40 sessions

Good Morning all

We have completed the initial 40 HBOT sessions. Although the results have not been as spectacular as the poster-boy for HBOT, we still have had very discernible improvements. Shawna has now been doing her treatments solo which would never have been possible before. She has been able to watch tv on occasion but mostly enjoys looking out at us and laughing at us when we are silly. We have decided with input from most of her therapists to continue with another round of 40 HBOTs because of the gains she has experienced. We will be taking two weeks off though while we put our family life back together and increase Shawna's therapy at home again. Pool therapy will soon begin again, and hopefully we can still fit a very busy therapy schedule in with the Tuesday, Thursday and Saturday HBOT sessions.

Physically Shawna has shown improvements in her ability to walk(of course with assistance) and her range of motion with her right arm. Her left arm and leg are moving more and more all the time. The spasticity or tone in her left side have been very diminished if not almost gone. As a result, Shawna is able to center her head at will and able to track right to left and back again. Many times now she has surprised us with that ability. She still experiences trouble with the Apraxia and stays looking left in a crowd. She has also shown that she has some extremely good days and conversely extremely bad ones too. The differences are stark and we are able to see them and sometimes alleviate pain or discomfort by repositioning or administering Tylenol.

Shawna has also shown a good increase in the ability to swallow even though we temporarily halted the swallowing therapy. We will be right back at it with also a scope to determine if she is having silent leaking into her airway. Although the thrush is not gone it is diminished and now that Shawna can swallow the nyistat, it is more under control.

She has also become more vocal and her laughter is almost to the stage of prior her accident. While we enjoy her new found abilities we constantly pray that she will be able to communicate clearly her needs.

We stand firm in the knowledge that God always provides our daily needs and even if we don't get everything we had hoped for we still experience His care and protection in all aspects of life and receive what He has determined is good for us. Thanking everyone for their continued prayers and assistance, we continue to lay our needs before our Heavenly Father.


Yours in Christ

Al, Deb and Shawna Bethlehem and family

28 of 40

Good evening all.


To date we have completed 28 of the initial 40 HBOT sessions that were planned. We can say at this point that there are definite differences which have been seen by all who work with Shawna and her close friends and relatives. We are so extremely thankful to God for giving us this blessing.

The treatments have not been without some difficulty though. Shawna has been able to get to the maximum pressure (2.88 ATM) now for the last 9 treatments. This has definitely assisted in getting rid of the thrush. There is only a small skim left on her tongue which we are now able to treat also with Nyastat along with the HBOT. Deb meanwhile is not able to continue to be in the chamber as it is affecting her eyes because of a stigma behind her left eye. She has been getting headaches as well and thus has to stop. This leaves me and aunt Ruth to be the ones to accompany Shawna on her journey. Twice also Shawna has been able to do the chamber solo. When I go in with her, aside from being very cozy, my metabolism is very fast and I generally produce a lot of surface skin heat. Combined with pure oxygen this process speeds up even more and the tube starts to get very humid and fogged up. When this happens Shawna begins to cough a lot and causes her some discomfort towards the last 15 mins of treatment.


We are hoping to get a SPECT scan next week on Wednesday in Newmarket. This will show us in colour which areas of Shawna's brain are functioning and combined with another scan after another 40 sessions will show if there is continued improvement. In September we are scheduled to speak in a volunteer panel to Toronto ABI association about our experiences with HBOT, and hopefully be able to assist with the advancement of this therapy so it can be readily available for TBI/ABI patients through OHIP.

Please continue to pray for Shawna's recovery using this therapy because we know that all blessings flow from God's hands only.


