Today was also Alison's annual IEP review. It was pretty straightforward, since the only thing it deals with is her physical therapy. She will continue to receive the same amount of physical therapy services as she has for the last year....once a week for 30-45 minutes. She has exhibited mastery of all but one gross motor skill through age 2 1/2 -- she cannot walk on her toes -- and scattered skills in the 2 1/2 to 4 age range. Most of the skills that she is having trouble with are balance related -- standing on one foot, hopping on one foot, standing in "1st position," stuff like that -- so we will be focusing our efforts on strengthening her leg muscles and improving her balance.

Even though we know that Alison is able to do so much more than she should be able to do, and even though we know that she is still not a typical child, it's still somewhat depressing to see how hard she has worked and how hard she tries and she is still lagging behind. But we'll keep working!

Alison went in to see the pediatrician this morning. We recently noticed that she could not fully extend her left thumb. Being horrified at the possibility that she broke it or something and we didn't even notice, we felt the need to get it looked at. The good news? Her thumb does not appear to have been injured. The bad news? It looks like the tendon in her thumb is being obstructed. In other words, she's got "trigger" thumb. And the treatment for it is surgery to release the tendon. The ped wants to see her again in a few weeks to see if it gets any better on it's own. If it doesn't, then he wants us to have her orthopedic surgeon look at it when we see him in April. Can you believe that of all the things she could need to have surgery for she's going to need it for something totally unrelated to Spina Bifida?

Alison had spina bifida clinic today. It was a rather unremarkable appointment, and we like them that way. Her doctor continues to be thrilled with her progress. A recent discussion on our e-mail list prompted us to ask some questions about TES therapy and if the doctor felt it might be of any benefit to Alison. He was very open to the idea of trying it, so much so that he was ready to write us a script for it today if we wanted it. There are no guarantees that it will do anything at all, and we definitely don't want to exacerbate her intoeing, so we're not going to rush into it at the moment. We're going to take some time to talk to Alison's pt about it and see what she thinks, as well as see if they do it at the hospital or anyplace else around here.

While checking out the valve of her shunt, the doctor did make an interesting comment. He said that he wondered, based on her function level, if her shunt was even still working/doing anything. That's the first time we've ever had anyone say anything about a correlation between function level and whether or not there is a pressure problem. Even if the shunt is not actually doing anything, it wouldn't be taken out. We know from Dr. Barr that they've found that taking them out disrupts whatever "fix" the body has come up with and they end up needing to put a new shunt in, so whether it's doing anything or not doesn't change the fact that she will have it forever.

All in all, it was a very satisfactory appointment.