28 Julai 2009

Adik tak hantar kakak ke tadika hari ni seperti biasa kerana abah yang bawa kakak dan abang ke sekolah ngan motor.Kereta abah breakdown semalam disebabkan fuel pump rosak. Dah dua kali rosak, 1st bln Januari tahun ni, bulan ni kali kedua. Baru 6 bulan rosak lagi. Mekanik kata nasib-nasib lar, kalau boleh katanya jgn amal tinggal myk kat 'e' selalu sbb boleh merosakkan fuel pump.

Hari ni adik ada appointment untuk ujian pendengaran dan jumpa rehab specialist, Dr Baha di Hospital Serdang.

Abah minta tolong ammah Ja dan ammah Na bawa adik. Abah akan bertolak dari ofis ke Hospital Serdang. Ummi pun sama. Lepas punch dan minta kawan-kawan ganti kelas, ummi akan bertolak ke hospital. Semua jumpa kat sana.

Ammah mandikan adik. Pakaikan baju dan seluar cantik2 biar nampak adik hensem. Tengah adik bersiap, tup2 dengar suara abah. Laaa.. Abah tak jadi masuk ofis. Abah cakap tak sempat. Dah lewat. Kita semua pergi ke hospital dengan accent ammah Ja. Pukul 8 pagi bertolak. Appoinment pukul 9. Abah ambik jalan highway ke Serdang. Alhamdulillah, jalan clear. Jadi sampai awal la pulak.
Parking lot penuh. Mencacah-cacah juga abah cari parking. Dapat kat tepi jalan nun jauh di belakan. Tapi yang bestnya adik boleh jalan-jalan atas pavement sambil duduk kat bench. Ammah Na buatkan susu. Dia ingat adik belum nak, jadi ammah Na masuk air panas lebih sikit. Sekali bila nampak susu, terus adik cakap "cucu! cucu!"..

Kemudian adik jalan sambil abah dan ammah Na pimpin. Ammah Ja snap gambar dan ambik video adik jalan.

Kebetulan ummi pun sampai time tu. Jadi kita semua naik escalator ke tingkat 2. Klinik ENT kat situ. Masa abah dan ummi urus pendaftaran, adik main kat sudut mainan. Ammah Ja temankan. Adik masuk dalam kandang bola. Banyaknyeee bola.. Macam2 kaler. Adik got excited. Hampir2 terjatuh..Adik campak2 bola keluar.. Adik seronok. Tapi Ammah Ja asyik marah je tak bagi campak ke luar. Kat sini adik jumpa kawan umur 1 tahun lebih. Mama dia cakap dia kemungkinan ada speech problem. Sebab dah umur 1 tahun lebih, dia hanya boleh sebut papa dan mama je. Tak pernah cakap 'nak', 'susu' ke.. Sebab tu doktor nak check hearing dia kot2 ada problem..

Tapi tak sempat lama berkawan, nurse dah panggil dia. Adik kemudiannya naik kuda biru, naik rusa merah dan main gelongsor. Tengah seronok main, nurse dah panggil..

Kat kaunter, nurse tanya berat adik. sambil2 tu nurse trgkan bhw kurang upaya pendengaran boleh diukur dengan mengunakan Ujian Kebolehan Mendengar oleh audiologis menggunakan alat yang dinamakan audiometer. Untuk ujian nI, patient mesti tidur. Adik pon diberi ubat tidur 10ml. Berat badan mennetukan kadar dos yang diberi. Tapi adik tak boleh lelap. Jenuh ummi suruh tidur. Ammah Na dokong. Abah pun cuba tidurkan tak dapat. Adik ngantuk.. Tapi adik tak nak tidur. Dalam kul 11 baru adik ttidur dan audiologis pun suh masuk ke bilik ujian. Baru je audiologi masukkan wire dan test bunyi, adik tersedar dan tak mo tidor dah. So, prosedur tersebut tak dapat diteruskan.

