1 in 4000 babies will have a stroke

PM is a stroke survivor.  As a result she has Hemiplegic Cerebral Palsy that affects her right side.  May is Pediatric Stroke Awareness month and today I want to re-post a video we made for PM after her first round of Constraint Induced Therapy (CIT).  CIT involves casting the “good” arm while participating in more intensive physical and occupational therapy to build stronger neuropathways for her weak side.  You can see the effects this has in just 4 short weeks!  PM did a second round of CIT in June 2009.  We would like to do more soon.  Therapy is so wonderful for her and has really improved her movement and fine motor skills.  We know it will never be perfect, but there has been a TON of improvement!!

You can learn more about Pediatric Stroke at KidsHaveStrokes.org !

A Thousand Words Thursday – Birthday tribute

Find your favorites photos worth a thousand words and share them at TheMomJen’s Cheaper Than Therapy!

I meant to get this done yesterday, for PM’s birthday, but it took me an extra day. I hope you like it. I tried to keep it under 10 minutes, so grab some popcorn!!

Friday Fragments

As prescribed by Half-Past Kissing Time - All the stuff too small to be a post, too goo to discard...

PM, 2, seems to have a saying of the week. It's recently been "what goin on!?" shouted by her dolls when they talk to each other. Is this her idea of how adults carry conversation?

MD ran out of Pull-Ups last night so I was forced to let him sleep without. I woke him at midnight and carried him to the bathroom, he went. He was dry in the morning. Is this all the effort I need - are Pull-Ups a crutch?

I need to post some photos of MD at gymnastics.

AM came home with a note about Girl Scouts starting. As far as I know there hasn't been a troop in town for some time. I'm actually very excited about this. I was toying with the idea of calling and trying to get something started here. I'm glad someone did!

Stupid Kinesio Tape left a rash again on PM. I'm officially done with the stuff, sadly. I was really happy with what it was doing for her. I wonder if there are alternatives.

It's almost 5 am and I'm up. Jackson is back to bed, so must I be.

Good Night!!

Constraint Therapy, Kinesio Tape, and AFO's

PM finished up her first round of constraint induced therapy in October, now I can stand back and see what we have accomplished. She has much improved motor control with her right hand and definitely more strength. PM is now more willing to use two hands to do two-handed activities rather than struggle with one. I posted the rest of the videos I had of her therapy HERE. She is also willing to wear the "clam shell" constraint during the day or during her therapy without complaint. Sometimes she doesn't want it off at all. However, I think she'll benefit from a second round perhaps in the spring. The reason I'd like to do it that soon is that she turns 3 in June, then there is a strong possibility that her state medical assistance will run out. Our insurance pays first, but so far the state has been able to cover the overage. It would be nice to get as many services in before we're on our own. At night, or any time she starts to get tired she tends to curl her right hand up in that little fist again. I don't expect CIT to work miracles, I know she will always have a deficit, but I can see that it helps. The fist has been happening more often during the day, so the clam shell has come back more often for full days. I just wonder when do we have full potential? Will over-using the constraint method eventually slow her expected progress in the "good" hand? I have decided to give the Kinesio tape another go now that winter is fully upon us. It will serve as a gentle reminder to keep her wrist up and open those fingers. My hope is that the dry, cold weather will keep her from getting the rashes she got this summer from it.



She will also be due for new AFO's before spring as well. Her little toes are peeking over the edge of the plastic and I was told to look for spots on her leg that may indicate they no longer fit. PM got the first set of AFO's in April, so it would be pretty good if she makes it a full year before upgrading. It will be several years before she will be out of AFO's. Her biggest hurdle is that her right knee still hyperextends any time the AFO is not on. She needs to build up strength and train the leg not to snap right back into that position. That will take time. Eventually the high AFO she has now will get shorter and shorter until she no longer needs them. In the mean time I was given several pairs of shoe specifically designed for use with an AFO. They belonged to my friend's sweet girl Caroline. The problem with regular shoes is that they are not nearly wide enough and you end up buying regular shoes several sizes larger than the foot...can you see PM tripping around in AM's shoes? Big shoes kind of defeat the effort of helping them walk better.

On the lighter side: MD went to Santa's Village with his preschool. I asked him who he saw there..
MD: (flatly) Santa.
Mom: Who else? (they each got a children's book signed by the author)
MD: (more animated) Mrs. Claus! (turns to AM) She's like a girl Santa!

Therapy with P.M.

I thought I'd post some of P.M.'s recent session. This was July 30th. She was recovering from the Kinesio tape rash, so she has nothing on her right arm. We usually use at least the tape during the sessions. Her OT has fun toys and good ideas for making her feel she is still playing while she does her therapy...and she's very patient! Since P.M. has become comfortable here, she exerts her will more often, deciding when she's done with a toy or cleaning up. Maybe thats just her being two.
Her hand strength has improved quite a bit along with dexterity and the ability to open her fingers up. The problem is that unless prompted, she will not use that hand.

This one is good for seeing just what she still has to work on. Her large motor skills are getting better, but her pincher grasp is still very weak. At the end of the clip I look up to talk to her OT and she quickly uses her other hand to pick up the beans!

Kinesio Tape Dilema

Our OT ordered Kinesio tape for P.M.'s hand for us. We received 3 rolls and they showed us how to tape her hand to help with wrist extension and to bring the thumb out of her fist. I at first didn't see any difference. With more time, I think it is helping. I actually think it does more good than the Benik brace does as it doesn't restrict her movements, especially since a big part of her OT is getting a good pincher grasp developed. The Benik seemed to be in the way and keep her thumb and forefinger from meeting easily. THEN I found a video on YouTube that showed a more extensive tape technique (more tape mostly) that seems to provide more encouragement to keep her wrist up. The technique involved more stretch placed on the tape across the forearm (http://www.youtube.com/watch?v=KD3xrQPqj6g). It really has been working well. BUT it seems P.M. is getting a rash from the tape :( Her wrists are prone to eczema anyway, but this was definitely from the tape remaining on. I'm disappointed. She never had a reaction to the original tape we were using, a flesh colored Kinesio tape (the backing only said Kinesio with some Japanese characters along side). The pink tape is Kinesio Gold and I'm wondering if there is a difference in the adhesive OR if it's the dye. My only other guess is that it's just to darn hot these last few days and it's just a heat rash exacerbated by being under tape days at a time. I am going to let it heal up, then try the pink tape again. If the rash returns, I'll talk to OT about some alternatives, or try out plain old flesh colored and see if anything makes a difference. P.M. doesn't seem too bothered by it, it was a little itchy for her, but not too uncomfortable. She's such a trooper. She likes her "stickers" and will sit nicely to let me apply them.

The pink Kinesio tape in action.

The lovely rash after 2 days.