Therapy 1/05/2012

1/4/12 

AJ's first day at an outpatient rehab, SWAN. Six- 3hr sessions. today was an assessment. He did really well. Speech; he cooperated with tongue movement and head nods toward objects he recognizes. Our homework is to work on oo, pucker, and ee and sticking his tongue out more. OT sat him up. He has more head strength and more range of motion when sitting up. He showed some hand strength. PT just contracted and needs boots will send assessment to Hacienda so we can all get on the same page. Continue with range of motion and boots 6hr on daily. sores on feet. leg and coccyx are better, Cocccyx is still bad and drop foot is developing, his hands are a little more relaxed. Still has good attitude and trying hard.

I played a voice mail where I had recorded of his voice. He recognized his voice, listened, then smiled. He also recognizes Eminem, and gets a kick out of Crystal, his sister. Crystal is his speech therapist, I am his PT, and his Grandma is his OT.

Dr. Thompson said that, "The ability for AJ to see straight, track, and process information requires a very complicated process within the brain, and takes 3 nerves in the brain to do accomplish this and AJ has shown that he can do this. Now we just have to work his mid-brain and make new paths.

January 5, 2012

First visit with the speech therapist at SWAN.

 I was amazed that he was attempting to follow her commands by pointing with his head to the correct category. This was the first time that I realized that he understands even more and is trying to communicate. With the way the health care (Medicaid)  is set up, he is only allowed 15 visits per year with a therapist. These visits are to be split up between speech, physical therapy, and occupational therapy. I cannot believe that any insurance company can put a time-line on a persons recovery.

OT



PT

1/27/12 He stands for the first time

January 2012 The therapy is working. This idea of standing him is to make a connection with his brain and his legs to activate movement. He hasn't stood on them since the accident, lying completely flat with limited range of motion due to his injury on the left leg. Every time a therapist tried to move his leg, it would start bleeding. His leg is healed and it is time to stand. He is full assist in getting up, and has no balance...but he is up! The first time he stood he passed out, but Kay got him right back up once his blood pressure was stabilized.

In no time after standing him, his leg began to move when I asked him to move it.
 It looks like a jerky reflex, but we will take anything at this time.

 

 1/28/12 His right leg moves for the first time

1/26/12 Sits in a wheelchair for the first time

1/5/12 He can barely hold up his head

2/2/12 AJ stands with assistance and tries to bite his therapist on the way up :)

3/1/12 With his physical therapist

Insurance allowed him 15 therapy visits;occupational, physical and speech in an outpatient treatment center called SWAN. They are affiliated with Barrows Neurological Inst. and treat damaged motor skills through Neuroplacisity.

"Neuroplacisity is the ability to change its structure and function in response to experience. Even when the brain suffers a trauma late in life, it can rezone itself. If a stroke knocks out the motor cortex that moves the right arm or in AJ's case his left arm, a new technique called constraint-induced movement therapy can coax next-door regions to take over the function of the damaged area. The brain can be rewired."

His leg wounds from the faciotomy are healed. He has lost so much weight from the pancreatitis problem and lost a lot of tone in his muscle. Also, he displays rigidity and atrophy in his muscles. I had to get him up right away to get some of his strength and tone back despite the wound vac, weakness, and loss of weight. He has been carrying  around the wound vac during therapy. The wound vac is to treat the pressure sore on his tail bone which is not healing.

 

2/9/12 Barium swallow test

He can barely hold his head up for the Barium swallow test. They gave him different consistencies of liquids, puddings, and crackers laced with iodine. Then as he swallows, consecutive ex-rays are taken to see if he can swallow without aspirating. They want to be sure the food is going down the right pipe. Up until now, the family has been feeding him pudding for a few months (against doctors orders). We were leaving the more solid consistencies to the experts, just in case he did choke and aspirate on the food.

Unfortunately, the doctor was not happy with the results of the barium test and feared that he did not have enough muscle strength in his throat to swallow completely.....so still no food and all nutrients would still be fed through a tube to his stomach. I thought they were just being to cautious. My argument was, how is he going to strengthen the throat muscles if he doesn't use these muscles....so the family will continue to sneak in pudding to feed him in the room.