Strollerderby : cerebral palsy

Preemie to Pediatrician

Amy Kuras — Tue, 24 Feb 2009 15:31:00 GMT

Imagine how proud you’d be if your child excelled in school, worked hard and achieved their goal of an important career.

And now imagine that 30 years ago that baby was born 12 weeks early and left for dead, covered up by a nurse who thought his heart had stopped beating long before birth only to hear him make some noises and see his foot move. And that he worked hard to overcome the disabilities that caused as he grew, finally graduating from medical school and becoming a pediatrician.

That’s what happened for Lisa Dalton and her son Jeremy. When he was born, doctors told her there was little hope of survival, and even if he did live he’d be unable to ever walk, talk or feed himself. But the little baby showed them otherwise and continued with that kind of determination the rest of his life. A lack of oxygen at birth caused cerebral palsy, but that never stopped him from achieving, even if it took him longer or he had to figure out a different way to do something.

It gets better – the doctor who cared for him in the NICU, Dr. Thelma Sutter, always remembered him. Lisa Dalton sent Dr. Sutter updates over the years. Soon after Jeremy began his pediatric practice, he ran into Dr. Sutter at a local hospital. The name didn’t ring a bell right away, but when it did she went running down the hall after him. When she discovered he was the baby she’d cared for so long ago, she told him “I was always so proud of you.”

I sort of love everyone in this story. Not only did Lisa Dalton always keep up with the doctor who cared for her son, she continued to send cards to the NICU, letting them know that premature babies could survive and thrive.

Pass the tissue please…and somebody get the Hallmark Channel on the phone!

Photo credit: AP Photo/Lubbock Avalanche-Journal, John A. Bowersmith

Pre-Term Elective C-Sections Are Dangerous: So Why Insure Them?

Miriam Axel-Lute — Fri, 19 Dec 2008 15:00:00 GMT

Michael McGuire is CEO of UnitedHealth, a health-insurance provider in New Jersey. In an op-ed in the Trenton Times recently he talked intelligently about the health dangers of elective pre-term c-sections.

The evidence keeps mounting—prematurity, even by a few weeks, means higher rates of breathing problems, cerebral palsy, NICU stays, etc. When the baby's not ready to come out, it's not ready, folks.

McGuire makes the impressive assertion that when he explained this carefully to a "pilot group" of physicians and hospitals and they stopped scheduling c-sections before 39 weeks, there was a 46 percent drop in NICU stays. Those are results to write home about. As he writes, "That's almost half the number of newborns with potential health problems, almost half the number of distraught parents, al most half the number of potential tragedies. The cost savings to these hospitals, the parents and the health-care system is enormous."

He notes carefully, as do I, that sometimes a pre-term c-section is medically necessary for health of mother and/or baby. Obviously, that is not what I'm talking about. But I would include c-sections that are planned for medical reasons,* but where there is no medical reason not to carry the baby to term. I think those are far, far more common than the over-hyped "too posh to push" phenomenon.

So here's what I want to know: If it's documented to be such a health risk, why don't McGuire and his colleagues just stop paying for c-sections that are unnecessarily scheduled at an unsafe time?

Insurers already go out of their way to not cover things they claim are optional (including some that are emphatically not), not to mention dangerous. Usually I question their judgment, but the evidence is pretty compelling on this one.

I'm all for educating docs, but it seems to me the insurers could stop this practice cold with their purse strings.

Photo by César Rincón.

*(Of course, many of those "medical reasons," like a previous c-sections or breech presentations, don't actually require a c-section, but that's a separate post.)

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They Say: Even Late Preemies at Higher Risk

Kate Tuttle — Mon, 15 Dec 2008 18:02:00 GMT

While it's long been known that premature babies face a much higher incidence of cerebral palsy and other medical problems, most of the infants thought to be at risk were those born before 34 weeks -- the tiny babies, notably premature, whose entire bodies can fit into the palm of their father's hands. But new research suggests that even bigger, healthier-seeming babies, when born before term, are much more likely to fall victim to the health problems of prematurity. And at a time when more and more women are giving birth early due to inductions or scheduled C-sections, that risk needs to be better communicated, according to the doctors who authored the study.

The study, which examined the circumstances of more than 140,000 babies born at 30 weeks or later, concluded that babies born from 34 to 36 weeks' gestation, although often appearing as big and healthy as full-term newborns, were three times more likely to have cerebral palsy than babies born at 37 weeks, and up to 25% more likely to face mental retardation and other developmental delays. Because the babies in the study have not yet entered elementary school, the authors point out, it's too early to know whether other learning-based problems will be detected.

