Tag: cerebral palsy

Wrapping Up HBOT

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When we first started hyperbaric oxygen therapy, the idea of doing 40 dives felt so daunting. Perhaps it was only because we could do one per day – or perhaps it was because the idea of being squeezed in a tube with a wiggly (and pinching, biting, and screaming) toddler was a bit too much. But when we packed up Solly and Bea to head to our 40th and final dive, I found myself already missing the very special one-on-one time I was able to have with Solly every day.

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Spending Mother’s Day with my boy

When I blogged about the gains we noticed after the first 20 dives, I mentioned that Solly was acting more like a 2 year old than he ever had before (hello, emotions!), he began making new sounds and even came close to using words, his normally tight limbs were becoming looser, and he had gotten strong enough to start bouncing when in a kneeling position.

With the second half of our treatment, we saw those gains continue to strengthen and grow. For example, in his new favorite bouncy move, he started to shift to almost walking on his knees, moving his legs reciprocally:

On top of those, we really saw him become more interactive with his surrounding environment. Instead of simply lying next to me and only playing with me or watching a show on the TV, he became more interested in sitting up and observing what was going on outside the chamber. He’d play peek-a-boo with the person in the chamber across from ours, mimic someone standing outside the chamber, or just be snoopy and watch what the technician was doing. It was really cool to see this awareness develop!

We’re excited to continue to watch Solly develop and grow as a result of HBOT, and we only hope that we can continue to build on these gains. But for now, it’s play time until we move onto the next big thing!

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Swinging in the park at Hilton Head Island

 

Inching Along

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Dad_and_Sol

First winter in Nashville

Today marks the beginning of our fifth month in Nashville. Four months down and we are finally getting into the swing of things with our therapy schedule. We have 6 weekly therapy appointments: 3 physical therapy (with two different therapists), 1 occupational therapy, 1 feeding therapy, and 1 developmental therapy. We are also being followed by a vision therapist and developmental optometrist every 3 months. Needless to say, combining therapy with our regular doctor and specialist appointments, we are on a strict schedule and are very tired at night!

That being said, every second we spend with therapists, doctors, and on the road to appointments is worth it. We’ve seen lots of tiny developments in all areas that are beginning to add up into bigger gains.

Pudding

Pudding is so yummy!

Quite literally, Solly is gaining weight! I wrote quite a bit last year about his stressful weight plateau and how we weren’t given any answers or solutions. Apparently, a weekly session with a feeding therapist is all we needed. Now, feeding is no piece of cake – I suspect Sol has some sensory issues that are contributing to this – however, he is consistently eating three small meals a day and drinking three bottles. He’s even trying a bit of table food, with french fries, chocolate pudding, and pancakes now his favorite foods. It might not sound like much, but this is a huge victory for us. More importantly, Sol has put on at least 4 pounds since we’ve lived down South, moving up in size from 9 month clothing to 18 month.

Another major gain has been learning to use his right arm. Many of our goals in OT include a stronger and engaged right side, so this has been much of our focus in our weekly sessions. When we moved to Nashville, Sol wasn’t sure how to engage his right arm or hand at all, so it typically hung at his side at all times. Now, he’s not only raising his right arm to give a fisted high five, but he’s also raising it to bat at toys. Take a look:

We hope to start some version of CIMT (Constraint-Induced Movement Therapy) this year to continue to increase the use of his right arm and hand.

When it comes to gross motor skills, Sol has made the most gains. Our therapists have added some new tools to our toolbox, which have made quite the different in his tone, strength, and skills.

Grocery_cart

Sitting up tall

For sitting, we purchased a GoTo Seat, which supports Sol enough to sit independently. While it does not make his trunk stronger (which is what we really need!), it gives him a feeling of confidence and independence to sit and play with toys alone. This paired with trunk strengthening activities in PT have made him much stronger. He’s now sitting independently using an arm to prop himself up and can now sit in a grocery cart all by himself, which he loves!

Stander

Stander time

We’re also starting to use a stander. A stander is exactly what it sounds like: it helps kiddos stand. Independent standing helps with developing hip joints, bone density and leg strength, but for kids with CP who are delayed in this milestone, like Solly, there is a risk of hip dysplasia and other impairments. Luckily, a stander will help Sol develop strength, density, and proper alignment, and it will also help decrease muscle tone. While we’ve ordered our own, we are still waiting for insurance to approve its necessity. Fortunately, United Cerebral Palsy of Middle Tennessee has a neat program called the Equipment Exchange that loans out used equipment, and we were able to borrow a stander from them. Sol now spends about 40 minutes a day playing in it.

