10 weeks post-op

Sorry for the lag between posts, Jason and I were on vacation (sans kids)!

No real big changes this week...everything seems to be very slow and gradual. I do notice Elena is better able to move her legs independently, and seems to have more control of her trunk while moving her legs. I see this as "her midsection and legs ceasing to move as one unit". For instance, Elena can now take off her shoes and braces (including all the velcro tabs) and socks off herself while sitting (and not falling over in the process). This is pretty new.



Overall, Elena's movements are more fluid, less jerky, and can be done while playing (movement does not take as much mental energy). There is still a long way to go, as her balance is still poor.

The big focus seems to continue to be getting Elena to move around without her knees caving in. At KCRC, Emily started off with E playing "Beanbag basketball", having her squat to pick up a bag, and trying to keep her knees apart.



This squat is actually better--when E reaches forward, she really gets the feeling of having her weight over her heels. Good stretching here...I have to believe this feels different for E, as she normally isn't in this position.



Emily said she "wasn't helping Elena all that much". But, if she were to let go while Elena was in a deep squat, I'm sure she'd fall.

I suggested an activity we'd been doing earlier this week--treasure hunting, where Elena squats down to different heights to pick up treasure. If she picks it up without falling, she keeps it. I had done this with coins, of varying heights--she DID pick all of them up, even the quarter on the floor--but it sure wasn't pretty (no pictures taken). Emily adapted this idea to a "scavenger hunt" where the objects were around the room, hidden under tissues.

Megan helping Elena read the scavenger list



Finding an item



The scavenger layout




Emily also tried to get Elena to do leg lifts independently on each leg. First she strapped ankle weights to each leg as usual, and told her which one to move. Like usual, Elena moved both legs at the same time. Then she took one weight off, and asked Elena to move the foot with (or without) the weight. She still moved both legs at the same time, but was aware they felt differently. Emily used a vibrator to stimulate one leg, while she asked Elena to move the other. It worked, a little. The awareness of moving her limbs/muscle groups independently is slowly coming.





Lastly, I had been inspired from my vacation massage to gently massage Elena's legs/feet after stretching every night. She seems to enjoy it, as long as it is gentle. Emily mentioned a technique called "ironing" (pic below). Starting on the upper leg, press gently on the leg and continue pressure as the hand moves down the leg toward the heel. It's sort of like petting, only a little firmer and in one direction. Emily said to do it before stretching (or before some activity, like therapy) and then again afterwards to see if it feels different or she reacts differently.