Thursday, June 26, 2008

Physiatrist Appointment Today.

Well, today was the much anticipated appointment for Leah to see the Physiatrist, or rehab doctor.

It went really well. She had a lot of interesting information for me and I can tell she really knew what she was talking about. She definitly had a wonderful bed side manner and was really friendly.

We started the appointment off by discussing my concerns and discussing what I would like to see Leah doing. I told her that my biggest concern was the lack of awarness of "lefty" and that I would love to see her volentarily grabbing for things.

As she was asking me all these questions about her history, birth etc., Leah was dancing and clapping away! There was a medical student in the room also and I'm telling you Leah was in love with him. She was such a little flirt! She was making such eyes at him! It was adorable!

The Doctor, jumped right in and started talking to us about Constraint Induced Movement Therapy, CIMT or casting. For those of you who don't know what casting is, basically they cast Leah's good arm so that her weaker arm is forced into doing the work. Casting is said to increase mobility and awareness in the effected arm by 20%. The Doctor said she would love to see Leah casted earlier rather then later, which would mean that she would like it to be now!! I have to admit that this threw me for a loop; Our OT and I have discussed casting to great lengths and her opionion of it, is that it is wonderful. She is really pro-casting and thinks Leah will make a great candidate for it, but not until she is walking. Lisa (OT) says that if we cast before Leah is walking then it will interfere with her ability to crawl properly. I find it interesting that the Physiatrist said almost the complete opposite! She said if we wait until she is walking we could be losing the time that we have now. She said that four point crawling isn't always nessecary and that some kids never four point crawl. So, now I'm super confused!! I have thought about Leah getting casted early, but now that it is so close and such a possibility i'm feeling a bit freaked out. I have yet to speak the the OT about it and can't wait to hear what she says. The Rehab Doctor did give us the name of an OT who specializes in casting, she also happens to work at the same office as our current OT. The doctor wrote a referall for us to see this new OT, which I suppose will help us make our decision about casting now or later. Hopefully, we can meet with her next week.

The Physiatrist had really great things to say about Leah. She said that she sees a lot of use of both hands at midline. She also says that it is only a matter of time before Leah is pulling up all over things. I see it already--she loves to grab onto everything!!

As far as a brace on her leg, she did say that Leah will need something. Not surprising! She said right now she can't really tell what type of brace she might need, probably something to stop her from going onto her toes. She said it might be higher up to the knee at the beggining but should go lower after that. She also said that most hemi kids walk later then normal but before 2 years old.

All in all, the appointment went well and was very informative. It looks like we have some decisions to make. We will see her again in 5 months, when Leah is 14 months old.


North Dakota Ward's said...

That is great you found a doctor that you like and trust. That is wonderful that you are going to CIMT soon. There are so many different ideas about when is the ultimate time to do it. I think you just have to find someone that you trust and go with that. My doctor likes to wait till they are walking, because he feels like when they are focusing so much on gross motor it is less affective. He says the best time is 18 months to 3 years. We will cast Sammy as soon as he is walking, I am really excited to cast him. It will be hard of course, but we have to try everything that we can for these little people!!!