United Brachial Plexus Network, Inc.

Hi there, my 7 month old has a left Erb's Palsy that has been diagnosed by pediatrician. Not much else has been said or referred to specialist. Her PT has been working with her twice a week and has now sent an assessment out that I do not understand. "left arm positioned in abduction and external rotation." and "left arm is in a passive position, slightly posterior to her body with shoulder external rotation and abduction."

She is also quite delayed with motor function. She has not rolled over or not actively reaching for toys with her left arm. But movement has been seen a few times. Can someone explain this to me and should I be getting a specialist involved or just keeping up with physio???? Any advice would be appreciated.
Thanks,
Dawn.
(Taylor) left BPI (almost 7 months old)

Sorry, I guess I wasn't logged inn. I posted as GUEST when I should be Kelownamom2003.

Dawn,
I would always recommend a child be referred to a specialist, this injury varies so incredibly from child to child, it takes an expert.
I am in the UK, there is a support group here who would give advice on a specialist nearest to you, and how to get the referral. Just contact Karen Hillier if this applies to you, she visits the boards quite regularly, I have contact details if you need them though.
I am unsure how you get a referral outside UK, but many here on the boards will inform you.
as for the delays, many kids with erbs are later to reach the first milestones, so try not to worry, but perhaps you may like to keep a record, as you soon forget at what age these were reached.

As for the assessment, perhaps the PT could spend some time explaining what the terms are and exactly what the implications from these are. Francine is usually great for supplying links for information too, I think she would agree that a specialist is the best initial place to get information from, as you can ask if you don't understand something. Also much of the info you can look up may not be relevant to Taylor.

I hope this is of some help.
Best wishes to you & give Taylor a hug from me!
Pauline

Can Taylor get her hand to her mouth actively on her own?

I feel a little nervous as I read your post and concerned as well. Is there any way possible that you can get in touch with a true bpi specialist as soon as possible? I know a few that would probably review a video tape of Taylor within a few days if you sent it overnight. Where are you located? I don't mean to worry you and maybe I am way out of line but I am just concerned about Taylor's age and possible need for surgery that have specific time limits on them.

Please ask any questions, research and learn all that you can. Knowledge is power, it truly is. You will learn that pediatricians and therapist often know next to nothing about this injury. I am so sorry that your precious daughter was injured. Best wishes to you.

Hi Kelowna mom, Calgary mom here the best advice I can give you is check out what the states have to offer and don't wait too long or you will miss the opportunity for primary surgery and then it will be too late to try and fix somethings that could be fixed- they don't do the same stuff here in Canada from what I can tell . Your child may or may not need primary surgery but find out from somewhere like Texas Childrens Hospital - it won't cost you anything for the consult -you can even send pictures, videos and information and they will advise you for free - you don't need a referral to see Dr.Nath and get his opinion you only need the referal if surgery is needed and you want Canadian Ins. to pay for it.I feel some of us up here in Canada have not gotten the treatment that would have been best so check it out and worry about the finances and insurance stuff after you get the info you need to make a good informed decision on what the best available latest techniques are. Many of the drs here don't really know what all is being done for our kids just across the border.

Hi Dawn:

Sorry to hear about your daughters injury. Glad to hear that she is in PT at this time. Early intervention is crucial at this time b/c so much can happen in your daughter's recovery. I think it would be a smart idea to get her to a specialist asap. You are at the 7th month which can be a very important time for you b/c surgery may have to be discussed now depending on how severe her injury is.

My advice is to continue PT and get into see a pediatric brachial plexus specialist as soon as you can. Where are you from? If you need ideas on who to see you can look at the medical resources directory on this site:

http://ubpn.org/medicalresources/

If you need to talk or have any questions please feel free to email me anytime at Ldybug4134@aol.com

~Krista~ (mom to Ella 2 yrs old LOBPI)

hi - like everyone else has said - you must get your child to a bpi specialist...and quite frankly - the time is right now! If your child cannot bring her hand to her mouth while in a seated position, this is a sign of a much more serious injury. And there are time frames in which this can be done and the window is closing fast. From the home page of this site ubpn.org hit the link to INFORMATION FOR NEW PARENTS and that will explain the time frames to you. Where do you live? Let us know and maybe there is a specialist in your neck of the woods?

About the movement....

EXTERNAL ROTATION: but both hands out in front of you like you were in the night of the living dead (hahaha). Put your palms up facing the ceiling and that is external rotation - external rotation comes from the shoulder joint itself.

SUPINATION: now bring your elbow down to your side as if you were holding a food tray- thumbs up.. and now turn your palms up without moving anything else

ABDUCTION: put both arms down to your side - now raise them up your side as if you were going to fly

ADDUCTION: not bring your arms back down to your body

memory hint: ADDuction = adding to your body - bringing your arms down, adding them to your body

POSTERIOR: towards the back
ANTERIOR: torwards the front

there are more explanations in the glossary...
you can find the glossary from the home page- hit anything Awareness and then go to Resouces Information and there it is....

Please get to a specialist ASAP.
good luck,
-francine

Thank you all for the info. I am in Kelowna, British Columbia, CANADA. I have been doing some research, and Toronto sounds like they have specialists. Does anyone else know???

HI KELOWNA MOM I'M FROM CALGARY ALBERTA - GIVE ME AN E-MAIL vroseboom@nucleus.com and I will share wilth you what I have learned.