My Journey with hydrocephalus and Cerebral Palsy

Morgan Grace was born 3 1/2 months early on Aug, 21, 2012 weighing just 1 lb 7 oz and 13 inches long. Morgan was hospitalized at Children's Hospital NICU in Minneapolis, MN for 108 long days. During this time she encountered many medical challenges common to "micro preemies" but most devastating was to hear she had suffered from grade III/IV Intraventricular hemorrhage (IVH / brain bleed). We were told she may never walk or talk and they would not be able to tell the severity of the damage until she is older. The IVH resulted in Hydrocephalus, a condition she will have for life. At two, Morgan was also diagnosed with Cerebral Palsy.

I have found it very difficult to find information online - stories and information on hydrocephalus, shunts and people's experiences - so decided to write this blog to share what we have been through. I hope some day that Morgan can take over writing from her perspective. More importantly I hope maybe it can shed some light for other hydrocephalus and Cerebral Palsy patients and families. We welcome comments and questions.


From Wikipedia, the free encyclopedia:

Hydrocephalus is also known as "water on the brain", is a medical condition in which there is an abnormal accumulation of cerebrospinal fluid (CSF) in the ventricles, or cavities, of the brain. This may cause increased intracranial pressure inside the skull and progressive enlargement of the head, convulsion, tunnel vision, and mental disability. Hydrocephalus can also cause death. It is more common in infants, although it can occur in older adults.
The cause of Cerebral Palsy is a brain injury that occurs while the brain is developing. As a result of the brain damage during brain development a child's muscle control, muscle coordination, muscle tone, reflex, posture and balance can be affected.

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Monday, December 11, 2023

Adaptive Programs & Athletics

I remember the first time I saw Morgan break a sweat.  It was just a few years ago (she was 8), when she stepped off the ice from her first Minnesota Special Hockey practice and took her helmet off.  Her head was soaked, her face was flushed pink, and she was exhausted from working so hard to try to skate.  I smile now at this picture in my mind because its something most parents wouldn't think twice about (sweating is a near daily occurance for my active son since the day he could start running) but for Morgan this was a sight that nearly brought me to tears.  I remember thinking it was so amazing to finally find an activity that she could get such great physical exercise from. 

We are a family that loves sports, I am a firm believer in keeping my children active with whatever activities they are passionate about and we encourage them to try new things.  Whether it be music lessons, hockey, baseball, rubiks cubing, dance, football, art class, cheer, swimming and so on, there are so many benefits for children to be part of something.  They develop physical and motor skills, get exercise, make friends, improve their self esteem, learn teamwork, and have fun!  For neuro-typical, able-bodied children this is simple, you find your local community and sports organization(s) and sign them up! The options are endless and the most challenging part is figuring out what they like best and navigating schedules.  Their chosen activities shape their core group of childhood friends,  entertainment values, and (hopefully) keep them busy and out of trouble.  

For children like Morgan with special needs (whether physically disabled, neurodivergent or children with complex medical issues) finding activities and sports to participate in is MUCH more challenging.  We started looking for activites for Morgan when she was a preschooler but realized early on the options were limited for a child who couldn't yet walk, had poor attention span, and limited fine motor abilities.  We started with music, something that seemed theraputic and catered to her sweet little voice.  After spending hours researching online and asking her therapists and hospital resources for recommendations, we settled on MacPhail Music Therapy adaptive program.  Taught by board-certified music therapists, she loved this amazing program and it gave her something to look forward to once per week.  But, like most adaptive programs, it was far (thiry minute drive each way), expensive, and individualized.  We then found an adaptive dance program at Studio 4, another amazing program and a chance for her to interact with other children with disabilities like her but also nearly a thirty minute drive.  A couple years later we were thrilled to learn about a Darby's Dancers program opening at our local Prior Lake Premier Dance Academy and made the switch so she could meet friends within our community.  I believe Darby's is still the only adaptive sports option in our city for elementary age children.  As Morgan grew older, she wanted to do and try all of the things she saw her brother and cousins participating in.  Over time, through various resources and word of mouth, we have found many awesome adaptive programs in the Twin Cities area and Morgan has been fotunate to participate in MN Special Hockey, Shockwaves Adaptive Waterskiing, Courage Kenny Adaptive downhill skiing, and Miracle League Baseball.  

These sports and her activites bring her so much joy and have helped her both physically and cognitively.  I love that she now has the confidence to participate in our family backyard baseball games and she can pridefully wear her hockey jersey to school on jersey day like her classmates.  We are so grateful for the programs that do exist but realize the barriers to entry are still so high for many children with extra needs- distance, costs, diverse abilities, resources, and even aptitude to find them!  Children with special needs already require so much EXTRA (frequent appointments, therapies, extra time to get out the door, additional time on school work, more coordination of resources, the list goes on) so adding a long drive to an activity that should be fun often just causes more stress. 

