Okay, it's not that dramatic. But how ever will I hook you if I don't spice it up a bit?
Last week I went to visit Mia's school on the day Krys was home sick. I wanted to have a chat with her school physical therapist and see if I could convince her to train the teachers how to put her into the gait trainer so Mia could spend more time in it at school. I had a nice conversation with her, and she told me she was concerned about the fact that when Mia stands, she pushes off on her toes and doesn't get her heels down. This leads to her knees hyperextending, which is never fun. She has done this ever since she started standing, and I don't know exactly why, although I'm sure it has something to do with her lack of balance. The standing on the toes and hyperextending of the knees pushes her butt backward, which she thinks will help her balance better. It doesn't, but it's an instinctive thing. So I get it.
The PT wanted to fit Mia for orthotic device, specifically an ankle brace to keep her heel on the floor. I gave her the phone number of Mia's home PT, and surprisingly enough, she called him last Friday (I say "surprisingly" not because I didn't think she'd do it, but because I didn't think she'd do it so quickly - she seemed a little disorganized). Mia's home PT explained to me yesterday (and to her during his phone conversation) that he did not think an orthotic device would help her very much at all. He said that what AFOs
do is lock the knee and actually decrease flexion, which is what we want to increase in Mia. He also mentioned that they cost $2000. Now, as my loyal readers (hi, everybody!) know, cost isn't really an issue when dealing with Mia, but it does make you do a double-take when you hear numbers like that. Her insurance probably won't pay for it, but we can. I would, however, like to see if we can fix the problem in another way before we go dropping that kind of green.
Part of the problem is the gait trainer they have at the school. It's smaller than Mia's home one, and made out of metal. Therefore, she is closer to the ground and more likely to lock her knees as she tries to sit down in the saddle, and it's much harder for her to move the damned thing because it's heavy. This morning I had her in hers, and she was actually walking without being prompted, which is what we usually need to do. The one at school looks difficult to move even if she weren't disabled.
I mentioned this all to her home PT. He said that the AFO might help her keep her heels on the floor, but that's it. He also said it wouldn't hurt her to have one for a while. My big concern was that the school PT would recommend that Mia stay out of the gait trainer when she's not there to supervise because she wouldn't feel comfortable with only the teachers looking after her. The school PT is only there for 30 minutes a week, and I'd like Mia to spend a lot more time in the gait trainer. So today, when I picked Mia up, I met with the PT. I kept thinking that Mia had two PTs with conflicting ideas on how to fix her, and that a battle was looming (hence the name of the post).
However, it was not to be. Stupid reasonable people! The school PT really wasn't concerned with Mia in the gait trainer. She has a stander at school in which she puts Mia, and it was there that her concerns lay. When Mia stands in the stander, she pushes off on her toes, and the PT didn't want her in that position for too long, something I can completely understand - it would really mess her up. I didn't get a chance to look at the stander, because in the one Mia used at home before she outgrew it, she didn't have that problem. We could put her in it in a way that her heels would be flat on the ground. She tried to push off, but she couldn't because her ankles were secure. So I wonder if the stander they have at school isn't as sturdy as the one she has at home. The PT said she wanted to have a meeting with me and Mia's teacher next Friday to show the teacher how to put Mia in the gait trainer and what to do once she's in it, and I said I would take a look at the stander then to check it out. I wonder if she even needs to be in it, because the gait trainer helps her stand as well as walk. But that's something we can discuss next week.
I was glad that both sides were reasonable. As the school PT pointed out, the beginning of this year is going to be tough because they don't know Mia and her capabilities. Once they get to know her better, they can provide her with better equipment. She's making great strides with her gait trainer, so I hope that she can be in it a lot at school. I think it would be very helpful. How can she work the fields if she can't walk?