Corey was having a spa night when I arrived. Laura cranked the heat and had her Ipod “shower” mix playing in her room. After the shower, we pulled out the Coconut Citrus lotion (which smells like the beach) and completed Corey’s spa experience with a massage and a mini mani/pedi! She was so relaxed; we actually think we saw a little smile.
There is still no word from the neurosurgeon. I know the films were sent over to him yesterday but haven’t heard if he’s had a chance to read them yet or if he’s decided to reactivate the shunt.
Many of you have asked about the Insurance decision. I have shared that our case manager calls the insurance company each week to see if Corey will have continued coverage. At the moment, we have approval until this Friday, the 21st. Bryn Mawr has given us approval to stay until February 1st. Our case manager calls the insurance company each week sharing Corey’s progress. If they feel that she’s building on her current progress and showing consistency, we’re approved for another week. Then we hope that Bryn Mawr will extend their date. If they feel Corey is not improving at the rate that “is typical”, she will be denied and 2/1 will be firm. That’s when we begin the appeal process. Bryn Mawr tries to make a case each week to show Corey is consistently improving and expanding on her achievements. This week, she hasn’t been consistent at all, despite the few new movements/responses she’s made. Her new motions and responses are important to us and worth celebrating, but they may not “count” in the insurance’s “functional improvement” world. This is another reason that Dr. Long is thinking of turning on the shunt. The increase in her ventricles could be the result of more pressure to the brain. If they relieve the pressure, she may begin to respond more consistently. It’s worth a shot and might buy us a little more time to try it…we hope!
In the meantime, we are searching for a sub acute skilled nursing facility that will continue the rehabilitation and nursing care that Corey currently receives at Bryn Mawr. This is not an easy process; there aren’t many choices out there for an 18 year old.
We mentioned the communication book that the team is now using to document her progress. After Corey’s spa night, I looked at today’s entries. I noticed that in her OT session, she moved her Left Leg spontaneously, this is new. Corey was relaxed and alert so I decided this was going to be tonight’s focus. I sat at the bottom of the bed, rubbing her left foot, asking her to wiggle her toes. I’m happy to say, she “flickered” 2 toes consistently. Laura came in to witness her achievement. I also have to add a funny notation. When I asked Corey to wiggle her left toes, she’d move her right foot over and press against her left foot! I had to laugh, ‘Hey! No cheating with your right foot trying to help the left!’
I’d also like to add that normally Corey’s eyes and head are fixated to her right. While I was sitting at the foot of her bed to watch for wiggling toes, Corey’s eyes and head were centered watching me!
Corey I had a lot of fun with you tonight. You are very busy with that right foot! It makes me so happy to see those wiggles and flickers. Remember honey, your right foot started with wiggles and flickers and now you’re lifting, kicking and moving it all over the bed. It’s starting Corey. We can see it in your face. We can see it when you move your hands and arms. Keep it up kiddo. I promise you, it will happen!! Happy dreams honey, xoxo