What is this now??

Serendipity: Looking for a needle in the haystack and finding the farmer’s daughter!!!


This is how I can explain what happened next. While the doctor was going through the MRI scan, it showed a cyst on Yatish’s tongue. He thought it might be a lymphatic malformation and may have to be removed surgically. He referred us to the ENT department to get it further investigated. We were completely stumped, this was turning out to be murkier than we expected. Now we had no choice and had to go ahead and get this checked.

http://www.childrenshospital.org/az/Site1256/mainpageS1256P0.html

We had to meet Dr. Trevor McGill, Otolaryngologist (phew!!), who is a super specialist in this field. He did an endoscopy, wherein the endoscope, which has a long tube with a lens at one end and a video camera at the other end, is inserted through the mouth to basically figure out what is happening in there. We also had the opportunity to see the video of my son’s oral structure and it was quite unsettling to say the least, but the doctor seemed all excited.

http://children.photobooks.com/directory/profile.asp?dbase=main&setsize=5&last=mcgill&pict_id=9904140

http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Endoscopy?OpenDocument


He felt this was “possibly a foregut duplication cyst or a dermoid and not a lymphatic malformation”. For us the question was is that good or bad? We eventually learnt that the foregut duplication cyst was quite a rare occurrence and it was basically a normal tissue in an abnormal location and in Yatish’s case was quite benign and would not cause any problem to him and there was no surgical intervention needed to remove it. We heaved a sigh of relief. After all, this whole exercise came to nothing, except that we made Boston Children’s Hospital a little richer. Dr. McGill is a very enthusiastic person and he had such a nice way about kids, that I still remember Yatish going through all this without much fuss.

This thing out of our way, were suggested to meet the pulmonologist next to do a barium swallow test. As I had mentioned in my earlier post, Yatish had a problem of reflux and a stridor, which is a continuous wheezing kind of sound, occurring due to his underdeveloped laryngeal cartilages. The barium swallow test would help us to know, if the food was going in the right tract and not getting into his lungs. But everybody felt that he had no visible problems and as it was Christmas time and a holiday season, we could not fix an appointment and we just let it go.

http://draft.blogger.com/goog_794409343

Next we had a physical therapy assessment, but then since the hospital was closed for Christmas, we also took a break and headed to New York.

Hoping against hope!!

When hope is hungry, everything feeds it. ~Mignon McLaughlin



As we continued to speak with Dr. Coulter, he suggested that we also do MR Spectroscopy just to rule out any other cause for his disability. The Magnetic Resonance spectroscopy is done to study the metabolic information about brain tissue. It meant that if there was problem at the biochemical level, it could be treated with drugs. This new development sent waves of excitement. We are all hoping that, MRS would be the indemnity we were seeking. It would mean all the efforts we put in coming to the US and not to mention the huge financial splurge would be justified.


http://spinwarp.ucsd.edu/NeuroWeb/Text/mrs-TXT.htm


All these tests are quite cruel to young children. If the test is the next morning, you cannot feed the baby after midnight, till the tests are complete as they will be administered anaesthesia and if the tummies are full they will throw up. But then you put up with all this thinking that the results would be worth the trouble.

I still clearly remember that day, we were up early in the morning, it had been snowing all night and we rushed to the hospital as we had an early appointment. I was so full of nerves and the MRS room was on the 36th floor. Yatish was sitting snugly in his pram, oblivious to what was happening, except maybe wondering why his mom was not force feeding him and must have been secretly happy about it. As we were going up the lift, somewhere on the 32nd floor an older looking lady got into the lift and the moment she laid her eyes on Yatish, she squealed “Oh my God, Oh my God”. I was taken aback by this sudden outburst and I looked at her, half nervous, half scared not knowing what had happened. Then she said “I have never seen such exquisite eyelashes like your son’s” and then she got out, wishing me all the best.

These are moments in life when it sets you thinking, we are so consumed with the thought of what we don’t have that we forget to appreciate these little things which we have. This is the beauty of creation. Here I have a son who cannot do anything by himself but has been endowed with so many beautiful qualities, what he does not have clearly pales in front of what he has.

The scan itself took about 3 hours and it seemed the longest 3 hours of my life. Now we had to wait for the results. That would take about two days.

When the results came, we were shattered. I am not quite sure whether it was the right thing to feel, but I was thinking since all the biochemical levels were well within acceptable limits, it meant, that the cause of his disability was nothing to do with the metabolism of brain tissue and hence no opportunity to treat and correct it.

