Helen's Hope

Helen's Hope: March 2014

Friday 7 March 2014

March 7 2014

Helen asleep when I got here. She's quite sleepy again today. She was watching Harry Potter when I got here. I out Scrubs on when it finished and she woke up. 

One of the nurses came to do her BM.  She really doesn't like doing them on H so she asked if I would do it.  I said to Helen that V was a big baby not wanting to do it.  H started smiling!! A massive smile that lasted for ages. V and I were wetting ourselves laughing at the timing of it - don't know whether it was deliberate or not but the timing was perfect. 

The physio came to see me. They are going some research on whether physio is beneficial on students with brain injury. He wants to use H as one of the cases, along with others. He will be using figures and measurements from the last 6 months and the next 6 months to show improvements or not. I agreed and he will get me a consent form to sign. 

He says that H is doing well with physio. Both sides of her body are the same, neither is stronger than the other. The only difference is the foot drop in her left foot.  He doesn't think that she needs any more Botox for the time being. 

Botox is used to treat the muscles that cause spasticity.  In a traumatic brain injury this spasticity, or increased tone, is due to damage to the brain which causes over stimulation of nerves and therefore contraction of muscles in the body.  

Why does treating spasticity matter?

Spasticity is not always harmful. Patients with a combination of muscle weakness and spasticity may rely on the increased tone to maintain their posture and aid standing or walking. There are patients with spasticity who need little or no treatment. However, muscle tone may change over time and therefore requires repeated assessment and management.
For some patients spasticity can be painful, distressing, and a potentially costly cause of disability. Secondary complications arising from spasticity include impaired movement, hygiene, self-care, poor self-esteem, body image, pain and pressure ulcers (see Table 3). These may be distressing for the patient and difficult to manage for involved carers and health professionals. In some cases they may interfere with rehabilitation and can increase the cost of this and longer-term care over time. For example the direct cost of healing a pressure ulcer (Grade 4) has been estimated at £10,551 over the period of healing (Bennett et al 2004). Successful treatment can improve physical functioning and can also prevent secondary complications (Boyd et al 2000).