Casting

Therapy has begun. For those of you who don't know about Ella's diagnosis, she has hemiparesis -- slight paralysis affecting her left arm and leg, but mostly her arm. The folks at the University of Alabama Birmingham (UAB) have established the Sparks Clinic at the Civitan International Research Center to help kids with hemiparesis gain better function in their affected arms and hands. They are on the cutting edge of research, and have had great success using a method called constraint-induced (CI) therapy. Similar to patching the stronger eye of a child who has a lazy eye, CI therapy involves restraining the function of the stronger arm to facilitate therapy with the affected arm. This is done with a plaster cast. Therapists around the country are learning about this method, and many therapists experiment with it, but UAB is the place to come for the very best practitioners following the most researched protocol that they developed themselves.

Yesterday, Ella received her cast. The casting went well. She watched a Sesame Street video while they wrapped her arm. Afterward, they cut the cast off with scissors in order to "bivalve" it, or allow it to open like a clam. This enables weekly removal to check the skin and let Ella stretch her arm. The cast is wrapped in a soft self-adhering tape. She picked red. Next week it may be another color.

We managed to work 2 1/2 hours of therapy into the day yesterday. Our therapist, Sarah, is from Boston. She's dedicated exclusively to Ella for the month. We're very pleased with her. Ella immediately warmed to her, and she has a very straightforward, caring, and enthusiastic approach. She also comes with a million new toys, which is a good thing since suitcase space was limited.

The hardest parts of therapy are eating and coloring. These are activities Ella loves the most, and they're the most frustrating for her to attempt with her left hand. We give her lots of help, but it's still driving her crazy not to be able to do them efficiently on her own. Sarah told us to expect major frustrations, especially in the first days, and this has been the case. We're working through them and balancing them with lots of new activities and ways to play that are interesting for Ella, and that we hope are rewiring her brain to give her better motor control. It's hard work for all of us right now, but that's why we're here. Therapy lasts for 6 hours a day. Normally, she receives 2 hours a week, so the intensity also requires an adjustment. For now, she does better when Greg and I aren't around, so we're camped out in other parts of the apartment, Greg taking care of work, me here keeping you updated. Both of us are listening through the walls every minute, but when we're around, Ella is distracted and wants us to rescue her from the hard work she's doing. When we're unavailable, she relaxes and plays and hopefully makes progress. Therapy should be finished at 1:00 this afternoon, and we will resume our roles as Mom and Dad and get out with Ella into the beautiful day.