Amahja pon cuba tidurkan adik,
tp adik x nak tidooorrrrr .. nanak

Abah tanya nurse, kot2 boley bg sekali lg ubt tido, tp nurse ckp itu dos mksimum utk knk2 sberat adik. Nurse suh bg mkn & main ng adik bg penat dengan tujuan supaya adik tido lena. Ummi lak de kelas kul 11.50 pg, so kena pergi sekolah balik. Abah pulak bw adik naik keter, bukak aicon kuat suh adik tido. Berjaya jugak akhirnya tidorkan kan adik. Dlm kul 2, bw adik ke ENT sekali lg utk ujian pendengaran. Sekali lagi, bila letakkan wire dlm telinga dan bunyi alat tu mgejutkan adik. Kali kedua prosedur terhenti. So boleh dikatakan ujian pada hari ni gagal.

Nak tak nak, tpaksalah amik appointment lain untuk adik pada 3 Ogos iaitu mggu depan.

27 Julai 2009

Pagi ni, lepas hantar kakak ke sekolah adik main2 sekejap. Sebelum turun rumah, adik muntah sikit.

Ammah Ja urut kaki dan tangan adik dengan minyak aroma.

Adik jatuh waktu jalan kat sofa dekat dengan komputer abang. Macam adik tak boleh nak imbang badan sangat.

Adik tidur. Bangun tidur, adik mandi dan bersiap ambik kakak kat tadika.

26 Julai 2009

Adik jatuh benjol dahi masa rancak main dengan kakak dan abang.

Hari ni adik tak muntah alhamdulillah.

25 Julai 2009

Muntah.

24 Julai 2009

Adik pi hantar kakak ke sekolah.

Adik tak pi bodi harmoni.

23 Julai 2009

Adik pi bodi harmoni ngan ummi dan ammah na.

Adik dok seat depan sambil baca buku yang ammah su beri masa kat hospital.

Adik muntah banyak.

Ammah na cakap, mungkin sebab adik baca glitter book tu, panas dan silau..

22 Julai 2009

Adik pi Bodi harmoni tapi sampai Serdang ummi patah balik sebab ummi tak sihat.

20 Julai 2009

Adik pi bodi harmoni sebelah pagi ngan ammah ja dan ammah Na.

Ammah ja test adik dok depan sorang2 pakai seatbelt macam waktu pi hantar kakak pagi2. Alhamdulillah adik ok je. Adik behaved very very well sepanjang perjalanan.

Sampai sana, adik jumpa Dr Sulaiman. Dr nak tengok progress adik, lepas kena strok tempoh hari. Adik dok atas kerusi sorang2. Adik properly behaved. Dr suruh adik angkat tangan kiri adik. Dia nak tengok setaat mana adik boleh angkat. Dia kasi pen suh ambik. Adik nak capai dengan tangan kanan tapi dr tak kasi.

Dr cakap foot adik stiff. Dr looked worried. Dr macam prefer kalau adik pakai something to support kaki waktu tido 8 jam. Untuk lembutkan kaki adik. So nanti time appointment untuk fisioterapi kat Hospital Serdang pada 3 Ogos nanti, nak kena consult ng dorang.

19 Julai 2009

Hari minggu ni semua bangkit lewat. Abah, ummi & abang tidur balik lepas solat subuh. Semalam abah cakap hr ni nak riki tempat kak raw di Gedangsa, tp dah tidur ni.... selamat larrr. Bangkit-bangkit pon dah kul 10 lebih, abah ajak kita org pi pasar cari lauk, tp last2 x jadi jgk... lepak lar kat rumah je kami pagi ni...

Dalam tengah hari, ummi sms ama ja, amahna dan amumi, ajak dorang pegi ke medic massage en Shamsul di Bandar Putera, Kelang untuk urut dan buat fisioterapi exercise adik. Abah yang suh umi ajak ammah & ammu sbb abah takut adik nangis mcm hr tu bila pakcik shamsul urut. alar... amana x der sbb teman amazie balik ke IKBN Dusun Tua mlm td. So, amumi & amaja je ikut sama2 ng abah, ummi, adik, abg & kakak. Penuh accent amaja. Abah cakap kalau dulu2 masa abah, amahja,amuje,amahsu,amudin,amana & amumi kecik2, kereta tok ma sesak mcm sardin pi padang pak amat. mana taknya, 7 beradik + tokma & tokmok. 9 orang dlm satu kereta... he he...

