Hi Everyone,
It’s Tuesday and we have another clinical update for you. I will note her NEW accomplishments for this week.
PT – OT
Corey’s right arm was casted today for tone. (New canvas for me!)
Corey withdraws from suction and the use of a toothbrush. This is not new! Whoever can get her to open her mouth to brush her teeth wins a prize! The Queen of Clenching is still in control.
Corey is still 2 person dependent (it takes 2 to lift and move her), she’s not participating in any form to dressing, bathing, independent transitions or basic body control.
Her eyes are open throughout her sessions and she maintains a midline focus (eyes are centered). She does exhibit Nystagmus during transition. This means that her eyes are moving rapidly from left to right. This is a natural reaction to focus and lock onto something stationary. We think she’s really thinking, ‘Hey! What the heck are you people doing? You’re moving me where?’
(New) She is tolerating the Tilt Table at 40 degrees which is reflected in stable vital signs.
(New) Corey’s head and neck control is improving. She’s holding her head independently for 15 seconds (an increase from last week!)
(New) Her trunk tone and muscle activation is improving! (She’s developing AB’s of steel) This is accomplished by using the bolster. She is independently supporting her trunk with minimal assistance from the PT-OT team until she gets fatigued. When Corey gets fatigued, she has generalized pain sitting upright independently. She then requires dependent assistance and the team allows her to lean back against them. As they cradle her, they rock from side to side which continues developing her trunk muscles. (Corey thinks she’s relaxing…these therapists know all the tricks!)
(New) She is fixating on her pictures for 5-8 seconds, occasionally tracking (following the motion) to the left
(New) Corey has increased blinking responses with noise stimulus on her left side.
Speech –
(New) Corey has rapid reflection from pain. (She’s drawing her arm back quickly and turns her head with a simultaneous motion to the pain stimulus)
Speech has seen her open her mouth as we reported and they have seen a change in her bite reflex.
(New) Her jaw clenching has mildly decreased making it easier for them to use a spoon in her mouth. Maybe Speech will win over the Queen of Clenching with something tasty…she is in a Culinary Program after all. Maybe we should get Chef D and Chef Young to whip up something tasty and that will get her to open up!
Our Observations – John sat with Corey while I had a meeting with the case worker. We use the “long blink” for a Yes. Tonight, he asked her to shake her head from left to right to signify a “No” and SHE DID! Later on, I was sitting to her left. When she woke from her power nap, she appeared to be looking around. I confirmed my position on her left and she turned her head. She not only engaged eye contact but held the gaze for a lovely chat!
It’s hard to believe its “ONLY” been 2 months. In September, these motions might seem inconsequential but today, they are truly monumental accomplishments! Way to go Corey! You’re on your way sweetie! xoxo