Monday, February 22, 2016

Sick week

This past week has been incredibly exhausting for Jonathan and me.  The kids and I were out of school and work on Monday for President's Day.  Jonathan didn't have the day off though, so the kids and I went to some friends house to play.  

Luckily Jonathan came home from work early that day to help keep everyone happy.  That evening though, Allie's right eye started looking weird.  Andrew, who has had a long running cold, also started pulling on his ear and crying.  It looked like we had pink eye and an ear infection to deal with.  Coincidentally, both kids had checkups with their pediatrician the next morning, so at least we didn't have to schedule new doctor's appointments.

At the appointment on Tuesday, the pediatrician prescribed Allie some antibiotic eyedrops and Andrew some antibiotics for his ear infection.  The doctor was very concerned about Allie's eye though.  She said Allie's cornea looked "foggy", which could be a sign of an advanced infection or it could have something to do with Allie's stroke.  Allie was put in for an urgent ophthalmology appointment on Friday to make sure something more serious wasn't going on. 

Later that day, Andrew starts vomiting.  It was short lived and otherwise seemed fine, so we chalked it up to taking a big antiobiotics dose on a nearly empty stomach.

On Wednesday, Andrew went to school while Allie had a home day because of her eye.  She milked it for all she could, suddenly requiring her sick pillow and a blanket to watch her favorite TV shows. 

Andrew, however, was devastated that Allie wasn't going to school with him.  He kept trying to bring her sweater to her.  Major disappointment ensued.

Both kids went to school normally on Thursday, and Jonathan and I both picked them up early.  We made a fire in the backyard and had a good time.  Andrew kept trying to stick his hand in the fire so he and I eventually went inside, but Jonathan and Allie kept at it for quite a while.

Allie could not have been better at the ophthalmology appointment on Friday.  She let the doctor look into her eyes, did awesomely on her vision test, and was shockingly patient in the waiting rooms.  The ophthalmologist said Allie's eyes look totally fine and perhaps the fogginess the pediatrician saw was just from the pink eye.  It's amazing how quickly the stroke-related medical fear comes back.

On Saturday, I had to pick something up from my office so we all trekked downtown together.  The kids loved running around my nearly empty building, playing tag, and taking in the views of the main lobby filled with science objects.  We then went and walked around the Smithsonian National Gallery of Art, then headed home for a unseasonably warm afternoon. 

That night, however, Allie started vomiting too.  The poor girl was sick the whole night and definitely required her sick pillow, a blanket, and even a milkshake the next day.

Here's to hoping everyone is a bit healthier this week.

Tuesday, February 16, 2016

Happy 5th Birthday Allison!

Our baby girl is now five!  I can hardly believe it.

She had three birthday celebrations.  One at her school.  One at home with her "boyfriend" (!!!!).  And a big party with all her friends and their families.

For her school party, I brought a couple dozen cupcakes for snack time.  The kids were so excited and Allie was very proud.  The kids were getting settled at the big table when she turned to me and said "But Andrew needs to be here!"  I rushed to his classroom and he took a seat at the big table right next to Allie.  She even helped him with the snack before everyone got cupcakes.

She didn't even mind when he started freaking out and threatened to disrupt her song.  She's a sweetheart. 

That night, her friend from down the street (whom she calls her boyfriend) came over with his parents for pizza and more cupcakes.  

Then on Saturday, she hosted 30 of her closest friends and their families at our house for a tea party, cookie decorating, and fun playtime. 

We made personalized teacups for all her friends using these cool ceramic painting pens.


And while I'm pretty sure none of the kids actually had any tea, they did like all the tea sandwiches.

Cookie decorating was a lot of fun.  Andrew kept sneaking spoonfuls of sprinkles whenever he thought we weren't looking.

We also had a Lego play area and a do-it-yourself Valentine station to keep everyone busy and spread out. 

This was the first time that some of her friends had seen her new room.  One of her friends took it upon himself to give everyone the tour.  It was so cute seeing him bring kid after kid up to show them all around.

Before we knew it, it was cake time! Allie had incredibly specific instructions for her cake.  She wanted it to be a big, square, chocolate cake with vanilla frosting, with a real train, bushes, edible train tracks, and a number 5 candle.  The girl knows what she likes.  This was the biggest cake I've ever made (I ended up cooking each layer in our turkey roasting pan) and I was so happy the whole thing didn't fall apart on me. 

She got a little bashful when everyone started singing, which is pretty understandable with 60+ people singing at you.

The whole party was a lot of fun.  We love you Allie!

Monday, February 8, 2016

Therapy evaluations

Wait, making grilled cheese sandwiches isn't part of the test?
Allie had OT and PT evaluations last week.  She's been out of OT for about 7-8 months and, while we've thoroughly enjoyed the break, it's nice to check in.  The OT said that Allie is doing really well (particularly with her elbow isolation) but could use some more wrist stretches and strengthening. We'll be doing a handful of OT sessions to get some fresh ideas and see how things go.

The PT evaluation was more standardized, using the Peabody again (here's her last evaluation).  I'm including more information than usual because the write-ups reference some of the information directly.

