[Viv Buentiempo]

My beautiful son, Ravi arrived out of the womb leading with his left hand at his head. At his first check up postbirth, the doctor said there was damage to the left arm. However it was not severe nor was it necessarily permanent, and he said the technical name for it was Grave's palsey. He said Ravi would grow out of it and he didn't anticipate any future problems. Because I had a heck of a time trying to breastfeed, we saw the doctor two to three x weekly for the first three months. He continued to watch the arm, and initially we pinned his left sleeve to his clothing to support the arm, because it hung limply by his side. Over time, Ravi did gain usage of the arm and develop strength in the hand.
Now two years later, my husband and I are noticing that he definitely favors the right arm and he does not fully extend the left one. He seems to be able to extend it, but he will not leave it in that position for more that a second. My husband thinks that if we get some very light free weights and Ravi sees us using them, he will do the same. I think flexibility in the arm is more important than strength. Actually, to me the hand seems able to grasp strongly. Has anyone else had any experience with this?
Why don't I go to the doctor? We just changed insurance and it has been a nonissue in his chart, but it was listed. I did not even think of it when I was filling out the paperwork. So I'm trying to get some help in a nonmedical way to try before we bite the bullet for a potential full pay scenario.

 

[Mama Lori]

What state do you live in? In CA, we have CA Children’s Services (CCS) that provides physical therapy/occupational therapy for children, for exactly these types of issues (medical). It is free, or almost free. It doesn’t require having any particular medical insurance, or any medical insurance at all. It is a state agency. We used this for my son, who had epilepsy that was so severe it cause a left hemiparesis (the seizures were on the right side of his brain, and weakened his left side). He went to PT once per week (this is the gross motor stuff; throwing balls, climbing ladders, etc.), and OT once per week (OT is “living skills”, the more fine motor stuff, like buttoning a shirt, or putting stickers on a page). Both therapies were EXCELLENT and he improved so much because of them. He now no longer needs to go, as his left weakness not even enough to be noticable at this point. This is due in large part to the fact that he stopped having seizures six months ago, but the PT and OT helped keep his left side in use and strengthened while he was going through that. The therapists were incredible and used a wide variety of fun toys and materials to help Eli. He loved it. I would highly recommend checking if there is such an agency in your area. If you have trouble finding something and need a starting point of contact, you could try calling CCS (even if you are not in CA; maybe they can refer you) at 415-479-2203. This is not the kind of situation you should try to handle on your own with handweights or anything, in my opinion, this requires professional support. You say you just changed insurance – so doesn’t that mean you still have insurance, it’s just different? This sounds like an issue a neurologist should be assessing. But feel free to pm me if you want ideas of things you can do at home to strengthen his arm; I can at least tell you what the therapists did for my son.

 

[Viv Buentiempo]

Good points! Yes, we have primo insurance, but not with a group so we are at the mercy of their obscene levels of good health in order to be qualified (did you read the comic "Chickweed Lane" last week?). Ravi and I were approved, but they still have yet to approve my husband.
Yes, we are in CA. What you said has really boosted my confidence in the situation, and our ability to handle it with or without insurance. A neurologist; I will ask our ped. about it. I feel like making an appointment for another reason and then once we're there saying, "Oh, and by the way..." The thing is that Ravi has been so healthy, we never see him. That's a good thing.

 

[Viv Buentiempo]

PS. I'm more than willing to take your suggestions so we can begin working on this before we see a doctor. It might make me better equipped to help a professional assess his condition, if I know what to look for. Thanks.

 

[Mama Lori]

Insurance never fails to confuse me. So, you say Ravi is approved, but you have to be concerned that if you say he's having this problem and needs help, they could deny his coverage because it's a problem he had at birth??

In any case, I can offer some suggestions. I thought it was interesting that you said that as an infant, Ravi's arm hung limp by his side; but that now, he tends not to extend it and not use it as much. So if I'm understanding this right, it used to be a limpness, and now it is a tightness? These two issues are handeled very differently.

Eli's issues were definitely a tightness. He held his left arm clutched to his side, his hand often in a fist. A friend of mine who is a chiropractor had told me that this was very positive, because tightness issues are much easier to resolve than limpness.

In general, your goal is to get his arm/hand to do the opposite of what they are currently inclined to do.

For the tightness, you want to get him doing things that require him to have his arm extended. (1) Set up a game or puzzle or some other stationary activity on the floor, sit him in front of it, then put his left hand on the floor so he has to sit supporting himself with his left hand/arm; you might need to actually hold him in place doing this, but getting him to do this for even a few minutes each day is good. He can use his right hand to play the game or toy or whatever. (2) Have him walk and pull a pull-toy (toy on wheels with string attached) with his left hand. You could hold his right hand and walk with him, and he has to pull the pull-toy along behind him. (3) Fly a kite! (4) Make a game where you place a basket on the floor, then make a line on the floor that he has to stand behind, and throw a number of objects (beanbags, etc.) with his left hand and try to get it in the basket. Make it as easy as possible for him at first, making the line really close if needed, then each day/week get progressively further away.

For the lack of use of his left arm, you want to get him doing things that require him to use it. The easiest way to do this is with activities that require the use of both hands/arms. Many of this will help with the extension issue too. (1) Playing ball with a large ball that he could not hold with one hand (such as a gym ball), throwing and catching. (2) Climbing a ladder or other structure. (3) Zoom Ball - if you can find this toy, it's great, not sure if he's too young for it. It's like a soft football with strings going through the middle of it lengthwise, with two handles at each end. It takes two players, one at each end, and you have to pull the two handles apart quickly to get the ball to zoom to the other person. This is so much fun and SO good for using both hands.

Those are just a few ideas. Hopefully enough to get you started. In general you want to make the activities fun, but at the same time, think of it as time you've set aside each day to do this WORK, because it is work. Maybe 20 min. per day is plenty. Eli did 45 min. twice a week. If motivation is a problem, you can use fun rewards, like give him a sticker or other prize at the end of each session.

A temptation can be to restrain his right arm as a way of getting him to use his left. This should be used only very sparingly. I had preferred not to use it at all, but on a couple of occasions it was helpful, like when we had to insist that he pick up a block with his left hand and held onto his right arm so he couldn't use it. But don't do anything crazy like tape his right arm down so he can't use it; that will just frustrate him.

Another thought is that since this is likely neurological, seeing an excellent chiropractor could be of immense help.

 

[Mama Lori]

Another fun thing, and something that will help him learn which is "left" is to call his left hand/arm "Lefty". So, "Use Lefty to catch this ball!"