Again we hit a dead end but then a new development happened and we were told to take one more MRI scan.......

The Big American dream....

Everyone who goes to American has this dream of making it big, but my dream was to see my son getting alright. If I went to the US, I thought I would be told, this is what is wrong with your son and this is what you need to do and we would do that and Yatish would be fine. We had sent all the medical records before hand and our first appointment was scheduled on the very next day we reached, thanks to the botched up visa process. Severely jetlagged and sleep deprived Yatish and me were in bad shape and there was this anxiety about what awaited us. Added to this was the cold winter. Unlike in India, car seats are mandatory in US and you are expected to have a pram for your kids. Thanks to my sister-in -law’s forethought and awesome planning abilities, she had made sure everything was in place and we settled in well and quick. No amount of praise can do justice to the way she and my brother took care of us. She was studying at the time, pursuing two masters’ degrees simultaneously and working part time. She had already done all the ground work and flawlessly worked out our appointments along with her own schedule. I am ever so grateful to both of them.


We had an early appointment; my brother dropped us at the Hospital and we walked in with lots of hopes. Our very first appointment was with Dr. Coulter, the paediatric neurologist.

http://children.photobooks.com/directory/profile.asp?dbase=main&setsize=5&last=coulter&pict_id=1746404


He did the mandatory weight and head circumference checks.

http://www.infantchart.com/infantheadage.php

He did a neurological examination checking his hearing, vision, muscle tone and reflexes.

http://www.neurologychannel.com/neuroexam.shtml


Based on all the initial assessments he did, he drew a plan of action and the specialists we would have to meet and all the tests Yatish need to undergo.

Mind you, as an international patient, the fees charged are much higher and the robust American economy at that time made sure it squeezed every rupee out of us. Each appointment cost us an average of 800$, so you can as well imagine.

First we had to go in for the blood and urine tests, based on which the doctor would undertake metabolic studies. The first blood report showed that his lactate levels was very high, which gave us some anxious moments but then we reasoned out that, due to long hours of travel and fatigue, the high lactate acid level build up might be a possibility. So we were told to repeat the tests again.

http://health.yahoo.com/blood-diagnosis/lactic-acid/healthwise--hw7871.html


We had already sent the MRI scans and Dr. Coulter had showed these to Dr. Joseph Volpe, who is a world renowned Paediatric Neurologist and Chairman of Neurology at Boston Children’s Hospital. He said that the scans were indicative of neonatal bilirubin encephalopathy, which means that this disorder was due to the jaundice he had after he was born. In fact, in Dr. Volpe’s book “Neurology of the Newborn”, there is a picture on page 540 of a child with same problem. The MRI in that picture looks like the MRI that Yatish had.

http://www.childrenshospital.org/cfapps/research/data_admin/Site169/mainpageS169P0.html

But Dr .Coulter wanted to make sure that there was no other cause for his disability. So this time he wanted us to undergo MRI Spectroscopy....

My pillars of strength..... Seema and Girish

What a Trip......

This was Yatish and my first international flight, even though we had travelled domestic quite a bit. Since my brother had warned us of the snowy winter which awaited us, we got ourselves some warm clothes and thermals and whatever we thought appropriate. As you know having prams or strollers for children is not very common in India and since Yatish was just 2 and half years and was quite tiny, we had just got him a feeding chair and also there was little choice in prams and strollers which would suit Yatish. So we decided to take the feeding chair along with us. We had a stopover at Frankfurt and the flight was of 21 hours duration.

Somebody suggested that I give Yatish, Phenergan, which is a mild sedative when on flight, so he would sleep during most of the travel. It was a bad idea and it just did not seem to work with Yatish, he was not only awake during most of the flight but created such a ruckus, that people around us promptly changed their seats. I regretted having travelled alone. In the flight I had asked for infant food for Yatish, which means only milk. The flight attendant took the bottle from me after asking me numerous questions about the temperature, consistency etc. and filled it up and got it of course, without sugar in it. Now my son is used to drinking milk with sugar as any typical Indian kid and he just refused to drink it. So I asked the flight attendant if she could put some sugar in the milk and lo, the heavily accented German lady gave me a lesson in oral hygiene and how adding sugar in milk is a bad for teeth and gums. But with a hungry and screaming baby, it is last thing you want to listen to, anyways I listened to her patiently and the moment she left to attend other passengers, I quickly went into the pantry, grabbed a handful of sugar sachets and saved myself from her lecture once for all.....


