Night and Day

That's botox for Annabelle, like night and day before and after.  She had the procedure done about 3 weeks ago now and you could totally tell a difference just a few days after the procedure. She always responds very well in the arm, less in the leg but it is still very well.

Here's a video of our first OT session after botox, she is willingly using lefty arm so much more than we had ever seen before and was much more accurate!

 

Her leg was casted after botox as well, just for 1 week. Thankfully, that's the only casting she needed to stretch her muscles out rather than doing serial castin. Her PT was really pleased with her range of motion once we took the cast off so I would say that the amount of botox to each area of the leg was good too. Nightly stretches have become less of a fight and more plesant as well :-)

While we were getting the botox done the rehab docs mentioned wanting to do some phenol so that they would have more botox to use in other places. One being her pectoral muscles (chest) to help her left arm reach out easier, I had never thought of that one. In any case we declined the phenol b/c it was mentioned the day of and I was not able to read about it beforehand. From what I do know it is much more painful afterwards and I don't think Jim and I were mentally prepared for that, plus we left 2 days later for Vegas and left Annabelle with his mom. We didn't want Annabelle to be extra cranky for her while we were away!

Another thing that was mentioned by both the rehab docs and PT was a Selective Dorsal Rhizotomy (SDR). Her PT, who I trust very much, is encouraged by how strong Annabelle is "underneath" the spasticity. It sounds pretty intense to me, it is essentially going into the kiddo's spinal cord and cutting some of the sensory nerves coming off the spinal cord. The patient then needs to lay flat on their back for 2 days and is followed by 10-14 days of intensive inpatient rehab. Most people struggle to walk at first and there is a large amount of weakness since it is the first time the spastic muscles are no longer taking control of everything.... Like I said, pretty intense. From what I read there are definate benefits, everything from improved lower extremity use as well as upper extremity use to improved cognition (presumably due to not needing to concentrate quite as much on the lower extremity muscles) and less ortho procedures. 

There is no way Annabelle would tolerate that at this point, only being 2.5yrs old and barely tolerating an hour of therapy here and there let alone 2 sessions a day. I think part of the reason it's being brought up so much is "THE guy" we would want to do the procedure is retiring in the next year or so.  We have a bit of discussing and researching to do...

 

 

 



PISSED

I am so mad at our hospital/ rehab dept right now!

So, in my last post I mentioned how Annabelle was starting to get really tight for stretches and her gait is starting to suffer, BUT botox was just a few weeks away and she responds really well to it (delayed to 5mos interval b/c of our regular rehab doc moving out of state).

Well fast forward to a week before botox and we hear from our therapist that a few of the rehab providers left suddenly so we should call and confirm our botox appt (said therapist is a few towns away from where all this is going down so she is just hearing things from other families).  So I call and sure enough the secretary is all like, "yeah we only have 1 provider doing botox now so we will have to reschedule you for NOVEMBER" (now >7mos delayed from our last session). I then ask her, "well this is now less than a week away from our original appt, was anyone going to call me?" and they are all, "yeah, at some point but we hadn't figured out how to handle this yet."

 Oh geeze thanks for figuring out your shit first (not really) while we are going along with time off of work and school and special therapy appt's set up for casting afterwards... great f*%king customer service!  And as it turns out through the grapevine other families were NOT called. They showed up at the hospital and there was no doc there to do the injections!

In any case, we got Annabelle into a private clinic (We *think* is in-network for our insurance) and got a new botox appt moved up to early Oct with them. It's about a month sooner than what the hospital could do and I'll take it. Even with putting Elmo on the Ipod Annabelle has been SCREAMING and crying during stretches for the past few weeks, saying it hurts and she has never done that before. Jim and I can absolutely tell she keeps getting tighter and tighter as well. It absolutely breaks my heart!

As a result of all of this, there is going to be one hell of a letter sent to the clinic manager about how incredibly poorly the whole situation was handled.  I'm also miffed that the providers we are now going to in the private clinic are the ones who suddenly up and left the hospital, leaving the families in a bit of a tizzy. It does kind of kill me to given them business but at this point it matters more that Annabelle gets the damn injections....

On a much happier and less frustrating note, this is GB petting the piggy (and then telling her
which way to go) at the local heritage park. So stinkin' cute!

