I always enjoy these appointments. Her neurologist has such a wealth of knowledge and such a breadth of experience that I always leave the appointments feeling very encouraged and optimistic for Taylor and her future. For the purpose of this update on the blog, I'll break down today's neurologist appointment into several sections below.
PHYSICAL THERAPY & TAYLOR'S OVERALL MOBILITY
Taylor Strutting Her Stuff On the Catwalk, YEAH, the Catwalk.
The neurologist was "very pleased" to see how well Taylor is now walking. He was "pleased" to see that Taylor is now gaining speed in her walking and is becoming more steady on her feet. The neurologist impressed upon me that continued stretching of her leg mucles and the range of motion exercises that I do at home as well as maintaining her physical therapy program at the clinic will continue to be very important, particularly as Taylor goes through growth spurts in the coming months. The doctor stressed how essential it is to keep Taylor's muscles stretched as she continues to grow and continues to gain strength and speed with walking in order to prevent contractures or further tightening of her leg muscles which can lead to injuries.
FORECAST FOR TAYLOR'S EARLY CHILDHOOD EDUCATION
The neurologist remarked that Taylor should be placed in a typical, mainstream classroom when the time comes for her to enroll in either preschool or kindergarten. He, once again, reminded us that Taylor has no intellectual impairments and therefore, will be able to excel academically as any "normal" child would in a regular classroom setting. This is the kind of information I like to hear! We always thought Taylor was a sharp little girl, but it's always nice to hear it from somebody else too...who doesn't love hearing how smart their kid is...so hearing that Taylor should only be placed in a regular educational classroom and should be expected to compete with her peers academically was truly music to my ears.
FUTURE CONCERNS & AREAS TO MONITOR
The neurologist noted that in the coming years, although Taylor will continue to demonstrate improved mobility in her walking and even in running, she will become at risk for certain "biomechanical" injuries.
For example, as her overall mobility improves, increased fatigue and injuries, particularly to her back, legs and hips can result. The neurologist referred to this as "physiological burnout" which is basically the sheer fatigue that occurs to young children with diplegia cerebral palsy due to the "high physical demands placed upon the body for their ability to adapt, compensate and manage their disability." The neurologist noted that sometimes this "physiological burnout" can be seen in a gradual (temporary) loss of function, decreased strength and stamina when walking/running, deterioration in overall mobility and coordination, along with physical exhaustion. The neurologist remarked that these impacts occur most often among those children with diplegia cerebral palsy who are the "highest functioning" (like Taylor) and who have been able to successfully compensate for their disability.
The neurologist continued by saying, "this is why physical therapy will continue to be a mainstay in Taylor's life for many years to come" especially as she continues to grow and her muscles/bones grow. The neurologist noted that as high-functioning children like Taylor continue to walk and progress in their physical abilities, they often begin to experience significantly reduced distances when they walk/run. The neurologist said the main reason for this is they experience increased fatigue when walking/running; therefore it will be vital to give Taylor a lifelong exercise program and recreational pursuits of a physical nature to continue to help her overcome fatigue and physical constraints inherent to her type of cerebral palsy. As Taylor becomes a young adult, Taylor will be able to manage her own physical recreational activities and maintain her own physical exercise program but until that time comes, we, as Taylor's parents must make it happen for her and help facilitate that to ensure that Taylor continues to make strides in overcoming her disability.
Finally, the neurologist noted that he will continue to monitor Taylor's progress, along with her team of physical therapists, keeping a close eye on any signs of deterioration in her physical abilities and/or levels of fatigue when she walks because at some point down the road, surgical interventions and other treatments may prove helpful to improving the efficiency of how she walks/runs; however the neurologist said that he would only recommend these types of interventions after Taylor has undergone many more growth spurts.
