We practiced getting up out of the wheelchair and onto the walker, walking down the hall with her walker, and we went to the stairwell to practice going up and down one step (for going up the one step at the front door). Lauren wears a blue Velcro belt around her waist that we can loosely hold on to, but also use to catch her if she starts to fall. Then Lauren got back in the chair and we went down to the parking garage to practice getting in and out of the car. It all went pretty well.
Afterwards, we went back to the PT gym and watched Lauren do exercises with her Physical Therapist Ashley. They took her to the parallel bars where Lauren would put her right foot on a 5" high wooden box then take it back down, then she would do the same with her left foot (the weaker one). This is called mirroring. By doing it with both the right and left sides, the brain will make new connections. They do it continuously and repetitively to build strength and make these neuro connections. Ashley turned her sideways then and put down a foam block that was 5" square and about 2' long. Lauren would have to side-step over it with her left leg, transfer her weight and then bring her right leg over next to her left one. Back and forth, over and over. The next exercise was walking along the parallel bars and high stepping, like a Clydesdale, and the last exercise was called "kicking your butt", where you swing your heel up high towards your buttocks. This was my first observation of her PT and I found it very interesting. The physical and occupational therapists here are remarkable.
A 3 pm, Lauren went off to music therapy while Sandra and I had the family meeting. We met with the Dr. Kim's nurse practitioner Danielle, the social worker Wanda, physical therapist Ashley, occupational therapist Kate and psychologist Rebeca. Dr. Kim was supposed to be there but had a conflict. We ended up meeting with him later, one on one. We are still on track for an April 13th release, but we found out that she will still be treated here daily for another 4 weeks after that. So, another three weeks as an inpatient, then four weeks in what they call the Day Hospital. They do this for several reasons. The first is that now is what Dr. Kim called the Golden Period. The most progress is made in the first three months after a brain injury, which is what Lauren is effectively recovering from now. More progress is made by working intensively now than would be achieved by working more moderately for a longer period of time. The brain is healing, making connections, and if we do not facilitate them now we will lose the opportunity. Lauren was disheartened by this, she was thinking that on April 13th she would go back to school. Instead she will be coming back to the Seashore House daily until mid-May. They also offered Lauren to go to Camp Cranium (http://www.campcranium.org/) which is in early June, so if she makes it to school this year, it will probably only be for 3 weeks.
Kate and Ashley both said that Lauren is a remarkable girl and they both said they loved her. They noted that she is making great progress. Ashley said that Lauren will walk, run, swim, and ride a bike again (not that she ever rode a bike much). It is also quite likely that she will wear an ankle brace for the rest of her life. Kate said that her fine motor skills are coming back quite well. Remember the exercise where she finds the beads in the silly putty? It was a quite intensive therapy then. Now, Lauren and Kate chit chat while Lauren makes beaded friendship bracelets for both of them. Which they both wear and of which Ashley was jealous and asked for one too. Kate said she literally uses a mirror when they do mirroring exercises so that Lauren can see how the right and left side of her body move differently and make the adjustments necessary to move similarly (bi-laterally). Kate said she is working on getting Lauren's core strong as sometimes she will slump to the left. She said with conditioning and mirroring that can be eliminated. I was thinking today about the quality and quantity of conditioning and exercise that Lauren is benefiting from, she has two personal trainers focusing on her all day long.
Rebeca said that while Lauren gets frustrated at times, her overall attitude is good. She is positive and motivated. Lauren seems more willing to participate in activities now, prior to her surgery she would not attend Epilepsy Foundation meetings or support groups. She wanted to just be normal, denying her condition. I was shocked when she was so enthused by Camp Cranium, I think Ashley did a great job of selling it.
So, all in all, it was an educational day. Learning about mirroring and the Golden Period.
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