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Moving right along

Most 15 month old children are up and walking on their own. While we are working on each milestone in chronological order, we also try and expose Sol to things typical 15 month olds are doing. Since he isn’t strong enough to walk on his own yet, we’ve begun teaching him how to walk using a gait trainer. It is similar to a walker, but it also includes lots of ways to support his weak trunk. At least once a week, we get Sol into a gait trainer and go through the motions of getting his legs through a reciprocal movement. He doesn’t quite have the hang of it yet, but he will try to move one leg forward a couple of times each session.

Finally, and most exciting, is seeing all of Sol’s hard work come to fruition. Last weekend, we watched as he figured out how to put one arm in front of the other and pull his body forward completely independently. There is no better feeling than watching him learn a new skill and then run with it! Here is Solly’s version of an army crawl:

 

 

Meant To Be

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The second we moved to Nashville, it was clear that we were meant to be here. After almost a full year of medical struggles where it felt like we were always working to get on one doctor’s calendar or fighting the guidance of another, once we got to Nashville, everything sort of just started to fall into place. Even our trip to the DMV was a breeze!

We largely timed our moved around the availability of Sol’s new neurologist, who, after receiving a referral from our DC neurologist, was able to fit us into her schedule on October 1st. We packed up our home in DC on September 29th and travelled (me and the pups by car, Mike and Solly by plane) to Nashville on the 30th.

At our neuro appointment, we were referred to a physiatrist (in short, a movement doctor who will follow Solly for all of his childhood). This particular physiatrist typically has a 3 month waiting period to get on her schedule, but the day after our neuro appointment, I received a call from the physiatrist’s office saying they had a cancellation for the following week and would I like that appointment? Yes, please! The physiatrist then referred us for evaluations by physical, occupational, and speech therapies, as well as an appointment with another hard-to-book neuro ophthalmologist. We saw the neuro ophthalmologist only days later, thanks to another cancellation, and even though a friend warned that it’d likely be several months before we would be seen by the therapy department, we had all of our evals and were on a regular therapy schedule within two weeks of arriving in Nashville. We couldn’t have asked for a smoother transition!

Here’s a quick update on where we are on the medical side of things:

Neurology

Sol’s neurologist is an amazing woman. Our first appointment with her was so unlike our previous neurology appointments where everything seemed like a guessing game. (In our last neuro appointment in DC, the doctor said she was “nervous” about ever taking Sol off anti-seizure meds, even though he’s been seizure-free since the NICU. I’ve gotta say, hearing a doctor say she was nervous without any game plan didn’t give me a lot of confidence!) Our neuro reviewed Sol’s MRI and while she agreed that his damage is widespread and that we’ve got a lot of catching up to do, she wanted to move forward with an EEG to see if he was having any sort of seizure activity. She explained that though he has quite a bit of damage from his strokes, that doesn’t make him any more susceptible to seizures than any other stroke survivor. About 30% of pediatric stroke survivors will develop epilepsy, so there will always be a chance of recurrent seizures.

We went into Vanderbilt Children’s in early November for his repeat EEG. It stirred up so many horrible memories of our time in the NICU, where it seemed that he was always hooked up for an EEG which typically meant that we couldn’t hold him. Awful stuff. This time around, Sol was, at first, irritable when the tech affixed the sensors, but we were able to get his mind off of it with songs and toys. The EEG involved seeing how his brain responded to a series of blinking lights, how it was at rest, and how it reacted to falling asleep and waking up. Solly was a trooper and we were done with the EEG in about 45 minutes. Easy peasy! The best part was receiving a phone call from his neurologist 3 days later, saying he should zero seizure activity and his EEG looked great. His left side showed delayed responses, which, given the majority of his damage is there, makes sense and isn’t surprising. Our plan is to start weaning him off of Keppra (his current anti-seizure med) in the Spring was cold/flu season is over. Our next follow up with Solly’s neurologist is in January.

Falling asleep during the EEG
Happily done with the EEG

Physiatrist
I was excited to meet our physiatrist. This is the one doctor I always wished we had in DC, but no one ever connected us with one. Basically, our physiatrist oversees all therapy and makes sure Sol gets exactly what he needs to support his development. Our first appointment with her consisted of a general evaluation of what he’s doing and how he’s moving, and what other doctors we needed to see now that we are in Nashville. Now that his physiatrist got us synced up with all therapists, the ophthalmologist, and a nutritionist, we are seeing her once again next week for an update. It’s obvious that this doctor has loads of experience and I really look forward to seeing her on a regular basis.

