United Brachial Plexus Network, Inc.

I frequently visit your website because my son who is 14 mths old has Brachial Plexus in his left arm. Dr. Nath at TCH did his Mod/Quad surgery July 31st. We recently took him out of his cast and were not prepared for what took place. He screamed like he was in severe pain. We finally got him calmed down. We called Dr. Nath and he told us to take him out of his cast for good. Our concern was that his palm was turned up (which it wasn't before) and that he doesn't seem any better. Someone recently sent a message regarding what to expect and someone replied saying their child was able to lift his/her arm up over their head. Cody (my son) can't. He seems very stiff. He is almost at the stage he was before the surgery. Is this normal? What else can we expect? We begin going back to our normal therapy sessions next week but we do all the strecthing exercises at home that we were told to do. I guess I am feeling a little discouraged right now and second guessing myself that we did the right thing by having the mod/quad surgery done. Any comments/suggestions are appreciated.
Thank you,
Melissa

Melissa - your sons reaction is kinda normal- it's painful to use a limb that's been immobilized for so long. A lot of us have had good results by taking it off and bringing the child immediately into a warm bath or warm pool and letting the water relax them.

It might be stiff for a long time. Your son might not want it to come off tomorrow - give him that time and allow him to set his own pace with this. It's scary for some,too. There were days when I would lay Maia down on a quilt, remove her splint and just put warm compresses and massage her arm before she even sat or stood up. It took Maia a whole week to get used to having it off an entire day with each surgery.

About the movement -it will take time for the stiffness to go away. Any therapy should be very gentle - just gentle roms really. Your son will come through soon enough and be doing a lot of things. Have faith.

I wrote recently that I really think that it took Maia an entire year to get the full benefit from the MQ but her range afterwards was just what I considered miraculous.

So...have faith, allow him to set the pace, relax and relax and relaxxxxxx.

big hugs,
I know this is a hard time, we want so much for our kids to just not have this!
hope you can get into a warm bath,too.
-francine

hey.... take a video of him now...and then again in a week...and each week.... it's very amazing when you watch the progress like that. It'll bring about awareness as well.

Melissa I remember feeling the same way you are. My son Joshua was 3 when he had the mod quad and right after it I felt like maybe I made the wrong decision. His arm was so thin and very fragile and he would barely move it. I would say maybe two week after the splint came off I starting relaxing, but really it takes a few months for the arm to really come back. I was scared too and even called dr nath and talked to lisa davis. It is a very scary experience and I know what you are going through. My sons splint came off on a tuesday and we started aqua therapy on a thursday. We did that for about 9 months 2xs a week. Two years after the surgery I can say my son has a lot more movement than he did before. Before the surgery you would never see my son with his arm over his head, it was just too tight and uncomfortable. Now I check on him in the middle of the night and almost always see his arm over his head (Yeah!) He can touch the back of his head (which he couldnt before). He still has problems supinating, but I hear that takes like forever. Hang in there you will see results soon. Good luck.

My son had mod quad July 30th, he was only in the splint for 1 week, the first few days he walked around holding his arm with his other hand, but it did'nt take him long to start using it, now, 5 1/2 weeks after surgery he can lift his arm over his head sooooo much easier than before the surgery. He has problems with supination also, but we are working on that. It just takes time, it is very scary at first, not knowing what to expect, give it time, hopefully you will see results soon!!

I think what really helped Nicole was warm water. When we first removed the SOL splint, we did it at the heated therapy pool. I removed the splint and held up her arm until we got into the pool and I gradually let it down. If you don't have access to a warm water pool (91-94o), then the bathtub or even warm compresses will help too. We've also given Nicole Tylenol or Motrin to help with the initial pain. Hopefully, these things will help. I'm not sure I understand about your concerns with his palm being up though. Can he turn his palm down at all or is it "stuck" facing up? I would be extremely excited if Nicole was able to supinate (turn her palm up) after Mod Quad or at any point, so maybe I'm not understanding your concern there. Nicole was able to lift her arm up over her head immediately after the splint removal (compared to about shoulder level before surgery). However, I know that while that's sometimes the case with children, it's not always the case and all children recover so differently. BTW, Nicole is 3 1/2 y.o. now and was 23 mos. at the time of her MQ surgery. One thing this injury teaches is patience. Don't second guess yourself just yet. Try to relax and give it some time. We pray for patience all the time. Take care. -Tina

I dont have after surgery experience personally but the warm water sounds like a very good idea-