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Thursday, May 19, 2011

Trouble With That Right Arm

Yesterday at Rehab, we had a case management meeting to go over Bob's progress, etc. I had been doing some reading/researching and had learned about a technique of using electrical stimulation on the hand to sort of "jump start" movement in not only the hand but the arm, as well. So far, everything that's been tried with his right arm/hand has been a dismal failure, and so, I asked if they could try the e-stim on his hand. I was happy when they agreed to give it a go and quite excited to find that they had a Bioness machine. This machine (which costs about 6 grand) is a "electrical stimulation orthotic", it fits around the forearm and produces electrical stimulation to the muscles that move the hand. I had actually seen a video of this on the internet and the device is pretty cool, and basically the patient's hand will begin to open and close on its own accord.  So you can imagine my anticipation when we went in for Bob's occupational therapy session.

The therapist connected Bob's forearm to the device and turned it on and ta da! ---- nothing happened. So, she took it off thinking the electrodes were not connecting with his skin and refastened it and tried again. Again -- nothing. So, off came the machine and different electrodes put on it and it was refastened a third time. Another therapist was brought in to help troubleshoot. This time, they jacked it up all the way to the highest setting, played around with the different "exercise modes" and there was a barely noticeable flinch in his thumb. A flinch. And that was it.


This was just such a crushing blow. The therapist think that he might have some kind of nerve damage in his arm. Nerve damage. And now I am worried, has the CIDP kicked back in? Or what?

It seems I was more crushed even than Bob, who gave me a look which could only be interpreted as Well, what did you expect?

Perhaps, I do expect too much. Right now, it seems as if his arm is stuck forever in "Stage 2" of Brunnstrom's Recovery Stages.  He has spasticity in his hand (it clenches into a fist, sometimes fiercely) but the rest of his arm is just sort of hanging there, limp.

We do have a follow-up appointment with his neurologist in a couple of weeks and of course I will ask him about this, but it feels as if we've exhausted every known therapy for that arm without any results. And I am feeling pretty much helpless as to what to do or try next....


oc1dean said...

When you see your neurologist ask for a damage diagnosis,that is what areas of the brain are in the penumbra or bleed drainage area, these are partially damaged and can recover with lots of work. have him/her map that to functions. And do the same with the dead brain area. And then get an explanation of how to move/recover the dead brain functions. If you are lucky your neurologist will understand the question but more likely will not answer or just use the brush-off comment, 'All strokes are different, all stroke recoveries are different'. On the arm I would just have them try a regular estim unit because then they can place the elctrodes anywhere on the arm, maybe his nerves are routed differently .

oc1dean said...

One more thing, have them try the bioness on them selves to see if the machine works at all.

Nikki said...

Oh man, that really stinks! Hopefully his arm will move on to the next stage soon!