Saturday, April 21, 2007

A Team Effort

After 14 days of intense speech, occupational, and physical therapy, Mike had his first rehab “team evaluation” on Thursday during a conference call that included Suzie and the Rehab Without Walls case manager. Mike’s therapists reported as follows:

PT: Mike’s currently working on 2 separate programs and a third will eventually be added. Physically, muscle memory patterns are improving, and his gait strengthening is coming along well. Ultimately, the goal will be to add a third, more difficult layer of activity to challenge Mike’s balancing skills, which should help improve his cognition, as well. Mike’s physical therapist has found that breaking down each activity into very small steps with repeated instruction, helps Mike stay focused and results in more wins for Mike!

Speech: Mike’s main speech focus has been development of external memory systems to help him with long and short term memory. His routine includes a daily schedule, and the use of a day planner, bulletin board, and “significant life events timeline.” He’s now able to concentrate better on paper & pencil tasks, with less fatigue. Although he needs a great deal of help with his planner, completing worksheets, and recall, in general, Mike’s putting forth tremendous effort and his therapist sees “nice improvement” overall in his ability to work on improving his cognitive skills.

Occupational therapy: Mike’s occupational therapist shared that Mike is a “special person to work with.” While repetition and check lists are still a critical part of Mike’s day-to-day activities, he’s able to concentrate for longer periods of time and has made small gains in balance and task endurance. “Cueing” is an important element in Mike’s ability to perform activities at this point, and his results are inconsistent from one day to the next. Mike’s progress to date doesn’t allow for him to be left unsupervised, as yet, due to a condition called “motor planning apraxia,” (inappropriate use of objects), which creates safety issues.

Counseling: Working with a counselor has been an important part of the recovery process for both Mike and Suzie. As the “point person” in Mike’s recovery, Suzie benefits from the support and coping strategies offered to minimize her potential for burnout. Friends and family are a huge contribution to Suzie and Mike’s wellbeing right now. When Mike shares a few hours with a family member or friend, Suzie is able to run errands, complete tasks around the house, or simply relax a bit, herself, knowing Mike is safe. Mike’s courage and determination are boundless, but he does become frustrated and sad, at times, which he is learning is to be expected under the circumstances.

Mike’s team of therapists all agree that it’s too early for any reduction in rehab services at this point, and a written report will be submitted to the insurance company recommending an additional 4 weeks of ongoing services for home and community orientation. The entire team hopes that the small gains seen now will turn into large breakthroughs with more time, patience, repetition, and therapy.

Mike and Suzie continue to be awed by the love and support extended by friends and family and thank everyone for each and every contribution to Mike’s Miracle.

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