Saturday, September 17, 2011

Ella’s journey through Physical Therapy…

I went into Ella’s 9-month appointment with one main concern: she wasn’t sitting up on her own. In fact, she wasn’t even close to trying. She was still a limp noodle. I know you aren’t supposed to compare your children and that “all children move at their own pace”. I knew those things. I really did. I wouldn’t even say I was “concerned”. I was just ready to do something about it. Still, when I left her doctor’s appointment with a referral for Early Intervention, my heart was broken. I knew that Ella needed some extra help, but having that fact confirmed by the pediatrician made it real. I didn’t want to play the game of denial AT ALL, but having a professional tell me what I already knew still hurt. So, I set aside my motherly pride and I made an appointment with Early Intervention. The process has been long and drawn out, and we still have a ways to go, but here is what we have done so far:
March 30th- 9-month check-up. Received referral to Early Intervention.
May 11th- Ella’s evaluation appointment with ESD. By this time, she was sitting up on her own, but she wasn’t steady. They did several tests with her to see how she scored. She ended up qualifying for Early Intervention services for gross motor skills and scored “normal” in the other areas. They wrote up her IFSP (Individual Family Service Plan) to include two physical therapy appointments per month.
June 23rd- Ella’s first appointment with Early Intervention and Physical Therapy. At this point, Ella was still really struggling with her social anxiety. She would fixate on a specific person and be totally terrified by them. She was practically inconsolable. This is what happened when she would look at the EI specialist. It made the appointment challenging, but thankfully, she was okay with the PT. That is who we needed her to like, because that is who needed to work with her more. The EI mostly helped us set goals and just tried to avoid making eye-contact with Ella.
Goals set after her appt: rotate her on both sides to her belly; teach her to tuck her arm under so she can roll from tummy to back; when she is sitting in place, put her toys on her right side so she has to reach and rotate her upper body.
June 29th- Goals set after her appt: encourage rotation when she is sitting and to come up from the floor; when she is on her belly, pull her back to her knees and let her shift weight to her side so she can sit; have her practice sitting in a tall knee sit, tilt her forward so she comes down to her arms in the creep position.
July 12th- If I remember correctly, this appointment was a disaster. She cried the whole time and it was just an “off day”.
Goals set after her appointment: Sit to floor- when she starts over to the side, help her to the floor by bringing her down with her arms and let her figure out how to get her leg out. Floor to sit- from hands and knees, help shift hips under her and counterbalance her upper hip.
August 5th- Goals set after her appointment: assist her in freeing up the left leg that gets stuck when she is going from sit to creep; place her toys all around her instead of right in front of her, so she has to move to them; help her by bending one leg up, then moving the other one to help her move her body forward; have her sit on your knee with her feet flat on the floor then offer her toys so she has to reach and practice balance.
August 11th- Goals set after her appointment: have her go over to her right side going from sit to floor and from floor to sit; start with her on her belly with her legs wedged between your legs and bring her back to her heels so she can practice leaning forward and catching herself (ending in crawl position).
Speed Bump: Unfortunately, the physical therapist that had been helping us through the ESD retired at the end of August. The ESD was going through a lot of cutbacks, so we weren’t sure if the services would continue. We decided to look into private therapy. Ella’s PT, Eileen (who I LOVED), had told us that the coveted therapist in town was Trent, at Salem Hospital Rehabilitation. I made a phone call and got an appointment with him and decided to wait to hear from ESD. A week later, ESD called and said they did, in fact, hire on a new PT and they scheduled two appointments for Ella in September. She is going to be a busy girl.
September 15th- PT evaluation at Salem Hospital Rehab. We spent an hour talking and “playing” with the PT, while he evaluated Ella. Aside from the part when she threw up all over the floor mat, and he had to clean it up, she did really well with him. He did lots of tests with her to see where she was at. She even showed off her newest skill of crawling, whenever he would put his laptop down on the ground. She would only crawl to the things we didn’t want her to touch. At the end of the appointment, I was feeling like she had done really well. And then he told me that she scored at the age of a “9-10 month old”. Insert dagger to my heart. There is no ignoring the progress she has made, but I was hoping for better than that. The biggest hang up right now is that she cannot get off her back. She cannot roll to the side and pull herself up and that is a major step in mobility. When she falls to her back she is stuck, and we need to get her beyond this point.
What is the plan? Four to six weeks of physical therapy at Salem Hospital. We could skip this, since she will be receiving in-home therapy from the ESD again, but Salem Hospital has more tools and equipment to get her where she needs to be. Hopefully the combination of all of these appointments will get her there faster.
Future appointments: September 19th @ SH, September 23rd w/ ESD, September 23rd @SH, September 29th w/ ESD, September 30th @ SH. And then we will plan six more in October (two with ESD and four with SH).

1 comment:

Meg said...

I know this has been a long journey for you, but your strength and faith have really shined. Ella has come so far in the past few months and I am so proud of both of you! The combination of ESD and Salem Hospital PT will be so nice! Girlie will be exhausted, but so worth it!