May 16, 2006
... so it
was with Lisa, that the time had come for Richard to ask her therapists, Marty,
Maureen and her physician, to speak candidly with him about Lisa’s progress, and the likely outcome of her therapy. Marty, the physical therapist said, “Lisa is working hard toward her physical rehabilitation.” “She wants it, she needs it; she knows it.” Here’s an example, Marty said, “... during Monday’s therapy session, we lifted her from a seated position with a rack or patient lift (similar to example 1 shown at the right) and with the standing sling (similar to example 2 shown below, left) that supported her standing upright. Lisa began flexing her extensor muscles w
ithout prompting. The extensor is a skeletal muscle whose contraction extends or stretches a body part. (The rack incidentally, is a device the physical therapists use to lift a patient from a seated position to being upright.) The term rack; however is probably not the true medical-technical term for the device, but, as-they-say, “if it looks like a duck and quacks like a duck, it’s a... rack.” I know you’ve heard this sort of logic before, but I don’t get to attempt humor very often, and I just couldn’t resist. Anyway, with the support of the rack Lisa’s body is able to bear its own weight. Then Richard bluntly asked, “What is her range of recovery?” “... from what I saw on Monday, Marty replied, “on the high-end, I can’t rule out her walking, and on the low-end, Lisa would regain enough stability to enable her to sit upright in a wheelchair and operate it.
Maureen observed, “Lisa’s recent and dramatic swallowing is
an encouraging sign of progress,” and added “She still has quite a journey ahead of her to communicate with speech and/or eat solid foods.” Everyday for Lisa is a day of opportunity and she faces it with grace and determination. But, last Thursday and again on Friday, Lisa became quite frustrated with her inability to speak. Maureen told Richard, quite plainly, that she did not want anyone to ask Lisa to attempt to speak or ask her to vocalize in any manner. Maureen’s judgment was vindicated today (May 17th) when Lisa mouthed the words, “I WANT.” Maureen spent the morning helping Lisa to form words with her mouth and tongue; 
without asking her to attempt to make a sound. She noticed that Lisa’s facial muscle tone was limiting her ability to move her upper lip, but not her tongue, lower lip or jaw. While Maureen did the work, Connie reaped the benefit. As Connie was placing Lisa into the infamous rack. Lisa mouthed, “I want” not once, but twice, and Connie said, “… unfortunately I could not make out the rest of what she wanted me to know.” But Connie continued working with Lisa, and a moment later had a thought, she asked, “Lisa, do you want to sit down?” To which Lisa produced a curt nod, “Yes!” to be rewarded with Connie’s prompt compliance. What a day in the neighborhood, huh? Group hugs all around.
Dr. Christine Kwasnika continues to struggle with balancing Lisa’s spasticity with the arsenal of medications available that are capable of controlling muscle tone; versus the adverse effect those medications could have on Lisa’s Long QT syndrome, which was the cause of Lisa’s cardiac arrest. Dr. Kwasnika acknowledged Lisa’s implanted cardioverter-defibrillator, the continual monitoring of her electro lights and the potassium/magnesium regimen. Dr. Kwasnika has agreed to further consultation with her cardiologist to explore the introduction of anti-spasticity medications.
I like the way this going now, how about you?
Michael (mlwintory@msn.com)
P.S. After more thought, Richard (during the time he is in Oklahoma) has decided to leave Michael in Arizona with Sherry and me in order for us to maintain Michael’s weekend trips to be with his Mother in Phoenix.
... so it
was with Lisa, that the time had come for Richard to ask her therapists, Marty,
Maureen and her physician, to speak candidly with him about Lisa’s progress, and the likely outcome of her therapy. Marty, the physical therapist said, “Lisa is working hard toward her physical rehabilitation.” “She wants it, she needs it; she knows it.” Here’s an example, Marty said, “... during Monday’s therapy session, we lifted her from a seated position with a rack or patient lift (similar to example 1 shown at the right) and with the standing sling (similar to example 2 shown below, left) that supported her standing upright. Lisa began flexing her extensor muscles w
ithout prompting. The extensor is a skeletal muscle whose contraction extends or stretches a body part. (The rack incidentally, is a device the physical therapists use to lift a patient from a seated position to being upright.) The term rack; however is probably not the true medical-technical term for the device, but, as-they-say, “if it looks like a duck and quacks like a duck, it’s a... rack.” I know you’ve heard this sort of logic before, but I don’t get to attempt humor very often, and I just couldn’t resist. Anyway, with the support of the rack Lisa’s body is able to bear its own weight. Then Richard bluntly asked, “What is her range of recovery?” “... from what I saw on Monday, Marty replied, “on the high-end, I can’t rule out her walking, and on the low-end, Lisa would regain enough stability to enable her to sit upright in a wheelchair and operate it.Maureen observed, “Lisa’s recent and dramatic swallowing is
an encouraging sign of progress,” and added “She still has quite a journey ahead of her to communicate with speech and/or eat solid foods.” Everyday for Lisa is a day of opportunity and she faces it with grace and determination. But, last Thursday and again on Friday, Lisa became quite frustrated with her inability to speak. Maureen told Richard, quite plainly, that she did not want anyone to ask Lisa to attempt to speak or ask her to vocalize in any manner. Maureen’s judgment was vindicated today (May 17th) when Lisa mouthed the words, “I WANT.” Maureen spent the morning helping Lisa to form words with her mouth and tongue; 
without asking her to attempt to make a sound. She noticed that Lisa’s facial muscle tone was limiting her ability to move her upper lip, but not her tongue, lower lip or jaw. While Maureen did the work, Connie reaped the benefit. As Connie was placing Lisa into the infamous rack. Lisa mouthed, “I want” not once, but twice, and Connie said, “… unfortunately I could not make out the rest of what she wanted me to know.” But Connie continued working with Lisa, and a moment later had a thought, she asked, “Lisa, do you want to sit down?” To which Lisa produced a curt nod, “Yes!” to be rewarded with Connie’s prompt compliance. What a day in the neighborhood, huh? Group hugs all around.Dr. Christine Kwasnika continues to struggle with balancing Lisa’s spasticity with the arsenal of medications available that are capable of controlling muscle tone; versus the adverse effect those medications could have on Lisa’s Long QT syndrome, which was the cause of Lisa’s cardiac arrest. Dr. Kwasnika acknowledged Lisa’s implanted cardioverter-defibrillator, the continual monitoring of her electro lights and the potassium/magnesium regimen. Dr. Kwasnika has agreed to further consultation with her cardiologist to explore the introduction of anti-spasticity medications.
I like the way this going now, how about you?
Michael (mlwintory@msn.com)
P.S. After more thought, Richard (during the time he is in Oklahoma) has decided to leave Michael in Arizona with Sherry and me in order for us to maintain Michael’s weekend trips to be with his Mother in Phoenix.
