In the middle of the night you awake with fear in an unknown environment.
You’re hungry, thirsty and unable to speak. The only sound you can make is sobbing and crying.
Someone grabs you and tries to sooth you by rocking and bouncing you in their arms, but you can’t communicate your needs.
The feeling of frustration from the person trying to sooth you, increases your anxiety making you cry louder and more persistently.
The person begins to shout, scream and shake you in an effort to quiet you. If this was a dream, you would wake up in a cold sweat and be thankful that it was only a nightmare.
For a newborn baby, this nightmare can be a life-threatening reality.
There are approximately 1,300 reports of shaken baby syndrome in the United States each year and it is the leading cause of child abuse deaths, according to the National Center on Shaken Baby Snydrome.
A similar scene may have played out for Mikey Stipeck of Effort, Pa., when he was just 6 weeks old. He was transferred to Geisinger Janet Weis Children’s Hospital with skull fractures, a rib fracture, a broken forearm and several brain injuries from child abuse from his biological mother.
The trauma inflicted caused respiratory failure and required intensive care support for Mikey to survive. He was intubated and placed on mechanical ventilation. He had emergency surgery to drain a subdural hematoma.
A CT scan revealed that he had had previous subdural hematomas that he had recovered from, a telltale sign of an earlier abusive event.
Mikey was left with considerable brain damage that resulted in seizures, cerebral palsy, developmental delay and feeding difficulties.
“Overall, Mikey is a fairly typical survivor of infantile abusive head trauma. While about 25 to 30 percent of infants die from such injuries, most infants do not,” said Paul Bellino, MD director of the division of child protection and advocacy for Geisinger.
“Of those that survive, only about 10 percent escape without any neurological difficulties. Children who present in a state of extremis, such as in Mikey’s case, almost universally have serious, long-standing neurological consequences.”
Mikey was placed into foster care and fortunately Colleen and James Stipeck and their family were there to accept him with loving arms and help begin the healing process.
The couple had three kids of their own and had recently decided to start fostering. They did not hesitate when they heard what Mikey had been through.
“They called and said they had an infant around 3 months old that was going to be released from the hospital and we said, ‘absolutely,'” Colleen said.
With cerebral palsy, Mikey’s legs became spastic and stiff making walking and balancing very difficult. He needs assistance getting to his feet and uses a pull-behind walker to help him balance.
His parents took him to an orthopaedic specialists for botox injections that helped alleviate some of the stiffness; however, the results were not long lasting and had to be repeated every 3 – 4 months.
“It was a lot for him to get the injections and his doctor said he thought Mikey would make a good candidate for a neurosurgery procedure called a selective dorsal rhizotomy that could help with his condition,” Colleen said.
They were referred to Cameron Brimley, M.D., Geisinger pediatric neurosurgeon.
“Cerebral palsy can cause the brain and the spinal cord to not communicate the way they are supposed to. The goal of the dorsal rhizotomy is to decrease the sensory and reflex input from the legs to the spinal cord and allow the brain to have better control over movement,” Dr. Brimley said. “Decreasing the sensory input, allows the patients legs to be more relaxed and less spastic.”
The procedure takes about four hours and requires a team to stimulate and monitor the sensory nerves in the spinal cord, determining which are the most aggressive. Dr. Brimley then cuts those nerves by 50 to 80 percent to decrease the sensory input.
Recovery from the surgery was rough, with Mikey needing to spend almost a week in the pediatric intensive care unit (PICU) that was followed by intensive physical therapy 4 – 5 days a week.
“We are seeing such great progress already from the surgery and he is only five months out from the surgery,” Colleen said. “The team explained to us that we will see improvements up to a year from the surgery.”
Mikey balances more effectively and has more endurance when walking.
“He is able to do things on his own and walk further distances,” Colleen said. “We hope that some day he will be able to walk unassisted with just arm crutches. He says he wants to run. That is a big motivator for him.
“I see this surgery as being life-changing for him,” she added. “He has more work to do, but the gains we are seeing so far have been amazing.”
Dr. Brimley is pleased with the outcome of the surgery and the difference it has made for Mikey.
“Seeing abuse victims is one of the hardest parts of my jobs. It is sad and discouraging but it allows us the opportunity to see these kids and hopefully get them in a better place,” Dr. Brimley said. “Mikey has been very blessed to have such a wonderful family.”
According to the National Children’s Alliance, more than 600,000 children are abused in the United States each year. Although child abuse is not a medical condition, child abuse has medical consequences, according to Dr. Bellino.
“Most people don’t start their day thinking, ‘How am I going to injure my infant or child’. Most people that this happens to are living a life that is frustrating. They are engaging in things that are challenging or engaging in things that may put them at risk to injure their child,” Dr. Bellino says.
“We know that child abuse occurs frequently in certain social situations. Raising awareness and educating our communities on the social aspects that predispose children to child abuse can help bring the problem to light.”
