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6 month old stiff arm flexed(41 Posts)
Sorry, bit of a re-post for higher traffic.
Just to start I have just been to the GP with this, but it's left me with more questions. She said she wanted to talk to a paediatrician and would get back to me in a week, would say no more.
My daughter was born at 36 weeks and soonish after discharge we noticed her right eye looked smaller and her right arm seemed to be curled/ have less movement. Didn't think too much of it as we were distracted by an admission for jaundice and generally being shell-shocked by the early birth, it seemed to improve hugely with time too. Her eyes look the same now, and she can grab with both arms, I think we may have got used to the fact she doesn't stretch her arm. My friend though has started watching her 2 days a week and we were discussing how she can't roll yet, seems a tad floppy, barely lifts her head when she's on her front and she asked if her arm had always been stiff in her right arm. It reminded me and I realised she cannot lift her arm above her should at all, when pulled up it's too tight to raise and when extended outwards it's possible to extend her arm but there's a lot more resistance than in the other arm which moves freely. It doesn't seem to be painful, though she did cry when the GP tried to raise it a little more forcefully that I'll push it (still remained bent at the elbow with the upper arm flat to the body. When she flaps her arms in excitement she hots her side with this arm. It's occurred to me it's the reason it's so hard to get a jacket on her, I thought she just disliked being handled that way. The only other thing I can think to mention is she smiled first left side only, grabbed with her left first etc but it always corrected in a few days so we didn't worry, she's not our first and babies have all sorts of quirks like the rolling eyes when sleepy that worry you at the time but then correct.
I know the GP will get back but in the meantime can I ask if anyone has had a similar experience or knowledge on this? I was expecting to be told to go away and keep an eye on it to be honest, now I'm wonder WHY it's a corcen.
It's her brain. I wasnn't expecting it tbh. I was quite ready to be dismissed and told to wait and went in with no expectations.
Glad things are moving, even if it's slowly.
I doubt he would commit himself until he had something more definite to go on, if you do the MRI (is it on her arm or her brain?) then you may get answers.
Rude nurse, I find it hard to hear with a lot of background noise, I think a lot of people do.
When I take ds to ENT when they call out the names, and then have to go round and ask individually "Are you Mr. X?". Then you hear Mr X going out with them saying at the top of his voice "My hearing aid's not working very well" . Never heard them being anything other than very pleasant with the patient though.
Well, he turned out just to be a consultant paed, so I don't know why the GP put 'rheumatologist'.
Very pleasant man, he gave though his honest answer which was he wasn't sure if there was a problem or not. He noted rigidity in her arm, also that she didn't weight bear on the same side. Also referred to her as mildly developmentally delayed in terms of motor skills, though he agreed with me this was only a motor delay. Weirdly the arm he noticed the rigidity/ fisting in was actually the other arm! I'm pretty sure that arm was floppy! Both are rather stiff now. She also doesn't use the arm well, on her front she pushed up for the first time this week but sort of curves that hand over and doesn't use it as much, often the palm is up rather than down. I wasn't expecting answers but wait and see so I was fine, but everyone else is bugging me for details of what he thinks the issue is.
He wants to see her in 3 months and attempt an MRI without sedation before then to see if there's a cause for the delay. Not sure on reflection if this is a mad idea to attempt and if she'll just wake straight up. I was on the spot a bit when asked if I wanted to do an MRI or not, I was swayed by him saying that if we did it now we might be able to do it without sedation but later on she'd need a general.
I forgot to ask about physio, I'd just had a barney with the nurse and was still nervy! She had a right go at me because she was shouting my dd's name in the waiting area and I didn't respond for ages. I have poor hearing and it was a tiny area with noisy kids, people on phones and a tv on so I could barely hear a word and was relying on lips. I explained politely to her and she was quite aggressive with 'WHAT, CAN'T YOU HEAR?!'. I remained polite until about the fifth time during the weighing/ measuring she bloody mumbled a direction at the back of my head despite being asked to talk to my face and I snapped at her about manners. She stomped off after doing the sloppiest length measuring ever, surprised dd didn't come out a giant.
ok...I have a referral to a paedriatric rheumatologist.
Not what I was expecting
thanks, I'm not very confident with these things. I wouldn't want them saying her arm is moving so why did I come.
Yes, the leg and arm correspond. The stiff arm is actually stronger, she can use it to balance and can stand on that leg. The other leg is bent with the foot rolled in, it's subtle but if she falls forward on that it just hangs straight.