Al, Deb, Shawna Bethlehem and family

18 of 40

Good Evening again. Well weve just finished the 18th session. This week had quite a few hurdles. The first one was the progression from 2.4 ATA to 2.5. I must say Shawna and Deb handled it very well, with no complications. Sure enough the thrush is going away on her tongue. What a blessing. When its completely gone hopefully a trip to the dentist to clean the rest of her teeth and throw all the teeth cleaning utensils away and start fresh. The thrush on her tongue could only be a small part as it could be in her blood but when we see it dissappear we know it is being killed off. Shawna's physio-therapist has beeen very excited about her progress and maintains high hopes now for this treatment. His work is very physical and as such he can notice her involvement in the therapy much more than the other therapists. The rehab-therapist came down on thursday night and also left very excited about the gains that Shawna has experienced. The other small incidents we experienced this week were a bit comical. We forgot to put ear plugs into her ears when she went for a shower. A phone call to the ear specialist calmed everyone down about the water in her ear. Right behind that came another incident where Shawna's feeding tube was cut off. That was a panic, although it was quite humourous watching all unfold as the trip to emergency to have the tube replaced by the family doctor. When the doctor arrived, Shawna was staring straight ahead at him and followed his every move. "Wow there IS something different about her", he exclaimed to the nurses and Deb. He was also very excited as he was the one who made the appointment for Shawna to have the tubes put in her ears, and now he was seeing results that he hasn't seen in three years of attending her. That night, thursday night was a fantastic night for her as she moved her head from side to side following a lot of people and laughing and smiling about it in the knowledge she could do it. Friday she was back to her old self but, we've found that sometimes the process doesn't stay and will reappear stronger later as the neurons are being excited and the pathways they create are not yet strong enough to stay intact all the time. Since friday was a holiday, we went to the clinic today for the fifth session for the week. Unfortunately Deb was feeling very sick today and could not go in the tube. Well the duty fell to me. Talk about stuffing the sardines into a can. It was tight enough for Deb and Shawna in the tube but now it was my turn. I didn't dare complain as Deb was such a trooper and resolutely has accompanied Shawna 17 times. The only problems were doing the first dive for me at 2.5 ATA to maintain the level for the fungus killing, and would I fit? Usually the max first time dives are done at 2.4 ATA. This was a first for the clinic. I asked them to bring us to 2.4 and after 5 mins bring us to 2.5. After climbing onto the stretcher amid Deb's concerns about total weight, they easily stuffed Shawna and me into the tube. It was quite cramped but if they couold put a 450lb linebacker in here, I'm sure we could fit as well. The doctor brought us slowly to 1.75 and as I was swallowing furiously to pop my eardrums all went well and we progressed a little quicker to 2.4 and later to 2.5. Whereas it was only 72 degrees F, the air is thick with humidity and it is a bit difficult to breath. Being so cramped it is very hard to move around and after a few minutes my left arm was starting to go to sleep. I managed to move the arm into a position which was more comfortable. Shawna meanwhile really enjoyed this arrangement as she didn't have to look around to find me. I was right there. She was smiling a lot and trying to vocalize a bunch of times. She was very calm and did not become agitated at all. 15 minutes up to pressure, 1 hr at pressure and 15 minutes coming back down, it was sure a stuffy ordeal. I was thankful to be breathing cool fresh air when we were extracted from the tube. You are a bit lightheaded when finished and I had the shakes till I ate something, and had a coffee. Deb and I will probably continue to alternate as the pressure will again be increased to 2.6 or 2.7 next week. We feel that Shawna still cannot be left by herself in the tube, as it takes too long to get back down if there was a problem such as her becoming agitated by herself and grabbing at things such as her feeding tube etc. This way we can take over for each other if one is sick and it won't be quite so much an ordeal.



Thanking you for your prayers. Al, Deb, Shawna Bethlehem and family

1/3 of test sessions

Hello readers Shawna has completed 13 of the proposed 40 HBOT treatments with very promising results. We are managing to increase the pressure successfully without incidents of discomfort or seizures. While everyone at surface level experiences 1.0 ATA (atmospheres), we started the treatments initially at 2.0 ATA and the first session was extremely uneventful..almost boring. This is eqivalent to being 33 ft underwater. We tried to increase the pressure to 2.2 ATA the next time but Shawna experienced a small seizure approximately 1 minute in duration. We turned the pressure down to 1.75 ATA and she completed the session. That Thursday became a fact finding day and we had her tested for a UTI, and eliminated other stresses for the next session. We kept the TV off and Deb did not try to move Shawna's head at all in the tube for her to watch TV. By the 5th session it was determined that Shawna indeed did have a UTI which was promptly started to be treated. The next few sessions were successful at 2.0 ATA and we slowly introduced the TV again for Deb's entertainment while they were being treated for approx 1 1/2 hr duration in the hyperbaric tube. At the 9th treatment we tried to increase the pressure again to 2.2 ATA but Shawna showed some discomfort to which we reduced it to 2.0 ATA again. In the next session we went successfully to 2.1 ATA and the up to 2.2 and by the 12 and 13th were leveled off at 2.4 ATA. Why all the numbers? Well at 2.36 ATA the pure oxygen at pressure kills bacteria during the treatment. So at 2.4 ATA goodbye UTI! When we get above 2.5 ATA it kills fungus. We are hopeful that this will mean the end of the thrush that has plagued Shawna for 3 years. We've tried so many different treatments to get rid of it but it always comes back when Shawna needs antibiotics, and because she eats nothing orally. In the next few weeks we will attempt to bring Shawna(and Deb) to 2.88 ATA where Bone marrow absorbs the oxygen and produces/activates Stem cells. This is the max amount of pressure which has been used for healing. It is a plateau of sorts. Although the chambers are good to 3.0 ATA it is unnecessary to go deeper. These chambers are rigorously tested because at 2.0 ATA there is 10,000 lbs holding the chamber together. At 2.88 ATA the pressure to keep the chamber intact is 29,000 lbs. Wow! This is also the equivalent of being 62 feet underwater! While Shawna has experienced gains from this treatment, so has Deb. Whereas Deb before the treatment had hypertension (high blood pressure) at 135/85 she was randomly tested after scooting around town for supplies and finally getting to doctors office to get papers signed. She was very apprehensive about the outcome but pleasantly surprised that her blood pressure was normal at 122/80. She has not been that low for 5 years or so and hypertension runs in her family(and mine). The hyperbaric doctor explained that the blood under pressure has been "feeding" the organs and taking the load off the heart muscle. It's also supposed to be a tremendous help for Asthma although Deb has that under control and is not ready to test that part of the theory. Shawna meanwhile has experienced gains in movement and awareness. The gains experienced would have taken months or years to get from what we've experienced over the last few years. There is only a little spasticity left in her left side and she has more movements both purposeful and spontaneous. She can readily center her head now. The physio therapist came again for his regular work with her and was very excited about her capabilities. She was able to stand using her muscles whereas she was using the tone to assist before. I had warned him that the tone/spasticity was almost gone and she was very "floppy". She was able to walk assisted by him from the living room to the kitchen 4 times. She was able to extend the gait pattern further than neutral on her right foot. Amazingly she got stronger as the walks progressed and was not tired completely after the 4th walk. Usually she becomes progressively more tired after each walk. This was the opposite and she was so energized when finished. Smiling and laughing she was laid down for a rest till she had to leave for hyperbaric treatments. Shawna no longer shuts down in a crowd and is able to engage herself with people who talk to her and tries to answer with her blinks although I'm sure she thinks she's talking to them because her mouth and tongue move now a lot! Generally she is very happy most times and when she starts laughing has a hard time to stop! Our lives have become very busy with a lot of help from our brothers and sisters. Whereas I'm still able to work 700am to 300pm, Shawna, and Deb start about the same time and morning routine is finished at 1030am followed by a therapy session each day whether physio, occupational, SLP, or rehab therapy. Deb leaves at 230pm to pick me up in Hamilton and we drive together to the Hyperbaric facility in Mississauga for treatment. We manage to make it home by 700 pm . A full day and then some further activities during the nights. We certainly look forward to the Saturday and Sunday! All in all we are so thankfull for the blessings we've been given. We know that all is in God's hands and we look to him for his guidance. Ps 59.16 " But I will sing of your strength, in the morning I will sing of your love; for you are my fortress, my refuge in times of trouble" Thanking you for your prayers. Al, Deb, Shawna Bethlehem and family

