Mabel's Physical Therapy session was yesterday morning. I was full of nerves and questions about this whole process since it seems impossible to find information online regarding 14 month old babies needing physical therapy after a spica case, brace, closed reduction or anything like that.Our morning didn't start so well. Do you ever feel that things only happen to you? Well, we got to our physical therapy office and our doctor's clinic is inside a larger facility. The larger clinic is usually open at 8am to allow her patents to come in, but no one else was there. We rang the bell and she came out to let us in, only for us all to get locked out in the hall. I felt really bad for her, obviously she didn't mean for that to happen and she had never faced this before because there is usually several other staff members for the clinic there. So we had to wait in the hall for someone to arrive, it only took about 15 minutes, but still not too much fun. Zack tried to pick the locks, he looked like he knew what he was doing, but that's about it. Mabel cried for a minute as she realized that this is not what should be happening. I just laughed, I mean you have to right! It was the perfect storm of "so-and-so was on vacation" and "the other guy was out of town" and the "first appointment wasn't until 8:30 so I figured I'd sneak in late" that is how we ended up waiting in the hallway for the first person with a key to arrive...
When we got inside things were much better than I thought they would be. The doctor observed Mabel as she played, it takes Mabel some time to warm up to new people so at first it was hard to get her to do much. She use to doctors talking around her not to her so I guess she was a bit confused. She then started to move around and played with the toys and the doctor gave us her input. She said that Mabel's range of movement is more than Mabel is aware of. She is turning her right foot in trying to compensate for not using the left leg at all and that needs to be corrected or she may continue to do that for awhile. She also twists her pelvis up to the left, probably because that is how she was in the cast, so that throws off her back alignment and makes it hard for her to sit up without falling when she turns her head to look at something. Obviously her muscle tone is very low, so that will come with time. The major problem is the main tendon and muscle group that connects the hip to the leg is very very tight. It is what is causing her leg to not straighten, and her ankle is also very tight. The doctor explained that in adults who have this injury they work out that muscle group manually which is very painful and hard on the patient, obviously we wouldn't do that to a 14 month old so she is coming up with play and games that Mabel likes to encourage the right stretches and movements to help her out. I like the doctors approach, she said that she learned long ago you can't force a baby to do things, you have to find away for you to help them do it while making it enjoyable. If it isn't fun she won't do it.
I asked the doctor about everything the doctors have told me before Mabel's surgery and all that I've read saying that babies and young children don't need physical therapy after a spica. She said that the basic school of though it kids will figure it out on their old, and they do, but she does see a fair of amount of kids that figured out how to walk after a spica or bracing and they developed a limp or strange stride to compensate for a weak leg that doesn't go away and needs intervention later. She said that caught early it is much easier to deal with. She also pointed out that the time frame that Mabel was casted was her formative self realization months that she realizes what she can do and as far as she's concerned her left leg doesn't do anything and she doesn't know that is should touch the ground like her right. She said we just need to help her learn that both legs feel the same again and can do the same thing. It seems very basic and logical.
Our first task is to have Mabel sit on a little foot stool with both feet on the floor and have her bend over to pick up a toy off the floor. I'm there to make sure she doesn't fall forward, supporting her as little as possible. She has done amazing with that task, a bit unsteady and scared to lean forward, but still she tries it. Honestly I never thought she could sit unassisted on a little stool like that, we have only been cast and brace free for a couple of weeks and never tried, don't forget she was only first learning to sit before the cast and for four months couldn't sit at all, I think I underestimate what she can do, she does too.
So I feel much better about this. The reality is finding out how much insurance covers of the physical therapy. Right now we have eight sessions, but the doctor said we may not need it all. So we are going to have our Thursday morning sessions for a few weeks and we'll see how things go.
The picture above is Mabel with our boppy. When I'm at work I guess she drags it out from where I keep it under the chair and she says "mama" and cuddles with it. How cute is that? My mother took a picture of it to show me, I love it!
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