Special Needs, Special Horses: A Guide to the Benefits of Therapeutic Riding

Chapter 25: Andrew—Infantile Strokes, Possible DPT Reaction

167 Chapter Twenty-Five Andrew—Infantile Strokes, Possible DPT Reaction Andrew฀Levy฀first฀had฀surgery฀when฀he฀was฀seven,฀to฀stretch฀his฀ right฀hamstring฀and฀heel฀cord.฀Six฀years฀later,฀another฀surgery฀was฀performed ,฀a฀heel฀fusion฀to฀stabilize฀his฀foot.฀About฀three฀months฀after฀the฀ hamstring฀surgery,฀as฀soon฀as฀the฀cast฀came฀off,฀Andrew฀began฀hippotherapy ,฀and฀he฀has฀been฀riding฀ever฀since.฀ “The฀doctor฀said฀it฀is฀usually฀necessary฀to฀repeat฀the฀first฀operation ฀at฀the฀age฀of฀fourteen฀to฀sixteen,฀in฀similar฀situations,”฀Andrew’s฀ mother,฀Elisabeth฀Livingstone,฀said.฀“The฀process฀of฀growth฀tightens฀the฀ cord,฀pulling฀the฀heel฀up.฀But฀at฀fifteen,฀Andrew฀is฀still฀walking฀flat,฀with฀ no฀evidence฀of฀the฀hamstring฀tightening.฀He฀just฀had฀his฀eighteen-month฀ check-up฀and฀the฀orthopedist฀said฀his฀foot฀looks฀great.฀This฀followed฀a฀ growth฀spurt฀in฀which฀he฀went฀up฀almost฀two฀sizes฀in฀pants,”฀Livingstone ฀said.฀“I฀know฀riding฀keeps฀the฀muscle฀stretched฀out.”฀ Healthy฀and฀strong฀as฀a฀baby,฀at฀four฀months฀Andrew฀could฀literally฀ do฀push-ups,฀to฀the฀extent฀of฀lifting฀his฀chest฀off฀the฀bed.฀At฀his฀fourmonth ฀check-up฀he฀was฀pronounced฀completely฀normal฀and฀healthy.฀It฀ was฀also฀time฀for฀his฀second฀diptheria/pertussis/tetanus฀(DPT)฀vaccination .฀After฀receiving฀the฀shot฀at฀the฀public฀health฀clinic,฀he฀fell฀asleep฀in฀ the฀car฀and฀upon฀arriving฀home,฀his฀mother฀put฀him฀down฀for฀a฀nap. “He฀ woke฀ up฀ crying,”฀ Livingstone฀ said.฀ “He฀ didn’t฀ push฀ himself฀ up.฀He฀didn’t฀even฀hold฀his฀head฀up,฀or฀move฀his฀arms.฀He฀did฀drink฀ some฀milk,฀and฀we฀thought฀he฀was฀just฀tired฀from฀the฀trip.฀The฀next฀ horse2.indd฀฀฀167 3/11/05฀฀฀2:10:38฀PM PROFILES 168 morning฀when฀he฀still฀wasn’t฀moving,฀I฀got฀concerned฀and฀called฀the฀ pediatrician’s฀office.฀They฀said฀some฀immobility฀was฀normal.฀He฀didn’t฀ cry฀when฀I฀held฀him,฀but฀cried฀when฀I฀put฀him฀down,฀so฀I฀spent฀the฀next฀ two฀months฀holding฀him.฀This฀didn’t฀worry฀anyone฀in฀the฀family.฀They฀ all฀thought฀Andrew฀had฀just฀turned฀into฀a฀fussy฀baby.”1 At฀the฀time฀of฀his฀six-month฀check-up,฀Andrew฀still฀was฀not฀moving,฀ and฀his฀right฀arm฀had฀begun฀to฀twist.฀The฀pediatrician฀thought฀there฀ could฀have฀been฀a฀brachial฀plexus฀injury฀ at฀birth2 ,฀a฀condition฀in฀which฀ symptoms฀would฀begin฀to฀occur฀as฀Andrew฀grew฀older,฀and฀he฀referred฀ the฀boy฀to฀an฀orthopedist.฀This฀doctor฀suspected฀neurological฀damage฀ and฀in฀turn฀referred฀Andrew฀to฀a฀neurologist. The฀following฀six฀months฀brought฀countless฀paper฀work,฀appointments,฀ and฀examinations.฀At฀about฀nine฀months฀old฀Andrew฀was฀beginning฀to฀hold฀ his฀head฀up฀again,฀and฀in฀the฀following฀weeks฀he฀started฀rolling฀sideways.฀ But฀when฀his฀first฀birthday฀came,฀he฀had฀not฀begun฀to฀walk. “MRI฀revealed฀evidence฀of฀two฀strokes,฀one฀on฀each฀side฀of฀Andrew’s฀ brain,”฀Livingstone฀said.฀“I฀believe฀they฀occurred฀after฀the฀second฀DPT฀ shot฀when฀he฀was฀four฀months฀old.฀That’s฀when฀he฀became฀unable฀to฀ move,฀and฀cried฀constantly.฀I฀didn’t฀know฀at฀the฀time฀that฀infants฀had฀ strokes—I฀thought฀it฀only฀happened฀to฀the฀elderly,฀so฀we฀didn’t฀even฀ think฀about฀it.฀The฀papers฀they฀give฀you฀to฀sign฀before฀receiving฀a฀DPT฀ shot฀indicate฀any฀side฀effects฀are฀rare.฀But฀I฀believe฀the฀shot฀caused฀the฀ strokes,฀although฀doctors฀never฀admitted฀it.฀After฀the฀MRI,฀Andrew฀started ฀having฀seizures.฀Some฀say฀MRI฀can฀cause฀seizures฀because฀of฀electromagnetic ฀energy฀going฀into฀the฀brain.฀There’s฀controversy฀about฀it.” At฀fifteen฀months฀old,฀Andrew฀began฀a฀rigorous฀program฀of฀therapy฀ at฀the฀Child฀Study฀Center,฀four฀sessions฀a฀week฀including฀physical,฀occupational ,฀and฀speech฀therapy. He฀ learned฀ to฀ crawl฀ at฀ two,฀ which฀ the฀ therapists฀ taught฀ him฀ by฀ moving฀his฀legs฀in฀a฀crawling฀motion.฀Almost฀eighteen฀months฀of฀steady฀ therapy฀passed฀before฀he฀began฀walking.฀The฀ability฀to฀speak฀did฀not฀ come.฀Andrew’s฀stability฀when฀walking฀was฀inefficient.฀If฀thrown฀off฀ balance,฀for฀instance฀by฀an฀uneven฀surface,฀he฀would฀often฀fall.฀ The฀muscles฀in฀his฀right฀hand฀and฀right฀leg฀were฀extremely฀spastic,฀ and฀his฀hamstring฀tightened฀to฀the฀degree฀that฀it฀was฀pulling฀his฀heel฀up,฀ horse2.indd฀฀฀168 3/11/05฀฀฀2:10:38฀PM ANDREW 169 causing฀him฀to฀walk฀on฀his฀toes.฀This฀is฀when฀the฀doctors฀prescribed฀the฀ surgery฀to฀lengthen฀the...