First HBOT treatment

Good Evening all Well Shawna had the tubes put in her ears on the past monday. We didn't know what to expect as none of our children ever had this proceedure done before. At first, Shawna was smiling untill the freezing was applied to the eardrum. We know now that she can express pain, with a clenched fist, kicking legs and huge wince. OUCH! The thing about it is she has never expressed pain like that before. After the proceedure was done she was smiling again especially when we talked to doctor about future appointments and our hopes for HBOT. When She got home she was still in good spirits until the freezing wore off. Then she turned white and needed to rest with a good dose of tylenol. Today she had her first treatment in Mississauga. Travelling down the QEW wasn't even that bad...got to use the HOV lane through Burlington and Oakville. That really saved time. We we were almost there and talking about where to park, Shawna started to laugh. She was still smiling when we got her up on the bed and rolled her into the tube with Deb as company. I think Deb was more worked up than her. It took 18 mins to compress the tube to 2.0 atmospheres. Then Shawna and Deb were breathing pure oxygen for 1 hr under that pressure. After the hour it took 18 minutes to decompress before they could come out. Shawna had completed her first treatment. A resounding success. Shawna was swallowing and yawning as the pressure built and when it was released. That was amazing! Almost made the ear tubes a redundant process aside from the fact we couldn't take the chance she would be able to equalize the pressure. We didn't want to have her inner ears damaged in the HBOT treatments. It only took us an hr to get back home and we were quite happy with our first completed session out of 39. Changes are not expected for quite a few sessions ..so i will post again when more things happen. Al, Deb.Shawna and family

