Monday, July 19, 2010

Casting Alex's Arm--Contraint Induced Therapy

Last week, Alex had his right arm casted. Since his right arm is strong and very capable, it does all the work for the left side, disabled by cerebral palsy. Despite therapy and all the work we do to every day to work that left side, we have reached a plateau. Erik and I knew it was time to take more drastic measures, and we researched constraint-induced therapy. The idea is that constraint is placed on the part of the body that is capable, therefore requiring the disabled area to work.

From the moment Alex sat in the doctor's office getting his cast, his left arm started to work. The doctor handed him object to hold to help entertain him during the casting, and "lefty" took them willingly. In the past, "righty" would have jumped in and not allowed lefty to play. After one week, we see tremendous progress. The hardest thing for Alex right now is eating with a spoon or fork, because lefty turns outward and has a very hard time grabbing anything as small as a utensil stem. But, with work, he is making great progress. He is also eating with his left fingers and reaching in all directions for his toys. The cast is removable, so we take it off during bath time, in the pool, etc. Everyone we know is signing the cast and although he occasionally complains that he wants to take it off, he is proud of his cool cast that has gotten him lost of attention.

I understand many parents would fear their child might completely reject the idea of wearing a cast, but children really do get used to things, even when they are uncomfortable. Seeing the progress Alex is making is all the encouragement we need to work with this therapy until we feel he can stop wearing it. I expect he will have it for many weeks. We had hoped to also use another form of treatment using botox injection in the muscles of the disabled arm, which deadens the nerve endings for about 3 months, to allow Alex to better use that left arm, but have read FDA warnings against using it. We will speak in depth with his doctor about this.

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