Friday, July 31, 2009

PT recap: Same issues, Different Exercise

Here is E working on 1) moving more independently, and 2) trying to move her feet in/out of obstacles--whether that be uneven terrain, swings, ladders, etc.

Every session now she does steps with her crutches. This is to try to practice for school this fall--there is a small set of steps to her classroom. I think it is highly unlikely she will be ready to use her loftstrands at the start of school. We'll probably have to go back to the walker. (Steps vids not here, but are on the YouTube channel).

E gets some choices as to what SHE wants to do during PT; using the swing was one of them--but she didn't realize getting out was part of that program.

some time after that, all learned another type of sit-up.

Sunday, July 26, 2009

Weekend at Maymont

Nana and PopPop came to visit us this weekend, and we planned a trip to Maymont (Richmond, VA). It is BEAUTIFUL! I can't believe I didn't know it was there before...if the day wasn't so hot, it would have been perfect. E loved the fountains, and flowers, and trees--spending time outside on uneven terrain isn't something she gets to do often. We were all pretty worn out by the end of the day...but what a lovely day!

E in a big magnolia (you KNOW I was sweatin' this one...I must have asked her a thousand times if she felt like she would fall)

E at one of the garden fountains

There's more pics on PopPop's camera...hopefully I'll post those soon.

A VIP luncheon

Last week Annette organized a lunch date with Elena and her Bright Stars teachers, Ms. Geisha and Ms. Ruth. She had a BLAST. These two are the creme de la creme, folks. Baby sister Vivian go to go, too.

PT recap: Scooter Boat, "Blue Cocoon"

E started off the session with her crutches like the week before (see youtube channel), going up the steps outside the therapy center as before. She's getting it, but she is unstable and lacks confidence.

They started off the session using the Sensory Swing (?), we call it the Blue Cocoon. It takes a lot of upper body/core strength for E to climb into the swing, and she loves being twisted up inside. She's a very happy caterpillar.

Later E worked on core strength/movement through her hips while using a scooter board. Here is one video; there are more on The Doodle youtube channel.

PT recap: Steps and uneven surfaces, with crutches

E worked hard with her crutches this week. Some days, she's very upright, and willing to move (this normally has to do with motivation)--other days she is a whiny, cripply mess. She's looking pretty good here. Teresa is very good at getting Elena's attention while speaking softly and reasoning with her when she is frustrated.

Teresa also helped E climb a rope ladder--while it was swinging, she used that opportunity to teach E where her hips/legs should be in relation to her torso for better balance.

E "runs" The Track

Elena wants to run BADLY. She wants to run and jump around the house...we tell her that this will be easier if she works on walking first. "Walk before you run" we tell her...yeah, try to reason with a four-year old, right?! Lots of bumps and bruises, but honestly, that's nothing new.

Here is E giving it a pretty good shot; notice she doesn't raise her right foot as much.*


*I noticed this week that she wasn't using her left leg as well as I previously thought she was. I did this by watching her head-on during treadmill (normally I am on her right side)--she REALLY leans on the left, b/c she does NOT like to weight shift onto her right leg. I asked about exercises we can do about this--I'll have to devote this to another post.

Monday, July 20, 2009

PT recap: Power of the Tutu

E wore her puffy tutu last week to PT. She spent a lot of the time working on controlling her movements while walking--start, stop, stepping up, and down.

Her movement on the mat was really great! We are starting to see her "stop" and "start" in normal settings. Very exciting!

New Hardware

A couple of weeks ago, E had her eye checkup with Dr. P. She was a very good patient. The eye exam was long, but that's because she is older now, and able to converse about what she sees and if corrective lenses help or hinder her vision. During E's eye exam, when they have corrective lenses on, she said "OH WOW I can see SO much BETTER!".

We left with a prescription for glasses (for astigmatism). She is slightly farsighted in her right eye at the moment, but it's not bad enough to correct.

Wednesday, July 15, 2009

Home Highlight Reel: Dinner Table

We can now say, "Elena, please come to the table for dinner", and she can do it by herself!


Check it

4-year checkup

E had her four-year checkup this week. She's 26 lbs, and I FORGOT HOW TALL. She took a hearing test (she did well--auditory analysis when she was a baby indicated she cannot hear one tone in one ear), and she took a vision test designed for depth perception. It's a little early for Elena to be able to understand the test, but overall she did well, and the results indicated that she has (at least some) depth perception. This is HUGE for us, given her vision history, and how long her eyes worked separately.

Her regular eye exam (both recently with Dr. P in Northern Virginia and at her pediatrician) showed that she has some farsightedness with her right eye.

Her language and comprehension are great.

