Monday, June 29, 2009

Shooting for the Stars

When I arrived at Kindred this morning Daniel was turned toward the door--his head turned to the left. He slept comfortably and I did not wake him. Instead I read the journal that Vero brought for all of us to sign and record any thoughts, reflections or prayers. It is an intimate acount of our visits with Daniel. Please feel free to log in next time you come to see Daniel.

As I read, two skilled therapists entered and quickly the room came to life. Isabella, the occupational therapist, jotted down some notes about Daniel's interests including hiking and traveling. It turns out that she has a shared interest with Daniel because she also knows jiu jitsu. Theresa, the physical therapist, also showed a genuine interest in Daniel and his family. Together they make a confident and expert team.

Working in tandem, the skilled therapists, quickly began to evaluate Daniel. He favors his left side they said. And that we should work with him to shift his focus to his right side; he needs to pay attention to his right side. On the PT side: Daniel is hyper extending...he is pushing his legs out. Daniel is very tight! His hip flexion was at 90 degrees which is good. His knees bent a little less than that, but his ankles are especially tight. His toes are pointing downward towards the foot of the bed constantly. This hyperextension can lead to contracture: the permanent shortening of muscles or tendons due to continued stress exerted on that muscle or tendon. Contracture cannot be excercized or stretched away.

The restorative therapists will work with Daniel for approximately 30 to 40 minutes a day, but this is not nearly enough!

We can help with range of motion excercises. Look for the diagrams that show how to perform these excercises on the cork-board with the family pictures. Or ask anyone who has done them to teach you how to do them, they are simple and easy to learn. As the RT puts it, WHEN Daniel is ready to walk, the more flexibility he has the better.

The highlight of my visit today was when I was able to sit next to Daniel side by side holding him up along with the help of the therapists (as they evaluated). I had my arm around him as I propped him up and his face was next to mine. Are words necessary to describe the joy of once again being able to sit next to my brother, shoulder to shoulder, heart to heart, in unity of spirit?

Skilled therapy really begins once Daniel is able to participate even minimally in his own rehabilitation. When he is able to follow commands and move on his own. Another high point today was that it was evident to the therapists and myself that Daniel was able to loosen his grip when asked: he was able to open and close his left hand on command after several repititions. The lesson here is that Daniel must relearn everything. It is not enough to simply tell him to do something, one must actually help him do it. These repititions will help train his muscles as neurons create new paths and circuits in his brain. Every interaction counts!


  1. Good job. I will go after my meeting at 3:30

    El nando

  2. Nando,

    Congrats on your new job! If the diagrams aren't there yet please ask the RN to call the rehab dept. Inquire with Isabella; she can get them for you. I cleared a space on the board.


  3. your a great person.