Fall Days

Determined to enjoy autumn to its fullest, Caden presented me with his "wish list" of fall activities.  I think we managed to fit them all in, including multiple leaf pile jumps, trick or treating, two corn mazes, a farm visit and a wagon ride.  He is even a little more fond of sitting through his brother's MS soccer games as he managed to find at least one 4-leaf clover at each home game, and once a 5-leafed clover.  Charming!  Mother Nature had her own trick or treat in mind, however, sending a substantial snow our way before Halloween.

Caden continues to adjust to his return to school.  He confided to me that some days are better than others.  I think we can all relate!  While he continues outpatient PT and OT, these therapies have also been added to the school schedule.  We are seeing Caden reap the benefits -- especially his ability to interact with other children:  playing tag and not always being "it", and being fearless on the monkey bars.  Still, he is cognizant that his peers sense that he is different; and with the help of his teachers he decided to tell the class his story.  He was met with support by caring classmates.

The academic scaffold that the teachers worked on during home instruction has proven to have a strong foundation.  Caden says that he now loves writing ;) and the haze that has obscured his once terrific grasp of math seems to be lifting.  In speech, he is working on learning and memory strategies in addition to improving the fluid quality of his voice.

Last week, Caden had a diagnostic procedure to ascertain whether the AVM had regrown and/or was still present in his brain.  We learned that Caden does not like needles, that it is easier to lie absolutely still for 6 hours if you get to watch Sponge Bob, and that everything looks good.  Phew!    

Happy Life Day!

This spring, one of Caden's ATs (awesome teachers) gave him the task of re-learning the months of the year.  Caden recited them perfectly, omitting September and October every time.  When she told me about it, I laughed and replied, "well, given Caden's experience of September and October 2010, I'd like to leave those months out too!"  So far, Caden has really enjoyed this September and is looking forward to experiencing fall again.  He has even said he is going to start his own leaf raking business, although I think our yard produces enough leaves to keep him busy for awhile :)

Before school started, Caden accomplished one of the goals that he had set for himself upon returning home.  He wanted to climb to the top of the Sourlands to that special spot where you can see NYC on a clear day.  I took the boys there on occasion and we would "wave to Dad" and/or call him on the cell phone and pretend to see him wave back.  Caden and I made it to the top on a warm, muggy day.  Although it was too hazy to see the city, it was a success nonetheless:  he made it all the way up and down on his own two legs, only holding my hand occasionally.

Caden has now logged more 3rd grade days at school than he did last year.  He is really enjoying being back at school:  he has made new friends and gotten to see old ones too; and he is settling in with his new teachers.  We were concerned about his adjustment to the full school day, and so far he seems to be handling it o.k.  However, he can be very fatigued when he gets home, and is experiencing a few more "wobbly" days as a result.  Hopefully his stamina will continue to improve.

The treadmill work-outs are going well.  Caden had gotten up to a half a mile in about 13 minutes :)  His PT has changed up the treadmill routine, adding 3 new workouts on the machine to challenge both his brain and body -- fascinating!  As he will be on the treadmill more often, we are hoping this also helps to improve his stamina.

September 23rd and the surrounding days could not pass without our feeling a twang of sadness, and a huge amount of happiness, gratitude and blessings.  What a long year.  What a short year.  What a year.

Summer Fun

From all accounts, summer school was a huge success.  Caden says it was FUN and loves to tell us stories about pool time, music class, whiffle ball at recess, walks with the high school volunteers, pizza day and the carnival on the last day of school (I'm sure they did some work in there as well!).  He seemed to be able to handle the half day schedule, and tolerated the bus ride too.  All good signs for resuming school in September.

Prior to the bout of rain that we have had the last week or so, Caden has spent a lot of time in the pool.  He is not quite the "fish" that he was last summer, but he has improved dramatically this last month.  He now remembers how to hold his breath and go under; loves to jump in with and without a board; tries to do handstands better than his brothers, and will "swim" for a few yards.