For those of you who want to take a disabled person on flight this site is useful to check provisions provided by different airlines.

http://specialchildren.about.com/od/inthecommunity/qt/airlineinfo.htm

The stopover at Frankfurt was about three hours. Had enough time to change and freshen up. There was this old Indian couple visiting their son at Chicago, who were a great help. Now I also regretted having not got a pram as I could not put Yatish down. Once we reached Logan International airport, my sister-in-law was there to pick us up. It was quite chilly and windy. We had thought that since I was travelling alone, I should carry this single huge 40 kg capacity bag, which turned out to be a bad decision, since it not only did not survive the long flight and handling, it was pretty unwieldy manoeuvring it in the airport. It is always better to carry two bags. Now we were supposed to meet my brother midway, we took a bus from the airport and finally reached home.

Now looking back, I am myself astonished as to how I could venture with a small kid, with multiple challenges and no help whatsoever, without even thinking about missing the flight or any other such mishaps. Maybe the fierce urge to find answers overshadowed the fear of risk involved in taking such a kid on a long flight. Anyway we both made it without any incidents.

Ground Zeroed??

With the hope that going to US may help us to understand Yatish’s condition better, we started exploring the options at US. My brother happens to be in Boston and without thinking twice he and his wife told us to come to US and made all arrangements for our visit. Sometimes when you feel you have reached the end of the road, God shows you some way. My brother and his wife were our saviours. They checked out the hospitals and we decided to visit Boston Children’s Hospital, which is attached to the Harvard Medical College.

http://www.childrenshospital.org/



http://www.childrenshospital.org/international/Site1396/mainpageS1396P1sublevel4.html

If you are an International patient, firstly you need to send the entire past medical records, scans, pathology reports etc. to the hospital. Then they will send you a rough estimate of the costs and you will have to make advance payments for the primary appointments and so they also check if you have enough financial resources.

We started the visa process. This was the aftermath of 9/11 attack and getting US visa was not very easy. We went to Chennai for our visa interview. If somebody had visited Chennai US Consulate in 2002, they would know that, the premise was getting renovated (courtesy the 9/11 attacks) and you had to wait in the queue for at least a couple of hours to get into the building, even if you had an appointment. Standing in a queue in hot Chennai sun is no joke and that too with a baby. After finally making it to the interview and for all this effort our visas got rejected promptly. They thought that my husband and I were potential immigrants.

Now we were stuck, while our travel plans and hospital appointments were all fixed, we had no visa. So we again contacted the Hospital, got payment receipts, a letter from the hospital, my brother had already given all the support documents and we re-applied, and we were rejected again. The Immigration official told us to take Yatish to Singapore as it was cheaper there, instead of spending so much money in taking him to US. Now he was the last person we wanted to hear from, thank God he was on the other side of the window and there was a bullet proof glass between us.

We were in a limbo, we had never expected that this would be a major hurdle, but here we were almost on the verge of cancelling our trip. Will we be lucky the third time??

I am not sure how it is now, but then there was no cafeteria in the consulate premises, you were not allowed to carry food and there was only a coke dispenser and few snacks, which you could get and was quite badly managed. I sometimes wonder, after travelling so much in other countries, that whether we are at the receiving end of such bad service, only because we are in India. I think it is high time we learnt to demand good service because nothing is free.

Finally after showing substantial bank balance, assets and also the appointment list and advance payment for the appointments and my hubby told the immigration officer to give us visa for 10 days, so we can consult and come back. we were finally granted visa in our third attempt. What would have been a 10 minute interview took us half a day. The other applicants, who were with us in this ordeal, gave us a standing ovation after our visas were granted. I had only one week to pack and move.

Is it the beginning of the END??

Yatish was about 2 years now and our search for answers continued. We met numerous doctors and specialists, some of whom were useful but most of them left us more confused. But then we also met quacks, astrologers and the sundry, which were not even remotely connected to this. We were trying everything and anything anybody told us, when I think back I feel like a complete nut case who had thrown all rationality out of the window. What was I thinking? Somebody suggested that we take Yatish to a quack lady, who gave some kind of herbal concoction mixed with milk early in the morning. Thanks to Yatish’s reflux, he promptly threw it out before we reached home. Thank God he had more sense. There is no miracle cure.


