Tuesday, March 19, 2013



This picture is of Liam at Stars Gymnastics Club. Jamie's Preschool attends Stars for a class once a week. It is so great for the kids to be able to take part in this!

A part of Liam's recovery has included neurotherapy, including PT, OT and speech therapy. Liam saw them daily when he had his first surgery to get him up and walking. When we first came home after his first surgery Liam could stand, but had troubles walking without falling. He had ataxia (shaking) for quite a while, and was weaker on his left side. Liam's tumour was in the cerebellum area of his brain. The cerebellum plays an important role in motor control, impacting Liam's motor skills.

After Liam's initial surgery, he was unable to swallow food/liquids. This was the original need for the feeding tube. The damage to Liam's vocal cord has also resulted in a change in his voice. Liam still speaks in a higher pitch than before his surgery and still has some nasality to his voice.

These monthly sessions are now Liam's favourite, he loves the therapists and all the activities they play. Sometimes we do PT/OT and Speech all in 1 hour, but often just 2 areas in one session.

PT (Physiotherapy)
As with everything, Liam has come very far with his gross motor skills. In therapy, I can see that Liam is benefiting from his Jamie's Preschool gymnastics class. He showed his physiotherapist that he can walk on a balance beam (assisted). Liam can jump forward with two feet very well compared to before. We can see Liam jumping farther every month. From our last appointment to today, Liam is doing much better walking up the stairs, one foot ahead of the other. We also do neck stretches, because he still tends to hold his head one way.

OT (Occupational therapy)
A few months ago, Liam didn't have the strength to squeeze a clothespin with one hand. We've been doing strengthening exercises, so he can now squeeze and pick up toys with tongs! This has given him the ability to hold the pencil so much more comfortably. Liam is not keen on drawing, so it isn't easy to get him to practice a lot. Similarly with the fine motor skills, a month ago Liam couldn't cut with scissors, but he is doing it on his own now.

It is great that Liam loves playing with Lego and putting beads on rope. These have both been very helpful with his fine motor skills.

Going forward, the occupational therapist is arranging to have some longer sessions dedicated to Liam's fine motor skills. They have someone experienced in working with preschoolers who will work with him to help Liam out with Kindergarten. Liam isn't alone at his age in prefering Lego to colouring. But we want to make sure Liam has the strength and ability in his hands, so he doesn't get frustrated.

Speech therapy
Last month, we did something a bit different for speech therapy. Liam played a few computer games to test his pitch. The game tested Liam's range of pitch and helps Liam understand high vs low. They were simple games where Liam spoke into a microphone and a character moved up or down the screen. Liam would have to adjust pitch to move the character and get the reward.

They tried doing a test to check how much Liam's voice is hypernasal. You can hear it when Liam speaks, and his voice is different than before his surgery. They put a mask on Liam's face which sits on his upper lip. He was scared to talk (it is a strange contraption) so the test didn't work. We'll try this again later.

Liam's biggest area of "challenge" at the moment is his "toileting". It's hard to pinpoint the reason for this setback, as he was well toilet trained until late summer/fall. Chemotherapy/antibiotics caused Liam a lot of diarrhea, it seems like the issues have continued ever since then. We've been working with the neuropsychologist and the PT team on this.

Someone wrote a good blog post on the "cost of surviving cancer", the writer's daughter also had Medulloblastoma, she speaks about her rehabilitation.
The Cost of Surviving Cancer - A Parents View


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