A Long Day at the Spasticity Clinic

I got this wonderful hand out today at the Spasticity Clinic
Even after 8 years with Cassie dealing with Spasticity and me thinking I knew what it was this handout really helped me again. It was produced at Mcmaster Children's hospital and I thought I would summarize the parts I liked

What is the Spasticity Clinic?
The spasticity clinic helps children with spasticity and their families. The clinic has a doctor who is a specialist in caring for children, a physiotherapist, an Occupational therapist and a registered nurse who help children with spasticity.
Spasticity affects:
Motor Skills-some children have problems with walking, sitting, using his or her arms or hand or everyday activities
Comfort-some children have pain when wearing braces, when sitting or sleeping or have problems with skin sores or contracted muscles
Posture-children's positioning can lead to changes to muscles or bones

What is Spasticity?
Spasticity is the medical term that describes muscles that are:
tight-too active and unable to relax
stiff-too much tone or resistance

Everyone has some resistance in his or her muscles. This can be felt when the arms or legs are moved. However, when a person with spasticity moves, the resistance increases.
The faster the arm or leg is moved, the greater the resistance.
The slower the arm or leg is moved, the less resistance

Spasticity increases when a child is working hard, is excited or is in pain, and it decreases when he or she is asleep. ( I see this with my daughter)

Spasticity makes movement difficult. It can make it harder for the child to do daily activities such as sitting, walking, playing, dressing and bathing . If muscles do not move well, they become stiff. Over time, the muscles shorten causing contractures to develop. Contractures are permanent changes in the muscles and joints that can affect your child's care and comfort.
Why does this happen?
During activities such as walking the brain sends many signals to the muscles. It tells some muscles to be active and tells others to relax. Spasticity occurs when the signals telling muscles to relax are blocked. The blockage in Cassie's case was caused by an Intra ventricular hemorrhage resulting in left sided hemiplegia Cerebral Palsy

Spasticity can not be cured, treatments can reduce spasticity and improve children's movement and comfort. Thus the need for all Cassie's physiotherapy, botox, serial casting!!

This really should be my first entry on my blog about my girl!! Sometimes I am slow on the Uptake.

I have sang the praises of the team at the Spasticity clinic before but I wanted to reiterate how much I like and respect this team. I had many questions answered today. I respect the opinion of the doctor very much. So we have a short term plan of care for now. No Serial Casting at this time it was determined it may not benefit Cassie at this time. The positioning of the calcaneous is still a problem. I continue to mobilize and stretch Cassie two times a day and have learned how to do this stretch. Botox has been helpful in the past. Both Cassie and I hoped she would not need Botox we have agreed to go again on January 11, 2009. The doctor went over the Botox treatment again in great detail outlining the complications clearly and informing me again so I could sign the consent. He was very patient answering my questions. I had heard of a case at my hospital where a child received Botox in the neck and reacted. Although the situation is different media articles can make me question and feel nervous for my girl. Dr. Gorter went over all the needles Cassie would get and this time it was explained to me about how they calculate how much a child can have (safe therapeutic doses). I appreciated knowing this. The Team understands Cassie's needle phobia and so the same strategies will be utilized which help Cassie and Mommy cope. The Question of SMO on the Right foot? This was answered today and the answer is no SMO or orthotic. Although her strong foot is slow in the take off it probably would not be corrected with a SMO. That makes two doctors that agree so I respect they gave their best educated guess. Thanks, I wonder why Cassie wore an orthotic on her right foot for eight years already? OH well lets look ahead not back. The results of the Motion Lab were explained and Cassie was given a picture or her hooked up. She looked like ROBO woman and can take it to school to show her friends. The team patiently showed us the results on a computer (after technical difficulties were worked through). The Motion Lab therapist made Cassie's image move forward and backward quickly (computer animation) this broke the ice and made us really smile!!. We need to follow up with Dr. Burrows the Orthopedic Surgeon on January 20th as a tendon transfer surgery may be needed in the more long term planning. Although I am tired. I shared all that was said with my husband and we can relax and have a good Christmas with the girls with a plan of lots to do in the New Year!!

I will leave my next project, how to advocate for the renovation of the dismal room used for after physio therapy. I did send a letter to the president of Mcmaster Children's hospital leading to a visit today from Dr. Mesterman head of the program and a letter to my MPP followed!!!