Tie up the good arm: usefull or bad

[admin]

Kate,
Her IVs were always in the uninjured hand. Believe it or not, she complained more about the IV than the Spica cast! Go figure! She hated the idea of this thing stuck in her hand!

Anyway, no matter what anyone will ever tell me, including doctors and therapists, this just isn't something that I would ever put my child through. I could read a million success stories and I still wouldn't put Ella through that. That is MY personal feeling. Like I said, a temporary restraint for therapy would be okay with me, but I would never intentionally restrain her arm for a long period of time. It isn't fair. And the overall outcomes may show some improvement and more use of the injured arm/hand, but what about the mental aspect of this. Is it REALLY worth it? I doubt it. I can acheive the same movements and more ability for her to move her arm by standard therapy. We just have to work a little harder. We just have to talk a little more to the kids about "not using that arm, put that arm down first" etc. Or hold the uninjured arm back while you do therapy and do this longer than regular therapy if needed. Age plays a huge role, but I am certain that any child above age 2 - 2 1/2 will remember that. At least that is my opinion on this. Ella was only 2 yrs and 4 months old and remembers surgery. That was ONE day. It may even play a role with the child's ability to deal with things down the road. Maybe they will get frustrated more easily, etc. No matter what, restraint therapy WILL NOT fix the injured arm so there will always be frustration. You will not help your child stay away from that down the road. Frustration will always be a part of a injured child's ability to do things correctly. You will not make it go away and you will not fix your child's arm by doing this. If that were the case, every doctor and every therapist would be talking and teaching this to parents. I can go on forever, but end here b/c there is no point since I already told everyone that I am AGAINST it and ALWAYS will be. Sorry. I guess that's all I have to say.
Let me just say that for those of you who chose to do this, I am not against your way of doing things. Obviously you think it is safe, fair and that it will work. You think the benefit outweighs the feeling of the child. I just think differently. BUT I do not think you are a bad parent if this is your choice. Everyone has the right to do things differently even if I do not agree with their way of doing it.
~Krista~

[admin]

"I am not against your way of doing things."

Well, I should have used a different word here huh? I am against you way of doing it, but I don't see you as less of a parent or a bad parent. I am against it b/c I would never do it.
Just to clarify what I meant.

~Krista~

[Tanya in NY]

I am a believer that encouraging the use of an injured arm is helpful. It's how you do this that can be controversial. We never formally used anything to "tie down" our daughter's uninjured arm, but instead put things in her reach on her affected side instead when she was an infant therefore encouraging her to reach with her injured arm instead. Verbal reminders to use her right arm have worked as she became older and could understand. Now that she is 3 years old, we say things like, "Amber, put your left arm on your hip while you use your right arm (the injured one) to do XYZ" and it works well as a reminder during therapy. During the rest of the day we allow her to use whichever arm she prefers because you and I use whichever arm is easier for us during the day, so she is no different.

I hope this helps.

Tanya in NY
Amber's Mom, ROBPI, 3 years old

[admin]

"During the rest of the day we allow her to use whichever arm she prefers because you and I use whichever arm is easier for us during the day, so she is no different."
Tanya,
You said that perfectly. I am also very much for encouraging the use of the injured arm. I do it all the time. I just do not do it as restraint therapy. The way I do it seems to be working just fine.
~Krista~

[Kristie]

So I see the flaming has begun.

And really it is no use to argue about it since people will diagree and when you chose not to have an open mind about something things just get mean and ugly.

I have a real issue with people call this type of therapy cruel. Because for me it translates into calling me as a person and parent cruel.

I think one can get the point a crossed regarding it being a decision they would not make for their child without using harsh hurtful words.

I struggled with using the cast 24/7 for three weeks but at the time in my childs life it was a good thing for him. And regarding the idea of frustration... he actually never did get frustrated with the cast because of it limiting him... because it never limited him... he would try to "cheat" with the casted arm but then couldn't do it and then switched to the other arm.

I at first I was closed minded to this type of therapy but I am so glad that we did it. I try not to be closed minded about many things. When I don't agree with something I try to look at it from other angles to see if I might gain perspective before I make my final judgement. I may still disagree and that is ok but I do try to refrain from telling others how they are _____ (fill in the blank with any description that would be considered less than kind)or telling them how it WILL make someone else feel.

I mean I have read how frustrated it WILL make my child but he wasn't at all frustrated. He went on about life as before. I read people saying how bad it WILL be and often (not always) they haven't tired it so they don't know. And the ones speaking from personal experience don't always have the same situation to speak from.

