Gillette Children's Hospital

The occupational therapist from the school district visited our house on Tuesday and did a few exercises with Brady and Ali. They will visit again in a couple of weeks.
The home care nurse visited on Wednesday. She weighed him and Brady gained 14 ounces from last week. We've been adding a little formula to each of Brady's bottles and that has seemed to give him the calories necessary to gain weight. She will be back again on Wednesday.
Brady also has an appointment with his pediatrician on Wednesday. Brady will have his follow up appointment with the NICU on June 29.
The biggest change this week is we finally had our first appointment with Gillette Children's Hospital. Ali went to visit a physical therapist at their Burnsville clinic on Tuesday.
After the evaluation, the biggest concern is Brady's increased tone through the lower extremities including adductors (hips), hip extensors (ability to pull knee down and backward), knee extensors and plantarflexors (ankles). There was also increased tone with elbow extension, wrist extension and finger extension. They also said Brady has a slight left head tilt and doesn't move his head equally both ways (neck muscle tone issues).
Muscle tone is defined by muscle resistance when it is being stretched. Muscle tone can be estimated using a 5 point Ashworth scale. They are: 1) no increase in muscle tone; 2) slight increase giving a catch when part is moved in flexion or extension; 3) more marked increase in tone but only after part is easily flexed; 4) considerable increase in tone; and 5) passive movement is difficult and affected part is rigid in flexion or extension.
Brady's scores on an Ashworth scale were between a 2-3 for all of those areas (1 is normal). The therapist also said that those scores weren't consistent. Sometimes he scores better when you try to move his arms and legs. Obviously, you never want to hear that your baby isn't "normal". However, we're hopeful that we'll be able to work with therapists to improve Brady's muscle tone over time. The therapists showed Ali a number of exercises to stretch those areas with Brady.

The people of Gillette Children's Hospital will work with Brady every other week for the next four months and then do another evaluation.
Brady has really turned into a happy baby. He is constantly smiling, laughing, and cooing. Ava and Casey are fantastic helpers and they both love talking to him and getting him to smile.
We had an active Memorial Day weekend bowling, boating and swimming. We hope all of you were able to enjoy the nice weather and extra time with your families.
With love,
Tyler, Ali, Ava, Casey and Brady