Now through her second week at Kennedy Krieger, Anna continues to get daily physical therapy, occupational therapy, speech/language therapy, different types of play/activity therapy, and evaluations by the neurologists.  Each evening, we are given her specific schedule for the next day.  Although each day is slightly different, she generally has 2-3 hours of therapy from 9am-noon, a break from noon - 2pm, and then a couple half-hour sessions mid-afternoon.

Physical therapy centers on addressing the stiffness in Anna's neck, the range of motion for her legs and feet, and fitting/adjusting/modifying her wheelchair and ankle braces.  This hour-long session may include time for sitting up out of her wheelchair to help strengthen her back and neck, time standing up (strapped to an inclined board at an angle of 60-70 degrees) to put weight on her legs and feet, and/or using a therapeutic "bicycle" that pedals for her to give her some motion therapy.  Also, the therapist keeps an eye on the fitting of her foot/ankle braces and her orthotic shoes to prevent pressure spots or areas of discomfort.

Occupational therapy centers on Anna's arms and hands.  This is generally two half-hour sessions each day to help push back against the muscle tightness and stiffness (muscle tone) that she experiences.  They are continually evaluating Anna's hands and wrists to make sure the splints that she wears overnight are not causing pressure spots, and this week they are working with a new brace for her left elbow to help control the muscle contracture she has in that joint.

The speech/language therapist along with the neurologists are constantly evaluating Anna's sensory experience.  They use lights, sound, touch, pain, and music to try and elicit responses from Anna.  "Look over here, I'm over here," or ringing a bell to encourage her to turn her head.  A sharp press to her fingernails to look for to pull away from pain.  An annoying tapping on her shoulder to see how she reacts.  This is the repeatable, controlled (scientific method) evaluation to measure and chart her level of cognitive awareness and look for improvements.  

During her first week, Anna was started on Baclofen, a muscle relaxer, to try and address the muscle contractures she experiences.  There has been some small improvement with that medicine, and this week they added Sinemet into the mix.

Sinemet is most commonly used as a treatment for Parkinson's disease.  It works to raise levels of dopamine in the brain and helps control muscle tightness, spasms, and tremors.  There is emerging evidence that those who have had strokes and other brain injuries can also benefit from these higher dopamine levels.  So, just like the Baclofen, they have started Anna on a low dose of Sinemet and are gradually increasing it while looking for improvements.  We'll wait and see what the combination of these two medicines can do for her.

Now that summer is here, Kathy (a teacher) is in town for a while and Jacob (a student) has started his summer break.  There is a Mass today at the chapel at Johns Hopkins hospital (thank you, Fr. Okoye!), which is only a 3-block walk from Kennedy Krieger, so we are planning on going to Mass - all five of us together - for the first time since before the accident.  I've had Anna at Mass several Thursdays at Lorien, but we haven't been able to get her to Sunday Mass in all this time.  Pray for us that we can find peace and comfort in this experience together.

"For this momentary light affliction is producing for us an eternal weight of glory beyond all comparison, as we look not to what is seen but to what is unseen; for what is seen is transitory, but what is unseen is eternal." - 2 Corinthians 4: 17-18, from today's readings at Mass