Q: My son was born at 29 weeks, and weighed 2 pounds, 14.5 ounces. At the age of 1, he was diagnosed with cerebral palsy. He's intelligent and relatively mobile. He is now (age 3) in day care with five "normal" children and is keeping up with them. He has made good progress in the things a 3-year-old is supposed to learn.
My problem is that while he makes progress in one area, he falls back in something else. And he is displaying new symptoms. The doctors and therapists are not very informative about what to expect. Can you help?
A: My heart goes out to you. You have so many questions and concerns about what to expect for your son (your letter was too long to print in its entirety here). I'm also surprised that professionals working with you aren't more informative.
Cerebral palsy is the name given to conditions characterized by impaired muscle function resulting from injury to the brain before, during or shortly after birth. These conditions can include poor muscle control, spasticity and paralysis.
Different kinds of birth injury "cause" cerebral palsy, lack of oxygen being one of the most common. Often, however, the exact underlying changes in the brain are unknown. Also, after birth but during the first few years of life, diseases, infections and trauma can cause similar brain injury.
Symptoms of cerebral palsy are related to the extent of injury, and can range from barely perceptible clumsiness to severe spasticity.
There are three major types of cerebral palsy. Most (70 percent) children have the spastic type, characterized by stiff and weak muscles.
Choreoathetoid (slow, spontaneous muscle movement with no control) and ataxia (poor coordination and shaky movements) are the other two forms of cerebral palsy. Many children have a mixture of types.
Cerebral palsy can affect movement in all limbs, in the legs only or the limbs on one side. In the choreoatheroid type, strong emotions can make erratic movement worse.
In addition to limb movement, the ability to speak is usually affected.
Vision, hearing and perceptual functions are also often impaired. About 25 percent will have epilepsy-like seizures.
Almost half (40 percent) of the children have normal or near-normal intelligence, but the remainder can suffer moderate to severe mental retardation.
Although there is no cure, much can be done in terms of care and therapy.
Physical and occupational therapy, braces and orthopedic surgery can help with muscle control and movement.
Speech therapy can help with speech and eating problems. Anticonvulsant drugs can prevent seizures. And, of course, both you and your son should take full advantage of available counseling and support services.
Cerebral palsy is not a progressive disorder, so I expect that the new symptoms you're seeing are only a function of his increased physical and mental growth and development, e.g., age, stature, awareness of his environment, and perhaps his frustration.
Along the way, you're going to need expert medical help, but perhaps what you need most right now is to be able to talk to someone who has been through this period in a CP child's life and who can talk about the future.
If you have not already done so, contact the United Cerebral Palsy Association at (800) USA-5UCP or communicate with others by pointing your browser to www.parentsplace.com.
Update on Y2K: About 15 percent of medical devices have a computer, so they too have the potential for the date change problem we've all come to know as Y2K.
But almost no medical computers rely on recognition of the correct date to work properly. So pacemakers, defibrillators and almost all implant devices are not affected.
However, a few products, primarily used in hospitals and laboratories, do need correct processing of date information to function properly.
The Food and Drug Administration indicates that it is actively monitoring all manufacturers and does not foresee any significant problems.
Dr. Allen Douma welcomes questions from readers. Although he cannot respond to each one individually, he will answer those of general interest in his column. Write to Dr. Douma in care of Tribune Media Services, 435 N. Michigan Ave., Suite 1400, Chicago, Ill. 60611. His e-mail address is DRFamily@aol.com.
This column is for informational and educational purposes only. It is not intended to provide medical advice or take the place of consultation with a doctor or other health-care provider.