Neuro Ophthalmologist 
Sol’s new neuro ophthalmologist took a look at Sol’s dilated eyes and told us what we already knew: the structure of his eyes is perfect, it’s possible he has a visual field cut (think: partial vision loss on one side), and he may also have strabismus. What’s nice is that he wants to wait and see how Sol’s vision develops before coming up with a solid plan of attack, so we don’t need to see him again for another year or two. I do, however, still have some concerns about how his vision is slowing down his gross motor development, so I may push to see another vision specialist sooner than that.

Nutritionist
The last of Sol’s specialists that will be following Solly is a nutritionist. You may recall that we’ve had quite a bit of trouble with Sol’s feeding over the last 6 – 8 months and this has (had!) been one of my biggest points of anxiety. Luckily, we’ve been having some major success with a feeding therapist (more on that soon), and as we’ve gotten better with eating, she and our physiatrist wanted Sol to see a nutritionist who could help us beef up Sol’s caloric intake. Our nutritionist is a super sweet lady. She walked me through Sol’s growth charts and said what we need to do is get him to gain some weight so his weight and height percentiles are more proportionate. (He’s about 25% for height and 2% or less for weight.) First of all, she took Sol off of Alimentum, thinking that he may not be eating as well because “it tastes like gasoline”, and put him on a high calorie version of Pediasure. Then, knowing that I’m a very goal oriented person, she gave me a target number of ounces he needs to consume every day as well as a daily calorie goal to fatten him up and make up for the weight he didn’t gain over the summer. Fortunately, after a couple of weeks, Sol has really taken to the Pediasure and has put on about 3 pounds since we’ve moved here. We check back in with her in February and I’m hopeful that Sol will continue to add the pounds so that appointment will be positive.

Solly has also been super busy at multiple weekly therapy appointments, but I’ll give a therapy update in our next post.

Thank you for keeping up with Sol’s adventures. We are so grateful for you!

Mama Guilt, Be Gone!

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Mama-and-Solly

Flashback to one year ago

All Moms struggle with guilt. Whether its choosing to go back to work a few weeks after her baby is born or wondering if she’s feeding her kids the right foods or any number of other situations, it’s a common feeling among all mothers. In my particular situation, I spent the first 10 months of Sol’s life feeling guilty that something I did (or didn’t do) caused Sol’s stroke. Again, this is a common source of guilt among Moms of stroke babies, and in 99% of the cases, the stroke was the result of a random mutation or a clot that no one saw coming. But, I always wondered if maybe I stopped running a little earlier or if I had passed up that occasional Starbucks Chai Latte, Sol’s situation would have been different.

Thankfully, right before we left DC, my feelings of guilt were put to rest.

After 10 months of choosing not to look at Sol’s MRI out of pure fear for what it looked like, I decided I would feel better knowing what it looked like. I asked Dr. Newport, the director of Georgetown University’s Center for Neuroplasticity, a woman who I greatly admire and trust, to view his MRIs and walk me through them.

Those 10 months of not knowing what those images looked like may have worked in my favor: based on what the NICU doctors had told us, I imagined the absolute worst – a sliver of healthy brain tissue and not much else. Not so much. I assure you, his MRI is still scary to look at. I learned that he had at least three strokes, one in the left MCA (ischemic) and one in left and right ACA (hemorrhagic), and these strokes were massive, completely destroying brain cells in these areas. The MRI also showed a spot in the right MCA, which could have been a fourth stroke or the result of blood in his brain after the brain injury.

Sounds like a lot, right? It is… BUT what’s promising is that, through the areas of research that Dr. Newport and her team are commanding, doctors are finding that if one area of an infant’s brain is injured, other areas on the other side of the brain can take over. For example, since the left MCA was impacted (this houses the speech centers, for example), the right MCA can take over those duties. Because both the right and left ACAs, the areas that control executive functioning (think attention and organization skills) were affected, we are unsure how his brain will rewire to compensate for these areas. In fact, we’re unsure how his brain will rewire altogether. Because the left side of his brain bore the brunt of the damage, we DO know that his right side will always be weaker. Other than that, how well he continues to recover is left up to God, good luck, therapy, and Sol’s will and determination. He could very well be wheelchair-bound or never gain use of his right hand, but watching him work hard on standing in therapy and seeing him concentrate to bring his right hand to a toy tells me that he will make strides in all areas.

