Saturday, March 16, 2013

Physiatry News

We drove to Indy this week to see Mikan's physiatrist.  She was pleased to note his progress, but she did mention that she was considering botox injections.  In the past she didn't think he needed them because he had good foot and ankle range when he relaxed.  He still has good range when he relaxes, but she said that his spasticity triggers during any activity, which gives him an awkward and inefficient gait.  She didn't say yet that she wanted him to have the injections, but she said she wanted us to try a new flexible AFO for awhile and see if he could continue to make progress.  The botox would relax the spasticity so that he could have a better chance of walking with a heel to toe gait.  The hope would be that during the time when the botox was effective, his brain would receive enough input to eventually train his body to walk more efficiently.  There is no guarantee there will be any carryover once the injections wear off, but the chance is there, and it has apparently worked for many other kids with varying degrees of spasticity.  We aren't close to making a decision about this.  We obviously have a lot of things to consider.

There seems to be some disagreement about whether or not Mikan's g-tube stoma needs surgical closing.  We will probably wait until the summer to make a decision about this.  While the general surgeon doesn't seem to think it is a problem, Mikan's pediatrician and physiatrist have expressed their concern.  For now we will wait until we gather more information.

Mikan has taken an interest in Dum Dums lately.  Butterscotch is his favorite flavor.  I am pleased that it is something different to add to his very narrow repertoire.

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