When a patient arrives at Bryn Mawr, the team thoroughly evaluates their physical/cognitive abilities for a baseline. The day before discharge the patient is assessed for a final evaluation. Today was performance day and Corey exceeded everyone’s expectations.
Cara, OT, evaluated Corey’s ability to eat breakfast, dress and manage her morning bathroom routine. She concluded her observation with ROM measurements. Corey’s initial evaluation for the left arm had a hint of isolated muscle movement. She could open and close her hand but any additional movement was limited and/or inconsistent. Today Cara measured her wrist movement at 58 degrees (an increase from Saturday). With initial help, Corey can push her arm from a bent position to full extension. More importantly; without help she can now bring her arm back towards her chest from full extension with a measurement of 85 degrees! Our goal will be to work on her ability to lift her arm independently (without her using her right arm to cheat). This goal is definitely attainable…look at what she’s done with that arm in a month!
Jessica, ST, is pleased with Corey’s word pronunciation. We’ve learned a few new games and Apps for the IPad that will help us continue her progress. One of her goals was to move to thin liquids w/o aspiration. We are happy to say she can now have thins by spoon. It’s a matter of time before she can start thins in a cup. Once again, a month ago we were introducing soft solids. Today she is on a full unrestricted diet and almost ready to add liquids. Our goal is to have her feeding tube removed by the end of summer.
Natalie, PT, has seen the greatest progress. Corey is now averaging between 75 and 100 feet of walking twice a day! She is still having pain in her ankles from the surgery and her legs from the exercise, horse ride and change in stance as a result of the surgery. All of this will dissipate with time. Her right foot is now at neutral position (a proper 90 degrees) and her left foot is a -6 degrees. Prior to surgery, her right foot was -10 and her left foot was -26. She has full range of motion on the right and we are working on developing the left. She is lifting, bending and straightening both legs on command ~ Sleeping Beauty is slowing waking up!
Tomorrow is graduation day…we are coming home. Our nursing staff is still thin but both agencies are working to share the case for full coverage.
In regard to therapy; our first 7 months at Bryn Mawr gave us a glimpse of what could be. The next year we were blessed to work with Gillian, Jen, Brittany, Alice, Diane, Christa, Jo and Jori. Without this team Corey would not have had the opportunity to come back to Bryn Mawr last month. They were her partners, helping her take her first steps, speak her first words and worked with her to continue to reach for more. The strides she’s made in the last month at BM has exceeded everyone’s expectations (including the Dr’s, nurses and therapists).
It is for this reason that we’ve decided to try Bryn Mawr’s Neuro Out-Patient program rather than home therapy. We are very nervous about Corey’s stamina, but then I think back to a year ago and remember how frightened we were to come home.
Graduation by definition is ‘arrangement in degrees, levels or ranks’. Corey’s progress has certainly mirrored pre-school through High School. Our goal is College! We will be enrolled in the Neuro program 3 days a week receiving PT/OT/ST and Cognitive therapy. If Corey can handle the full day (10-4; which will include lunch and rest periods) we are pre-approved for 13 weeks between Insurance and Medicaid coverage. Once we are home I will discuss the services she will receive from the school to round out the additional 2 days.
It has been our mission to give Corey the acute level of rehabilitation therapy (15-18 hours a week). Her progress is proof that in conjunction with the natural course of healing, the acute level of therapy is the reason she is achieving and exceeding every goal we set. It’s time to enroll her in the “College Prep” courses so she can start cooking!
Summer School is now in session…xoxo