Here and Now

I'm a big fan of summer, always have been. As a result, I haven't posted in a long time because #1 we've been so busy with summertime and #2 I just really have not felt like it.  I'd sit down to write a bit and be all like "eh, not too much going on" and it kind of made me sad that we stalled out for a while on gross motor skill progress.  I'd also start to think about the coming years and feel kind of overwhelmed.

Bad Veronica for doing that! Focusing on the negative again and  more on the future (school) than the here and now.  I still get caught up thinking about school stuff for Annabelle since I'm seeing all the kids for school physicals at work but I've been making a conscious decision to stop myself in my tracks as soon as my thoughts drift anywhere past kindergarten. It can still be stressful trying to decide if she should be in daycare now versus this Montessori preschool a few friends love versus head start once she's 3 versus regular preschool..... but at least I can handle that.  Sometimes I even need to say it out loud to myself, "Stop! not past kindergarten". I probably look/ sound funny but it works.



Hiking on her own at Craters
of the Moon

I would like to brag a bit, about the here and now :-D I knew Annabelle was picking up a lot of things, especially from her "Elmo TV" (NOT that we use TV to teach her and she's really only allowed to watch Elmo on weekends or special days. We just use a lot of the characters and songs to teacher her things) what I didn't realize was HOW MUCH she's picked up this summer: even though she needs a fair amount of translating she communicates incredibly well. She knows half her letters and can kind of sing the ABC's, she can count to 5 and she knows her colors! She also knows the words to a ton of different songs- Sesame Street and NKOTB ;-) hahaha.

With the gross motor we did kind of stall, although I have seen her trying to put a piece of thread and then a thing of yarn into lefty hand. I thought that was weird, maybe it's a texture thing for lefty and I will be trying to exploit that. I think part of it though is we have gone since April since our last round of Botox and girlfriend is TIGHT... we don't go for another round until we are at 5mos out and we've decided that is waaaaay too long, you could tell it was too long before we even hit 4mos. Kind of a bummer that she metabolises it so fast but at least it works for that bit of time. Her rehab doc mentioned some different botox formulations that were coming down the pipeline that may last longer for her, I'll be interested to read about those though I bet the cost would be astronomical.

So now we're toward the end of summer. We've had a very fun time, Jim and I have been racing, we went beach camping, went on a few hiking trips, took Annabelle to a few splash pads and community pools, lots of family bike rides.... We're excited for fall now too though, apple picking, pumpkin, hiking in the leaves and FOOTBALL!

Playin in the sand while beach camping

Elmo Brace

Concentrating so hard the
 tongue is out

Soooo lefty arm, it doesn't like to cooperate very well (duh). For a little while Annabelle was doing well with just a reminder of "use lefty". Not that it was very functional but she'd put lefty up on the handle of the cart or up on her highchair tray, things like that.  More recently she's just been ignoring our suggestions to use it.  Jim and I also got pretty lazy about setting aside specific times to do therapies at home (gosh we were soooo good when she was a baby baby, 30-60min practically everyday. It got so much harder when she realized she could say no and just not participate...oh toddler-hood).

Go lefty!

In any case, now that we are getting older and wanting to do more things it's going to be more and more important to make lefty arm functional as possible.  Can anyone say POTTY TRAINING, hard enough to do by itself let alone without the function of one of the toddler's arms. So after talking with OT and a lil nudging from mama we got a brace made for righty to do a bit more formal lefty work. So while it's not full-time like "real" constraint therapy it is making Jim and I set aside special time to work on lefty. Since she loves Elmo and the color red we had her OT make the cast out of red material and Annabelle now calls it the "elmo bwaay"...

Workin hard with the
Elmo brace on

She likes to say it, then hates when we put it on. It makes a great weapon too and she took a fabulous gouge out of her changing table when she was wailing it around in a fit.... boo. She did pretty well with it on in our actual therapy session when she was given some snacks to get into her mouth (so my kid... easily bribed by food). She's not too keen on puttin blocks into the jar though. Next on our list at home is to try the snack idea!





"Elmo bway ooooff". Also, we are
ignoring the W-sitting while working with
the arm, thanks for noticing ;-)

 



Race Day!

So Race Day was last Saturday. I couldn't have asked for better weather and my bike was fixed up (at the start of the race anyway). We woke the gummybear up bright 'n' early to head out to American Fork about 45min away, packed with all my gear as well as hers. Whodathunk we could fill the car when we were just going out for the morning!

Marked up and ready to go. All in purple (including nails)
 and with my ribbon on my arm!