Gait training is still his therapy theme.  His PT has reintroduced him to the treadmill:  back in December/January Caden used the treadmill a little to remember how to walk; now he is using it to remind his brain and body of the natural, fluid movement he had pre-injury.  He has worked up from 5 to 10 minutes (going over 2 mph) with a goal of 15 to 20 minutes, and we noticed improvements in his gait immediately.  Weight/balance shifting is another focus, and his PT has him using a scale to shift his weight from one leg to the other -- clever!  Still, Caden most enjoys therapy when it doesn't seem like therapy :) so we've incorporated walks along the stream and even a hike in the Sourlands (great balance practice on the shifty, rock strewn path).

Many of the teachers and therapists who worked with Caden this summer mentioned his sense of humor.  We had to smile this week when Caden told his older brother, who had just suffered a soccer injury, that it would be o.k.:  he has some cool therapy tools he would let him borrow, and he could recommend a great Physical Therapist.  As Caden said, "She really knows her stuff!"

   

 

Summer begins!

Like most parents and their children, Caden and I shared a "get ready for school" ritual each morning, pre-injury.  It included making sure those shoe laces were tied, and helping him with his back pack.  Then I would admonish him to be a very good boy, and he would sincerely reply that he would.  With heartfelt good-byes on both sides, he would traipse out the door and begin his day.  Except that.... 

As I watched him step down from the back porch, I would spin on my heels and tear through the house as quickly as obstacles allowed.  Similarly, Caden would skip or run (his choice) down the driveway.  Our mission:  to see who could reach the front porch first.  Sometimes I would win; sometimes Caden; mostly we tied.  Caden would then continue to skip to the end of the drive, giggling en route.  He would pick up the newspaper and heave it toward me:  launched skyward, it would brush tree leaves and land just a few feet away from where he stood.  More giggles.  He would pick it up again and wing it.  So far!  And 95% of the time it would land in a bush or a tree.  Giggles again.  By then the bus would come and he could really start his day.

Yesterday was Caden's first day of summer school.  Our ritual began the same way, but then we walked to the bus together hand in hand.  He stooped and got me the paper and we both grinned.  Because it was the first day, I was fearful as he negotiated the steps in the bus.  Today, I watched with admiration as he gripped the hand rail and confidently got on.  New days and new rituals :)

The end of the regular school year meant saying good-bye to the wonderful teaching team that has helped Caden regain the power of his voice and his mind.  After four months of having them daily in our home and in our lives, they felt like family.  Thank you!

With summer's arrival and our pool open for swimming, Caden started his pool therapy at home.  His older brothers are a great help with the home pool exercises.  And who knew about all the cool, pool therapy equipment?  Rory says Caden has the coolest therapy "toys".  I'm not certain Caden feels the same way about them ;)

We've really been working on trying to improve Caden's gait and to narrow his stance.  I placed a narrow, straight road in painters tape on the living room floor for Caden to practice on.  Then Carl helped me put a slightly wider, meandering road perpendicular to it.  (We'll see if these new floor designs show up on HGTV)  We know Caden's walking has improved because he has far fewer bruises on his knees!

One of Caden's favorite activities has been to follow the lawnmower (at a safe distance) on the paths that it cuts through the grass.  Sometimes he goes on his bike, or else he just walks along in the freshly mown swaths.  Yesterday -- maybe was inspired, or maybe his legs were just antsy after sitting in school for half of a day -- he took off after the mower at a run!  So his form needs a little work....  It's a start!

New Heights

A couple of weeks ago, Caden's OT decided that all of his upper body strength training was paying off, and she let him try out the rock wall in a therapy session.  Caden made it about 2 feet off the ground, and then maneuvered his way about 4 feet to the right, then down, up and back again.  While the space covered was small, it was a huge accomplishment in terms of strength and motor planning.  As you can see on the left, he is now reaching new heights!