Is the leg she's standing on the same side as her strong arm?
If it is then I think you need to be checked out for general weakness on that side.
I would still get it checked out. It could be just habit that meant she wasn't moving it, but in case it's anything that can cause problems in the future, it's much better to get it seen early rather than later.
I would start making notes to take to the appointment-even if she grows out of some of the things, it may build up a bigger picture. Anything you think is a bit unusual or late can be useful, the paed can decide whether it's all linked or just a late development etc.
thanks dewe, we've been doing that among other things.
Fantastically he arm with loads of exercise and massage is already nearly at a normal range of movement, it just seems to be stiff muscles. I noticed her leg was a little stiff too? She's moving it herself too more, and is now able to briefly lift her head on her front and is getting closer to sitting. Instead of just jelly slumping she can sit on your lap when held under the arms. She looks like she might roll soonish. The tightness must have been affecting this.
The only thing now is a strength difference, she stands on one leg and on her front is attempting to push up on only one arm (so she goes sideways). She can hold herself sitting with one arm, not the other. It's mild though and not as obvious. Does this still warrant going to get checked out? Should I ask the gp? She was referred simply because she couldnt straighten her arm.
Try big things to get her to play with both hands perhaps.
Dd2 didn't have a left hand, and we used things that she needed to use both hands to play with to make sure she used her left side.
Her favourite thing ever was an empty 2 litre bottle (you can put rice in to rattle, or glitter to sparkle if you want it to be more interesting), but we also found balloons and big balls great for getting both arms working together.
That's ok, its very hard to say without actually seeing your dd.
You're right in not dwelling over it - nothing will change over the weekend that hasn't changed this week but please don't think you are wasting their time - I certainly wouldn't. And sometimes (sadly) you have to be persistent.
(by nervous I mean I have only ever been to a doctor in my adult life with pregnant and even then only at the point where I've been admitted to hospital, I will ride out anything from tonsillitis, weeks being unable to bend to 5 month coughs. Two of my children have only been to six week checks)
thanks colleys, any input is appreciated. I think I'm just looking to talk around concerns rather than expect solutions.
I'm appreciated your post as I'm one of those people nervous to see any doctor for being fearful of wasting time/ being seen as fusspot.
I think I just need to stop dwelling, even just looking at old pics on facebook strike me of the differences, her brothers and sisters legs in every picture hang straight at this age whilst hers are always crossed at the calfs. Every non-issue is striking me.
I think my job (SENCo) puts extra worries in my head, but I have no pre-nursery experience despite having worked with many many children with various motor problems.
Hello op I tend not to comment too much because its very hard to comment over the internet but I really wanted to add my thoughts. I would add that services do vary differently across the country (a debate for another thread!) As do waiting lists for services - some areas have longwaiting lists but others don't always. I can only speak from what we would do if you were local to me.
Maybe it is nothing to worry about but if your hv or GP called I would without doubt want to see your dd for a proper assessment. Any asymmetry needs to be checked even if it is just simply to reassure you or monitor her progress. Some physio services do a clinic particularly for children whose parents are concerned but other professionals necessarily aren't - it would be worth asking if this happens locally to you.
Even if everything is fine and eventually resolves I would much rather see a child and be able to reassure parents or monitor them than have a family worrying. Occasionally yes more significant things are picked up but (and its a big but) if this the case then the earlier the right people get involved the better in the long run.
Wishing you the best.
Thanks, that's pretty much what we're doing, not being experts.
Things like getting her favourite toys out and putting to the side she uses less, peekabo lying on her front (though it can feel pointless at times with her flopped out!), moving her arm in play more and more, massaging her and tickling, trying to help her roll to a toy etc
dont beat yourself up though with not doing enough exercises etc, general play & tickles are just as good
I'm doing these kinds of exercises as much as I can, I've noticed that when sitting she will save herself with one arm and not the other. I've noticed her stiffness can be induced with a few bounces if otherwise floppy, she tenses up with a few light rapid bounces.
Hopefully the letter to find out who and when I've been referred to will arrive and I'll go from there.
We had to teach ds2 how to put his hands out to save himself as the reflex did not naturally develop.
Same with rolling over.
Lots of lying him on a towel & tipping & rolling him
docs & HV are very likely to tell you to watch & wait, go back & ask to be refered as waiting lists are long.
