Monday, May 11, 2009

A Blessed Mother's Day In-deed

Happy (be-lated) Mother's Day to all!


Mine was rather mundane. Hubby is re-training (i.e. going to school) on account of lay-offs and no work in his career field. 20+ years and he has to turn around and start over. Not easy, but he is enthusiastic, and that helps. At any rate, he had massive homework/studying to do f0r finals this week. I have my fare share this final week as well.


I'm plugging away at my very last piece of homework: my final project power point on APD (Auditory Processing Delay). I found a great book, When the Brain Can't Hear; Unraveling the Mystery of Auditory Processing Disorder by Teri James Bellis, Ph.D. Amazon has a good price on it (I bought mine at the local Borders with my homeschoolers discount).



As I am reading and searching for info to include in my presentation I discover the chapter on APD in Children. More specifically, a section that talks about the Joint Committee on Infant Hearing (JCIH) and their identifying factors that an infant or toddler might be at risk for hearing loss.

I have to side-step for a minute... hearing loss is an important factor in APD because it is often the cause of APD, though not always. I will be discussing the causes more in depth in a later article. Briefly, here, however, I can explain that infants and toddlers who struggle with hearing will miss out on critical developmental connections within the brain. They use all of their senses to form their understanding of the universe around them as well as to develop learning abilities that will assist them later in life. If one of their senses is critically impaired, these developmental steps are missed and therefore, they experience delays.

B, my 3rd child, was diagnosed as "def" when he was almost 4 years old. A result that was not all that shocking but I did not believe was permanent. He hmmmmed when he talked instead of talking most of the time. He wouldn't respond when talked to unless you were looking right at him. He was quiet. (We are not a quiet family!!) But when a specialist performed a test (which I didn't feel were entirely thorough) B passed with flying colors. Perhaps fluid on the ears previously? We can't know. However, these symptoms and events are typical of an APD child.

To further side-step and offer a visual pre-lude to what I am about to share, here is a piece of history:

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I was surprised to find out, on my anniversary no less, that we were expecting our 3rd child. Nervous, but excited, I had a strange feeling it would be a boy. I always seemed to know these things. I had predicted every single one of my babies' sexes, and I would turn out to be right again. My morning sickness was the worst with this one. I don't know why. I just couldn't seem to stay out of the bathroom. Having had one boy and one girl already, I couldn't attribute it to any old wives tales in that category. But as I began to approach the 2nd trimester, it was slowly easing up.

Into my 11th week I was planning nurseries and names. Nothing official yet. But pregnancy is an exciting time for me. My excitement quickly turned to horror after one of my frequent visits to the bathroom when I wiped and noticed blood. Bleeding in pregnancy is not typical in my family, much less in me. I knew something was wrong.

After some phone calls and heightened worry, I made an emergency trip to ultrasound. It would seem the tiny life inside of me was preparing to extinguish. The placenta was detaching. It was between 20-30% detached when we arrived. My Dr, a well known OB-GYN in the area, had delivered my daughter and was great. However, something was different this time around. When I asked her what I should do, should I bed rest... ? What? She said there was nothing I could do. If I was to miscarry, I would miscarry and I couldn't stop it.

Heartbroken I went home. My husband and I agreed that I would bed rest in hopes that the Dr. was wrong. So I did, until the bleeding stopped, which took a little more than a week. A follow-up ultrasound showed that the placenta had fully re-attached and we felt blessed. We had a miracle baby on our hands.

My stomach was smaller than it had been with my other babies. Even weeks before I delivered I looked a month or two behind my typical pregnant belly for that time. We joked that I was having the runt of our litter ;-)

The big day came and we headed in. The nurse told me that I was having braxton hicks contractions (never mind the fact that I was 38.3 weeks). I didn't believe her. I had been through labor and delivery twice at that point and I knew what braxton hicks felt like... these weren't those. She attributed my irregular contractions and lack of dilating beyond 4cm to her assessment and sent me home without ever bringing in the doctor.

I labored for 2 1/2 days. I couldn't eat, my body was exhausted, I had no energy. Finally, at 3a.m. on June 6th, my strength couldn't take much more. The contractions still weren't regular but every now and then they would come 2 or 3 minutes apart before going back to 7 minutes apart. My husband dragged me into the hospital.

It was my roughest labor (and my second smallest baby) I think because I was just bone-tiered. As I felt my son exit my womb, I was almost relieved until I realized he wasn't crying. Panic grabbed my heart as I asked if he was OK. I kept asking and finally, someone told me it was alright, he was fine. But he wasn't crying. All babies cry when they are born... don't they?

They brought him to me, if nothing else but to ease my worries. He was beautiful and perfect... and quiet. He looked at me but he didn't say a thing. As I held him in my weakened arms we all noticed his color start to change. They quickly took him back and laid him down on the infant examination stand. He was turning blue... lack of oxygen. They proceeded to administer oxygen until his rosy pinkness returned.

In the meantime I still had one more delivery to push out: the placenta. I could feel my doctor moving the umbilical cord around (No, I don't use any pain killers in pregnancy). It had been maybe 5 or 10 minutes at most since B had come out. But here she was, "coaxing" the placenta to make its entry into the world. She gave it a hard YANK and I screamed. I think everyone thought I was nuts. She apologized. But the damage was already done (I am convinced this is what caused the "injury to my uterus" that led to having Adnomiosis which subsequently caused me to have to have a hysterectomy). As she pulled the placenta out and made the usual inspections I heard her comment, "That is why that was happening". Puzzled, I could tell she was talking to the nurse.... "The umbilical cord had a knot in it".
*******

That vivid memory has been with me since 2000. I have always heard umbilical cord knots could be fatal. If she knew, or had some incling because of decelerated heart rates... or whatever... why didn't she say or do something?? I trusted her with my son and something fell short...

So here I am, Mother's Day studying. I am looking down the list the JCIH has and I see factors such as:
  • Infant conditions after birth such as severe jaundice and breathing problems requiring the baby to be assisted by a ventilator or to be given oxygen (consequently, B had severe jaundice for a month after he was born requiring the use of a bili-bed that whole time)

The author goes on to explain that, "A lack of oxygen at birth, for example, can cause a number of developmental and sensory difficulties, hearing loss being only one. " (p.70)
I had to cross examine this.

The March of Dimes website stated that "...the knot or knots can be pulled tight, cutting off the baby's oxygen supply." Something most moms know. However, other than fatality, which we were blessed didn't happen here, what can that do? My prolonged labor probably distressed his situation.


An article by George M. Morley entitled, The Effects and the Injuries of Immediate Cord Clamping (ICC) shed some more light. The correlation here is that, a cord knot when pulled tight is similar to cord clamping because the blood flow is cut off.

Mr. Morley makes various notable points:

  • Cord clamping before the first breath always causes some degree of asphyxia and loss of blood volume
  • It totally cuts off the infant brain's oxygen supply from the placenta before lungs begin to function.
  • It stops placental transfusion -the transfer of a large volume of blood that is used mainly to establish circulation through the child's lungs to start them functioning.
  • Immediate cord clamping is clearly identified as a cause of newborn neurological (brain) injury ranging from neonatal death through cerebral palsy to mental retardation and behavioral disorders.

Cord clamping is increasingly common and the rates of behavioral disorders from ADD/ADHD to developmental disorders like autism, Asperger's, etc, continue to climb.


My question is... might this include APD? He also names Dyslexia as one suspected result. My miracle baby is a double miracle: The placenta re-attached and he did not die from lack of oxygen on account of the umbilical cord. I will take my living, breathing, wonderful APD/Dyslexic son any day over the dismal alternative I may have faced. We are truly blessed.

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