Caden's story was included in the UMDNJ magazine's Spring issue on the brain. The interview was conducted in late January/early February, and the photo taken in March.  It is truly amazing how far he has come and how hard he works to get better every day.   http://www.umdnj.edu/umcweb/marketing_and_communications/publications/umdnj_magazine/spring-2011/9.htm

Swinging

Caden has been keeping super busy with therapy and schoolwork.  The amount of re-learning that he has accomplished in both areas is staggering, and of course there is so much work still to be done.  I am reminded of my grad school statistics classes, and how we would analyze scatter plots, variability, best fit lines and outliers.  Caden's days can look a lot like those graphs:  some days up, some days down, occasionally a day that is way out there, but overall an upward trend.

There have been some new activities in therapy.  OT has challenged Caden with the wii balance system.  It is tremendously difficult for him, yet it brings out his inner competitor and he vacillates between frustration and determination to master the machine.  Additionally, his therapist noted this week that his hands are much stronger and tremor less -- progress!

PT put Caden on a swinging platform this week to do part of his work out.  I was very impressed with Caden's strength, coordination and balance.  His exercises are challenging on solid ground, let alone with the additional difficulty of having to orient himself in space.  I was certain it would make him dizzy, but he handled it well.  New PT homework is to swing on our swingset at home.  Let me tell you, that simple act takes lots of coordination and motor planning!

Progress has also been made on the bike (sans pedals).  Caden now cruises down small slopes for several yards with his feet up and maintaining his balance.  Not only is this great for balance practice, but he can join in the fun with his brothers and friends and bike around the yard.   

Knees

Today was the first day back to normal after 10 days of Spring Break.  Caden delighted in having his brothers home :)  For the duration, we scaled back the time spent doing therapy and homework and dialed up the play time.  This meant more time hanging out with his brothers, playing outside, going on walks, riding his bike a la Fred Flinstone, and spending time with friends.  To ease back into the routine this morning, Caden did the first half of his PT at home, and the second half on the playground.  We were both impressed with his balance on the suspension bridge; and his new and improved arm strength meant hardly any help from me on the monkey bars.

Back in February, Caden was allowed to slowly transition from using a walker to using a cane.  Well, Caden is Caden, and he never really took to the cane -- preferring to use it more like Fred Astaire, although without the cool jump kicks.  His preference was to use my hand and/or arm which he affectionately calls the Mommy Walker.  Last week he was given the go-ahead to freestyle, and we put the cane aside.  Caden is once again my toddler, or a boy with lots of swagger in his step, or a cowboy, depending on his mood.  To give him more freedom (and me peace of mind), he has a "crash helmet" and knee pads that he can don before swaggering out the door to play.  As he still needs lots more therapy and conditioning to get his balance under control, Caden spends a decent amount of time practicing falling down and getting up :)

I can remember pulling up my knees at the end of a fun-filled day, and smelling the sunshine and grass that lingered there.  We have often told the boys that we can tell how good a day they have had by what stains they have acquired on their shirts.  Caden's days can be read by his knees:  frequently bruised, but joyfully splashed with mud and grass stains and a dash of pet hair.  Guess those knee pads can't cover everything!     

Desks and Ducks

Spring is finally in the air (sometimes), and Caden can smell it!  He wants to get outside and play, and do the things that were normal for him pre-injury.  One favorite is to ride his bike.  This results in great enjoyment for Caden, and a total work-out for me and whichever one of his brothers I can entice to hold up the other side of the bike ;)  Just as we were digging around for a pair of training wheels, his PT suggested lowering the bike and taking off the pedals completely.  We'll give it a try!

With over a month of home instruction under his belt, I think Caden is getting used to the routine.  His amazingly creative teachers are great at adapting the work to help Caden relearn some of his skills.  They have even brought him his very own school desk!  Aside from being the right size to help him with his posture and fine motor skills, it makes home a little more school like for those hours of the day.

During one of Caden's first outpatient PT visits in early January, the therapist recommended that he add the crab walk to his repertoire.  He was just really getting a handle on crawling, and attempting the crab walk for the first time proved very frustrating -- his arms were not strong enough to support him and the motor planning involved made the whole activity beyond his reach.  Two months (and a lot of practice) later, Caden can sidle like a crab around the mats with confidence.  His new challenge:  to walk like a duck.  I told him he can quack to his heart's content.