Her pediatrician sees a big difference post-SDR. He's real happy with her progress!

Mommy's Birthday: Hill Top Berry Farm

We went blackberry picking for my birthday. I figured using crutches was probably out of the question-the terrain was just too long, too hilly, too big. Elena was a champ, though...she walked a LOT. She walked independently on the patio tile, which was textured and uneven. She walked all over the wine tasting area (flat flooring), and fell only once. She walked all along the orchard, holding one hand.

She did a great job walking all the way up this hill. One big change I have noticed with her "hand-held" walking is that her weight seems more properly situated in her own body space (as opposed to a constant, unstable lean). Her balance is still "rickety" from her hips to her sternum--a weird description, I know--but she seems to be commanding her own space. I think this is b/c even with her hands held, her knees aren't caving in as much, which keeps her weight better situated over her heels. I hope that makes sense...

Neurosurgery Follow-up #2

Last week E had her second post-SDR follow up.

I have to say, I'm disappointed with the visit. Overall I feel like Elena is doing fantastically--Dr. Elias echoed that sentiment, but he really didn't examine her much. I thought he'd be pretty interested in her range of motion, how much lower her heels are, her ability to squat (some), or how much LESS tight her legs are--but maybe he got all the information he needed by watching her move a little. She walked across the room, independently, a couple paces at a time (nowhere near her best effort, as it was past lunchtime, and she was out of her shoe). She sat on a bench, and crossed one leg over the other (with her shoes on), each side. He asked if she was having any problems toileting, which she does not. He was very pleased.

He did say that I should expect her to improve a lot more. I had the impression that the majority of the changes come in the first 6 months after SDR; he said "double that" and then some. I'm pretty excited about that!

The PT there also examined her, and took a video of her walking. We waited a long time just for her to do that. I could have directed her to this blog--better videos, and we wouldn't have had to wait so long. Hmph.

Tuesday, July 7, 2009

Eating Wheaties, or Something

This has been a great week so far...E is really moving around pretty well. Still having some falls, but no real bad ones. Here are some great videos from hippotherapy with B!

My favorite--watch her knees when she sits back down! :)

Big ups to Annette for filming!

E has been trying new things (most with heavy assistance)--navigating curbs, walking around the house while carrying items, trying (unsuccessfully) to independently stand up from the floor, etc. Her attitude has been very willing, especially when using pretend play as a reward. Such as...her current favorite, Operation!

Saturday, July 4, 2009

Loftstrand walking, faster now!

After a long, grueling morning, and after lunch, and before E's (late) nap, she came to my work. Our agreement was she could bring her dolly stroller IF she agreed to walk the "Life Less Ordinary" hallway with her crutches. (I don't know how long it is...50 paces or so?)


We did this 3 (?) months ago, right when we were starting our transition to loftstrands from her walker. That first time (not posted yet, b/c it's on another camera) took us well over 10 minutes, with lots of crying.

GREAT PROGRESS. Or, as E says, she's "awesome sauce".

Third of July at Pen Park

E went to the park with her friend LC. She preferred to stay on the toddler playground; they have a larger playground for bigger kids (she did that too, but needed extra help, so no vids taken). She still needs constant supervision, especially while descending or climbing.

Steps, though, are getting much better. The toddler playground has appropriate handrails!

Elena, like most kids, loves slides-but she can't seem to stay sitting up while sliding. This normally means we have to be RIGHTTHERE to catch her at the bottom, or she whacks her head as her bum falls of the slide. At this playground, the slide is shallow, so I didn't have to catch her. I told her to stand up.

She can do better. I know she can stand up just fine from this slide, but on this occasion, no dice.

PT recap: Balance, weight bearing, and Dorsiflexion

A great session with JM! E spends time at PT with the emphasis on weight bearing on the right side:

Sit-to-stand drills on an uneven surface makes E bear weight on the right to balance. She was pretty patient, especially since she prefers (unconsciously?) to stand on her left leg. She was a champ during this drill!

JM then got E to do turns while moving her feet to accommodate her turn. I believe E can do 90 degree turns with ease--but her feet do not always end up "straight" at the end of the turn, there is a lot of over/under correction after she turns while walking. I'm also not sure if she can turn 90 degrees in both directions. She probably does one direction better than the other.

More of the same. I think E is getting tired of her schedule. Still, she is slowly and steadily improving. Here is Theresa getting E to balance/bear weight on her right while engaged:

E is getting the idea that she is neglecting to bear weight on the right. She DEFINITELY knows her right from left, and now, when we mention she needs to "put her right foot down" or "use righty" she complies.

E also did great in the macaroni pool--from this video (I couldn't be there in person), it seems like her dorsiflexion has improved!