New Treatment March 2011

Hello Dear Readers

Just when we thought we were settled into a routine for years to come, we get a new breath of fresh air. It doesn't start all too nicely though as Shawna's neurologist passed away quite unexpectedly from a fast growing cancer. Now we have to go it alone until a new one can be brought on board. Our Case manager has been assisting us in trying to line up new brain imaging technology which would show the areas of Shawna's brain that are working and those that are not. This would give us ways to reach her and understand which therapies would be more effective...It would give us a direction for therapy. A couple of weeks ago I was researching SPECT imaging on-line and came across a very interesting article involving SPECT and Hyperbaric Oxygen Therapy(HBOT) and successful treatment of late TBIs. Needless to say I was energized and became totally engulfed in reading articles, printing them off for Deb to read(who was at choir that night), and emailing potential treatment centres for information. One facility which was OHIP funded declined to treat Shawna as it is not an Ontario-approved treatment for her condition. The other facility in Mississauga readily set us up for a consultation on Saturday March 12. The facility operator stated that he had several TBI patients attending with varied results. It was hard to sleep the next few nights as we waited for Saturday to come. We arrived at the facility on time and were expecting to be interviewed by a doctor regarding using this treatment. We were a little disappointed to find out there was a doctor on staff but this facility was just the treatment provider and did not do any research before or after the sessions. While we were ready to start the treatments right away we came away with more questions and concerns. Shawna would have to have tubes put in her ears to equalize pressure as she cannot yawn or swallow or chew on command. The MRIs and SPECT imaging would have to be lined up by us or our insurer as OHIP would take weeks to get it. Medicines are absorbed into the body faster under pressure so we would have to alter her medicine intake or arrange for treatment at a specific time to avoid complications.
The basics of Hyperbaric Oxygen therapy are fairly simple. The patient is enclosed in a chamber which is brought 1.5 to 2.8 times the regular pressure we endure every day. When breathing pure oxygen the oxygen is absorbed into the body not only by the blood but it is absorbed into the plasma, spinal fluid, and bone marrow. With a brain injury there are brain cells which are damaged but not destroyed, and the neurons are not getting proper oxygen because the blood cannot get into the constricted areas. When the oxygen finds another vehicle such as plasma and spinal fluid to get to these neurons they become active and brain pathways are strengthened. There is a theory that the oxygen in the bone marrow produces new stem cells which also aid in healing. Regular air is pumped in and exhausted at regular intervals to eliminate Oxygen poisoning. These treatments take 2 hrs. Deb will be going in the first few times for company to ease the claustrophobia of being in the tube. Shawna can watch TV and the sound is piped in. We also can hear what is going on inside the tube. For the first few "dives" the doctor will be there to make sure all is right. Later on some of Shawna's friends have volunteered to be a dive partner with Shawna.
Our Insurance company has agreed to fund the MRI and SPECT imaging to be done in Newmarket at the start of treatment and are also covering the first series of HBOT treatments. Shawna will have tubes put in her ears on Monday Mar 28,2011 and her first HBOT session on Mar 30,2011 at 400 pm. We will be doing 40 sessions at 1 per workday for 8 weeks. All other therapy has been cancelled for two weeks to see how things go. Later we will reintroduce the therapy in the early afternoons, and may increase the therapy depending on how she responds to the treatment. After the 40 treatments we will take a break to asses the results and determine if this was a success. If Shawna experiences more brain function we will dramatically increase other therapies to maximize opportunities for 3 months as we prepare for our daughter Jessica's wedding. After that we will continue with the HBOT sessions. If there is no discernible results looking at the imaging and physical results then we will continue with the regular therapy as we have in place for the last year or so.
We realize this is in God's hand and we continue to rely solely on Him for our daily bread. We are so thankful that He put this information on our path because nothing comes by chance but all comes from His fatherly hand. Others had brought this to our attention previously but on advice of our neurologist we were told not to pursue it two years ago. So it stayed buried till our neurologist passed away and we continued to try to find ways to assist Shawna. The medical field continues to develop and this type of treatment is accepted in USA, China and U.K. Studies have shown some fantastic results which we can only hope some of them Shawna can experience.

Isaiah 26: 3,4 "You will keep in perfect peace him whose mind is steadfast, because he trusts in you. Trust in the LORD forever, for the LORD , the LORD is the Rock eternal"

Thanking you for your prayers

Al, Deb, Shawna and family

3 years

Hello out there!

I don't know if anyone still looks at this blog but since Shawna is still unable to post for herself, I thought I would update her progress so far. Progress is very slow but there still is progress. We've been tweaking the meds and still working with new ones to improve initiation and response. The most exciting progress has been in the area of walking. This summer Shawna started walking with her right leg in her Grandparents pool. It was an amazing development. Rapidly through the summer Shawna progressed to taking 100 steps with her right leg only in chest deep water. By the end of the summer we were concerned this treatment would have to stop because there are no pools with 90 degree water that are chest deep. We tried to have her walk in the shallows and lo and behold she could still do it!. Off to the Valley Park warm recreational pool for the next sessions of pool therapy twice a week. From September to December Shawna improved dramatically. She not only increased the distance she could walk being supported, but also started to use her left leg, bending it at the knee and dragging the foot to neutral position. We stopped when it became too cold to transfer from the pool to the frigid temperature outside. By this time Shawna had managed to walk 16 lengths of the pool using both legs......approx 1000 ft! Simply amazing, praise God! She now continues to "walk" on the hardwood at home which is considerably tougher to do but still manages 6 trips from our living area into the kitchen with assistance approx 30 ft each trip.
Other areas of improvement are her ability to assist in getting out of, and into bed, sitting stationary, and standing for long periods of time in a standing machine. Her ability to swallow has progressed to 20 x 1.5 mls and sometimes if the timing is right 2 teaspoons of yogurt at supper in 1/8 teaspoon increments.
Oral communication is still an issue. Shawna has been vocalizing a lot but not consistent on a "need to basis". Most of the vocalization comes from excitement and spotanaity. Communication has been very consistent with long blinks for yes and two short for no. Her friends have been able to harness this communication style and have taken her out for many trips and visits to their homes, shopping and weddings etc with fantastic results. The engagement and stimulation she recieves from these outings ususally result in her being very revved up and unable to sleep. She wakes up laughing and very excited. Shawna's ability to follow conversations has also improved. Her laughter at funny parts of the conversation tends to improve the aura and bring it to a higher plateau where everybody is now laughing and clowning around.
Shawna with Grandma Bethlehem's tutelage has been doing a fantastic amount of hand-over and independant painting lately which involves her choice of colour and textured brushes. Hopefully this can help her to develop more finite control and point/touch abilities as she continues to complete pieces for an art showing scheduled for 2012(more news to follow when this comes closer).
I have been the recipient of some fantastic two armed standing hugs lately and she does not want to let go. Her left arm is starting to get more movement as is the left leg. Shawna can easily grab something that is put before her and has been scratching her chin and head lately.
Neurologically there will be some more work coming up in the near future at the General in the ABI clinic, but first we are taking her for a trip to Florida, breaking up the winter doledrums.
We continue to walk on the paths chosen for us and are thankfull for the continued support we recieve from our brothers and sisters in the Lord Jesus Christ. We rely totally on God's faithfull promises which always guide our path. Praise God from whom all blessings flow!

