Sara and the Neurologist

We had a really surprising appointment with the neurologist yesterday. This doctor has not seen Sara since her brain bleeds were first discovered and the initial CAT scan was done. The NICU pediatrician called him in to advise us about the severity of Sara's condition way back in week 2. That week he informed us that the damage in her brain was the equivalent of a 45 gunshot wound and we should consider the possibility of DNR orders and comfort care.

His tone was just a bit different yesterday. He was ecstatic and amazed at how well Sara is doing. He just couldn't believe how good she looked, how well her reflexes were working, and he said she is acting like a normal newborn. There is one reflex that has a long medical name, but if you turn the babies head, which ever way she is looking she will stretch out that arm and bend the other one behind her head. This is a primitive reflex. But this reflex has to go away if she will ever roll over. If it goes away that is an upper brain ability, not just the primitive brain stem reflex. Well, Sara not only has the reflex, but also stops doing it on her own. Signs of good upper brain development. These are the little things we will start watching for to see how the upper brain has been affected by the infarction and bleeds. So far so good.

The next ability he was looking for was fixing and following. Can she fixate on an object and then follow it. She is too young for that right now. We go back in November.

One other interesting tidbit we learned concerning therapy. All the doctors and nurses have continually encouraged us to make sure we get therapy started, work with her every day, therapy her to death during these first crucial years of brain development. In fact, starting next week we will have a therapist in our home once a week working with Sara and showing us therapy we can do with her also. But no one has ever told us why it is so important and we haven't asked. Our assumption was you wanted to do all you could just to make sure she has the best chance of reaching her developmental milestones. The neurologist gave us a good explanation.

He said if damage to the brain from a stroke were to cause the right arm to be some what paralyzed then therapy for the right arm would send signals to the brain like - "what is this thing moving down here, oh I have another arm". And the brain would begin to create new pathways to control and sense that arm. Obviously in a newborn the brain is more elastic and new pathways can be created easier than in a fully developed adult.

We don't know how the damage to Sara's brain will show up in her development. We had been told it could be as severe as eating, sucking, walking, etc. It could be as less severe as learning disabilities, trouble in Math, speech problems. But as we work with her we can begin create new pathways and prayerfully circumvent possible developmental problems. The brain - very cool thing God created. We are indeed fearfully and wonderfully made.

We are off to celebrate Jennifer's b-day today. Well, we aren't off, we can't really go anywhere. In fact the four of us and her parents celebrated a few weeks ago when Sara was still in NICU. But we sure can go pick up some big juicy hamburgers, play some games, watch a movie tonight, and eat some fudge (yes my wonderful wife has a serious chocolate addiction and wants fudge for her birthday cake). Have a great Friday!