The state you are in, you start believing that there is a miracle cure, and imagine that one morning you wake up and your child is walking, talking like any other child. You begin to trust everything blindly. We continued the physiotherapy, but were completely clueless about where it was leading to. There was no great improvement in his condition physically but cognitively he was improving which was a great sign. We also ended up doing more CT scans; endoscopy etc. and nothing conclusive came out of it all. What should we do now? There was nobody who could tell us definitively what we should be doing and what kind of future awaited Yatish. I was reading a book called “Stumbling upon Happiness”, which says that when the frontal lobe of your brain is damaged for some reason, you lose the concept of future. You only have the concept of present and now. For once I really wished frontal lobe of my brain was damaged because thinking about future was scary and dark. My frontal lobe is intact and hence the future seemed bleak.

The frustration was really building up and since Yatish being the first child in our family, there was no legacy to fall back on and all of us were first time mom and dad, grandparents, uncles, aunts etc. Every time we got a phone call, the first question anybody asked me and my hubby was if there was any improvement in Yatish. We really did not know what to say. While we wanted answers now, the doctors knew nothing much could be done, so they just wanted us to take it easy. This kind of conflict created a volatile situation. In one such situation the Paediatric head at a leading hospital in Bangalore, suggested that if we had the resources we could take him to US or UK. Then we started thinking about it. Maybe this was what we should be doing we thought. During the course of this we also happened to meet an Oncologist who is close to our family and looking at the state we were in he suggested that it would be a good idea to take Yatish to US and we may get some answers there. He said we should check if we could get to Stanford Medical Centre.

This seemed like an answer to our question !!!

Looking back at the year gone by...

While Yatish started physiotherapy in his second month as soon as his paediatrician found stiffness in his legs, the massage lady Mehboobi sensed it on the 15th day of his birth. I am sure this illiterate lady would have handled hundreds of babies in her life time and instinctively knew something was not ok with him. In her own way she tried to tell me and also assure me in the same breath that everything would be alright with him. God has sent me so many angels to help me along the way and she definitely is one of them. A physiotherapist in my hometown gave me a home programme and she also recommended a splint for his neck, as he had no neck control and as his neck muscles were weak.

http://www.seriousinjurylaw.co.uk/cerebral-palsy-massage-treatment.php


http://www.healthoutsource.co.ke/articles/sci/uploads/SPLINTING.pdf


Yatish did not like to wear his splint and it took all my skills to make him wear for 15 minutes in a day. Moreover, it was done very crudely with whatever material was available and I am not really sure whether it was the best option. Once we returned to Bangalore after 4 months, Yatish had his naming ceremony. Beginning with his first train travel to Bangalore, in his 9 years of life Yatish has travelled so much that he can give any CEO a run for his money.

Once in Bangalore, we consulted a paediatrician and he asked us to get a CT scan. To take a CT scan, Yatish had to be completely still, when placed in the scanner and that is too much to ask of a 6 month old. So the lab technician suggested that I put him to sleep and when he is asleep we can take the scan. So we tightly wrapped Yatish in a sheet and placed him in the scanner. The AC was in full blast and just then Yatish decided that he needs to pee, throwing all our efforts to wind. It took us almost half a day to get the scan done. I am sure there must be an easier way to do this.

Yatish’s first flight was also very memorable. We were on our way to Mumbai to meet Dr. Johari and Asha Chitnis. I was sitting on the aisle seat with Yatish and the air hostess was standing just next to me and she was telling about the safety precautions and looking at her gesturing, Yatish burst out laughing and the poor airhostess was so distracted that she forgot what she was saying and had to start all over again.


Asha Chitins clinic was one more experience. It was actually a tailor shop converted to a physiotherapy centre. At any given point of time, there would be 10-15 kids crammed into that small hole and the hapless parents waiting on the footpath. The sight makes you cringe with anger and helplessness. Anger because these kids definitely deserve better facilities and helplessness because you cannot do much about it. It is like a sweat shop and the kids are put through a rigorous regime, without much thought for their comfort or their state of mind. It makes me wonder, why we always settle for less, when actually we should be demanding a better deal for our children.

During this trip we were also to make his first AFO (ankle foot orthosis). Taking the measurements is a process in itself. First the casting is done in plaster of paris bandage as in when you have a fracture and the mould is made and then the orthosis is made with polypropylene. This was a new experience for Yatish and absolutely did not like the feel of plaster on his legs and was wailing so much by the end of it all we were completely exhausted.

http://en.wikipedia.org/wiki/Ankle-foot_orthosis

Yatish had a quiet first birthday because we were not sure what to celebrate. We just had a pooja in the temple and just gave away some sweets at Sophia school.

