Pending Breakthroughs

I realize it has been a long time since I've posted any updates and it hasn't been for any lack of progress in Liam's developing independence. He has been busy these last few months as we set the course for his next milestone breakthroughs. In September, his therapy sessions were renewed as per a bi-annual evaluation requirement. Last month, he was measured and fitted for a new supine stander which will be customized for his unique needs. 

However, Liam has been showing a lot of determination to learn to stand on his own two feet. He really wants to take off running especially when he sees other kids close to his age taking off. I decided to put together a little riding toy to see if it would encourage him get used to the idea of using his legs. It came with rockers to attach to the wheels to start off as a rocking toy, but Liam didn't care for that function. So I took off the rockers and here is the result. 

Now, even his Physical Therapist questions whether he will even need the customized stander by the time it arrives. Even during therapy sessions when she stands him on his feet, he no longer resists and instead continues to instinctively push down into his feet increasingly bearing more of his own weight through his legs. 

Practice standing in Physical Therapy (look at his arm bending!)

To further add to the topic of Liam's independence, we are also seeing much more use in his hands and arms. He has even started to bend his right elbow independently! In response to this breakthrough, his Occupational Therapist has spent the last few weeks designing a customized splint to fit to his elbow to encourage him to use it more. She has also taken one of his feeding spoons and creatively applied a combination of weather stripping from the hardware store, a tongue depressor, and electrical tape to fatten up the grip and lengthen the handle so that Liam can attempt to feed himself. For now, we are working on getting him accustomed to the elbow splint so that he can get more range in his elbow before we tackle the self-feeding obstacle.

Bending his elbow! (He's only crying because he was cranky. He gets this range in his elbow by himself).

Customized elbow splint.

Playing with the splint on.

What's New?

You're all familiar with the saying "no news is good news," right? This certainly applies to Liam currently. Next week, we return for a routine check-up with his orthopedic doctor for the first time in 4 months! Why the exclamation? Well, it's pretty exciting that we have not needed to see this specialist for so long, considering the first 8 months of Liam's life meant weekly visits for cast changes and two separate surgical procedures to his ankles. We are all certainly blessed!

Liam isn't walking or standing on his own yet and we are still working on his mastering sitting upright unsupported. However, the stander, mentioned in the last post, has worked wonders in strengthening the muscles that will help him to stand.

Initially during therapy, Liam's physical therapist would stand him up supported against a couch or ottoman and try to help him strengthen his leg muscles in that way, but Liam would just scream and cry. After three 15-minute sessions in the stander, we tried standing him up against the ottoman again and he instinctively pressed his heels into the ground and stood (with support) tall and proud as though this was what he was born to do. The stander has also helped him to enjoy his ExerSaucer more than ever, giving him more strength in his knees and ankles to bounce around.

Also, so as not to leave anything out, Liam's arms and hands are still making good progress. He uses them more than ever to play with his toys and reach for things that catch his interest. Lately we've noticed him bending his elbows when he presses his hands against our arms. Where there's a will, there's a way!

Work and Play

It seems we are always looking for new ways to help Liam increase mobility in his muscles and joints. Well, it turns out, that over the course of the last few weeks, Liam has shown us a thing or two in what works best for him. When his physical therapist introduced him to a toy that he can activate by sitting and pressing a button, he was thrilled and shrieked in excitement.

Overnight, he seemed to be sitting up so much better on his own. Keep in mind, that though he is 10 months old, he is still struggling even with prop sitting. This is due to the awkward positioning of many months worth of castings on both of his legs. He has not been able to work to this milestone without a major obstacle. In the meantime, we have worked on other milestones, such as rolling front to back and back to front which he has mastered.

Most recently, we have been trying to find a way for Liam to effectively play with his toy laptop computer. It has these wonderful buttons that he loves to press. However, the restrictions in his elbows, wrists and shoulders prevent him from controlling the toy. Then I remembered we have a little stool that converts to a little chair. We use it as a makeshift desk for his little computer. Now, for the first time, he is motivated to press the buttons with his individual fingers rather than the flat side of his hand.

Can't you see I'm working here, Mom?

This little guy is going to be a computer whiz like his Dad!

We are also seeing a lot of increased range and mobility in his shoulders. We can lift his arms pretty high and open them up pretty wide. But the distance he can stretch himself is a different story as he is challenged by the shortened tendons in his joints. But as he continues to explore his environment and play with his toys, the tendons stretch and loosen and create less of a challenge each day. Also, of course, aggressive therapy plays a major role in his continued success.

Playtime and Other Things

Just as the last several months, this past month has flown and now we are few days away from Liam's 10th month birthday! I have been witness to a steady increase in his alertness and perception of his surroundings. In therapy, Liam has been introduced to toys that create a "cause and effect" scenario. For example, when he presses a button or a switch, the toy will make a loud cheerful sound or release another toy such as a ball. His success in activating such toys is lately met with a delighted screech. It's so unexpected, I haven't been able to catch it on video yet.

Further to Liam's success with his toys is that he is even more motivated to learn to sit upright unsupported. This is also somewhat unexpected. After many months of castings on both of his legs, we expected Liam to be further behind schedule in this milestone. In this, he is proving to be an overachiever and in a good way!

And speaking of milestones, we have accepted that Liam will likely learn to walk without ever crawling due to the restrictions in his elbow and shoulder joints. However, he is rolling around all over the place. So we now have a large play mat for him to roll all over to his heart's content. He loves it!

As a last note regarding toys, he particularly favors any that he can easily get a grip with his hands as pictured
below. His favorite is a rubber ball with holes all around it so he can hold on to it and move with it. It provides an incredible stretch to his fingers, hands, wrists, elbows and shoulders that he does all by himself! So, to any others out there who know children with arthrogryposis in the upper extremities: this toy should be high on your list!