Saturday, May 15, 2010

The Left Side

The other major side effect of Ryder’s stroke is the weakness in his left side.  Now that he has been pulling up, we have noticed a huge improvement in the strength of his leg.  The only concern we have with his left leg right now is that his foot rolls inward when he’s standing, but until he starts walking we won’t know if it’s even an issue or not.  And, when he goes from kneeling to sitting, he often forgets to swing his left leg around, so it’s stuck under him.  We just remind him, “fix your leg”, and help him get it out.
 
His left arm is where the biggest challenge comes, specifically with his hand.  He currently doesn’t have a pincer grasp with his left hand, or the ability to point or use his fingers separately.  With that said, he is finally gaining awareness of his left hand and passes objects back and forth frequently.  In most cases, “righty” is holding something, but then Ryder sees something new that he wants, he passes the old news object to “lefty” to hold onto as he grabs the newer, cooler toy.  Somewhere in the process lefty has let go of the toy that was old news anyway, and its out of sight out of mind for that toy…unless of course “righty” decides it’s cool again.  Did I lose you? 
 
In therapy we are working on stimulation a lot with lefty.  We have all kinds of different brushes, fabrics, and vibrating machines that we rub up and down his arm and on his hand, trying to get his brain to recognize different sensations.  It’s hard with a baby because you can’t ask them “can you feel that?” or “what does this feel like?” so we aren’t exactly sure how much sensation he even has in that side.  We know he can feel it, because he’s ticklish, we just don’t know to what extent the feeling has come back. 
 
Two-handed play is a huge challenge, and I’m sad to say that Ryder is at the age now where he’s starting to get frustrated.  If there is a round ball that he wants to pick up and throw, it sets him over the edge to not be able to.  Sometimes he will completely surprise us and pick up the ball using lefty to assist, but most times he will try so hard with one hand and then swat the ball away and crawl off all disturbed, until he sees something better to play with anyway.  Take that big round ball!  We’re working on a lot of different two-handed activities in therapy, mostly just trying to get him to hold a big object with his left hand so that his right hand can play.
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Two of the most challenging parts about his affected hand are 1) getting him to stop fisting.  He tends to ball his hand up and squeeze so tight any time he is balancing himself, concentrating on something, or eating!  And 2) is supination, which is turning his forearm over so that his palm is facing up.  That is by far the tightest muscle on him, I try to stretch it out every day, but I can tell it’s going to be one of the hardest parts for him to overcome. 
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I feel like Ryder is doing great in therapy and coming so far, especially in his gross motor skills, but I’m not convinced that the amount of therapy we have him in (just one session a week) is sufficient for the amount of work he needs for his arm.  I’m so excited for his evaluation at Children’s Hospital at the end of the month, to see what they think about Ryder and what they suggest as far as therapy goes.  For now, I have to resort to my homeade therapy sessions.  Such as, Noodle Therapy, and Puzzle Piece Therapy!  Hey, whatever works, right?!
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I’ve been doing a lot of research on a program called Constraint Induced Movement Therapy.  It involves putting a cast on the good arm, which forces use of the affected arm.  I know, it sounds like torture, but the results that can be seen during and after the casting are AMAZING!  So it makes me feel like it would be completely worth the month of frustration, to reap benefits that could last a lifetime.  So here is my make-shift version of Constraint Therapy, haha.  Mine only lasts about 5 minutes in the evenings and is made up of his straight arm stabilizer & a gray sock, but the real deal puts a permanent cast on for a month.
 

As you can see in the video it really does work!  If he hadn’t had the cast on, he never would have initiated doing something with his left hand.  So, it’s something I’ll continue to look into and see what is available for Ryder.  If we do find a program to get him into, I most likely would wait until he’s around two.  I want him to be able to fully understand the statement “use your left hand” to hopefully eliminate some of the confusion and frustration that will come along with casting his strong arm.

So, that’s where we are today with lefty!  Time is critical right now because his brain is so plastic.  The more we go over and over and over things, the better the signals are getting to his brain and creating muscle memory, so that he can learn to do things the right way.  I know I say this all the time, but I’m so confident in Ryder, he’s strong and determined, which I think is exactly what it takes to overcome an obstacle like this.  And, it helps that Lefty has such a huge cheering section, on the sidelines for support.  Don’t know what we’d do without you all!

4 comments:

  1. You are going to be a certified occupational therapist after this! ;) I think it's so great that you come up with your own "therapies" to help him! He's a very lucky boy to have parents that care so much and fight so hard for him.

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  2. I agree with Nicki completely. You are the best mother Ryder could possibly have and I know that he will be able to overcome any obstacle with you by his side.

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  3. You three are an amazing family! So strong in the face of adversity! I am so so excited to meet him next week! Yeah!

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  4. I think the cast is a great idea and I love your trial run. : ) Ryder is a lucky boy.

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