And, going back to that talk of guilt, Dr. Newport said that, based on his MRIs, it was obvious that nothing I did during pregnancy and nothing that the doctors did during delivery caused Sol’s stroke. It was most definitely a clot or multiple clots that broke off from the placenta during delivery – nothing more, nothing less.

While this news doesn’t make Solly’s situation any better, it does put my mind at ease and allows me to focus more on creating the best environment for his recovery – and that WILL help him improve.

It Takes a ‘Ville

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Working on sitting

Working on sitting

It’s been one heckuva month! After feeling like we’d been in plateau-mode for so long with Sol’s milestones, this month, Sol kicked it into high gear and ticked a couple more items off his list.

In the gross motor skill department, he started rolling over his right shoulder. Previously, he’d only been able to roll to the left. This is amazing news since his right side is so much weaker than the left: this means all of our work in PT is paying off and his right side and shoulder muscles are getting much stronger. This also means danger: Sol is no longer immobile! If I put him down for 2 seconds, he rolls to the other side of the room! Speaking of mobility, Sol is also starting to pull himself forward on his belly. We get one or two scoots in a row, primarily to get to toys. This kid wants to move! He’s also getting so much stronger with sitting and can sit for longer periods of time. Our next goal with sitting is to sit taller and teach Sol to catch himself with his hands if he begins to tumble over. Since he is scooting forward using his arms, we are now working in PT to get his legs moving, primarily by teaching him how to pull up from kneeling to standing.

Eating avocado

Eating avocado

Sol has global delays, but one area in particular that began to worry me was language. He started cooing around 3 – 4 months, but months 6, 7, 8, 9, and 10 came and went with absolutely no babbling. Last week, I was talking to our OT about Sol’s eating and told her that I was reluctant to start him on table foods given his tricky history with feeding. Our experience with therapists and nurses repeated itself as she, one, reminded me that he actually didn’t have feeding issues, that any issues with “feeding” were actually related to reflux and constipation. Two, she figured that he was actually putting his hands and other things in his mouth not only because he was teething (we’re up to 6 teeth now!), but also because he was naturally craving something to chew. So she sat Sol down, cut up some watermelon she’d brought for lunch, and gave it to him. It was a hit! Sol is now having blueberries, raspberries, avocado and other small bites with every meal. And the most amazing thing is – with this new venture in feeding, he has also started babbling! He is now saying bwahbwahbwahbhwah and mamamama quite frequently and is constantly jibber jabbing. I’ve said it before, and I’m sure I’ll say it again, these therapists are AMAZING.

Our appointments this past month were generally the usual, with the exception of a hearing test (we passed!) and an aerodigestive clinic. The latter was a 4 hour appointment that focused on Sol’s feeding and is probably better addressed in a separate post altogether. (Let’s just say it was a very long day!) I also sat down with the director of Georgetown’s Center for Brain Plasticity and Recovery to walk through Sol’s MRI for the first time. I learned so much and while Sol’s MRI is a bit terrifying to see, the director reassured me that it she’s seen kids with similar MRIs go on to walk, talk, attend college, and live relatively normal lives. I will also likely walk through this meeting in a separate post, so stay tuned!

Hanging out in the park during an Open House

Hanging out in the park during an Open House

Finally, and most exciting of all, is a huge decision we made this month. As we found over the last year, there’s a lot of value in the old saying “It takes a village to raise a child.” As organized as you can be, it just isn’t possible to be superMom or superDad all the time – you need help! We’ve had incredibly supportive friends in DC who would be there in a heartbeat if we needed them, but it’s hard to ask for help, even when it’s offered often. So, it’s off to family we go – we are moving to Nashville, Tennessee in just two weeks where we’ll live 5 minutes from my sister, 10 minutes from my parents, and 10 minutes from Vanderbilt’s Pediatric Stroke clinic. This move is bittersweet – we’ve loved starting our careers and family in DC and will miss our friends immensely. However, we are very much looking forward to going “home” where we can really focus on keeping ourselves happy and healthy and, most importantly, continue to help Sol recover and get stronger (and not to mention, let his Nana, Papa, Aunt, Uncle, and cousins spoil him rotten!).