 I was so nervous before the start, I got all my bike and run gear together in the transition area and went out to meet back up with Jim and Annabelle (who I swear was eating every time I saw her that morning!). GB laughed at me while I was warming up, a lot, which calmed me down quite a bit. Then it was time to line up by the pool. It was self seeding so everyone went around going "what is your average time on the swim". I was generally a 5:30 but put myself with the 6's so that I would hopefully not have to pass anyone in the narrow lane with someone comin down next to you in the other half of the lane.


Boy was that swim chaotic! There were still a bazillion people in front of me to start and there were gals breast and back-stroking in the pool. Don't get me wrong, if that is your stroke of choice all the power to ya, buuuut let's be real, your time is not 4-5min for that swim breast-stroking. In any case, my turn came and off I go. And yep had to pass LOTS of people. This was a good thing, as I was swimmin my butt off but kinda stressful too. So in the end my swim time was ~7min for 300m, not great but I had to slow down and breast stroke for a while to get around people in the middle.

Crazy swim. I got my arm out of the water

Oh them jacked up gears! Holdin' em
in place

Next was the bike, 2 loops around this cute lil neighborhood, 1 giant hill and the rest flat or downhill. It was a great ride and my time was ~48min for 12.75mi! It was kind of funny towards the top of the big hill because EVERYONE was slowing waaaay down and there was this bottle-necking effect, musta looked crazy. My gears got jacked up again in the middle of my second loop but thankfully I was already up the giant hill.


And finally the run, no gear just off the bike and go! It feels weird if you ever try it some time and when I do my next race I totally need to work on this transition because of that feeling. My run was decent, I had to power walk up that giant hill but afterwards someone found me and told me that I kept them going because I was still quickly workin my way up, even though I wasn't running at that moment. My run time ended up being 28min for about 2.9mi

Almost there, don't die yet!

So overall my time was ~1:29, I finished faaaar from the bottom and in the upper half of all the gals that finished. I was so proud of myself, I actually did it! Annabelle was chillin the whole time in her stroller and cheering me on. Even after I was done and we were just sitting around on the grass she would randomly start clapping and say "Yeah mama, yeah!" What a great cheerleader and motivator.




Most importantly, I was able to raise $700 for CHASA throughout stroke awareness month. Thank you so so so much to everyone who donated to my streak. It means the world to me to have your support and to know that each and every person loves and wants the best for Annabelle as well!

My biggest cheerleader and the reason for it all!

Adversity...

My daughter is going to face it, she already does on an almost daily basis. She's just so awesome I don't think she realizes it, and I'd love for her to hold on to that as long as possible.  But when she does realize and she wants to just say "fughettaboutit" I think it will be important to be able to share with her different examples of how everybody everywhere has SOMETHING they are trying to overcome, so that she #1 doesn't feel alone and #2 keeps on trying to do her best.

Two days ago I was going out for my final bike ride before race day (which is tomorrow) and as I was going up a hill I tried to downshift my gears so that I would actually make it to the top. Well something popped somewhere and my gear would not stay in place, it would "default" spring back to the highest flippin gear! I finally made it to the top of the hill and hopped off the bike to assess the situation, remind you I have absolutely NO bike experience other than recreational. I had no idea what was wrong and could barely ride on a flat surface with how it was resisting me, let alone try to ride in a race. So there I was throwing a fit at the top of the hill, miles from home... very becoming of an almost 30-year old mom (luckily I was kind of in the middle of nowhere so no one saw and this is the only account of that so shhhh). I finally made my way back home by holding the gear in place manually for half the ride then walking my bike the rest of the way.

What in the world does that story have to do with the first paragraph? And why is she racing without knowing the first thing about the mechanics of her bike? Great questions... To the first: while it ended up being an easy fix and there was not much for me to throw a fit about on the hill, I didn't know it at the time. I felt down and out and a bit defeated as it was only a few days before the race. However, once I got the bike home I was prepared to get the it into the shop, and if it wasnt ready in time I was also ready to go out and buy a new one. I am going to finish that race!  Adversity, although minor, overcome! I realize this does not even compare to what Annabelle deals with on a daily basis but it is a similar feeling and while I could have just said "oh well, guess no race" I instead put on my big girl panties (Jim hates when I say that) and moved forward. And like I said, now the bike is fixed back up and ready to go.  As for question 2 above: ummm... I don't always think things through and just kinda thought I could ride with no issues coming up?... I have since seen how to refix the gear issue if it happens again and kind of know how to change the tires if they go flat, although I feel like that might be a very looooong process for me.

