Ariel HIt wasn’t long before she knew something was wrong. After a very difficult labor, Carol Holbrook gave birth to her third child, a little girl named Ariel, on November 18, 1993.

“She was more than 10 pounds and there was no time to do an emergency C-section,” explained Carol, “Ariel wasn’t breathing when she was born.” Carol and her husband Joe watched the medical team quickly attend to the newborn. “The doctor and nurses were able to get her breathing right away,” said Joe, “But then we noticed she wasn’t moving her right arm at all.”

In the traumatic delivery, Ariel suffered a brachial plexus injury, when her right arm was pinned behind her back in her mother’s birth canal. Brachial plexus injuries occur in about one in 1,000 births. Of those injuries, most heal gradually on their own. But 10 percent of these injuries, like Ariel, require surgery.

The Holbrook’s doctors in Quincy, Illinois referred Ariel to Dr. T.S. Park, a pediatric neurosurgeon at St. Louis Children’s Hospital.

“I was told Dr. Park could perform surgery that may give Ariel a chance to use her right arm,” said Carol, “and it became our mission to do everything possible to let Ariel do all the things that she wanted and live a more normal life.”

After preliminary examinations in St. Louis, Dr. Park told the Holbrooks that Ariel was an excellent candidate for the brachial plexus surgery. But he cautioned that even the most successful outcome may not give her good mobility.

In March of 1994, four-month-old Ariel underwent more than 10 hours of surgery at St. Louis Children’s Hospital. Dr. Park removed the injured portion of Ariel’s brachial plexus and grafted nerves harvested from the backs of her calves. “We did very extensive repair of the brachial plexus,” explained Dr. Park, neurosurgeon-in-chief, St. Louis Children’s Hospital, Shi H. Huang Professor of Neurosurgery and Professor of Pediatrics, Anatomy and Neurobiology, Washington University School of Medicine, “The hope was that the nerves would regenerate, giving Ariel some mobility and sensation in her right arm.”

Following the surgery, Ariel began a rigorous program of intensive occupational and physical therapy. With support and coaching from her entire family, she made tremendous progress, gradually strengthening her right arm. She made the 3-hour trip from Quincy to St. Louis at least twice each year for routine follow-up visits.

At the age of 5, Ariel had a second surgery in November 1998 to straighten her wrist and give her better mobility of her fingers. In the absence of specialized local therapists near their hometown, the Holbrook family took a very active role in Ariel’s ongoing therapy by learning how to help her stretch and exercise her arm.

Today, 11-year old Ariel leads an incredibly active lifestyle. Her right arm is still not as strong as her left arm, but she can lift it shoulder-high and grasp objects with her right hand. “There’s nothing I won’t try,” says Ariel, who plays softball, soccer, volleyball and swims. She also enjoys riding bikes, including her father’s Honda scooter motorcycle.

Ongoing physical and occupational therapy helps Ariel keep the mobility and strength in her right arm. She also makes periodic follow-up visits to St. Louis to see Dr. Park and the therapists at St. Louis Children’s Hospital. But it’s Ariel’s ongoing strength of spirit and her drive to overcome challenges that continues to inspire and amaze everyone she meets.




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