Wednesday, March 28, 2012

Finally some answers!

March 2012 How we got to this point! Chloe Anderson When we started this journey we kept hearing the shoulder is the most magnificent joint but still a mystery in our body. We heard this from: Chloe's primary doctor, an orthopedic doctor, neurologist, physical therapist and now occupational therapist we worked with or presently working with. Chloe was born low tone given the diagnosis of a floppy infant. She needed to do many exercises guided by professionals so she could walk by two years of age and to reach other milestones. Her health issues are asthma and allergies which are monitored and intervene if needed. Chloe needed to be home schooled due to to many allergy issues like varnishes and paint fumes at school. She spent about 7years in music therapy which kept her fingers moving but had the best use of her arms when the upper arm was tight to the sides of her chest. Her fine motor was working even though she could not raise her arms over her head with any degree of control. The farther away from her body Chloe had less and less control of her arms. Her doctor said he never thought of working on fine motor first. I responded that was all we could do! The first physical therapist used a neurological focus. He devise a exercise program that helped Chloe worked with the neurological issues that were causing her shoulders not to achieve the range of motions it should have. This was carried over to the YMCA where she worked with a personal trainer on a neurological focus work out. Chloe was able to hold her arms in a T- shape but still had little control of arms over her head. So she was referred to an Orthopedic doctor who took ex rays and said it appears to be more a muscle not a bone structure issue. He reminded us the shoulder is a most complicated joint in the body and some of the many core muscles are possible the issues. So Chloe went back to exercise 2-3 hours a week with a personal trainer and I work with her 1- 2 days also. Still Chloe arms would become weaker with any activity over her head or away from her body. So Chloe's doctor referred her to a neurologist who seeing the asymmetrical shoulder and prescribed a pain medication that seem to calm Chloe . The neurologist comment was;”Where is all that pain coming from?” She referred Chloe to a physical therapist who worked on the upper back issues to help lessen headaches from the orthopedic perspective. Chloe's therapy was quite different. Chloe for most of these session laid flat on her back and the physical therapist assisted her arms to move in different directions to rotate the shoulder joint as much as possible. Chloe was still obviously in pain and medication was not helping at times. So the Neurologist suggested an MRI which she failed the first MRI unable to lay on her back without waking up in pain. At Children's Hospital they able to use stronger medications so they were able to finish the MRI. It found a mild disc bulge at C6-C7 which makes sense why a topical pain patch in that area helps. The neurologist prescribed medication that blocks some of Chloe's pain receptors in her brain which seemed to help combine with the pain medication she was already on and referred her for therapy. Working on coordinated hand activities, the occupational therapist also used electro stimulation of Chloe's arms and we saw some improvement. Then the OT used this the electro stimulation just on her shoulder Chloe's, her left side of her neck, forehead and shoulder weaknesses improved . Her use of her hands and arms have greatly improved away from her body too. Her doctor suggested she try a postural control shirt and checked her gait finding the left leg is slightly longer than the right leg which might be corrected by just one insert in the right shoe. Chloe is 5 feet 8 inches tall and her T-shape body may of caused her to have to work doubly hard to over come these pinched nerve issues which caused her possible to be a floppy infant at birth.