I did a very easy swim this morning just to get the muscles moving, as this week has purposly been very lax. I am still hoping I don't die tomorrow (or freeze, the temps have dropped around here in the past few days and we may be swimming in like 40-something deg weather... Brrrrrr).

Mmmm chicken wings... she's a true Buffalo girl deep down :-D

Happy Happy Birthday Baby...

Well back to the grind this week. After that last pukey post Annabelle started havin some good blow outs, ewwww. And then mommy got it! bleck for being up all night and then not being able to move off the couch for a day and a half.


Last week the lil one and I traveled to NY for her 2nd birthday party (take advantage of the free under 2 flying as loooong as possible). It was an exhausting but wonderful time! Annabelle absolutely LOVED her Elmo party. She woke up from a nap to a decorated house and going "Oooh elmo! Ooooh Ernie! Ohhhh Abby!" when she saw the curly-q's hanging from the ceiling. Then she went into the living room and almost died when she saw the Elmo balloons that her Aunt Kris had gotten her, "ELMO BALLOOOOON!" Oh my gosh it was too funny! Annabelle also loved being the center of a lot of attention from the whole family (she's such a ham) and meeting new little friends that are about her own age. All the little kids seemed to get a kick out of the pinata, as did some of the adults (tip, hide some mini liquor bottles in the pinata, the "big kids" were all over it once the pinata broke open!)



On her actual birthday, Jim and I took Annabelle to the aquarium. It took her a little bit to warm up. When I first tried to put her down so she could see some frogs she literally screamed and wrapped her arms around me super tight in a scared way, that was the first time I've ever seen her react like that to something. She loved the otters though. She got lots of presents and lots of junk food, I'm pretty sure she had a great day.

Playing with the kitchen her daddy and I made for her

Enjoying some birthday cupcake and ice cream

So like I said, now it's back to the grind. I'm back to work, Annabelle had therapy this morning and Jim is back to school. Annabelle is going to get casted for her righty arm next week by her OT with a removable cast so that we can do a bit more intensive work with left hand. The OT has been hesitant but I was pushing for it. OT is worried that Annabelle will spend the entire time just trying to get the cast off. She was also worried that if  we did "real" constraint therapy and left the cast on all the time, she could get really hurt. She still falls over a fair amount and does not have a protective reflex to put lefty arm out to cushion the fall. So it won't be on all the time, but I think Jim and I need a lil more structure to work on that arm more. Saying "use lefty" just ain't cuttin it no more!  Her botox should also be around its peak now too. I'm sad to say I have not noticed a HUGE difference like we did with the last round. She is easier to stretch but she is still ignoring her left arm most of the time, fisting at least 50% of the time and her gait is none better (in my opinion). We shall see...

So with all that going on, my triathlon training kind of took a backseat. BUT now that we are officially into May and streaking month and the Tri is only 17 days away I'm back on my regular schedule. Since the weather is much nicer now I've been able to bike and run outside a bit- OMG is it so much harder than at the gym... Gotta keep pushin for now and geeze I hope I don't die on the day of!!!

Pukiness

Tahehe, medical terms? yeah right, I'm a pediatrician I talk in "mommy terms"...

Alright so pukiness + toddler = totally normal viral gastro. Still a big boo and not fun but when your kid has hydrocephalus and is not shunted and daycare calls and is all like "She seemed totally fine, running around playing then (((bleck))) twice. But don't worry she's back to running around and playing"... no fever, no being clingy, no diarrhea. It makes me nervous. A symptom of increased pressure in the beautiful big head of hers would be vomiting.

Got her home from daycare yesterday and she was her super cute normal self, lotsa kisses and hugs too for mama. But then she took a lil nap with her daddy and when I went to get her up a bit later she immediately puked on me. Totally fine and smiley afterwards.  Then I was a bad mommy and pedi and let her gobble down her veggies for dinner (she asked for them!) but then even worse she pounded her sippy of water (oh she's gonna be fun tailgating someday)... and there it was again, although this time she was pissed about it. This was immediately followed by bath and cuddle/story time

All logic and reason and medical training points to the 'ol viral gastro as being the culprit here and I'll be totally honest when she felt a bit warm last night I was hiphip-horay'ing in my head. Didn't actually take a temp 'cause she was out after story time.  She was a bit fussy overnight and is still sleeping now (late for her) but to be totally honest I'll be doing a huge happy dance once she starts in on the big 'ol poopy diapers, I'll even take the blow-outs (who asks for that?)

