Cerebral palsy (Focus on Epilepsy)

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I honestly feel it would be a huge disservice to myself and my  previous work place to skip making a post on Cerebral Palsy. I have stories to tell Fam! Thankfully, no names are attached to my stories as that would be unethical, however I would share a few for the sake of enlightenment. 

Before I go into this post proper, I would like to announce that I worked for five long years as an in-house doctor at a government owned establishment for children with special needs. The challenges at my workplace transcended all borders lol! But I wouldn’t have had it any other way. 

While at the establishment, some colleagues became amazing friends while others probably aligned as foes, I wouldn’t know because I am more focused on spreading love. I also learnt at the centre, valuable life lessons that have made me bolder and stronger today.

Now,  most of the kids I managed at the centre (about 80 percent) were children living with cerebral palsy, a few were autistic and another tiny percentage had other neurological conditions such as hydrocephalus and the likes. 

It wasn’t easy managing these kids, I must add, especially those who had co morbidities (add – on conditions/illnesses) but I give all glory to God for his guidance throughout my stay there. 

Just in case you are clueless on the Neurological condition known as cerebral palsy, illd give a brief overview.

Brief Overview of Cerebral Palsy

Let’s begin by dissecting the two words- Cerebral and Palsy. Cerebral simply put, refers to the brain while Palsy indicates difficulties with using the muscles or weakness. 

Therefore Cerebral Palsy could easily be defined as a group of brain disorders affecting an individual’s ability to move and maintain balance/posture.

Cerebral Palsy is caused by an abnormal brain development or damage to a developing brain. This damage could occur in a child during the pregnancy period and even up to five years of age, as the brain is still actively developing before the age five.

Simply put, anything that could disrupt the supply of oxygen to a baby in the womb could lead to cerebral palsy. Likewise, when a child is born, the baby needs to take in oxygen to activate the lungs immediately after birth by crying. When a new born fails to cry immediately after birth, it poses a very high risk of developing cerebral palsy. Finally, even after a successful birth, babies still need to be watched carefully to prevent them from accident such as traumatic falls, especially before they clock 5. Fall from heights or traumatic falls involving the head could be very dangerous and ultimately lead to Cerebral Palsy. 

Now, it is important to know that this condition is a life long condition. There are varying degrees of this movement disorder. While some children living with cerebral palsy could move around themselves but get off with an abnormal gait, many of them are bed ridden and cannot care for themselves without help. 

If I am being honest, this is not a pleasurable condition, as it comes with a plethora of associated complications and disorders such as 

  • Seizure disorders 
  • Gastroesophageal reflux disease
  • Feeding difficulties 
  • Drooling 
  • Communication difficulties (most can’t speak normally)
  • Fractures
  • Vomiting 
  • Recurrent bowel obstruction and many others

The funny thing is that most parents who bear kids with cerebral Palsy especially where I am from, might be oblivious to the condition of the child until they start to notice signs/symptoms such as 

  • Developmental delays; where the child does not attain expected milestones as they grow
  • Abnormal posture 
  • Abnormal muscle tone (extremely floppy or too stiff)

The sad part of the condition is that it has no cure, all that can be done for these individuals is an improvement in their quality of life by doing regular physiotherapy, speech therapy, nutritionist supervision, and specialist management where necessary. 

Unfortunately, many of these parents have false hopes when the kids start to see a physiotherapist or physician. They have high expectations of the Medical personnel and believe the condition would eventually fizzle out, which is near impossible. It is always advisable to inform such parents about the intention to improve the child’s quality of life as opposed to miraculously curing the condition. 

Shocking stories from a few parents I met at the centre

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Literally how I struggled to stay calm after listening to these bizzare stories

STORY 1 

There was this parent I always had issues with at the Children centre, she was usually cranky and in fight mode every single time we had a conversation. Being very well read and educated, I used to wonder why she gave me so much trouble until I heard her story. Apparently, the delivery of her child who was now living with cerebral palsy was facilitated by a medical officer with close to no knowledge on how to properly resuscitate a limp child. 

See, for every minute a child born fails to breathe and take oxygen into the lungs, there is serious trouble. Unfortunately her child ended up with cerebral palsy and she blamed this young female doctor. Fast forward to many years later, she saw another young female doctor (that’s me by the way) and the memories came rushing back. Now as much as I empathized with her about the whole situation, I pretty much got tired of her impolite mannerisms and resort to anger. All I wanted was the best for said child but she didn’t seem to understand it. She was just too bitter and had developed a personal vendetta towards young female doctors. Anyway, the situation could have been averted if only this young female doctor was a bit more pro active or called her senior colleagues for help. But then again, no one knows the true story as there are always two sides to a story, unfortunately the doctor in question wasn’t there to defend herself. 

STORY 2 

This one was a pretty terrible and heart wrenching story guys! I felt so sorry for this particular mother. Though she was not the most educated individual, she certainly didn’t deserve the injustice that was dealt to her. 

