighten it completely straight though. I just emailed Dr. Nath about this and I am hoping that he says it just takes time.
Jodi