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“My cardiologist was so impressed with my results. By following Dr. Dunaief ’s advice, I’ve been able to stop all three of my blood pressure medications. My heart palpitations, which were limiting my activities, have dramatically reduced in frequency, my energy levels have increased and I have lost 15 pounds in two months.”

~ Nurse, age 62

My Personal Story

 

I was diagnosed with cerebral palsy (CP) as an infant.  CP usually occurs at birth, and one of the most common causes is a breach birth, where the infant is born feet first. That was me, trying to slide feet first onto the baseball path of life.  

Unfortunately, during the birthing process, the umbilical cord wrapped around my neck and cut off my oxygen supply for an instant.  Of course, the longer the cord is entangled with the neck, the greater the potential damage.  

Cerebral palsy is a musculoskeletal disease that affects motor coordination by causing a lesion in the upper motor neuron region of the brain.  The most common type is called spastic cerebral palsy, which is the type that I have.  More specifically, I have spastic hemiplegia.

What is spastic hemiplegic CP and how did it affect me?

Dr. Dunaief rock climbing at Banff National Park, Banff, Canada (photo by Laura Smith Dunaief).Hemiplegia means that it affects one side of your body.  In my case, it impacted the left side of my brain, and therefore the right side of my body.  Originally, I could not extend my right arm, and my right foot was turned in about 90 degrees.  Muscles on my right side were hypertonic, which means an increase in tone and a resistance to stretching or lengthening.  As a result, I am left-handed, which may not have been the case, otherwise.  

Needless to say, I had gait abnormalities. I was an extreme toe-walker on my right foot.   This meant that every time I tried to walk or run, I would trip and - not uncommonly - fall on my face.  I had involuntary muscle contractions while trying to stretch my right arm and right leg.  I could not hold a drink in my right hand without spilling it.

CP is non-progressive.  In other words, you don’t get worse with time.  However, there is no medical treatment that cures CP.  

When I was first diagnosed, several doctors suggested to my parents that I have a rhizotomy and that they cut my Achilles tendon to reduce the spasticity.  A rhizotomy is a surgical procedure that involves cutting a portion of the cauda equina, which is a segment at the end of the spinal cord.  

I was very lucky to have parents who were knowledgeable in the fields of science and medicine.  My father was a physician, and my mother was the science editor for Time Life Books at the time.  They refused to accept that I needed surgery.  This was a turning point; if they had chosen an invasive procedure, I would most likely have been wheelchair-bound for the rest of my life.

My parents found Dr. Leon Root, a pediatric orthopedic surgeon who specialized in CP at the Hospital for Special Surgery in Manhattan.  He believed the most effective approach was a non-invasive one.  In the early 1970s, it was not called lifestyle medicine, but that was exactly what Dr. Root was practicing.  He suggested that, with intensive physical rehabilitation, I would eventually overcome many of the difficulties of CP.   

So began my childhood odyssey of trips to New York City every three to six months for physicals and progress assessments.  Dr. Root was the most caring and empathetic physician, getting to know me a bit more with each visit.  He was not only helpful, but became a significant influence in my determination to become a doctor.  

The physical therapy was not easy.  At first, I wore a thigh-high brace that was attached to my shoe, even when sleeping.  I eventually graduated to a knee brace, until my mother threw the brace in the woods in frustration.  My grandmother would come for frequent visits from the city and help me with leg-strengthening exercises for hours. 

Eventually my right foot straightened out, and I was able to extend my right arm.  Not only was I able to cut my own meat, as some doctors had told my mother I might not be able, but I played numerous sports.  My goal had been to be like everyone else physically.  Once I reached that goal, I knew I could be even better.  

While in junior high school, I made the tennis team. I became a skier with the rest of my family.  In college, I rowed crew and began intensive weight lifting, so that I could gain weight to be a starter.  I found that my increased muscle tone reduced my spasticity dramatically.  Ever since, I have continued to work out with that same intensity.  

Today, my toe-walking has improved dramatically; I still have a moderate limp when I walk, but one that doesn’t slow me down.  I run approximately five miles several times a week to complement my weight-lifting – and I am happy to report without falling on my face, and without a limp.

Those who notice ask me why I limp.  They are not bigoted; on the contrary, many times they want to share their personal stories of injuries.  I take it as a compliment that they think it’s due to a minor injury.  Besides, it’s all perspective; to me the rest of the world is limping.  

I find I am still of great interest to neurologists, however.  While I was in medical school, I explained that I still have my Babinski reflex, an involuntary response to stroking the sole of the foot that is normal up to the age of two years old, but not beyond.  Demonstrating it was a wonderful party trick during my medical training.

I have learned a great deal from CP. It has taught me to take nothing for granted.  I see CP as a “gift” in that it has provided a drive to succeed.  I have always wanted to contribute to society, rather than be dependent on it.  I believe that if I can do it, many other people can improve their situations, regardless of the severity.  My goal is to inspire others as Dr. Root and my family inspired me.  Understanding and empathy are critical to the doctor-patient relationship.  This is something that comes naturally for me.