Girl Overcomes Birth Injury

Daisie Losee

Daisie Losee had a rough introduction to the world. Her mother, Melissa, struggled to deliver her sixth child at an Idaho hospital. During the birth, Daisie suffered two injuries. Her broken right arm was discovered as they changed her clothes for the first time. Doctors tried to put a splint on her tiny bone, but the break between the shoulder and elbow was in such a small area that it was difficult to keep stable. The doctors had to improvise and make a sling that held her fist against her sternum to let the bone heal.

The second injury, brachial plexus, was more mysterious.  Neither Cory nor Melissa Losee had heard of that condition. For the first month after Daisie’s birth, she had no movement in her left arm and hand. The Losees saw five different doctors at the hospital in the first seven days of Daisie’s life. None of them talked about the injury to the left arm and the Losees were unsure what was happening with their newborn daughter.

“She was so delicate when she was first born,” Losee said. “We were so focused on her broken arm, but we also knew her left arm was paralyzed – we just didn’t know if it was a permanent condition or if there was anything we could do for her.”

The inactivity of the left arm went unexplained until a young physician from Seattle doing a rotation at the Idaho hospital finally explained the condition. He told them that brachial plexus is a nerve injury that occurs during birth when the neck or shoulder is contorted during delivery. It varies in severity and can either resolve itself or have life-long effects.

Learning about brachial plexus

The Losees were told there were two hospitals that could help Daisie. One was located in the Southern United States and the other in Seattle. At this point, doctors were uncertain if Daisie’s injury was just a bruised nerve or if the arm was fully paralyzed. They waited two weeks and saw no improvement. It was then that Melissa started researching Seattle Children’s Brachial Plexus Clinic.

“We had no idea what brachial plexus meant or what it entailed. We always thought doctors are the magicians that fix everything, but no one was able to fully tell us what was going on. We had little trust in the medical field, if any, left at this point,” Losee said.

Melissa decided she needed to reach out to Seattle Children’s.

“They were so kind and understanding,” Losee recalls.

It just so happened that an appointment was available in two weeks. Despite being a 12-hour drive away from Seattle, they booked the appointment and made their way to Seattle Children’s where they met Dr. Raymond Tse, director of the brachial plexus program.

“Brachial plexus cases are difficult because no one wants to talk about them,” said Tse. “If you Google brachial plexus, there isn’t a lot of useful clinical information.  There is a notion out there that nothing can be done in these cases. We want people to know about our clinic because we can help these kids. There is hope.”

Preparing Daisie for a better prognosis

Tse and his team ran tests to establish the baseline function of Daisie’s left arm.

“We wanted Dr. Tse to say ‘she’ll be fine, just take her home,’ but he didn’t,” Losee said.

Instead, they were told to return when Daisie was 6 and 9 months old. At 9 months, Daisie could barely lift her arm to the level of her ear. She could not bend her elbow at all. Even though she could crawl and her mobility was good, it was at this point Tse knew surgery was necessary.

The Losees were extremely apprehensive because the surgery would be a marathon, lasting between 12 and 14 hours.

“I felt like we were gambling,” Losee said. “I couldn’t live with myself if Daisie didn’t come out of it. I was afraid, so we initially said no.”

The Losees returned to Idaho and put thoughts of surgery on hold. It wasn’t until Melissa went back on the internet to research their options that she spotted something which changed her outlook. Online, Losee found a story of a girl similar to Daisie who was a ballet dancer. The photo she saw showed a young girl with her arm proudly stretched out above her head. It was then that Losee realized she wanted that same outcome for Daisie. After much consideration and prayer, she called Seattle Children’s and they scheduled another 12-hour drive to Seattle.

The family drove all night to get to Seattle Children’s. Exhausted, they arrived in the early morning and Daisie had an MRI. Tse determined that Daisie, now 13 months old, was a good candidate for a nerve graph surgery.

“These are some super dedicated parents,” Tse said. “To drive 12 hours each way to come to our clinic just shows how much they care.”

The procedure that changed a young girl’s life

The surgery, like the injury itself, is complicated.

“The brachial plexus is like a really complex web of nerves,” said Tse. “It was damaged and because of that the muscles didn’t work. It’s a complex thing because you have to replace a part of the nerve with a spare nerve from the leg. From there, the nerve has to regrow all the way down to the muscle and then the muscle has to wake up again.”

“Even though it was complicated, we had a feeling of peace after Dr. Tse explained things,” Losee said.

They returned for the surgery when Daisie was 14 months old. Nervous and hopeful, they met an anesthesiologist who reassured them by saying that he would be there the whole time ensuring Daisie was alright.

The operation lasted more than 12 hours. Melissa was at ease during the procedure, but her husband Cory paced the halls of the hospital. When Tse emerged to tell them how things went, he showed them what nerves were torn. He also explained the recovery process would take time as nerves only regenerate at roughly a millimeter a day.

“We’re so grateful for Seattle Children’s. They were so open and transparent about everything,” Losee said.

The best possible outcome

Daisie on her pony, Polly

At just two months post surgery, Daisie showed signs of progress. At four months, she was wiggling her fingers and could almost raise her arm over her head. Slowly but surely, things continued to improve from there.

After her second surgery with Dr. Tse, at 5 years-old, Daisie was sitting on the floor and actually pushed herself up using her left arm. She was even able to reach her arm all the way to the back of her head and make a ponytail.

“I thought Dr. Tse was going to fall out of his chair when he saw that,” Losee said. “Daisie is a miracle. She is 10 pounds of dynamite in a one pound sack.”

Tse agrees and calls Daisie a remarkable girl.

“I keep on thinking of how great their family is.  Daisie gave me a five minute hug and told me that I was just as good to her as Santa Claus,” said Tse. “Their warmth and generosity has touched the entire care team of nurses and rehabilitative medicine, physical therapy and occupational therapy specialists.”

Now 5 years-old, you can find her outside playing at the Losee’s Idaho farm riding her pony, Polly, or at a cheerleading event doing somersaults and climbing to the top of a pyramid three people high.

“She came into the clinic and blew the team away by demonstrating her cartwheels and handstands,” said Tse.

For some kids, these activities might seem like afterthoughts, but for Daisie, they are proof that exceptional care in early childhood can change the course of one’s entire life.

Daisie showing her full range of movement as a cheerleader

“I think Daisie’s progress is remarkable and I am so pleased we were able to provide her and her family with a hopeful future,” said Tse.

“We are fortunate to have such an amazing team that is ‘all in’,” said Tse. “Everyone is 100% invested in these kids and their families and it is through their tremendous care that we can provide families with hope.”

 

Resources

Brachial Plexus

Brachial Plexus Symptoms

Brachial Plexus Treatment