And you thought you were a neurotic mama.... ;-)

Finding Easter eggs in the back yard- greatest toddler entertainment EVER!

Second Verse....

A lot worse than the first :-( boo! Annabelle had her second round of botox this past week, needless to say it did not go as well as the first and was overall kind of a crappy experience. She did pretty well throughout the morning eating just her jello- her daddy kind of tricked her into trying it and then she decided she really liked it! We spent a lot of time playing outside to keep her occupied and not wanting to eat.

We got to the hospital around 12:30 and she actually continued to do pretty well, though was starting to get really tired since we were in the middle of naptime.  She played with some of their toys and ran around the unit with Elmo in a stroller. She got to play with the anesthesia mask again and picked out her cherry smell for the gas.

Then it was time to take her back, and rather than go into the procedure room, my lil miss wanted to continue running around with Elmo (mama strike one). After a bit of coaxing we sat down in the back room. Unfortunately, rather than letting me hold her with the anesthesia mask to her face like we did last time, doc wanted her laying down on the table (mama strike two and prolly even three 'cause she does not like to be laid down at home let alone in a strange place with new people). I had to pin the poor girl down to keep her from grabbing the mask off her face (which dude smooshed on rather than holding it near her- did not need to happen that way) all while she was crying hysterically (mama strike four). I sang her her bedtime songs and had to really work to keep my voice from cracking in front of everyone. Then she was out and I ran out of the room crying...  BOO!

Procedure itself went fine and fast as expected. But then lil miss woke up and she was NOT PLEASED! Last time I walked in and she was sitting up with a cracker and was all like "oh, hi mama" with a smile on her face. This time she was tearing at the BP cuff and pulse ox and wanting to get out of the bed. She wanted to sit up then be held then get back down again. She wanted her fruit cup that I had brought but then got mad for I don't know why and threw some fruit on the floor. Wanted her juice then didn't.... Oh I felt terrible I just couldn't help her to calm down and feel ok. She was such a crank that the nurses in recovery were trying to get her out of there ASAP!

Luckily she had calmed a lil bit by the time we got outside, so we sat on some benches and let her finish her snacks and juice. She cuddled up into my arms while we walked back to the car and seemed to be doing much better, thank goodness! After that we took her out for a real lunch and she took a lil nap in the car. By evening she was back to her good 'ol self laughing and teasing.  It was just this mama that was traumatized for the rest of the night!

She had PT the next morning and Miss Beth was kind of amazed and felt like Annabelle had no tone in her lefty leg (although the botox really should not kick in for another week or two!). She also felt that Annabelle's right ankle was looking good and took her right brace off!!!! YaY! One of our new assignments is to have Annabelle walk around the house a bit more without a brace on lefty- her left calf muscles are starting to atrophy (get small and weak) because she does not go up and down at the ankle (plantar- or dorsiflex for all you med nerds out there). 

Oh my love-hate relationship with Botox, thank goodness it's only a once every 4 month occurrence and hopefully we will see some more improvement over the next few weeks!

Coloring Easter eggs all on our own this year!

Toddler-hood

Check out what I got crafty making...

That's right, a "time out chair" hahaha.  I just hope it works 'cause my lil diva thinks it's a great time to sit on things at her level- the bottom step, her lil chair, the pillows etc... it may defeat the purpose but we'll see.  Wow, a time out chair! Almost 2 years ago I would have never thought I'd be making something like that. So while we're getting into some "regular" toddler-type behaviors with the hitting and throwing things when she is upset it's an incredibly wonderful thing and to be totally honest I think it's great (ok maybe not after a long day at work and she's tired and throwing herself on the floor and hitting because dinner wasn't ready 5min ago but you get the idea...). She has the ability to decide what she wants, let us know, understand our answer, know that she doesn't like that answer and then try to do something about it. I don't really know how many people really appreciate the complexity of all that but I sure do! Let's just hope it's a temporary thing and isn't going to last for years and years and years, like maybe her mommy did :-P

Potty training? psssshhht... not even going there. She sat on the dang thing for one day. Now it's Me: "Annabelle do you wanna sit on the potty?" Annabelle: "No, all done, all done". Me: "But you're not all done, you didn't go peepee in the potty." Annabelle shaking head vigorously: "all done, all done."... 'k fine, she's not even 2 yet, I'm not pushin it.