You can never be prepared for life.....

In our case we also did not know what to prepare for.....Since taking care of Yatish was 24/7 and more effort, I had to quit my job. It was very difficult decision, since I was climbing the corporate ladder well and I loved my job. This was the worst nightmare of any career loving person. To give it all up and do something which you have no clue where it is going to lead you to...but then I had no choice.

It was a matter of priority and my priority was my son...But in between all this, there were many a time when we felt completely cornered and helpless. While my hubby had his job as an outlet to meet people and do something different, I was becoming a complete basket case...I had to do something to keep me senile. We had a talk and I decided to join an evening college to pursue a post graduate diploma. It did wonders to my state of mind. I felt a sense of achievement. We went about looking for options for Yatish with more gusto.

During this time, we met Dr. Bernard Brucker, Founder of the Biofeedback Laboratory at the University of Miami’s School of Medicine. He was in India on a visit. Dr. Brucker, developed an internationally recognized biofeedback method that uses precise techniques to restore lost functions in those with neural impairment, called the Brucker Method. According to Brucker, this method helps to improve the lives of those with neurological motor impairment by providing a bridge between neuroscience and rehabilitation.

Since in this method the patient has to work on commands, and since Yatish was too young, we had to wait for some time before we could use this method.

http://www.sci-therapies.info/biofeedback.htm

In India, Dr. Brucker has set up a centre at Asha Rehabilitation Centre.


http://www.ashafoundation.org/asharehab/index.htm

On the Disorient Express....

While Yatish progressed very well cognitively, his physical progress was very slow, which was a great concern to us. He was constantly having congestion, was not putting on weight and his reflux continued. He also had a condition called laryngomalacia, a condition in which the tissues in the larynx or voice box periodically block the airway, creating a noisy sound upon inhalation called stridor. Congenital larygomalacia affects children with neurological disorders, and particularly those who have low muscle tone (hypotonia) in the trunk or neck.

http://www.articles.complexchild.com/00011.pdf


As if this was not enough, he also had sternocleidomastoid tumour (a misnomer for muscle fibrosis in the neck) The possible cause of sternocleidomastoid tumour may be injury to the neck during delivery causing muscle injury and subsequent fibrosis. The result was that his neck was always turned to one side most of the times. As of then the only treatment was physiotherapy.


http://pedsurg.blogspot.com/2008/05/sternocleidomastoid-tumor-of-infancy.html


As a parent you intuitively know if something is not right about your child. By now we had done all the possible tests thyroid, Urine amino acidogram, CMV IgM, VDRL, BAER, Echo- cardiogram, X-rays of neck etc.. Nothing really came out of that. So we were back to square one. We continued with physiotherapy, but we always thought if we were missing something, have we done enough and if there is a possibility that there may be some cure for this and we were missing the boat.

We had heard about Botox treatment and headed to Mumbai to explore. We met Dr. Ashok Johari (http://www.thechildfoundation.org/aboutus.html)

We also met Dr.Asha Chitnis, a renowned physiotherapist ( Dr Asha Chitnis, +(91)-(22)-65042623 +(91)-(22)-65042623 +(91)-9821054309 +(91)-9821054309 , 9769989155 Mistry Building, Ground Floor, Shivaji Park, Near Dadar Catering College, Cadell Road, Dadar West, Mumbai – 400028)

While Dr. Johari advised us to wait for six months and then have a relook, Dr. Chitnis gave us a home programme, which meant we were back where we started. There were no easy answers and it was frustrating to say the least.

The Early days....

The first few months of his birth seemed endless...He had severe reflux, which meant he threw up often and we were constantly worried if he was getting enough nutrition. Anybody who has seen him at that stage, including me did not feel he would survive long...but the fighter he is managed to pull through...Then began the endless trips to hospitals, doctors, quacks, astrologers....Every doctor we visited wanted to wait and watch, which I think is right to some extent because the babies brains are growing at a faster rate and there are constant changes and development, which means you cannot correctly anticipate what they can achieve and what they cannot..


Those were days when we were in a state of denial. Any doctor who gave us hope was good and anyone who did not, did not know what he was talking...By now we had done CT scans, MRI scans and what not...