Sebelum ke kelang, abah nak belanja makan kat Kulaifornia Restaurant atau Zee Zee cafe yang femes dengan masakan asam pedas, ayam goreng kampung, gulai kerutub & mcm2 masakan Kelantan & Johor. Restoran ni kat Prima Saujana Kajang (dekat Giant). Tghri td abah tonton JJCM@tv3 citer pasal tempat makan area kajang.. tu yg nak ke sana tu. tp abah ni terkenal ng tabiat suka tukar2 plan, masa otw ke sana abah ckp tak jadi lar ke sana, takut lmbt gi massage medic pakcik Shamsul. Abah pon bawak la ke La Rizz di Sg Merab... tp dah habis lar pulak lauk2... kalau tak, abah ckp boleh makan sotong & kambing panggang. So abah pi pulak ke food court depan INFRA. sama jugak.... lauk dah habis... tp makan jugak lar apa yg ader. dah tak der rezeki kan...

Lepas tu kami terus ke Klang dan tiba kat sana dlm kul 3 petang. Abah, amumi dan ummi pi solat zohor dulu kat surau sblh rumah pakcik Shamsul. adik terus gi urut, mula2 adik nangis.. amahja, abg & kakak siap pujuk adik. Lepas dorang pujuk baru la adik sporting... Pakcik Shamsul dapat urut adik lebih dari sejam, mulu2 urut betis, tangan dan seluruh anggota badan mgikut titik-titik elektromagnetik.

Balik dari kelang, amumi sms amahna ckp nak pi amik. Tapi... amahna ckp dia, amahzie& najla otw nak pi giant. sedang molek lar... kami pon pakat untuk bertemu kat sana. Masing2 sonok, dapat lar jugak pi makan kat Kulaifornia Restaurant atau Zee Zee cafe sptmana dirancang tgh td. Abang paling sonok nak p Giant sbb nak mintak abah beli reket Yonex. Abang ni selalu ckp abah & ummi sayang kat adik sorang jer, sbb bagi spenuh phatian kat adik. Kakak lagi lar... cakap kat semua2 orang, abah & ummi selalu beli mainan kat adik, sbb tu kakak ckp abah & ummi sayang adik sorang jer. Abah recal balik teringat masa appointment dengan Dr Baha, rehabilitation specialist di Hosp Serdang tempoh hari, Dr Baha tanya ader tak perasan pasal perubahan sikap adik @ abang @ kakak. Abah terus jwb, nmpk mcm biasa jer, x der apa2 pon. Tp bila jd gini... oooo ... ini lar barangkali maksud Doc tempoh hari...

Pi Giant, abah beli reket abg, mainan utk kakak dan bola utk adik.... semua dpt, baru lar adil. he..he.. he... Lepas tu pi makan kat Kulaifornia, amahja belanja. Habis2 tu kami balik rumah... penat dan terus tidor..

18 Julai 2009

Amah Zie sms amah Ja bagitau nak datang rumah adik dengan Najla. Best adik dapat main ng Najla & kakak & abang. Main basikal, main buai, main mainan... Tapi hari ni abah lak cadang nak bawak adik gi Body Harmony kat Subang Perdana, pastu nak gi urut kat pakcik Shamsul di Klang. Kalau sempat, abah nak gi riki tempat Kak Raw di Gedangsa. So abah tangguh lar.. pergi besok, hari Ahad, insya Allah.

Dalam pada tu, abah call En Safuan, physiotherapist kat Hospital Pakar An-Nur bertanyakan perkhidmatan fisioterapi & occupational therapy yang disediakan di sana. En Safuan maklumkan kemudahan fisio di sini terhad untuk chest sahaja. Beliau pon cadangkan supaya buat di hospital kerajaan seperti Hospital Kajang kerana kemudahannya termasuk gym yang lengkap. Tapi itu lar, appointment kat hosp kerajaan, lama2 sekali.. al-maklum, ramai patients.

16 Julai 2009

Pagi ni adik bangun lambat lagi.
Pukul 9 pagi baru adik guna inhaler oren.
Adik batuk2 hari ni. Mungkin sebab jerebu.
Adik kena pakai inhaler biru balik. Ammah Ja bagi pukul 10am. Ummi cakap bagi 6 jam sekali.

Lepas minum alfalipid, adik minum susu. Muntah lagi. Mungkin sebab ada kahak. Entahlah.. Nak cakap sebab banyak minum susu, adik baru je minum.