Morgan has also asked me many times why she can't be a Laker and play for Prior Lake like her friends and brother.  I wish I could give her a good answer for this!  As a communinity, I believe we can do so much better to be more inclusive with our offerings to accomodate for children (and adults) with disabilities and extra needs. 

There are over twelve hundred students in our district receiving special education services yet there is not a single adaptive program offered in our community education catolog.  Our city boasts more than 55 parks and close to as many baseball/softball fields used by our athletic program but not one of them was built with our adaptive athletes in mind.  Even activites like Choir or Play Theater, which may seem very accessible, are challenging for someone like Morgan who has dyslexia and can't read the lyrics/script as quickly, could be easily modified to better accomodate.  It is something we should all be mindful of for programs and events, to explore possible modifications and accessible offerings for people with physical and cognitive challenges.  Some activities might require minor modifications to be more sensory friendly or better cater to children with cognitive delays and of course other options like building an adaptive baseball field or park require much larger financial support, but as a community it is important to give opportunities to citizens of all abilities!  For me of course, my passion to help and support local adaptive programs is fueled by the smiles and joy I see them bring to my daughters face and the adaptive athletes and buddies around her. 






Thursday, August 24, 2023

11! and Summer Updates

Hard to believe summer is almost over and Morgan just turned 11 earlier this week and off to 5th grade in two weeks!  We've had a crazy past several weeks with lots of appointments and some fun times also with our annual camping trip up north, a trip to the Jersey shore to visit family filled with waterparks, boardwalk and beach time and celebrating Morgan's 11th Birthday.  Trying to fit in as many appointments (even the regular stuff like dentist) as we can before school starts and while we thought a lot of this was routine follow ups there have been a few concerns raised to update on.

We saw endocrynologist earlier this year I don't think I ever updated on, since Morgan's height continues to plot before the 1st percentile, discussed the option of going forward with a growth hormone stimulation test, but she thought unlikely to show a growth hormone deficiency since Morgan's rate of growth is within normal limits. We did a bone age x ray for now and thought the results were interesting:  her chronologic age at the time was 10 years + 5 months, Bone age approximates were 8 years + 4 months.  So ~2 years behind still on bone age growth.  We will just continue to monitor growth and check back in a year or so. 

Gillette Children's is where she sees her PMR (Pediatric Rehabilitation Medicine Physician) and orthopedic surgeon.  We've had a few follow up appointments there to do another gait analysis following her osteotomy surgery, new AFO fittings to get back to hinged and give her more flexibility, and general CP follow up.  They noted some onset of right knee flexion contracture (her joint can't be straightened) and recommendation is to continue stretching, wear her knee immobilizer regularly overnight (we have been really bad about and got fitted for a larger size) and ideally do another round of seriel casting for ~4 weeks- ugh.  We see her orthopedic surgeon in a couple of weeks again and know it is recommended to schedule her pin removal near a year post op so one thought we discussed is to see if we can have them cast her right out of surgery since she will have stiches and have to stay out of water for a few weeks anyway.  Will make a decision and look at timing at this appointment coming up.

MHealth Fairview is where her new neurosurgeon is and we did have some concerns in May with some consistent headaches she was having so bumped up her annual MRI appointment to May and her symptoms seemed to go away so kept our July follow up with her neurosurgeon.  He is not comfortable with where her lateral ventrical size is.  Fluid in her head has increased some and might be impacting her negatively (potentially related to some of the behavioral & incontinence things we have seen).  This led us to some choices on next steps for testing and decided to do a dye injection into her shunt to check the flow.  She was quite nervous about this procedure and in tears until it started and realized she couldn't even feel it!  The dye flowed into her ventricals quickly (no obstruction in the catheter) but while laying under observation it did not flow down her tubing to her abdominal cavity until they had her up and moving around for about 30 mins.  So its draining slower than they would like which might be just due to pressure level in her head or might be some intermittent blockage in the tubing.  We had a remote meeting with her neurosurgeon to discuss next steps and today I took her in to try to turn her shunt setting down with the goal of having it drain more.  Well unfortunately after 2 1/2 hours of nurse and doctor trying to reset and a couple of x rays to confirm they could not get her shunt to program to lower setting :(.  Odd thing is we thought it was at 120, found out it was at 70 somehow from the x ray (we don't know how long its been like this but potentially since May maybe it didn't reset after MRI and they are trying to get it to 40.  Will wait to hear from Neurosurgeon tomorrow but we will likely have to go back in and see if he can get it to program maybe with the Codman rep.  Praying we can get this reset and an MRI in a few weeks shows smaller ventricals, want to hang on to this "old" shunt as long as possible!  

We've wrapped up summer swimming lessons (still really pushing this to get her swimming independently) and Miracle League (adaptive) Baseball but already started sideline cheer and will start up fall ML Baseball and swimming lessons again in a couple of weeks!