Choose your doctors with care, because if your doctor is not giving you the correct picture, you will lose out on precious time and any timely interventions, which might have helped the child. Sometimes you go by reputation and sometimes by experience and sometimes by intuition. I really appreciate doctors who have the guts to refer to other doctors , when they know they do not have expertise rather than misleading the hapless patient...

Those were crazy days; I would interact with anybody who was even remotely connected to this condition. One such doctor I met was a paediatrician from Chicago Children’s Hospital who was visiting his parents in India and he told me the story of his brother-in –law who had severe brain damage and that he was pursuing his university degree. He took one look at Yatish’s MRI scan and told me don’t ever give up on him, give your best and he will do the rest. At that moment, he seemed like God to me....

http://www.learninginfo.org/neuroplasticity.htm

Every parent wishes that her child should be the most intelligent and smart, but then the onus is on us. If you provide a nurturing and loving environment every child will do well. I believe that every child has immense potential.

http://www.umext.maine.edu/onlinepubs/htmpubs/4356.htm


The most important thing is to start early as in Early intervention, if you think your child is not catching up. Yatish started his infant stimulation programme at the age of 6 months at Sophia Opportunity School

(Sophia Opportunity School Sisters of Notre Dame, # 70, Palace Road, Bangalore 560 001 Tel: 22205683, E-mail: sr_naina@hotmail.com; Directress: Sr Mary Naina, Web: http://www. sophiaos.org. )

It not only helped Yatish, but it did wonders to my state of mind. I learnt more and more about his condition there. I met some very dedicated therapists and special educators. Riteish, Priya Sandeep, Arati,Cedricia and of course Sr. Naina. They have a decent set up and the advantage of access to resources from generous donors to their missionary....

My story....

Why me? Every time I ask this question to GOD and many I am sure in my position would do...I can hear only one answer...why not you? After 9 years of bringing up my special child with cerebral palsy, I realise what an extraordinary journey it has been and there has never been a dull moment in all these years...My life seems purposeful, more meaningful and challenging ... Along the journey I have met some wonderful people, who have helped me in my struggle.....My blog will contain some useful articles, links and I also encourage people who are working in the special needs sphere to share their contacts, so other people looking for resources can be benefitted... I value your feedback and would love to know if you are interested in any particular topic to be discussed ........


My story....


The beginning....
After marrying the man of my dreams, enjoying a great career run, my bundle of joy came in the form of my son Yatish. Even though my pregnancy in itself had no major problems, towards the end, we were worried about the growth of the baby...(maybe the stress of managing a start-up business, left me with little energy for myself and my baby). Yatish was born 2 weeks premature after a brief labour and forceps delivery, a tiny little thing with beautiful eyes. To top it all, he developed jaundice which prolonged for 12 days.

Physiological jaundice is a common occurrence among new born, which results in yellow colour of the skin and whites of the eyes caused by excess bilirubin in the blood, which is produced as a by product of normal breakdown of red blood cells. Very high levels of bilirubin, usually 25mg – can cause deafness, cerebral palsy or other forms of brain damage in some babies.

http:///kidshealth.org/parent/pregnancy_newborn/common/jaundice.html


This brings me to the most important issue, which I think is sadly lacking in our country is parent education, counselling and participation in decision making. As a parent of a newborn, I am entitled to know what is happening to my child and what options I have. When I look back, I feel completely short changed. I urge all parents to ask questions and not give up till you are completely satisfied with the answers. Because end of the day, you are left to face the consequences and the laws being lopsided you will never get any justice in this matter. Many of our doctors still do not take APGAR scores which give a good measure of the baby’s physical health and instead of just eyeballing, which is the norm especially in the non metros in India. This test is also important if you take your child for other countries for evaluation.

(http://www.mychildhealth.net/apgar-test-score-of-newborns.html)

The early symptoms...

Yatish lost almost 40% of his birth weight ( which is quite a bit considering that he was only 2.1 kg to start with....) and he seemed a bit stiff in his legs and had major difficulties in breastfeeding. He did not develop head control even after two months, but then he did achieve the social smile after 3 months, the only milestone he achieved at the right time and even today his smile is a sight to behold...

http://www.special-needs-hope.com/signs-of-cerebral-palsy.html

Once we noticed the stiffness in his legs, we asked the doctor what we could do and considering he had not achieved his head control, he advised me to start physiotherapy.....