Al, Deb, Shawna Bethlehem and family

2 years

Good Evening to all the readers. I know we have'nt posted in quite a while. As yesterday was the two year anniversary we thought it appropriate to make this post the last one to close off this blog dialogue. We are extremely grateful for all the helpful and uplifting messages we have read. Hopefully in the future Shawna herself can post her own thoughts on this blog.
Since the last posting Shawna did end up staying in the hospital quite long almost 2 full weeks. When she finally came home her feeding had been trimmed down to the minimum to keep her stomach from being upset by the antibiotics she was recieving. She was very weak and it took a long time till she regained her strength, almost a month. The Spinal tap she recieved was deemed to be unreliable so she was scheduled to have another performed by her neuro-surgeon, Dr Wells. When this was done it was confirmed that there was indeed no extra intra-cranial pressures that were contributing to her issues of tone. Her Neurologist, Dr. Gillett, prescribed a new medication to combat the condition of "Appraxia" which Shawna suffers from. When movements are not rehearsed, Shawna is able to do many with ease. When asked to point or move this or that she becomes agitated and stiff, and unable to comply. The meds which are slowly increased month by month to their maximum at 6 months have been giving wonderfull results to this point at the halfway mark. Vocalization has been steadily increasing. No words yet but loud sighs and laughter. Shawna has been standing by her pole while we only help her left hand to hold on, for periods in excess of 15 mins at a time. During this excercise we take away her comfort zone by moving her right hand from the pole and leaving it in midair to see what she will do. We also push her sideways to help her learn to make the minute adjustments she requires to remain standing. In all these exercises she continues to do very well, especially maintaining her standing posture. We also assist her to walk across the floor from the livingroom to her bedroom and kitchen area. Shawna maintains her own weight over her legs, but we support her side to side, and slide her legs across the floor. Her speed and strength going from sitting to standing is steadily increasing, as well as her ability to relax and place her feet on the floor working against the tone. On the reverse side her ability to go from standing to sitting is almost getting perfect. She is now able to hold up her head unassisted when you pull her up from lying down to sitting. She is easily able to center her head but still favours looking to the left. Her eyes track left to right and vice versa in very quick motions now. Her eye to hand co-ordination has been steadily increasing. Somehow on Sundays she has always managed in the last month to grab my tie when I assist her into her wheelchair. She smiles immensely at this small success. Once just recently when Deb and I were assisting her to get to bed, she reached up and removed her own glasses as if "here I can do this to help you guys". We were amazed! Once she reached up and removed Deb's glasses too. The therapists working on helping Shawna learn to swallow have been stimulating her mouth muscles for quite a while with some success, not a huge breakthrough but consistent. Another really good development has been the use of her computer. We have several new attachments which are making the use of the computer from her wheelchair very successfull! It may take a long time but there is promising developments in that area. Her computer will make it possible for her in the future to communicate with others and regulate anything that uses a remote in the house. Shawna is very consistent with her Yes/No eyeblinks, and communication showing her cognitive ability has been fantastic. Some of her therapy sessions have been happening at night now when she is very awake and ready for family things. These sessions have been integrating her friends one at a time to show them her abilities and help them to feel part of the solution, making it very easy to socialize in other situations.
The two year milestone again brought many memories to the foreground, but the most important one is how we were upheld by God's almighty power. Last night we read with Shawna and our children from Isaiah 40, where God gives strength to the weary and increases the power of the weak. The chapter ends with the words that those who hope in the LORD will renew their strength and soar on eagles wings. Looking back now on this journey we can see how we've been strengthened and protected by God's gracious providence. When I talked with Shawna about how we found strength from this portion of God's Word, she vocalized her agreement and smiled at me as tears made their way down my cheek. We ended the day with singing Hymn 9 vs 5

They shall mount up with eagles' wings;
Unwearied they shall run.
They'll neither falter nor grow faint
As they in faith walk on