I amsure I have more to say but I have an appointment to be at so I must let this rest for a moment.
Blessings,
Kristie

[admin]

Kristie,
I hope you don't think I was starting an argument here. If you read the bottom of my post I did say that I have nothing against you as a parent, but I just do not agree with that sort of therapy so I am against that therapy. I am sorry that my true feelings on this believe that it is cruel. I am sorry that you dislike my taste in words. That is only MY opinion and the first word that came to mind on how it made ME feel. I am NOT saying you are cruel. If you take it that way, sorry to make you upset. I agree with you that everyone will always disagree with things. I am a VERY open minded person. People who know me good will agree to this. There is a line that I draw though. To me, casting or restraining my childs ONLY arm that works crosses that line. It isn't about being open minded. It is about NOT doing something that makes me sick when I think about it. I am glad it worked for you. I am sorry that you are uncomfortable hearing that I disagree with it. I never meant any harm to anyone. I am just sharing my feelings on it as you are. They are just extremely different feelings.
~Krista~

[katep]

This is a particular technique that needs to be carefully applied to any individual child.

I see concerns about the child being "frustrated" and "upset". Our child does not get frustrated or upset. The first couple of times after he is restrained, he tries it "the old way" and then he quickly forgets about it and does it with his left hand.

The level of frustration, and thus the determination of whether or not this technique is wrong for a particular child, seriously depends on the child and also what they are trying to do while restrained. If their use of the injured arm is sufficient, or the tasks sufficiently limited to what they are able to do with the injured side, so that they only need to exert just a little more effort or concentration, they are unlikely to be upset by the restraint or frustrated by the demands placed on the injured arm.

Yes, if you tied up the uninjured side on a seriously injured child, so that they couldn't do *anything* (because of severe limitations in the injured arm) I agree that would be cruel. If your own child gets very easily frustrated and such therapy would make them upset, then I can see how it would be cruel. If the child is old enough to respond to verbal cues such that restraint therapy is unnecessarily invasive or threatening, and they would just see this as punishment, I can see how it could be cruel. If your child has sensory or claustrophobic issues so that the very act of being restrained is distressing to them, I can see how it would be cruel. I can think of a lot of situations where this technique would be wrong for a specific child.

But if the young child reacts with a temporary, mildly confused look... and after a moment of adjustment proceeds to use their injured hand and arm on tasks that are doable (but might require more effort and concentration) and it doesn't seem to bother them, I can't see that as anything but beneficial.

I really hate parents in that position being told they are being cruel. You can say *for your child* because you know your child. You can imagine how your child would feel. But you do not know my child; you have not seen him with his uninjured arm constrained in therapy today, happily playing along and not being bothered at all, and using his injured arm with significantly more dexterity and ability than he otherwise would put into it. Yes, we could sit there and constantly say to him "no cheating" (he knows that means use the left arm more) or we could constantly hold his uninjured arm out of the way. Or we can just put a splint on his right arm and let him just concentrate on playing with his left hand. Since it doesn't bother him, it really shouldn't bother anyone else

Kate

[LoriV]

When my son had surgery he was immobilized for 3 weeks. In that time he got very used to doing everything with his un-injured arm and sort of forgot he even had another arm. So his therapist gave us a wrap for the un-injured arm. We used it for short periods at a time (about 15 minutes). It wasn't a complete restraint - it basically just made using that arm a little more cumbersome, thus encouraging use of the other arm. It just basically helped get him back up to speed.

[admin]

Lori that reminds me that I do have experience having Ella only able to use one arm, but it would be her uninjured arm. When she had secondary surgery she wore a Spica cast for about 5 weeks and therefore was only able to use one arm, her uninjured arm. She did cope well. She did it quickly and not much bothered her. BUT would I do this on purpose for an extended period of time...NOPE. Especially not with the injured arm being the only arm free.
Kate,
You make some good points although I still strongly and 100% believe that it is wrong and not a good form of therapy. Nothing will change my views on that. Do I speak for every child that it is cruel? Well, no b/c I don;t know every child here. BUT many children in life enjoy the same things, dislike the same things and get frustrated with the same things. For those who have children that are not getting frustrated by restraint therapy that is wonderful, but I believe that most children would. Not sure why your aren't. but I know mine would be easily frustrated and it isn't fair if I tried that. This debate will go on forever, but please understand that I will not change my mind on this and to me it will always be NOT EVEN a last resort. In my mind there is no such thing and shouldn't be. (For extended periods of time.)
~Krista~

[katep]

Krista,

Perhaps if your child ever does have her "good" arm incapacitated for any period of time, you might change your mind... I'll bet that she would get over any frustration and adapt quite quickly to getting things done with the injured arm

Kate