Femoral Nerve Palsy Diagnosis

Remember how I mentioned that baby girl's legs kind of laid there when she was in the harness? In hindsight, a red flag. But, we didn't recognize it at the time.

After the first day ish in the harness, I think the uncertainty/shock wore off for baby girl. She started lifting up her hips again and slamming them down into her bassinet at night (think a whale tail motion) and she constantly moved her feet and toes. In the blur from the first appointment, I recalled the doctor saying femoral nerve palsy (FNP) would be like a dead leg and no movement. Well, she was moving her hips/legs up and down and her feet/toes were moving. I thought this was all normal, since she was in a harness designed to restrict movement to begin with.

At her two week check up, the doctor took the harness off and moved her hips around. He said the "clunk" was gone and he seemed sure that the hip was still in the socket, a very positive sign. He gave us a few moments to give her a sponge bath (we had brought washcloths, a pre-soaped rag, etc). While he was gone and we were cleaning her, we noticed her right leg was kicking a ton. The left leg kind of just laid there. This was the first time she had been out of the harness in two weeks and suddenly the difference between her legs was stark. When he came back, we asked about this lack of movement.

He moved her around a few different ways and the left leg didn't move. It really didn't even twitch. He diagnosed her with FNP and explained that the necessary movement was a knee extension motion. Hips and feet aren't in the same network as the femoral nerve. So, what I saw with the whale tail motion and foot movement didn't have any bearing on FNP. He decided to stop treatment and hope the movement came back. We were told to slightly massage her leg as well.

Long story short, he blamed me, the mom, for not recognizing the signs of FNP, not removing the harness earlier, and for the extreme possibility that she may never regain her motion in that leg. I was crushed. I don't think I have ever felt as much guilt in my life before over the possibility that I may have caused my baby girl paralysis in one leg. I barely slept for two weeks due to anxiety and nightmares that I was at fault for causing this. I went back and reviewed all of the prior visit notes and directions. They did mention the risk of FNP, but described it as "no movement." There was no mention that it needed to be a specific knee extension.

It took nearly two full weeks for her to regain motion in her left leg. As she did, my guilt started lessening and, honestly, my anger started rising. I am not a medical professional and I have had ZERO experience with hip dysplasia/FNP. I reviewed every note and direction multiple times and they never described the knee extension motion, but did emphasis the 24/7 nature of our harness and to not remove it. Ultimately, I believe his approach and post-visit notes to our 2-week check up was entirely a CYA and ultimately not professional. He could still have accomplished a CYA notes, without including charged and aggressive language blaming me. I seriously considered finding another doctor, but options for this pediatric speciality are very limited in my network. I am already driving about 45 minutes to see this doctor each time and other covered doctors would be 1.5-2 hours away.

Since then, I have been very explicit with my questions and asking that things be noted. I also started sending messages through my portal with questions, so that I have things in writing. I haven't done it yet, but I know now that I can ask the doctor to correct the visit notes if I believe them to be inaccurate (another component of my anger with his notes from the 2-week check up was that I don't believe he accurately portrayed what I communicated to him). Or, if they refuse to change notes, stating that I wanted it noted they are not updating the notes or sending a follow up message to that effect.

Her movement has fully come back and the FNP is no longer an issue. But, I have learned a lot about how to advocate for my baby girl.