Adik tido lama hari ni. (1pm-5pm)

14 Julai - adik bleh duk mcgkung.15 Julai - adil leh pegang ng tgn kr brg ckt2. Hr ni 15 Julai ke Bodi Harmoni Energy Centre, Subang Perdana.'Vein Stimulation' adk 70mnt. asyik tidur ats lantai je hr ni,baling botol susu,tpwr maruku & towel.Kt rmh pon pg asyik tdur ats lantai,muntah lg hr ni.mkn pun kurang coz x bg multivitamin kot!

15 Julai 2009

Adik leh pegang ng tgn kr brg ckt2. Hr ni 15 Julai ke Bodi Harmoni Energy Centre, Subang Perdana.'Vein Stimulation' adk 70mnt. asyik tidur ats lantai je hr ni,baling botol susu,tpwr maruku & towel.Kt rmh pon pg asyik tdur ats lantai,muntah lg hr ni.mkn pun kurang coz x bg multivitamin kot!

Kawan ummi bagi hadiah toy hari ni, untuk aktiviti gerakkan tangan kiri adik.

Adik pegang tangan kiri adik dan gerak2kan kat kerusi makan adik. Malam ni ummi paksa adik makan ngan tangan kiri. Sampai merah2 tangan kiri adik.

14 Julai 2009

adik bleh duk mcgkung.

10 Julai 2009

Sejak petang semalam, ummi nampak adik berjalan punggung tertonggek cam nenek kebayan.

Seharian adik berjalan tertonggek2 sebelah.mak dh x bg lg g sana.nek tmh ckp loknya 3 hr trut urut.
amy seacrh blk sekolah g bintang ng acik Fari, dapat 2 mainan adik( teloruntuk aktifkan tgn kirinya.

9 Julai 2009

Jumpa nenek Timah di Selayang Mulia. Adik ok je urut dengan nenek Timah.

Time buka puasa, adik muntah bayak. Habis kotor kedai. Tak pasal abah kena mop lantai.

8 Julai 2009

Adik ada appointment dengan rehabilitation specialist, Dr Bahanordin Jaafar, kat Hospital Serdang. Dr buat referral letter supaay adik jumpa occupational therapist. Next appoinment dengan Dr Baha 8 Oct 2009, 3 bulan lagi. Dr Baha cakap kat abah, kena banyak sabar. Dr suruh isi borang OKU supaya adik dapat hak adik. Dr cakap adik tak perlu pakai AFO atau ambik any medication untuk lembutkan nerves and joints.

Petang 2.30pm adik ada appoinment dengan Puan Hamidah untuk physiotherapy. Adik kena cantum2 kan gelung magnet bagi gerakkan tangan kiri. Adik masuk dalam walker untuk aktiviti berjalan. Appoinment fisio dan OT adik pada 3 Ogos, sama dengan appoinment ngan paediatrician.

I Learn To Walk With My Walker

4 Julai 2009

Pukul 630pagi, adik pergi Gombak dengan ummi, abah dan kakak ke Syifa al-Hidayah. Dapat nombor 16. Pukul 1:05 pm baru boleh jumpa dengan perawat. Berubat sekali dengan kakak. Kakak tak ada sebarang masalah. 15 minit je jumpa. Abah kena baca ayat2 Surah Yusuf (selepas Maghrib/Isya') dan Ibrahim (selepas Subuh) untuk adik.

Lepas tu terus ke Kelang untuk berjumpa dengan En Shamsul, fisioterapis Medic Massage. Abah beli buku untuk urut adik. Adik nangis2 waktu diurut fisio. Encik Shamsul ajar ummi dan abah cara urut fisio dan buat exercise.

3 Julai 2009

Appoinment dengan pakar di klinik pediatrik.
Adik buat x-ray lagi sekali.
Berat adik 10.8 kg. Tinggi adik 70 cm.
Dr Rohaizah bandingkan x-ray pagi tu ngan yang last adik ambik masa kat wad. Dr cakap paru-paru adik dah clear. Tak perlu makan sebarang ubat lagi. Sebulan lagi adik ada appoinment.

Adik dah boleh jalan sendiri 2, 3 langkah. Alhamdulillah.

