When you come to the Cerebral Palsy Clinic, I will meet you and introduce you to my Team.
We then carry out a full assessment which starts with a medical history. I then move on to ask you about the problems you are having with your arm(s), hand(s) and carry out an examination. This gives an overview of the situation.
My therapists will then go through our hand and arm assessment form separately.
Although my policy is to see my patients on more than one occasion before finalizing a treatment programme, I always briefly outline what my initial thoughts are to you.
If surgery is a possibility I will also give an overview of the process and some details about the operation(s) and stages involved. Timescales are clearly very important and I will always endeavor to give you some idea of a plan at this stage. You should understand however that this is an initial assessment and we are very much at the gathering information stage.
I like to see patients from as early an age as possible i.e. before contractures (tightness) and weakness have set in. I am very happy to see infants. In this age group my aim is to monitor progress so that intervention if required can be carried out at the right time. My Team and I will discuss stretches, exercises and activities to maximize hand use and if necessary will provide splints. I do not routinely advocate splints as they block sensation to the hand and in the absence of tight joints are not necessary at night. Sometimes however we will use splints to stretch tight joints and /or mimic the effect of surgery.
At the end of the consultation I will arrange a follow up assessment. At that stage if surgery is required I will detail the plan to you.