I got the story surrounding the birth of her child while I took history from her and her husband for a possible admission of the child into the centre. The sad part of it all was that they had no idea of the culprit who was solely responsible for their child’s predicament. 

It was a callous nurse people of God with no conscience whatsoever. This woman had opened a maternity centre somewhere down town where she handled cases that were way above her pay grade. 

At 35weeks of gestation, the then pregnant mother was summoned by the nurse to come in for an emergency birthing of her child. This decision the nurse took solely because she was travelling out of the country and wanted the child out before her departure. She obviously didn’t want to miss out on the funds. My people! Is this not legit another form of witch craft? 

A perfectly fine pregnancy with no cause for alarm was spiraled into a chaotic birthing for another human’s selfish reason. It is highly despicable and preposterous! 

Apparently the nurse gave this woman all sorts of injections in a bid to induce labour, and of course the labour was one hell of problematic. Baby came out limp after his mother had been dragged through hell and back courtesy of this nurse. Guess what, not only was the baby limp, he was also jaundiced. At this point, you would expect the nurse to give up and refer to the appropriate centre right? 

Unfortunately she didn’t and continued to milk these uneducated parents. Her Jaundice management included shaking the new born to stupor and spreading him under the sun. It wasn’t until the baby started to convulse (have seizures) that she let them go. 

As the mother to this child narrated her story, I cringed on the inside and tried my very best to remain professional but anger was written all over my face. I was enraged, that a fellow human could cause a life long burden for her selfish and irrational reasons. It was deeply saddening to say the least. 

KNOW YOUR DOCTORS (specialty breakdown)

Gone are the days where the elites are satisfied seeing medical officers only. Most of them now request to be seen by specialists. You could still check out the post on knowing all the medical specialties via the link above.

Before I end this post, let me quickly discuss Epilespy, one of the most common complication of Cerebral palsy. 

Definition of Epilesy

Epilepsy is a brain condition in which an individual develops repeated seizures/convulsions due to abnormal activity of their brain cells.

Just in case you were wondering, yes there is actually a slight difference between seizures and convulsions, although most times they are used interchangeably. 

Seizures involve the abnormal or rapid neuronal activity of the brain while convulsions are characterized by abnormal or involuntary muscle contractions. It is a very distressing situation and there are many different types of seizures which I would rather not delve into

While those who witnesses a seizure could panic or result to all sorts, it is always better to do the following instead 

  1. Call on a medical Personnel for help, in case the seizures lasts longer than 5 mins or is continuous
  2. Clear the area around the victim to ensure that no injuries are sustained 
  3. Loosen any tight clothing around the neck of the individual to prevent choking/ breathlessness
  4. Place something soft under the head of the victim such as a pillow or a fluffy jacket
  5. Place the patient in the recovery position; Left lateral decubitus position (That is you turn the person gently into the side) This would help them breathe better. 

Management of Cerebral Palsy and associated Epilepsy

Sadly, Cerebral Palsy like I mentioned earlier is a neurological condition with no definite treatment. All that is possible is the improvement in the quality of life of a person living with cerebral Palsy. Please never believe lies from anyone who tells you they have a special proceedure or medication that could make it go away.

The actual management of Cerebral palsy is multi disciplinary with the inclusion of a neurologist.. This means that all hands must be on deck to ensure that the child’s quality of life is significantly improved.

When I was employed into the special needs centre, I was given the job alongside some other professionals such as the Physiotherapists, Nutritionsits, Public health officers, and nurses. The kids also required speech therapists to help with their communication deficits.

For the Epilepsy/associated seizures complication of Cerebral palsy, the affected children are usually placed on anti seizure medications such as Carbamazepine and Sodium valproate to reduce the seizures to their bearest minimum. However, these medications should never be stopped abruptly or prescribed without consulting a Neurologist first. Abrupt stoppage of seizure medications could cause rebound seizures worse than the initial presentation.

At the centre, most of us worked hand in hand to ensure an improvement in the children’s quality of life. Even after leaving this super controversial job, I pretty much miss the kids over there and pray that they continue to do well. I did bond with a few of them, especially one who had an asthma comorbidity. On another note, we lost a few over the five years I worked there and I cried my eyes out.

One thing I have come to realize is that even these kids with a seemingly abnormal medical condition have feelings too. They know when you are nice to them and also can sense when it is otherwise. So regardless of their situation, they also deserve a fighting chance. Many of them might have been abandoned at different odd places by their parents but are certainly not forgotten.

I remember the way some of them jubilate each time members of staff walked into the center, or the way they are usually filled with Joy with every invitation to parties. Their feelings are definitely valid guys.

A few times when I ran out of ideas on what more to do for those who were critically ill, , Ill’d find myself praying for them.

I definitely would always miss these kids.

With all that has been said, I hope I have been able to enlighten you on the subject topic Cerebral palsy as my goal is to keep you informed and not necessarily to school you. Stay blessed peeps.

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