Question: Delivered fraternal twins. My daughter vaginally, my son emergency C-section. XXXXXXX was XXXXXXX breech, 2nd twin to be delivered(B). Induced labor with pitocin, labor 14 hours. XXXXXXX apgar 8/9. XXXXXXX 9/9. XXXXXXX needed oxygen immediately. XXXXXXX failed first hearing test. Barely passed second hearing test. Twins were jaundiced. XXXXXXX was more jaundiced. XXXXXXX immediately had difficulty breastfeeding, sucking. GI reflux. Blake's Glucose in nursery after birth was 42. XXXXXXX was 6#8 oz and XXXXXXX was 6#9oz. Reason to induce labor was back discomfort. No foreseen medical reason to induce labor, Delivered at 36 weeks/1 day. XXXXXXX has had chronic medical, health issues including the following: frequent ENT infections, c-diff, myringotomy and tonsillectomy. Several MRI studies of spine and brain. Chairing malformation has been diagnosed by a neurosurgeon and orthopedic surgeon, systemic yeast infection, motor vehicle accident(12/08/2010). Scoliosis. Joint pain in knees, shoulders. Numbness and tingling around mouth, hands, fingers. Dystonia. Difficulty with speaking, articulation seems to be difficult and uncomfortable or painful. New onset crouching at age 9 1/2 after mva of 2010. Difficulty swallowing. Maple syrup urine intermittently. Used to have urinary frequency when younger, then hesitancy while also discovering his mild scoliosis approximately age 6-8y/o. Then could not release urine only once every 24-48 hours. One time he was unable to release full bladder of urine for 46 hours and hospital was unsuccessful catheterizing him due to musculature or sphincter of bladder. XXXXXXX continuously keeps legs drawn up towards trunk of body. Knees always bent continuously whether walking, sleeping, sitting on potty with feet on toilet seat. XXXXXXX used to be physically XXXXXXX and active without restrictions....swimming, running, climbing, jumping on trampoline.....now, he can barely walk 20-40 feet near falling every time. It's like his cord may be tethered. He has multiple bulges in spine throughout. Has difficulty withy bowel and bladder, swallowing, talking. Head pain, posterior neck pain, low back pain. Left shoulder pain since he was very young if not birth. Tight hamstrings diagnosed, also. Multiple skin bumps on elbows, fingers, knees. Chronic intermittent elevated total bilirubin.....jaundice, vomiting, abdominal pain, critical total bilirubin hospitalization last summer, 7/2015. 6/2015 11 day hospital stay with excruciating pain in head and posterior neck with CK levels over 700-800. He seemed to have excruciating pain in his head and posterior neck many times triggered after eating, coughing, sneezing .Chronic elevated BUN,27-60+, elevated creatinine/BUN ratio ex: 59, chronic elevated BCR8, elevated wbc counts, low Na levels at times. Protein sometimes low. Blood pressures have chronically been intermittently high. Tachycardia, pupils large 4mm or more. He failed first PKU test. I really almost think I remember second one was ok, however, false and negative positives.....so I am so concerned as his health seems very brittle.....he appears jaundiced, frequently at least a degree. Dark circles around eyes, no appetite at times, pain, mobility issues, there has to be answers. I believe chairing malformation, tethered cord, brachial plexus nerve injury....I also am concerned of his metabolic issues.....perhaps PKU. He has schmorls nodes in his spine. Curvatures in spine. He is really needing someone who will help.

Thank you very much for your time and consideration for my son, XXXXXXX XXXXXXX has had multiple sets of genetic testing. All negative. I do understand from experience, that when medicine does not have the explanation, genetics appears to be an umbrella diagnostic cover.
What laboratory and medical findings should I be most concerned about if I am considering birth injury? What laboratory findings are hallmark for PKU from a standpoint of a 14 year old boy? What labs should be consistently found relevant and abnormal findings for a chronic missed diagnosis of PKU?? If I am to look for phenylalanine in his lab tests, what is comparable?? Ketones? Total Bilirubin, maple syrup urine disorder, BUN, creatinine? Do we get new PKU? I mean it seems to make sense that XXXXXXX seems affected greatly by diet, especially gluten, dairy.....why would a child suddenly and intermittently turn jaundiced, mental status changes, nausea, vomiting, pain, significantly elevated liver enzymes, RBC counts....

Do you not consider the induced labor of 14 hours turned to emergency C-section subsequent from XXXXXXX breech presentation after deliver of his twin sister delivered vaginally? Hypoxia in neonate, jaundice, glucose 42, failed hearing test #1 and barely passing # 2, moderate difficulty sucking, breastfeeding, swallowing, speaking, and choking spells significant? PKU test repeated due to positive 1st test? Significant shoulder pain, numbness and tingling in face and fingers and hands? Difficulty with bowel and bladder? Scoliosis? Kyphotic curvature, scoliosis, pain in head and posterior neck, pain in low back, loss of mobility significantly after Mva in 2010?