I have decided to start a blog.  What? That is so 2010…you say.  Well so what if it is.  I am doing it for myself, I want to become a better writer (which you must practice writing to do) and I want these stories to be told. If someone decides to read this thing great and if they read it and get something out of it FANTASTIC.  It is really for me and maybe my wife who has to endure me telling her all about what happened at work yesterday typically at 4am in the morning due to both of us suffering from the terrible effects of perimenopause.  I am starting my blog with Friday's therapy session and what happens when things feel good and you know that you are having a positive impact on children’s lives beyond the work of their muscles.  This while having fear, anxiety, shame, blame about how you might have totally screwed up your own kid as your teenager is going through a time when they have trouble making any kind of eye contact with you let alone a smile.  Back story, I am a pediatric physical therapist so my job is to help children learn to move, crawl, walk that sort of thing.  But in this line of work we often have to  build deep connections with our patients if we want them to trust us to do the hard work.  Think about a really great coach you had or teacher or personal trainer that pushed you past what you thought you were capable of.  You had to trust and respect them right?  Well often I have had the privilege of knowing some of my “kids” for many years now since I own my own practice and have built up a relationship with them, watched them grow.   On Friday I was working with one of those children.  A father who is typically quite reserved during our sessions told me a story.  He stated that he and his wife had taken their kids to a restaurant and as typical the kids did not engage the waitress as they are very shy.  They are 4 years old.  The parents ordered the kids a chocolate chip cookie to share and when the waitress came back to bring the check my patient looked up at her and stated very clearly, “I like cookies!”  This was much to her surprise as there had been no interaction the entire time prior.  She said quite startled, “Oh, yes, I like cookies too!”  The dad was telling me this story because I have been using flash cards for over 1 year now to help with visual vestibular integration for balance and in one of these pictures is a large chocolate chip cookie. When this picture comes up I typically state in a Ms. Rachel’s voice “I like cookies! Do you like cookies?” 

The makings of a cookie is really the same ingredients as many other things; flour, sugar, butter, vanilla, eggs and a leavening agent. You can bake pancakes, waffles, different types of sweet bread (banana, pumpkin) or many other things with these same ingredients.  What is it that constitutes it a cookie?  It is just the correct combination and amount of these ingredients in the right order.  And if you are like me and love the British Baking Show you have learned that the best way to have a "scrummy" cookie is to beat the butter and sugar together first for 2-5 minutes until very fluffy.  This will help merge them together.  They must become one.  Just as our systems in the body must be incorporated to make them function correctly.  Now you don’t need to do this with pancake or waffle batter but why?  I find food science fascinating. Is it so that the cookie can hold it shape all on its own? Is it similar to how we must integrate our systems so we can stand on two legs? We are the only bipedal mammal.

Back to why this dad telling me this story about his family at the restaurant meant so much to me.  His child has significant balance challenges and is also visually impaired.  I have been working on how to help with balance which uses three systems; vision, vestibular (your inner ear) and proprioception (knowing where you are in space).  But it is the integration of these systems that is critical. You can’t just use one and get better with balance.  Just like the cookie.  You can’t just put any amount of the ingredients together in a bowl or you might get pancake batter instead of cookie dough.  They must be incorporated with the exact quantity.  I have been working on having his child spinning in a circle while holding good balance in a chair with erect posture and looking for a picture (spotting).  Just like figure skaters or gymnasts do to not get dizzy while they spin.  We have been doing this for over a year (not every time mind you). But there is significant improvement in balance in sitting and standing AND now to know that this activity also brought social engagement brings this therapist's heart such joy. I could see in this father’s eyes that it meant so much to him that his child brought a smile to a stranger. A genuine smile because of what they said and not because of how they walked or looked but because of true connection. It is not often that we are told that our impact often goes beyond the body and into the heart.

Consistency, continuity of care and practice matters.  

I like cookies!

Marcella