Melanie Krishna is blind and confined to a wheelchair, due to her cerebral palsy. She doesn’t have total control over her arms or legs, but when she sings, she feels powerful. Her amazing voice dazzles an audience as she sings songs such as Schubert’s “Ave Marie.” Melanie also enjoys singing an occasional rock song, although opera is her genre of choice. The talented singer also composes her own music. Her favorite piece is called “Within My Faith,” which depicts how Melanie deals with life’s daily struggles and challenges caused by her disabilities. She hopes that when people hear her song, they feel inspired with whatever struggles and challenges they face.
Melanie has always tackled her struggles head-on. At the age of 5, she began singing. By the time she was 9 years old, she had performed her first solo. Melanie says music is part of her life–it feels like a prayer to her. Melanie’s music coach says that the gifted musician has a true passion for life and is always smiling and laughing. Melanie has to work extra hard to control her vocal and breathing muscles, but the strength of her hearing more than makes up the difference. Melanie’s coach feels that Melanie has a perfect pitch that is “absolutely amazing.” Melanie can match vowels beautifully, and when she is singing with others, she can cut off at the exact same time as them because her hearing is so precise.
Melanie knows she hasn’t reached her vocal limit yet. She plans on working hard, with a special focus on her breathing. Performing will always be on Melanie’s schedule. She often is nervous when she begins singing her first song, but as she continues, her nervousness disappears and she feels confident. Melanie especially enjoys singing with other people because of the harmony it adds. The young singer is described by her friends as being extremely giving; she is constantly writing songs to thank people in her life that mean a lot to her.
Melanie was one of the artists performing at Unheard Notes, a piano festival with performances by people with disabilities, such as cerebral palsy.
What Is Cerebral Palsy?
Cerebral palsy may mean that the child has to use a wheelchair for the rest of their life. In some cases, cerebral palsy affects all four limbs. In other cases, it impacts one limb, three limbs, one side of the body, or just the lower limbs. Children with cerebral palsy usually have problems with large muscle groups as well small ones that control fine motor function and help a child hold a crayon or piece of cereal. In addition to muscle problems that affect movement, balance and posture, children with cerebral palsy often have vision and hearing problems as well as dysfunction in oral-facial muscles that make it difficult to speak and/or take in nutrition.
A child with cerebral palsy cannot move their muscles normally. The muscles don’t work together, and they often seem to work against each other, which can cause multiple additional problems. Cerebral palsy is the most common cause of childhood disability, and spastic cerebral palsy is the most common type, affecting 70-90% of all children with cerebral palsy. The muscles in children with spastic cerebral palsy are constantly rigid or spastic, which means movement is stiff and jerky. This is caused by an abnormally high muscle tone, called hypertonia, and both the legs and the arms are affected.
The other types of cerebral palsy are ataxic, athetoid/dyskinetic, and a mixture of the different types. Ataxic cerebral palsy occurs in about 10% of all cases. Some children with ataxic cerebral palsy have hypotonia (low muscle tone) and tremors. Motor skills such as writing, typing, or using scissors may be affected, and balance problems–especially while walking–are common. Children with ataxic cerebral palsy also usually have difficulty with seeing and hearing.
Athetoid cerebral palsy or dyskinetic cerebral palsy is mixed muscle tone, both hypertonia and hypotonia, mixed with involuntary motions. Children with athetoid cerbral palsy have trouble holding themselves in an upright, steady position while sitting or walking, and they often have involuntary motions. For some children, it takes a lot of work and concentration to get their hand to a certain spot (like scratching their nose or reaching for an object). Because of their mixed tone and trouble keeping a position, these children may not be able to hold onto objects, especially small ones requiring fine motor control. In newborn babies, improperly treated jaundice (high bilirubin levels in the blood) can lead to brain damage in the basal ganglia (kernicterus), which can cause athetoid cerebral palsy.
What Causes Cerebral Palsy?
There are many events that can damage a child’s brain and cause cerebral palsy. Cerebral palsy is often caused by conditions that occur during labor and delivery, or shortly before or after delivery. The condition can occur when there is an injury to the developing brain, so children can get cerebral palsy up until approximately three years of age.
