Three weeks post-op

Elena has been getting stronger and her endurance is improving, but there are still some lingering concerns--not really surprises, though. Her posture is more even, and her tone now allows her to move better... but she continually leans on her left side/left foot/left hip. Sometimes this is more extreme. She continually needs to be reminded to stand on two feet (instead of having all her weight on the left one), have these feet even (she postures her right one back), and to try to keep her feet flat. Her right foot stays better in her AFO/shoe, but needs to be fixed (heel back down) several times a day.

Example of her preferred posture (right foot back):



Left leaning while using posterior walker:



Extreme lean on the hippity-hop:




Here's the good pics!

She can do the hippity-hop for a few bounces herself. She tries hard to right herself, and does a pretty good job. She can bounce, pushing off her heels--but she hasn't figure out that's how you do it (right now she's just lucky)



Riding the therapeutic trike--she even propelled it herself for 3-8 feet! That's a first, she hasn't engaged on our trike at home (but that was last year). Her right leg caves in, but not nearly as much as it used to (but that could be b/c of the different type of trike).



Abduction/Adduction--she could not do this before the surgery.





Trying to flex her feet out of rice/lentils (she did it, a little)



Bridges--she had a hard time with these last week. Little sister Vivian is mesmerized.



Sit-ups (assisted, for now)



Standing tall, after building her tower (with help to bear weight centrally)



Incision



Overall, looking pretty good!

Swinging Sunday

Last weekend, E got to do a very small amount of sledding b/c we got a couple inches of snow. This weekend, it was 80 degrees and beautifully sunny. Perfect weather for swinging!

We've been trying to teach Elena to swing herself--pumping her legs back and forth to keep going. Before the surgery, Elena "stiffened up" anytime she was engaging her upper body--which meant pumping her legs while holding on to a moving swing didn't happen.

After the surgery...well, it took 20 minutes.





How cool is THAT?!

Weekend at CMOR

We spent Saturday at the Children's Museum of Richmond. We love this place, but it was a gamble b/c it was our first day where we expected Elena to be playing hard without a nap (unless she took on in the car--which she didn't, of course).

We were at the museum for over 2 hours, well past Elena's naptime, and in a word, she was...AWESOME. Using her walker, climbing (assisted), going up/down stairs (assisted), standing, sitting while playing, etc. Here are some favorite pictures:


Playing Doctor in the CMOR ambulance





Going to the CMOR bank



Dinosaur Area





A little too early for bumpy slides...not too happy after that one (back still tender)


So, aside from crying the whole way home....a perfect day!

Flat is beautiful

We're getting back to our same-old-routine (plus a few more exercises). Back to the treadmill...leg lifts...





Elena had her PT session last week, mostly barefoot. She still likes to point/keep on her toes on the right side, but we learned a new voice cue: "squish your feet". When we tell her that, she puts her heels down and tries to squish the floor.





Next was trying to have her bear weight on either side by playing in half-kneel. When she bears weight on her left, her right knee caves in badly and she starts falling on her rear b/c she doesn't know/understand to steady herself by keeping her right knee up. She does it beautifully on the opposite side (not shown).



She did some assisted walking without her braces on (this is rare at PT). I immediately noticed she would nicely extend her leg (through the hamstring) on her left side (strong side). Her gait pattern on the left looks more "flat footed" than "toe-heel", but this has always been the case--only now it's a more fluid motion. The right is still "toe-heel", but it too is more of a relaxed motion than a laborious, dragging effort.

Gait Lab

Elena's walking pattern was analyzed before her surgery--twice, actually, once in January 2008 and again in January 2009. The technology they use to do this is pretty cool. They deck out E in a bunch of sensors after taking tons of measurements of her body and her flexibility. We sang "I'm a little robot" (instead of '-teacup').



Elena walking down the track--this video quality is poor, but you get the idea.



They do this several times under different circumstances (with/without braces, walker, loftstrands (wrist crutches), etc) and then based on the sensors and her measurements, construct a digital representation of her bones moving. Pretty cool.

Bones--walker, no braces


Bones--walker with AFOs and shoes



Bones--loftstrands, with AFOs and shoes


We'll do another gait lab analysis now that the surgery has been done, between 6- and 12-months post-op.

On the Move Again

After some tweaks to her AFOs, we've been getting Elena up and moving again. That's been easy, b/c she wants to be independent. We let her cruise by herself (with someone close by) and have just let her start pushing things (walker, stroller, cart, etc.). We don't let her do much without supervision b/c she hasn't fallen since her surgery, and we're worried she could hurt the incision. That should change in a week or two...or whenever she falls and we don't catch her.

Activities from this weekend: Saturday Shopping at Harris Teeter





We let her push the kiddie cart. She was standing or pushing for at least 20 minutes. We'd hold the "flag" on the cart to keep her moving slowly--and keep her from leaning into her stride too much. She wanted to look at greeting cards, so she did, and aside from taking pictures, I kept her right leg straight and her hips neutral as she perused the card selection.




Sunday Visiting Mommy's Work (UVA Hospital)



Back at the Life Less Ordinary picture hallway! I might change my blog picture soon. She pushed her walker for about 15 minutes after "playing scientist" with her knee immobilizers for 15 minutes. After a visit to the coffee ladies, she used her walker some more, but not as long. The biggest difference now is that she is willing to shift her weight to her right side more often (but still defers to the left), and we haven't seen her drag her right foot ONCE since the surgery (she used to do that ALL THE TIME).