Milestones

Last week marked 6 months since Caden suffered his brain injury.  Sometimes it seems like September 23rd was yesterday, and at other times we would swear that it was years ago!  In commemoration (ha!), Caden had an MRI.  If you ever want to witness an 8 year old boy fidget, lay him in a tunnel wearing a helmet that looks like a hockey mask, create clankety, clackety noises at incredibly high decibels, and tell him to be still for an hour :)

It has also been 3 months this week since Caden came home.  Therapy and school keep him very busy.  Our living room looks more like a gym each day; and I may have to clean out a china cabinet to store his school supplies.  To break up the home therapy routine, we've started to create some mini obstacle courses.  So far they are pretty simple, but seem to keep Caden amused.

Just as when you are with your child every day, you don't notice how much they have grown; when you are with Caden daily, you may not perceive how much he has progressed.  When he left rehab he was just getting used to his walker - now he can walk with his cane and/or holding hands.  At that point he was only beginning to speak again - now he likes to chat, albeit slowly ;)  Little steps, every day. 

Happy St. Patrick's Day!

Caden wanted to share a little luck o' the Irish today!  He has been working hard:  the whistles, curly straws and milkshakes seem to be paying off as his voice continues to get stronger.  Another PT milestone was made as Caden took some hops on the mini-trampoline.  He is working on his handwriting workbook with the goal of catching up to his classmates :); solves a money math problem each morning with his breakfast; and is striving to be able to read and retell his reading homework. 

Last week Caden was able to participate with his classmates in after-school Bingo.  It was wonderful for him to see his friends again!  Caden enjoyed playing Bingo - especially when it was his teacher's turn to call out the numbers.  He can't wait to go in and visit his class again.

Although we have assured Caden that his injury could have happened at any time and anywhere, Caden was a little fearful of the school playground.  With the company of one of his teachers, the three of us headed out to the playground after Bingo so that Caden could see it wasn't such a scary place.  Confronting his fear was a great success:  Caden even went down the slide and decided the playground is A OK!

A Hop and a Walk

Caden continues to make progress in therapy, practicing some old things and trying some new ones.  For example, his PT has been encouraging him to try and jump.  Nothing big.  Just a little jump.  He has stood on a mini-trampoline a few times and tentatively bent his knees.  It is obviously a little scary for him, and the motor planning is hard as well.  As he was navigating an obstacle course, the therapist asked him to jump down from a mat while holding on to her hand.  Caden gave it some thought the first go around, but stepped off instead.  The second time, off he went with a little hop.  Hurrah!  Since then, I have caught him practicing jumping when he uses his walker -- some times he is a little more successful than others :)  

This week also brought an addition to the schedule:  school!  Caden started home instruction with 3 wonderful teachers.  He looks forward to their arrival each day.  They have brought whistles, manipulatives, and wonderful stories.  By the end of the week he was logging in more school time than he had at rehab. 

One of Caden's favorite things pre-injury was taking weekend walks with his dad and his dog.  We reminded Caden of those walks often during his hospital and rehab stays--both to bring back happy memories, and to remind him that with hard work he would go on those walks again.  Well, the weather got a little warmer this week and we were able to venture outside a little.  First, Caden and I ventured around the block; then on Saturday, off we went with Carl and Scout.  The walk was a great success:  Caden made it out and back, and got to visit with a friendly horse and donkey along the way.  While Caden was petting the horse, the donkey slurped Caden's hand resulting in at first surprise, then a whole bunch of giggles :)     

Riddle of the Sphinx

Valentine's Day was a great opportunity for Caden to get some practice writing as he filled out cards for his classmates. He is pretty shaky with a pen, but using finger grips and weights on his wrists seemed to help. He was very excited to visit with his teacher and the school principals when we dropped the cards off; and being able to participate in a school function over the weekend reminded him why he has been working so hard.