In other news, I'm pretty sure the botox is completely out of her system...boo! She's fisting a TON with lefty hand over the past few days and not really paying as much attention to lefty as she was before. Her gait is about the same now that she is regularly using the larger brace (confession: I know it's a custom one and we kinda got too big for the pre-fab ones but I have no idea what kind of brace it is, I should really look). We meet back up with her rehab doc this coming week and April would be the earliest we could do another round, maybe we can increase her baclofen dose for a little while, we shall see.

Our second birthday is coming!!!! I'll be taking the little miss out to Buffalo for her party so she can see everyone (and then I have an excuse to actually throw a party!). I was gonna scale back buuuut we're doing elmo and I found soooo many cute and crafty elmo things to make for a party.... it's on!

Helpin' to make pizza on family night, followed by the viewing of "Tangled"

I'm STREAKING!!!!!

So I realize it's a little early but May is Pediatric Stroke Awareness Month, and as part of the campaign to raise awareness and funds people are asked to "streak" throughout the month...

"Pediatric stroke survivors work hard everyday, whether it’s doing therapy or finding a way to adapt a task, and we will honor their hard work by committing to a 31 day streak." The streaking is run by the Children's Hemiplegia and Stroke Association (CHASA) and you can read more about what the streaking donation go towards on my sponsor page...

Tri to Streak Sponsor Page

My particular streak will be training for a triathlon. The tri I'm lookin to do is actually the 19th of May which is why I'm getting started a little early! I can use all the training my butt can get :-) Now there are a few reasons I decided to do a Tri as my streak.

#1- For Annabelle. It's hard and it can be painful. It's even harder when the majority of your training days you gotta get up at 4:45am before work. I want to be an example for Annabelle, so she knows that she can do anything and overcome huge obstacles by working hard at it, even if it's hard and not always a ton of fun.

#2- I started going to the gym, just in general, a few months ago because my BMI was creeping awfully close to the "obese" category (no lie, ugggggh). Now that I'm down a few I wanted to do something to keep myself motivated, and what better way than publicly doing a tri and not wanting to make a fool of myself. I want to stay as healthy as I possibly can for my little girl. If she ends up needing a lot of help as an adult I want to make sure I'm around to be there for her.

#3- For myself. Since starting to get more healthy I have felt better about myself, had more energy and overall been a better mom to Annabelle. It's been a great way to channel my frustration, anxiety and sadness over her diagnosis and all that comes with it. Go figure I also have a higher tolerance for her naughty toddler behavior that has started even before hittin the "2 year-old" mark.

So those are some of the reasons. I'll try to update any interesting things about training on here, in addition to Annabelle's awesomeness. Speaking of which, thanks to the hubby, I have figured out how to get videos and pics off my iPad and onto my computer so I can put up Annabelle's before and after botox gait videos!

Brushed our own hair AFTER mama already put it in a ponytail!

Botox round 1

So we went ahead and did it in the beginning of January. I was hoping to put up some pics of "before and after", particularly with her ankle and gait so that I could go "Oh gosh, look at what a difference!" But alas, that ankle still was collasping in a fair amount. And the night splint we had made for her to stretch out her calf muscles was too tight and we had some skin breakdown... so she got casted and I couldn't see her ankle anyway.

Before- Lefty ankle collapsing in and some hyperextension at the knee

     

Her gait did in fact look much better with the cast on. There was a lot less hyperextending of the knee, her hips were more equal and her squats were much better. And once the cast came off, OMG the ability to stretch that girl... it was fantastic, stretches had not been that easy since she was little little!

After- casted and running around

I think lefty arm benefited the most from the botox, Annabelle was much easier to stretch here as well BUT the huge thing has been her paying much more attention to lefty arm! It's kind of funny sometimes because she'll treat her hand like another friend "Hi lefty, hi lefty." and "Lefty open". She's also reaching out from the elbow much more on her own to chase after bubbles and using lefty to help hold her babies, because we need to carry around at least 2! We're still working at her actually grabbing but on her own, because that's the only way girlfriend likes to do things, she has opened lefty and grabbed objects a few times!!!

Overall we will likely continue to do botox in the future as we saw a benefit with a total low dose for her weight. I think next time we will see about increasing the amount of drug that goes into her leg and maybe slightly higher in the arm and thumb, it wore off awfully quick!

Making Valentine's to send out to the fam!