Raw Score: 57
Age Equivalent: 67 (She's currently 59 months old)
Percentile: 63
This subtest measures a child's ability to sustain control of her body within its center of gravity and retain equilibrium. Allie has improved from a raw score of 55 since August. She is able to stand on her left leg for 19 seconds and her right for 4 seconds. She can stand on her tip toes for 8 seconds. She is able to imitate 4 movements with her arms. She completed 21 crunch like sit ups in 30 seconds. She completed 5 push ups which was impressive. She will soon max out of this category (max score 60).

Raw Score: 172
Age Equivalent: 63
Percentile: 50

This subtest measures a child's ability to move, including running, hopping and jumping forward. Allie has improved in this area from a a raw score of 167 in August.
Stairs: Allie is able to complete a reciprocal pattern ascending and descending the steps without the rail 
Jumping: Allie is able to jump down from a 21" bench landing on her feet. She is able to jump forward 33.5" with both feet. She can jump over a 9" hurdle. She can jump forward on her left leg 13" and jump up with air time. She is able to hop 8 times on her left leg and 1-2 reps on her right leg with a break in between. She can complete a turning jump and jump sideways. She can hop on her left leg across the room in 4 seconds. Harder to hop on the left and then switch to the right. Hopping on her right foot is a huge accomplishment but this was her biggest limitation in this section
Balance: Allie is able to walk on her tip toes on a line. She is also able to walk on a line with work on tandem pattern and backwards without heels touching toes.
Running: Allie is able to run 45 feet in 4.97 seconds. She runs with a flight pattern but no arm swing on the R. She is able to run and stop within 2 steps with a verbal cue. She is able to run and retrieve an item in 3.28 seconds. 
Other: Allie can complete a forward roll without deviation from the center
Gallop and skip: Allie is able to gallop. She attempts skipping but with decreased smoothness. This is another area to focus on.

Object Manipulation
Raw Score:41
Age Equivalent: 50
Percentile: 25

This subtest measures a child's ability to coordinate arm and leg movements in order to manipulate balls (catching, throwing, kicking). Allie scored the same in this area as she did in August.
Throwing: Allie has a very strong throwing arm on the left. She is able to throw over and underhand strongly. Still working on accuracy. From 5 feet away she is able to throw to a target accurately 2/3 reps underhand and 3/3 overhand. More challenged from further away, 0/3 overhand.
Kicking: Allie is able to kick the ball across the room but not in the air.
Catching: Allie has improved with catching but it is still inconsistent. To catch a ball she needs to bring the ball to her chest to trap it. She is able to catch a ball if she brings it to her chest. She can catch 1/3 reps with her left arm alone if she brings it closer to her body (not hands alone). She was able to catch a bounced ball 1/3 times.

Allie has improved in 2/3 of the areas in the Peabody. She is on target for her age. We have not focused on catching much these past several months. She does very well with throwing. She has greatly improved with her jumping skills especially hopping and single limb stance. We will continue to work on right leg hopping to progress skipping and higher level motor skills.

Continued physical therapy will address:
Body Functions and Structure
  • Balance
  • Endurance
  • Range of Motion
  • Strength
  • Hypertonia
  • Flexibility
  • Gait
  • Coordination 
Activity Limitations
  • Unilateral stance
  • Walking on uneven surfaces
Short Term Goals:
  • Allison will gain >5 degrees of right ankle dorsiflexion to help prevent tripping and optimize gait pattern. Time Frame: 2 months. Goal Progressing
  • Allison will be able to perform single limb stance on each leg x3-5 seconds demonstrating improved balance. Time Frame: 2 months. Goal Met on 10/14/14
  • Allison will be able to step onto uneven surfaces without falling 3/5 reps demonstrating improved balance. Time Frame: 2 months. Goal Met on 10/14/14
  • Allison will be able to jump over a 6" hurdle with a two foot take off and symmetrical landing. Time Frame: 2 months. Goal Met on 01/13/15
  • Allie will be able to walk across a 4.5" balance beam in tandem with a 3 second pause without stepping off. Time Frame: 4 months. Goal Progressing: Able to walk across and is starting to attempt tandem 8-18-15
  • Allison will be able to hop on one leg 10 reps each without support. Time Frame: 5 months. Goal Progressing: 2-4-16 Able to hop on her left leg 8 times and R 1-2 reps. Will continue to work on right leg hopping
  • Allie will perform single limb stance x20 seconds on each leg without additional support for balance or grounding. Time Frame: 3 months. Goal Progressing: 2-4-16 able to stand on her left leg almost 20 seconds. Right leg is more stable at ~4-5 seconds. Continue to progress stability.
Long Term Goals:
  • Allison will ride a tricycle without leg stabilization x10 feet. Time Frame: 4 months. Goal met- Allie is able to ride a tricycle without leg support now.
  • Allison will be able to catch a >5" ball with 2 hands 3/5 reps. Time Frame: 4 months. Goal met 10/14/14
  • Allie will be able to gallop with a smooth pattern x15 feet. Time Frame: 2 months. Goal met 8-18-15
  • Allie will walk with a consistent heel strike or heel contact without catching her toes >75% of the time. Time Frame: 3 months. Goal Progressing:
  • Allison will be able to consistently complete a reciprocal pattern ascending and descending the steps with one rail or less. Time Frame: 4 months. Goal Met 2-4-16. Able to complete much more comfortably down the steps now without the rail
  • Allie will be able to skip smoothly >10 feet without stopping or loss of balance (2-4-16). NEW