United Brachial Plexus Network, Inc.

Hi. My daughter was born 2 months ago with a severe bpi on her right side. After these months of intensive therapy, we have seen very little improvement. We will be heading down to the brachial plexus clinic in Houston within the next few weeks for evaluation and probably surgery. I had never even heard of a bpi before her birth and am trying to find all information before we make any surgical decisions.

Here's my questions... Are the causes of this injury strictly the fault of the OB? I absolutely adore this man, but if her injury was his fault... However, I can't imagine any other reason this could have happened. In all my reading, it said this was more common with large babies.. She was 3 1/2 weeks early and barely weighed 6 lbs.

If surgery is in our future, what is the likelyhood that she will regain full use of this arm? What sort of realistic goals should we set?

Sorry for the rambling. I'm so glad I found this board. Thanks for any info you can give me.

Cherie Hohertz
Arlington, TX

Welcome to the boards Cherie
Let me begin by saying I'm sorry this happened to you and your family. It's a shame that it is STILL happening! Second, you are doing the best thing possible by "trying to find all information, before making a surgical decision". The general Board is FULL of information and many Mothers of children going through exactly what you are. Most of us here thought we were the only ones until we found this site and all the wonderful people on it.
As far as your babies birth weight, yes.......it is more prominent in larger babies (i believe). However I was born 46 years ago at right around 4 lbs., and suffered a bi-lateral injury. I had very little movement in my right arm, which sustained the worst damage. However, after much hard work on my parents part I have quite good use of my arm and hand. I would by no means say I have the full use, as you asked regarding your daughter but I have led a very full and productive life. I do things a little differently then other people might, but I have learned to compensate for my weakness in both arms and can honestly say there is not much that I cannot do. I think with or without surgery the best advice I could give you would be to help your daughter find her own ways of adjusting. Things were much much different 46 yrs ago, as there were no surgical procedures to even consider. And the best thing my parents ever gave me regarding my injury was the self confidence to realize I was not just an arm.....I was a wonderful little girl who happened to have bad arms........end of story
Good Luck in your search for information regarding this injury. Knowledge is a powerful tool and you need to be well informed. These boards are a great source of information and friendships, and again, I welcome you to them.

I am also sorry that this has happened to your daughter. There are many wonderful articles in the medical literature regarding incidence and prognosis that may help with answering your question regarding the involvement of the OB. There are many "reasons" that this will occur as a result of the birthing process, or something that may have occurred prior to birth. Contact your local librarian or university librarian to see if you can conduct a MedLine search on obstetrical brachial plexus palsy. There is also an excellent chapter by Roberta Shepherd in Suzann Campbell's book Decision Making in Pediatric Neurological Physical Therapy. That should help answer many of your questions/concerns. Regarding recovery, nerve regeneration is thought to occur at approximately 1 mm. per day. This would indicate that at about three months of age, your daughter should be demonstrating some elbow flexion. Elbow flexion is an indicator of functional return, and is often what the physicians/surgeons are looking for when completing an initial assessment of your daughter's arm function. Surgery is a very difficult decision for any parent of a small infant. Use the resources you have within the "chatroom" as they are the resident experts on their own child and the recovery they have noted. Best to you and your daughter. an OT up north