July 30, 2012

Back to therapy

     Amaya had another rough night. Although she didn't need any Tylenol throughout the night she did moan and cried throughout the night. This morning we had an early therapy session and when we woke up I was very tired. On the way Amaya wore her ankle weight to help stretch her knee and get it ready for bends. She also listened to The Eye of the Tiger twice to get her pumped up. I reminded the girls about their jobs at physical therapy; Amaya has to work hard and do her best and Lidie has to be patient, cooperative and helpful. After missing five days of therapy I was curious and nervous to see how they would do. Amaya did excellent, but Lidie had a couple of meltdowns. She was very tired and cranky, and thankfully she fell asleep at seven tonight.
      The girls were excited to see Melissa and share about the fun they had swimming yesterday and the fun they had in Las Vegas. Lidie shared her Bethany Hamilton Barbie with her. Melissa thought it was cool that Lidie amputated her Barbie's arm so that it would look just like Bethany's arm. We updated Melissa on Amaya's leg (her knee pain at night, the pain in her top pin sites, and that we've got the tightness in the hamstring under control). Melissa massaged Amaya's knee as we talked then stretched it. Amaya asked if she could work on the ladder so Melissa let her do that first then she rode the bike, stepped over cones, and used the total gym machine. 
     As a side note. I emailed Dr. Nelson some of the video of Amaya swimming from yesterday and he thought it was great and is going to share it with some surgeons during an upcoming lecture. I thought that was pretty cool. 
      Before Amaya started her bends Melissa had her lunge forward to stretch her knee some more. She did about five of those. Amaya's starting knee measurement was 61, which is great! That's one of the highest numbers since we stopped lengthening and very good considering we missed five days of therapy. Melissa was very impressed. She was also happy that we had scheduled in physical therapy time during our vacation (we had an alarm on our phone to remind us to go back to the hotel to stretch). Melissa asked Amaya what her goal was for today. She said, "90 or up." Ninety is the minimum that we want her knee to get to each day. Melissa said that if she could get to 90 within two minutes then they could work for a higher number. Amaya agreed then began bending. In ten bends she was up to 69 degrees. Then she go to 75 then after another ten bends she got 85 degrees. By this point Amaya was in pain; her top pins were bothering her, her knee was sore, and the stretch itself was hurting her. She cried and kept saying. "ow, mommy, my pins. Ow, mom, my knee." It was sad to see her in pain. It always makes me sad when she cries out for me. All I could do was encourage her to keep going. In a few more bends she was able to get 91 degrees. We were all happy with that number. She worked hard for it, and got it. Although she was in pain and in tears, she did exceptionally well considering she had missed so much therapy (that's the most we've missed in almost five months). Melissa was happy with how Amaya did today and we're going to continue with a three day a week schedule to see how Amaya does. Amaya still has her own personal goal of reaching 110 degrees, so hopefully now that we're back and on a regular schedule she can begin to work toward that again. 
    Tonight she fell asleep pretty quickly but has already been up three times in pain. Her knee is what's causing her the most pain at night. The only thing that seems to help is when I push on it and massage it. Wish us luck tonight; hopefully she won't have so much pain and hopefully I can get good rest. 
Amaya asked if she could start on the ladder today. Melissa had her climb up it five times, grab a ball, toss it then climb back down.
Then Amaya rode her bike down the hall and made a big loop into the adult gym. 
Lidie didn't want to ride a bike today, instead she kicked the soccer ball down the hallway. 
While someone else was using the total gym machine Melissa had Amaya step over the cones. The cones give her a bigger stretch and are harder to do because of how high they are. She normally steps over the "gum drop" balls, which are about half the size of the cones. She only stepped over six, and went back and forth a few times. 
Here's another view. 
Here she is working on the total gym machin. Melissa really wanted Amaya to work on this today, because it gives Amaya's leg such a work out and helps her knee bend a lot. After missing five days, she needed to do all the work she could before starting her bends. Melissa had Amaya fully extend her leg (to try to straighten it completely, which was a bit painful) and then to bend it as much as she could. Amaya also tried doing it with only her left leg, but she kept slipping. 
      Before I put new gauze on tonight Amaya asked if I would take a picture of the bottom of her pins so she could see what they looked like. The dark stuff on the middle pin is blood. Thats the first time its bled since she fell a couple of months ago. Amaya  said she bumped her fixator on the bottom of the pool (it has a very shallow end), so maybe that's why it bled. It's hard to say. There aren't very many scabs on there right now, because the pool water helps remove the scabs. Her skin was tight and itchy again today so we massaged some coconut oil after her shower and that helped her. But what causes the most pain on the top pins is the weight of the fixator. It pulls on her skin and hurts. She props it up with pillows or stuffed animals, but sometimes its just hard to get comfy.
I decided to also take a picture of her middle pins. These are looking good and aren't really bothering her. 
Here are the bottom pins. The picture is a bit blurry (sorry), but you can see that there aren't any scabs on those pins either. These were bothering her a few weeks ago, but thankfully they've cleared up now.

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