While overall rates of prematurity are fairly steady, the number of babies born from 34-36 weeks is growing, and currently represents one in 11 births in the US. The study did not look into the reasons for the late preterm births, and some surely were medically indicated (pre-eclampsia, for instance, pretty much demands that a baby be born early, to save both lives).According to the study's authors, however, some of those "late preterm" births were due to early inductions or C-sections that were not medically necessary (remember that the next time a Hollywood starlet says she's due "sometime in the fall" and has a six-pounder).

Pre-term Elective C-Sections Are Dangerous: So Why Insure Them?

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They Say: Antibiotics For Preterm Labor May Do More Harm Than Good

Amy Kuras — Tue, 23 Sep 2008 19:30:00 GMT

For most parents, the fear lurks that something you did to help your child -- supplements or prescriptions while pregnant, drugs during labor, or vaccines, for example -- will later turn out to have been harmful.

A British study shows that to have potentially been the case for children of mothers who were given erythromycin during preterm labor when the membranes were intact. Standard practice is to give it when membranes have been ruptured prematurely, to lessen the risk of infection to both mother and baby, and some doctors give antibiotics even when the membranes remain intact but the mother has gone into labor too early.

A study of more than 3,000 children whose mothers participaited in a widespread health study when they were born were tracked at age 7 to see what, if any, difficulties they may have experienced as a result of getting antibiotics. The study, called the ORACLE Children Study 2, was completed in 2001 and the findings were part of a follow-up conducted on the children at age 7.

Children whose mothers received erythromycin, were at 18 percent greater risk of functional impairment compared to children of mothers who had not received erythromycin - 42·3% to 38.3%, respectively. No increased risk was found for children whose mothers had received another popular antibiotic.

Also, either of the studied antibitoics during labor tripled the risk of the child devleping cerbral palsy -- although that went up from 1 percent o 3 pecent so the risk is still very small.

The study showed no increased risk for children whose mothers had received erythromycin because their membrances had ruptured prematurely, which puts them at higher risk for infection.

Bottom line: If there’s no signs of infection or a risk therof because the membranes have ruputured, avoiding antibiotics might be a good diea.

Botox Kills Kids

Kelly Mills — Mon, 11 Feb 2008 12:40:00 GMT

Yes, it clears up those frown lines for a while, but could there be a darker side of Botox, aside even from the weird face paralysis and all that? In a word, yes. In fact, four children using Botox or a related drug have died, and there have been at least 180 documented cases of serious side effects in kids and adults, including severe difficulty breathing and swallowing, which can lead to a kind of pneumonia. One drug watchdog group wants a more serious FDA warning issued for Botox, as well as providing physicians with guides to give to all patients warning of the problems associated with the drug.

Now the children who died were not concerned with the ravages of time, but were using the drug for an "off-label" use, the treatment of muscle spasticity associated with cerebral palsy. Off-label uses for drugs are not uncommon. However, I have a funny feeling that even if cosmetic-use patients are given detailed information about the cases of side effects and death, it won't deter many of them from going forward with the pursuit of a more youthful look...

Disabled Boy Turned Down for Daycare

Karen Murphy — Mon, 09 Apr 2007 11:31:00 GMT

Discrimination in daycare: an Austin boy has been repeatedly turned down by provider after provider for daycare because of his disability. Dustyn Henson is eleven and is in a wheelchair due to his cerebral palsy. The daycare providers who have turned him down, however, claim that the wheelchair isn't the problem. No, it's his pants. Dustyn can manage pretty much everything himself during the course of his day but can't undo and redo the fastening on his pants when it's time to use the bathroom. Daycare providers have therefore denied him service, claiming that child protection laws prevent them from helping Dustyn with his pants.

Say what? A daycare provider practically potty-trained my older daughter; are you telling me that they never touched her pants to do so?

It sounds to me that the daycare providers in question are skipping out on their burden to be accommodating to children with special needs. There could be more to this story of course, but it appears that Dustyn's family is making very few demands in terms of accommodation. We're talking about doing a button on the boy's pants here! Not, say, intubating him or providing therapy or any number of other special-needs accommodation-type requests. Dustyn's mom, Niki, has appealed their case to the state of Texas, and I'm hoping some workable resolution can be found for this family. Until then, Niki will have difficulty being able to work without care for her son.