Tomorrow is the last day of camp. We head to the Smokeys for a little fun before going home.
Josephine's therapist reviewed her progress with me today. Although Josephine worked very hard at camp, her progress is not yet very noticeable. The camp was a great starting point for her, and a very positive first constraint experience. However, her hand is severely affected, and time, maturity, and additional therapy will be needed to reach our goals.
She still needs full hand over hand support to do bilateral activities. An example of a bilateral goal is holding a large ball using both hands. She still needs full support for weight bearing activities, which entails holding her hand to the ground to prevent her arm from pulling up to her chest, and full support at the elbow.
She cannot yet release an object, but the good news is she now visibly concentrates to try to release an object. So, she is trying to figure out how to open her hand!
I feel like opening her hand is like me trying to wiggle my ear. ....I can picture my ear wiggling, maybe even watch someone wiggle their own ear...but there is no path from my brain to my ear telling it to move. Josephine's stroke killed the part of the brain that sends a signal to her hand, and until her brain rewires that control, she can't open her hand. The key to helping her find the control to those muscles is weight bearing which will provide sensory input to her arm and hand and strengthen the muscles to support the desired movement.
Hemiplegia means paralysis on one side of the body...and paralyzed is descriptive of her hand. Most doctors use hemiplegia and hemiparesis interchangeably. Hemiparesis means weakness on one side of the body. Josephine has no movement in her hand, but almost normal movement in her foot. Whereas, Madalyn has movement in her hand, but no movement in her foot (no dorsiflexion or toe wiggling). I guess that is why the two diagnosis ended up being used interchangeably.
Tomorrow Madalyn's therapist will go over her progress with me. I was told that she significantly increased her speed of fine motor tasks (stringing beads with affected hand, etc.) so I'm excited for Madalyn. I also know that Madalyn had a great time at camp. I'm most thankful for that, since I was worried about "making" her come.
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