Wednesday, August 26, 2009

The unexpected connection between hips and lips

Max polished off four bottles of the witches' brew that Carolyn and our friend D. ("the baby whisperer") have been concocting lately. I hear the blender whirring and I see the superfund-worthy residue in the bottles after he's done, but I try to ignore what's going in. Peas, that's okay, but maybe they're mixed with ... milk? That seems less okay. But never mind that; the key is that Max can now routinely tackle a 60 cc bottle. Today he got down four of them, for a total PO intake of 240 ccs.

After a month-long hiatus thanks to the confluence of vacations and being quarantined for the pox, Max was back on the therapeutic grind today, with visits from physical therapist L. and speech therapist D. Both commented on Max's development since they last saw him. L. noted that Max had made one of his goals--sitting with assistance for five minutes.

L. gave Carolyn lots of tips for how to manage Max's hypertonic legs. Rather than supporting Max by holding him at mid-torso, she recommended holding him at the hips as much as possible, and rotating them as a strategy for reminding Max's nervous system to relax his leg muscles. As L. said to Carolyn: "You know the old saying--you'll never get the lips without the hips". To be clear, this is what passes as humor among physical therapists and not at all dirty like you might have been thinking. Basically, no kid masters full oral competence without also gaining some control over tone in the legs (I think that's what that means). In other words, Max's two major challenges--controlling his legs and mastering eating--are at opposite ends of his body but are deeply connected.