Caden's fingers are getting a "work out" now.  Daily activities with the thera-putty, including cutting with a knife and fork, and now with scissors have been complemented by playing with clothes pins!  Caden's OT recommended playing with them as a way to improve his pinching - and it turns out it is kind of fun too :)

PT is going well, and Caden's homework is always enjoyed much more when we grab a couple of brothers to tough the exercises out with him too. We were all tickled last night when Caden led the boys in a round of push ups.  I think he may have outlasted a couple of them!

Walking with the walker is becoming second nature for Caden.  He is moving more quickly and only teeters or wobbles with it when the surface is rough or he tires.  The next step has been practicing around the kitchen with a quad cane.  Caden thinks this is pretty cool, and can really get moving with it; but will need a bit more practice before he takes the cane on the road.

So here you have Caden's rendition of the Sphinx's riddle:  what starts out on 4 wheels, then on 6 legs, then on 3 legs, and then....?  We'll have to hold out for the last part of the riddle, but we know Caden is hoping it starts with the number 2!

Hey Mr. Groundhog

Caden has not let all this snow and ice deter him from his therapy.  Not only has he made it to all of his outpatient appointments, but he has done some of his homework out in the elements!  Turns out snow tunnels are great for crawling, snow forts are awesome for climbing, and snow ball fights...well, those are just great fun.  Caden's most recent milestone on the PT side is getting to walk down stairs with support.  He had been "bumping" down the stairs, so this is a big step up :)

Pool therapy has continued to be his favorite, but he has also started OT "on land."  It has been great to see him working with his fine motor skills.  He is now using a tougher consistency of thera-putty than what he had been working with at rehab; and is removing/replacing small beads from the putty rather than pennies.  Cutting the putty with a knife and fork is another homework task for Caden.  A combination PT/OT task has been for him to use window crayons to write and draw on the kitchen windows.  It has made for some interesting window dressing, especially when his older brothers decided that was a pretty fun way to study for midterms!

Caden completed his speech evaluation last week, so we are looking forward to the start of speech therapy.  He is chatting more and will occasionally join in with songs playing on the radio just like he used to.  It brings a smile to all of our faces.

 



On the move, with a crawl

These have been busy days for Caden as we are finding some rhythm in the new routine.  PT has introduced new and more difficult exercises for him to practice, and he continues to work on stabilizing his trunk and strengthening his core.

Caden's favorites at the moment are his race track (where he has to crawl around the perimeter of the living room on all fours - two weeks ago he couldn't crawl more than a yard and now he makes it two laps!) and "Ping Pong Therapy". The latter is just playing assisted ping pong with his brothers, but brings lots of giggles and must involve PT (he stands) and OT (hand-eye coordination), right?

He is now able to use his walker by himself; and we have visited school hallways, malls and supermarkets to do some walking despite the snow and ice outside. The therapist noted this week how much he has improved since they did their initial evaluations.  Keep up the hard work, Caden!

We've tried to get out as much as possible, despite the weather.  It appears that Caden is talking a little bit more with people outside of the family; it just takes him a little while to get warmed up, literally! :)

Starting a New Year

The first week of the New Year was a busy one as Caden adjusted to being back at home. The PT and OT evals went well at the outpatient facility, and Caden even managed to squeeze in a pool therapy session. Caden enjoys pool therapy, and particularly liked trying out a squirt toy that he managed to spray both mom and dad with from some range ;) Definitely improving those fine motor skills!

Meanwhile, our home therapy sessions have gone well too. Caden is really making progress with his walker and needs much less support. His speech continues to improve (or we are getting really good at speaking Caden!). And nothing beats "brother therapy".

We have had fun getting out and about this week, including watching some basketball games. Caden was delighted to speak with the boys Varsity team and coach prior to a home game this week; and then got to help cheer them on to a great victory. The team autographed a ball for Caden that he takes very special care of so that the names don't come off. Thank you so much guys!