A baby in the womb is in a very fragile position, because delivery is necessary in order to be directly helped by physicians. Physicians handling labor and delivery must be very skilled at interpreting fetal heart rate tracings on the baby’s heart rate monitor. Abnormalities in fetal heart tracings must be promptly recognized so the medical team can prepare for a quick delivery. Indeed, when there are non-reassuring fetal heart tracings, a quick cesarean (C-section) delivery is usually indicated. Non-reassuring fetal heart tracings are almost always an indication that a baby is being oxygen-deprived, and when oxygen deprivation is occurring, a quick delivery is necessary to avoid brain damage.
High bilirubin levels, improperly treated neonatal hypoglycemia, infections in the mother that travel to the baby during delivery, and a lack of oxygen in the baby’s brain, called hypoxic ischemic encephalopathy (HIE), all can cause brain injury and cerebral palsy. The brain can be deprived of oxygen when there is a restriction of blood flow in the brain or when the oxygen supply to the baby is decreased or cut off, which causes decreased oxygen in the blood and brain.
Conditions that can cause a lack of oxygen in the brain, HIE and cerebral palsy include the following:
- Ruptured uterus (womb)
- Placental abruption
- Placenta previa
- Umbilical cord problems, such as a nuchal cord (cord wrapped around baby’s neck), umbilical cord prolapse, short umbilical cord, cord in a true knot
- Failure to quickly deliver a baby when fetal distress is evident on the fetal heart rate monitor (delayed emergency cesarean (C-section) delivery)
- Oligohydramnios (low amniotic fluid)
- Anesthesia mistakes, which can cause blood pressure problems in the mother, including a hypotensive crisis
- Premature rupture of the membranes (PROM) / premature birth
- Prolonged and arrested labor
- Fetal stroke
- Intracranial hemorrhages (brain bleeds), which can be caused by a traumatic delivery. Forceps and vacuum extractors can cause brain bleeds. Sometimes intense contractions (hyperstimulation) caused by labor induction drugs (Pitocin and Cytotec) can cause head trauma. Mismanagement of cephalopelvic disproportion (CPD), abnormal presentations (face or breech presentation), and shoulder dystocia also put a child at risk of having a brain bleed.
- Hyperstimulation caused by Pitocin and Cytotec can also cause oxygen deprivation that gets progressively worse.
- Improper management of the baby’s respiratory status after birth. This includes failure to properly manage apnea (periods of breathing cessation), failure to properly manage a baby on a breathing machine (which can cause overventilation injuries, such as hypocarbia and holes in the lungs), and failure to give proper amounts of surfactant, which helps with lung maturity and lung compliance in premature lungs.
- Improper management of anemia (low red blood cell count), which can cause the baby to lack the capacity to carry oxygen to the cells and tissues in the body, including brain cells.
Choosing An Experieced Cerebral Palsy Lawyer
There are many lawyers in Michigan that call themselves “cerebral palsy lawyers” or “birth injury attorneys.” Jesse Reiter, president and founder of ABC Law Centers, is the only lawyer in Michigan who focuses solely on birth injury cases, and almost all of his cases involve children with cerebral palsy. Jesse is past chair of the Birth Trauma Litigation Group, an international group of lawyers who represent babies and children injured as a result of birth trauma.
Jesse helps children in Michigan and throughout the nation, and once he takes a case, he spends a great deal of time getting to know the child and family he is helping so he can fully understand the child’s needs. Over his 25+ year career, Jesse has won numerous awards for his advocacy of children, and he is currently recognized as being one of the best medical malpractice attorneys in America by U.S. News and World Report 2014, as well as one of the 10 Best Attorneys in Michigan by Super Lawyers magazine. He was recognized by Lawyers Weekly as a Lawyer of the Year, a Leading Lawyer, and has recently been awarded the Respected Advocate award by his peers.
Cerebral palsy is a difficult area of law to pursue due to the complex nature of the disorder and the medical records that support it. The award winning lawyers at Reiter & Walsh ABC Law Centers have decades of experience with cerebral palsy cases. To find out if you have a case, contact our nationally recognized firm to speak with an experienced cerebral palsy lawyer. We handle cases in Michigan, Ohio, Washington, D.C. and throughout the nation. We have numerous multi-million dollar verdicts and settlements that attest to our success and no fees are ever paid to our firm until we win your case. Email or call us at 888-419-2229.