DS2 has spastic diplegia with low muscle tone in the upper body, he was born at 28 wks & suffered brain damage.
His spasticity is worse on movement & gets stiff if excited.
We always manage to get the best relaxation & stretches by massaging in the bath or swimming pool.
There are lots of things you can do while waiting to see the paed or physio & it will do no harm at all if all is well
I remember the watch and wait with ds1, he coughed for the first 3 years of his life. To the point where we got no sleep, as a baby it shook him most the night. We waited until it outgrew it after 6 monthly appointments to check if it had stopped. To be fair it worked.
prissy-we may share gps. I went at 32 weeks for a flu shot and was told 'this is only for people who are ill, old or pregnant'. Though I was secretly flattered she didn't notice! I was size 8-10 at 8 months when I gave birth, she was rather obliging
unlike ds who made me put on 5 stone
I've been leaning towards she's fine, after only a week of exercising it deliberately the arm has really unstiffened nicely. She even pushed up on her front for the first time! DH though burst my bubble by pointing out she pushes up on one forearm and one straight arm as is also attempting to sit with on leg bent and one straight. She got both hand in her mouth....but to get one hand in she turns her head. She's starting to weight bear on her
legs leg. It' s mad, the more you look the more you notice, 'tis where madness lays.
Well at least I know for sure one thing, by the time the appointment comes through it'll all be different in one way or another.
If it makes you fell better, I once took dd2 to the doc to see if she should have the flu shot, and it was a locum. So I started off and said 'well, with her having cerebral palsy, and having had so many respiratory issues, I was wondering if she should have/ or would be eligible for the flu shot?' And the locum said (I shit you not) 'what makes you think she has cerebral palsy?'
I couldn't decide whether to be hysterical or livid, but managed a terse 'well, the five weeks in special care on oxygen, the four years, of physio, speech and language therapy and occupational therapy, and portage, the two brain MRIs, the high rate care and mobility DLA award, the walking frame, the house full of physio equipment, and the diagnosis from the consultant neurologist...'
She did apologise. I would have thought the big flashing red box on the co outer screen on her record to warn stupid gps would have been a big clue, but apparently she hadn't noticed it...
Well, you know, she still could be absolutely fine. But the fact that people that know her well notice the movement issues, and the gp is concerned enough to do a referral, possibly means the hv doesn't have enough knowledge to recognise where physio might be useful.
An ordinary hv will just have a check list. They are more concerned with weight and growth, and are out of their comfort zone with neuro or developmental issues. They are not trained, and only supposed to pass the buck. Their main role is to reassure mothers.
Even a specialist would demur at this point, because developmental delays are tricksy beasts. You just don't know whether a child will have a developmental leap and movement will normalize, or whatever.
That isn't a reason not to investigate and to withhold potentially invaluable support though.
Let the referral take place and see what happens next. There will doubtless be a whole heap of watching and waiting for the next wee while. It's what paed's are great at
Well, I thought I'd ask the hv today how things might work about physio rather than bother the gp again before the letter. But she's assured me there is no need for all this as dd is fine.
I said to her I was concerned 6.5 month dd couldn't (quoting):
roll either way
lift her head on her front, she just gets upset with her face flat on the surface over her mouth/ nose
seem to reach for things with purpose
seemed wonky in movement...
cut short here and told dd could sit with support as she was doing so there and then. I was reclined in chair, dd was facing forward reclined against my belly, head between my boobs. Is this unsupported? Even tinies do this? She would also sit if I had her firmly under each armpit weigt bearing for her, slightly curled forward. I thought this meant lighter support, eg just at hips or propped with pillows? Also she said dd could move arms fine looking at her (well they aren't paralyesed, just wave around mainly). She said many don't reach as this stage. As she's so alert she said she's fine and can't be delayed.
her advice is:
-wait until dd is nine months, if she can't sit then it's a problem
-dd's development is very normal, this is a 'funny age' where the range is very big
-not to worry about seeing gp
wrote is red book:
'mum concerned ie not rolling, head lifting. baby content and fully breast fed. mum reassured re concerns'
Sometimes I feel there's this huge huge gap between mumsnet advice and any real life advice I get.
Did she have antibiotics for the Strep B at birth? Because it could be a late side-effect of the strep. See here- strep B bone and joint infections
And I say this because paediatric physios have a really long waiting list as well - you really need to be on it...
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