Physiotherapy 1

Pincer Grasp

• Picking M&Ms out of an egg carton
• Water Bottle Fun. Using clear plastic pop bottles. Using tweezers and chop sticks, have the child place items in the empty bottle (we had removed the label and washed them first). Items can be anything that will tolerate being in water such as plastic flowers, glitter, metal confetti, etc. Then fill the bottle with water which is colored or plain. If you are concerned about the child opening it, you can tape or glue the lid on. This engages the hands and is visually appealing.
• Finally, for kids working on pinch/fine motor, place stickers on the non-affected hand/arm. This way the child has to use the affected hand to remove the sticker. My preschoolers love stickers and love to make pictures with them. A word of caution: to lessen the hold of the sticker, place it on a shirt, etc to minimize the adhesive before placing it on the child. Some of the adhesives are really strong.
• Tissue paper scrunching is a really low tech exercise. Have the child crumple up p bits of soft paper and then throw them round the room. Then they have to chase them by walking or crawling and pick them up with their toes. This helps with hands and feet!

Supination Ideas (Turning the hand over, palm up)

• Ringing water out of a towel by twisting it.
• Turning pages of a book.
• "Guess which hand" games, where something is hidden in one hand, the partner guesses which by tapping the guessed hand, and the hider turns both palms up and opens her hands. If correct the guesser gets a point. If not, the hider gets the point, and so on.
• A simple "Slinky" is a great toy to encourage supination.
• Build with cones (I use discarded spools from textile factories). We build towers or set them up for "bowling", etc. If you place or the child grasps the cone closest to the thumb, the child has to actively supinate at least to neutral to effectively place the cone.
• For older kids, grasping a magnet (adapt type and size to the child's needs) and guiding a magnetic "car" along a path (the path is drawn on oaktag or similar thin but sturdy paper). The path is held with the non-affected hand and the child holds the magnet in the affected hand, under the path to guide the car.
• Benik splints with the supinator straps, especially for children with some active supination.
• Another idea is sand or water play. Scooping up sand or water and pouring into another container, or sand/water wheel toy (Discovery Toys has a good one). Making sand castles, etc use the pronation/supination.
• Using a snack activity such as scooping and eating pudding.
• Placing stickers, stamps, etc. on the inner arm - turn to look at it.
• Playing with money and reaching for change
• "Give me five"
• Fill plastic Easter eggs with varying items; the easier it is to make a sound, the easier the child needs to work. Things that don't make sounds easy make the child work harder. You can actually do a number of motions with these. Supination to pronation, flexion to extension of either the wrist or the elbow, crossing the midline...
• Hiding little stickers on the bottoms of large pegs in a pegboard

Sensory Activities

• Playing in rice, sand, different textures
• Weight bearing provides sensory input
• Be sure to include lots of bilateral activities so she is actively using both hands together. Not a lot of two year olds tolerate direct handling to an affected side, so you need to be creative and fun. You may also want to consider a neoprene splint if she continually rests her hand in a fisted position.
• A tray full of - chocolate pudding, whipped cream, jello - makes a great place to "paint" with two hands - also nice to lick the stuff off both hands.
• We also do the pudding on a marker board easel to help with her wrist
• The classic containers of rice, beans, sand for weight bearing. Just have them get a small tupperware container and bury treasures in it.
• Weight bear on the affected hand into the container while she searches for treasures or search with the affected hand. (Also, works for toes and feet).
• Paint fingernails wild colors to stimulate interest in her hand.
• Colorful handsplints and rings and bracelets.
• Bugs, so we let those rollie pollie bugs crawl on her affected arm - she thought it was very funny. She often painted her arm with washable markers, I think seeking stimulation, and we let her do this.
• Refrigerated cookie dough is wonderful for play with both hands.
• "Indoor bean sandbox". Take a shoebox sized tupperware and filled it with all kinds of raw beans and macaroni noodles, etc. Use it just like a sandbox with shovels and pails, etc.