Yours in Christ
Al, Deb,Shawna, and family

1 year + 8 months

Good day all. We've had a small setback this week as we are in the hospital with Shawna again. Two weeks ago She had a small siezure which was followed by increasing tiredness and sleepiness. Four days ago Shawna became unconscious during her therapy session at home for approximately 25 mins. She could not be roused during this time. She was hospitalized that evening and a series of tests and monitors performed. She had another siezure on Wed. morning for about 5 mins. By this time the doctor had determined that her bloodwork was good, in fact her kidney and liver functions had returned to normal finally after medecine changes. The Urinalysis however confirmed an infection which they promptly started to treat. There was an advantage to Shawna being hospitalized in that she could now recieve certain proceedures which we've been waiting for since May(good health system). Shawna went for a CT scan yesterday which showed no internal brain changes since Dec 08. That was good news of a sort. She recieved a Spinal tap this morning which showed that the intracranial pressure was normal and not elevated. Unfortuneatly the Dr. could not withdraw 30cc of spinal fluid which was required to test if lowering her brain pressure would lower the amount of tone in her body and increase her cognitive function. Since the pressure was considered normal the tap was discontinued for Shawna's comfort. She is now resting and has to lay flat on her back for 24 hrs and thus will not be coming home till Saturday morning. It is quite possible that all the symptoms she was experiencing were from the infection.
We are thankful that we could experience one last fling at summer with Shawna at Long Point. Although our test beach wheelchair did not arrive we managed to get Shawna down to the warm beach and lay her in the sand where she could let the sand trickle through her fingers. Although Gramp and Gram's pool has been closed for the season Shawna's pool therapy can continue at home in the hot tub. Shawna continues to pull herself to standing from the wheelchair with great effort. We have also patern walked her for 40 ft to which she smiled immensely for hours. The use of the MyTobi computer has been integrated into therapy and Shawna continues to use it successfully. She also continues to do swallowing trials. Shawna also spells words and phrases with her eyeblinks using flipcharts of letters. One of her first phrases was "Big Brother Will". That was immediately follwed by a visit from her big brother two days later as she requested. We are still blessed with small advances every month and continue to rely on our Father's hand for our daily needs. Thanks for your prayers and support. Al, Deb, Shawna, and family

1 year + 7 months

Good morning all. It's been a very busy summer. We've been on many outings with Shawna and she is still progressing slowly. She enjoys these trips and holiday outings immensely and is very stimulated by them. We went to a cottage mid July on Lake Kennebec which was posted as handicap accessible. When we phoned in January to set it up we inquired about wheelchair access. We were told no problem. Well it was a good thing all our children were there because it was a few steps up to the patio (not a ramp) and all the doors were tight, and the trips to the beach and boat dock were feats of strength to let the wheelchair slowly down the hills and pull back up later. Needless to say we should have checked the cottage out further by tripping down there before making arrangements. All in all, the holiday was thouroughly enjoyed by all, esp. Shawna when we were all together for a week. We have been may times to the pool at Grandpa and Grandma Bethlehem for therapy swims and sometimes just for fun. We get the water heated to 90deg F which enables Shawna to have more independant mobility. Sometimes she moves her right arm in a swimming motion as we move her left arm and that way moves herself around the pool. We also have the hot tub at home now accessible with a lift for Shawna once the pool becomes too cold to heat efficiently. We still have one more camping trip lined up for next week. We are supposed to recieve a beach wheel chair for trial but so far it has failed to show up. We really could use it as we will be going to Long Point in hopes of giving the chair a fair trial in the sand. The Mytobii computer useage seems to be on hold for the moment as the OT continues to pursue a better mounting system for the wheel chair which will accomodate Shawna's needs. Therapists continue to take Shawna on trips into the community to shop and sightsee. We took her to the Toronto Zoo as well. Too bad it was sooooo Hot. It was a good thing we had zoo-mobile tickets to travel which took away the great amounts of wheelchair pushing up and down the hills.
Physically Shawna's distonic or tone has been steadily decreasing with occasional flareups which may be weather pressure related. She has been able to independantly turn her head all the way over to her left shoulder. She can track her eyes now completely from left to right although it requires a lot of effort on her part and is not something she does without stimulus. The lack of tone in her left leg has made standing up more difficult as the tone was assisting to help her stand. She used to stand by activating her left leg first and the right would follow. Now it is reversed but this time it is her own ability to turn on the muscles to stand which sometimes is a bit slower but still forward progress as she is now in control. The physio therapist is still baffled by the way Shawnas body is reacting. Some days she has absolutely no tone which is supposedly an impossible thing for an ABI person, and some days she has it back. He tested her reflexes and her right side acted normal as if she didnt have a brain injury while her left side was only slightly slow. Shawna has been for a Botox injection consultation to determine if we can alleviate some of the tone in her left and back and neck muscles so she can further develop her own messages to those muscles without having to overcome the tone first. Before the injections take place we are waiting for a Spinal tap and immediate testing by the Physiotherapist and Speach and Language therapist to determine if the decrease in brain pressure has a positive effect on her physical and cognitive abilities. If this is determined to have a postitive effect we will go ahead with the insertion of a shunt to further Shawnas possible abilities and then redetermine the necessity for any Botox injections.
Speech still seems to be a major hurdle for Shawna. Although we get by with the long blink method for yes and two rapid blinks for no, it remains difficult to communicate in this method. She has been making more and more noises ususally when she is lying down and more often when she is not concentrating on making noise. It seems that when she tries intensely to do some things, they become impossible for her to do them.
Shawna is waiting for an appointment with an Opthamologist to determine if her vision has changed due to the accident. We have noticed she doesn't like to have her glasses on, and seems to see quite well without them. We're just not sure how clearly she sees. She is also waiting for an appointment with a bone specialist to determine if any corrective surgery needs to be done for her hips as they seem to be a bit misaligned from the accident and subsequent healing which was not done by surgery but externally since she was so badly injured that surgery would not have been possible.
As we celebrated our 25th anniversary with our children we were reminded that God is in control of all our lives. We could easily be missing one of our dear children if that was God's plan. We are very thankful to Him that we could enjoy that precious time together at the cottage. We pray that he will continue to heal our dear Shawna. Although we continue to plan for her long-term impairments we also pray that she may recover fully. We are thankful for her healing to this point, that she is able to stand and return our hugs, that she can smile and wholeheartedly laugh, that she is able to recognize us and that she is able to hear the faithfull preaching of God's word with her brothers and sisters in Attercliffe.
I'm sorry for missing a post at the end of July but we've been so busy this summer trying to balance all the "family things", that it was just one of the tasks that were shelved for more important ones. I thank you for reading along and keeping us in your hearts. We are constantly reminded by occasional aquaintances that they and their small children continue to pray for Shawna. Once again thankyou for your prayers and support. Al, Deb, Shawna and family

