stable in movement/freedom to move
I didn’t know at the time,
But it would be months before we realise,
Just how much his speech is setback from his surgery,
Yet my only tactic in the present is to channel my despair into productivity,
And so I go into therapy all guns blazing,
Fundamentally a plan of attack.
Because nothing is ever as straight forward as we’d like to believe,
I am conscious of the fact that the assault to Isaac’s system is so wide spread,
Beyond just the disruption to his voice,
That his recovery cannot simply be only about speech therapy.
We must once again bring it all back together,
To formulate our plan.
We must look forward,
The single most profound goal that encompasses all,
Almost blindingly obvious,
But took me to this point to highlight it undoubtedly,
Which crosses over all disciplines in therapy,
All aspects of Isaac’s life,
Which I write down,
Almost buzzing with a high,
And a new sense of fiery direction is,
Stable in movement…. Freedom to move.
The surgery took any sense of stability away from Isaac,
It shackled him with fear,
And a new sensation of self was left in it’s wake,
Which wasn’t familiar to him,
Taking away his freedom as he knew it,
And virtually freezing him in uncertainty.
So we see,
Beyond the increased dribbling due to excessive efforting,
And the dropped open jaw from intense concentration,
As well as the lag of the tongue trying to find it’s way around a foreign mouth,
We see the W-sitting dominate again,
Lost is his freedom to side-sit,
To comfortably be slightly off his centre of balance,
We see the overriding left eye his seemingly only available point of vision,
Turning his head dramatically to view anything in sight,
We see and feel the tensity of his locked neck and shoulders,
As his right arm finds its default pulled-back position,
All in a bid to help himself feel stable,
In the only ways he knows how,
When his body feels like its in crisis.
And while I feel helpless,
Our team have the expertise and direction Isaac needs,
And the tonic to help me see the way forward.
We must reintroduce many elements touched on regularly,
And new techniques which might just help settle his system,
Predominantly we must reduce all threat.
We help him hug himself while on his back,
Arms crossing the midline in a giant bear-hug,
We show him how to narrow his legs when on his knees,
To tuck the feet under his bottom reducing the pronounced internal hip/thigh rotation,
We roll him this way,
In a nice way to help him revisit the diagonals,
And freedom in his pelvis.
Eye patching is reintroduced to help break the bias,
And ease the squeeze through his neck and shoulders,
We must help him release his right arm,
If for no other function than the give him a chance to rest at this point,
Allow him to lean onto it to help him feel stable enough to lift and operate his left,
We need to give him confidence once more on his bottom,
By showing him how to use his upper body to move between flexion and extension,
By curling his core and straightening it to become tall,
To help him see he doesn’t need to be afraid,
If he knows where his head is in space,
Can confidently correct his position to restabilise.
We do lots of work on his tummy,
And right hip,
To seek the freedom and fluidity he needs to bend his right leg,
Which is unfamiliar to his system,
And we roll him across the therapy table gently,
To loosen the tension,
A show him the feeling of his body being in multiple positions,
And moving through it with ease,
By being on his tummy or back we eliminate his fear to move.
We lengthen his neck in the safety of child’s pose,
Curling him peacefully,
And moving him through to sitting by anchoring his pelvis,
And keeping the head tucked,
To fight off the power of spasm that throwing his head and shoulders back invokes.
And by the end of one session our practitioner is able to get him into standing,
With flat bare feet,
And a reduction in tone we hadn’t seen since before surgery.
We focus again on roller work,
And the control required in order to put his hands out in front to catch himself,
We explore forward and side bending orientations,
Finding the expansion in the shoulders and trunk,
Lost in his protective mechanisms after the operation,
Seeing a fantastic extending of his legs,
Which is very absent when in standing.
Because he feels safe enough to release the body,
So tight with fear of repercussions,
It hadn’t let go since pre-op.
Speech sessions now occur in lying down,
To continue the reduction of fear and effort,
To help Isaac be relaxed in his whole body,
In order to rebuild on lost function.
His words are no longer the focus,
But the simplicity of individual sounds,
“MM” “T” “FFF” And “Shh”,
For without the sounds the words will never come,
The idea of bringing his lips together again,
His tongue moving separately from the jaw,
All imperative if we are to regain the conversation,
And these currently cannot occur if there is tension and effort.
So the patience must once more come in spades,
If we are to help Isaac stabilise and find his freedom to the degree he had before surgery,
The effort must be replaced with ease.
The fear must be replaced with confidence.
And we all must breathe through this process collectively,
If we are to make it through.
The End of Chapter Sixteen.