Different thoughts on hand therapy for children with hemiplegia

• Bilateral upper extremity weight bearing activities and unilateral reach to both side (works on lengthening the involved side)
• trunk rotation (both ways)
• bilateral activities where both hands move together and where one hand stabilizes and the other manipulates
• bilateral and unilateral reaching in different planes in a variety of positions
• holding large light objects when walking such as a ball.
• In terms of grasp try to stabilize the arm as much as possible when grasping eg. rest forearm on the table initially.
• Need to work on wrist extension also for a good grasp. Keep in mind that you may only get to a functional assist on that side.
• A soft thumb abduction splint will probably help with grasp
• Wheelbarrow walking is great for weight bearing.
• Bilateral coordination tasks: pushing a swing with both hands, scooter in prone propelling with both hands, and waving bubble wands in the air with the affected hand is a good way to make it fun!
• To encourage reaching with the involved hand, position the child so that the involved side is close enough to reach to touch a lamp which would turn on and off by touch.
• Cozy coupe cars are great for children with left hemiplegia. Encourage the child to open the door by pushing with left arm. It also helps develop lower extremities to power the car.
• Use squishy balls to squeeze or toys that required gripping in 2 hands. McDonald's Happy Meal toys often require two hands (I know you love this idea as much as I do!)
• Finger foods like pizza and burgers were also helpful in getting the hand involved. Have the child pick up every other potato chip with the involved hand with assistance.
• Try to incorporate these activities into everyday play and routines.

In the kitchen

• Have the child hold onto the mixing bowl with the affected hand and stir with the other hand
• Help unload the dishwasher with the affected hand pulling out all of the silverware
• Putting up boxes of cereal, etc. when unloading the groceries.
• Pouring just about anything - hold cup with affected hand (find one that's the right size)

For the wrist

• Finger painting on easel.
• Shaving cream on the wall of the bathtub.
• Colorforms on a mirror - puts on and pulls off with affected hand.
• Leaning into the wall with the affected hand while she paints a picture.
• Batting a lightweight ball or balloon (like volleyball).
• Play dough activities, pretend cooking (flipping pancakes), and the shaker bottles with corn syrup and glitter, plastic confetti, etc. (can make your own with water bottle, or small plastic bottle).
• Toys with the keys you turn, toy oven knobs, etc.

...playing 'waiter' (hold the tray under the bottom side with one hand)...turn keys in a treasure chest to open it...

Weight bearing

• Wheelbarrowing
• Side sitting and weight bearing while we play board games or do puzzles.
• Pretending we're animals and crawling through the jungle (I mean house!). Take the cushions off the sofa and chairs - jumble them up and hide toys
  underneath - have child crawl up and over cushions and weight bear on hand while reaching for toys.

Bilateral activities

• Catching balls.
• Carrying containers of toys when we clean up.
• Opening packages of CANDY (much motivation) and baggies of food.
• Lots of two handed baby toys - those popping beads, duplos/legos.
• Dressing Barbies.
• Emptying the trash cans.
• Clearing the dinner table (buy non-breakable dishes).
• Zoom football that's on a string.
• Trapeze bar swing in the backyard.
• Stringing beads.
• Sewing - get a embroidery hoop and place fabric in this - hold onto hoop with affected hand and sew with other hand.
• Holding paper down with affected hand and drawing
• Holding paper with affected hand and cutting -
• Pushing a laundry basket with two hands on the floor (fill with heavy phone books, cover with a baby blanket and then put baby doll inside) - do it on
  knees and get in some leg work also.

Balance

• There's a toy called a jump-o-lene that's inexpensive and great for helping with balance.
• Walking on curbs with arms extended.
• Wrestling for fun.
• Lots of swinging at the park.
  

Music and hand play

• Percussion instrument like the marimba might be a good one,
• The glockenspiel
• A tambourine is also a great instrument to use for supination/pronation because it is so visual. Get one of those cute animal ones for children that has a handle in the middle. The weight is more easily distributed.
• He might be able to develop the fine muscle movements needed for writing by doing exercises on the keyboard/piano geared for strengthening. There are some great books available, and he can do the exercises whether or not he knows how to play the piano. The key thing is that he gets feedback-he makes sound when he plays.
• In terms of the right brain/left brain ability, music is one of the only activities that a person can do that requires the whole brain.

Page content created by parents of CHASA and Jeanne Ross, OT, MT

1 Julai 2009

Hari ni adik ada another progress. Selepas terkial2, adik berjaya bangun dan berdiri sendiri untuk beberapa minit. Adik sungguh gembira. Mok, ammah Ja, ammah Na semua tepuk tangan. Alhamdulillah, adik berssyukur. Adik cuba lagi a few times...

bodiheath treatment 70 mins