1 year + 5 months

Good morning all. Shawna continues to improve and we are constantly reminded that God is in control and continues to provide us with his blessings. Shawnas standing at the standing pole has continued to improve and there is now a new variation to it. We park Shawnas wheelchair about 1 ft away from the pole, put her hands on the pole and with little to no assistance Shawna pulls herself to standing. This is a huge development and now we will have a standing pole installed by the w/c (toilet) to facilitate bathroom use. Shawna has been out in the community a lot and it shows by her level of excitment when she returns. She's been to soccer games, Port Maitland pier, mudcat activities and more. We've had a few more stressors especially when our son AJ was involved in a motor vehicle accident recently. We were called to the same hospital that Shawna went to, where he was sent for observation. Thankfully he only had a minor concussion and no further injuries. God is merciful and we have been spared additional hardship. Right this instant we are in the middle of our Buist family reunion at Selkirk and Shawna is enjoying this trip immensely. She was exicited about the trip before we left and the excitement continued to ramp up as we got closer. We bought a toyhauler/camper which has a ramp and lots of room for her hospital bed. Shawna enjoyed watching the little children play at the beach and feeling the sand in her hands. She became a bit upset during this time as tears came to her eyes but she quickly became happy again as Brandon Oosterhoff wheeled her speedily around the campsite. She enjoyed sitting around the raging campfire. She went to bed smiling and laughing and had an unevenfull night sleeping soundly. On Thursday morning as she was waking she started laughing before she even opened her eyes. The rest of our holiday has also been very enjoyable as Shawna enjoys the company of her family and extended family. We haven't had as much rain as the weather network predicted and certainly not near as much as last year when the bottom of the group site became a 1/4 acre lake and the campers had to be towed out by a tractor. We are thankful for the blessings we have received from God's hand and continue to rely on him for Shawna's continuing recovery. Thankyou also for your prayers and support. Al, Deb, Shawna, and family

1 year + 4 months

Good morning all. I hope everyone is enjoying this beautifull Sunday. Shawna continues to recieve God's blessings as she continues on her road to recovery. Albeit the progress is quite slow there is still progress. With physio She is able to stand on her own for 1+1/2 minutes holding on to a standing pole with both hands. The physiotherapist pushes her slightly to get her off balance and watches to see if she makes necessary corrections, which she is able to do. As a result Shawna has been able to stand and give her family members a full hug.We finally met with Shawna's neurologist who made a whole bunch of reccommendations. One of these has been to adjust her meds slightly to see if that would reduce the dystonic(tone) on her left side. So far, after 1 week of this treatment the tone is visibly getting less and less. There is a down side to increasing these meds. She must be regularly monitored by blood and urine samples to make sure her liver and kidney function are not compromized. We continue to pray that everything may work properly. Pool therapy has been quite a success. Shawna has been able to move her left leg in the bouyant environment without tone present. When the kinesiologist got excited about that and Shawna also became excited and was smiling all the way home. The pool at Grandma and Grandpa Bethlehem has been made ready for use with reinstalling a heater unit, and the hot tub at our home renovated and repositioned so that Shawna can be lifted in. The other modes of therapy have also continued with many variations. The most important has been a big brainstorming session on how to use the mytobii computer so that Shawna will not become frustrated . At first they will only use three screens and progress from there when they can see purposefull use. One of the screens is a tv remote which is actually can turn on the tv and adjust settings through the computers hardware. Another screen is a simple yes/no board where they can continue with communication instead of eyeblinks. The last screen is a music choice page where Shawna can choose her music the computer will play. The computer is capable of so much more than this but it is important to start out slowly and build Shawnas confidence in using this as a communication tool for hopefully using in community settings. There are many more outings into community planned for her as the weather contiues to improve. She has been getting a bit of sun outside as she watches the garden being planted and construction on the new ramp to the front door. Our children all enjoyed an enriching experience last weekend as they banded together to take care of Shawna for 4 days as Deb and I slipped out of Canada and into Holland, Michigan for the weekend. There were many notes to read and schedules to maintain as Deb wouldn't leave until all the finest details were covered including lining up extra psw's and grandparents. It was good to get away for a few days and sort of build back up the reserves as we ramp up for a busy summer. We couldn't do many events last year but we have a full plate this year. Lots of Soccer, Buist family camping and cottaging to mention only a few things will keep us quite busy. We continue to rely solely on God's providential care as he continues to care for us. Thankyou for your paryers and support Al, Deb, shawna, and the family

