Just a little bit of PT went a long way

Well, PT has just left and Fiona is passed out cold.

Today's goal was first to be stretched very slightly. Hamstrings, Abductors or is it Adductors?(inside thigh) and Gastrocs (bending at the ankle while keeping the leg pretty straight). This was to warm the muscles for movement. She tolerated this really well. The therapist got more range than I have ever seen from Fiona, and she was kind of just day-dreaming through it all. The therapist asked her to let her know if it hurts, but I told her, she would likely just resist and pull her leg away.

Next she was brought to a sitting position on the edge of the bed. We got there by first rolling to her side, then tilting up without twisting. She is free to twist as she is comfortable, but we cannot. She's a little pillar of strength. I could tell that the Tylenol was working because her eyes were closing already, but her trunk and head were straight up and down. She has better posture than I do! She was not talking much, and all along we were asking her if she had "owies" anywhere, but no response.

Next the therapist gave her a big hug with one arm wrapped around her back, and then the other arm goes under her legs to support her hips, and lifted her into her Convaid chair. No pillow or anything! She said she had intended to belt her in, but Fiona was holding herself up.
Then the big hick-ups started. She still was not showing any signs of pain, but the therapist thought the hick-ups were pretty forceful. I also suggested that the hick-ups could be a stress reaction because she doesn't want to tell us that she is uncomfortable.

I feel like I have to translate for everyone into Fionish. Fionish is really just a dialect of English. Actually, it is truncated English to accommodate her information processing challenges. I would think that many children with CP have processing issues, but it never ceases to amaze me how therapists use TOO MANY WORDS to ask a question. Not their fault of course, and how could they know which word triggers the idea for each kid? I just have to laugh, because I feel like we are at the United Nations.

Example:

Therapist says: "Fiona, can you tell me if anything is hurting you?"

Chris translates: "Fiona. Tell mummy. Do you have owies?"

Therapist says: "Fiona, are you o.k. sitting in your chair a little longer, or would you like to go back to bed?"

Chris translates: "Fiona. Tell mummy. Up (pause) or Bed?.

Then Fiona started raising herself away from the back of the chair to sit up in it without leaning against the back. Such strength. Still no signs of pain, but hick-ups still there. The therapist asked me and her if she wanted to go back to bed, but she seemed fine. I got an idea, that maybe Fiona and I should be left alone for the truth to come out. Therapist said "o.k., I'll be back in only minutes".

Sure enough, Fiona tried to sit up again, she looked a little queasy and started crying. I asked again about the owie on her back and she said yes. She must have been making a brave attempt for the new person, but couldn't articulate that she was done.

So we went back from the chair to sitting on the edge of the bed, then we raised the head of the bed a little more and laid her back down, and put a roll under her legs. She went to sleep immediately.

A very brave and successful first movement! Yay Fiona. The therapist told me that in many cases, although children want out of bed for the two recovery days, when it actually comes time to do it, they have great difficulty, and she ends up laying them right back down without moving to the chair. So I think Fiona has accomplished a huge amount this morning!

Speaking of movement, for all my nurse friends: Big BM on her own yesterday. Sorry for the gory details folks. IV also came out in the middle of the night. Fiona was really restless, and finally I figured out that she wanted to sleep on her stomach. She practically went to that position herself, I just helped a little and tried to protect the IV hand, but it was done. She went straight to sleep as soon as she was on her stomach.

So I have to move her into the chair for this afternoon's PT session. I asked the PT to come and supervise me, just to make sure I don't twist the wrong way. We are always in such a hurry in our lives and I am used to just picking her straight up, tossing her onto my left arm, grabbing everything else with the right, and almost sprinting to where we need to be. At 42 lbs, this is fast becoming a challenge and potential injury for both of us, so I have slowed down, but I am still not used to protecting a particular area of her body.

I only took a couple of pictures of the whole process. I too have information processing issues, so I wanted to be listening to and watching the PT, and couldn't be photographer as well. I really wanted to take a picture of the therapist stretching her, because the way her legs look and move is quite remarkable, but I didn't want Fiona to feel like a spectacle. I needed Doug to be in the background with the zoom lens.

I tried to add a short video and some pictures to this post, but I don't know if it will work. I might have to send them to Doug to add. Looks like short video might have worked but pictures don't.

So I'll let you know how things go later this afternoon with round 2.

p.s. It's snowing here!