1 year + 3 months

Good evening all. A lot has happened since the last posting. Our prayers have certainly been answered as the tone or Distonic in Shawnas left side is continually lessening. The physiotherapist is excited to have Shawna almost back to the point she was before her brain turned all the muscles on her left side on full. We are once again working on sitting her nice and straight to work on strenghthening her core muscles. Accupunture is being used regularly to relieve tone in her arm with a lot of success. We have another new machine to use which is called an Acutouch which uses very strong magnets to change energy flow in the muscles. It works on the same principles as accupuncture with the pressure points but the skin is not pierced. Shawna seems very relived when we use this on her and tends to fall asleep almost immediately. Pool therapy also is a huge succes as we go onces a week every Sat night to Valley Park. When immersed in the 96 degree water the tone immediately dissappears and Shawna can move her limbs bit by bit Shawnas cognitive ability has become increasingly evident as she answers questions with eye-blinks. She is also increasing her food intake by mouth she's gotten as far as nine big teaspoons full swallowing successfully. She likes pureed pears and yams. Communication continues to be the primary goal and her eye blinks are very consistent but it takes a long time to determine what she is thinking. Shawna received her own P10 Tobii computer which uses eye gaze to manipulate screens and text editing as well as environmental control and blue toothed to her cell phone to text her friends. Much of this will take her years to learn but we have a very excited young lady on our hands chomping at the bit to learn. When the tone decreases significantly enough we can bring the computer with her everywhere for her to communicate as it speaks the words she types. Shawna has had several outings for social interaction aside from regular church attendance. One of the most intriguing was when her friends came and took her out for an evening of shopping and out for supper. This was totally unsupervised by us but we were very confident of her friends. After all one is a paramedic another is her OTA another is a nurse , one is her PSW and others trained to care. It is truly a blessing to have friends that care and are willing to sacrifice their time for Shawnas benefit. She was so energized when she came home that she was vocalizing for almost an hour and could hardly go to sleep. Our addition is finished and now we just have some landscaping to complete the walkways and gardens around our home. We have been so blessed by our Heavenly Father to experience the riches of His grace as he continues to provide for us. We belong to a community that continues to uphold us and strenghthen us with their word, works and prayers. We stand amazed and thankful to God for his blessings. Thankyou all. Al, Deb, Shawna, and Family

1 year and +/- 2 months

Good morning all. I hope you are all enjoying a beautiful Sunday. Just a little reflection first this time. Many times we are travelling around in Hamilton and surrounding areas and people come up to us and say " We're still praying earnestly for Shawna and your family". When we hear this we are deeply humbled and at the same time tremendously strengthened. We know that God hears prayers and by our daughter's progress we can see the answer to these prayers. We join many others at this time who pray for the Bos family in Smithville who yesterday buried their beloved Ricky Bos. She succombed to a form of brain injury in the form of an anuerism. We know in faith that God has called her home, and that her earthly work is done. On the west coast (B.C) my cousin Evelyn Cumming (Debruin) was devastated with the loss of her daughter, Leena (24), in a car crash on March 4. She leaves behind her young daughter Elissa. We continue to pray for our family out West. These accidents teach us how fragile our lives really are, and that we must always be prepared to meet our creator. Live every day to the fullest doing the best work to the tasks we are given, and giving thanks for the blessings we have recieved.
On to Shawnas progress we continue to watch the small steps she continues to take. The thrush in her mouth is steadily lessening with a special diet of probiotic powders and anti-oxidants and some good old fashioned tongue scraping. She has been to see the dentist and amazingly enough she opened her mouth for him to check one time and on another appointment opened her mouth for the hygenist to be able to clean half her teeth this time and hopefully the other half in another appointment. We could not do all her teeth in one appointment as she would have too hard a time to keep her mouth open that long.
We are still waiting for the family doctor and specialist to confer and come up with a recommendation or prescription to administer a different drug to combat tone(dystonic). Her tone is steadily decreasing on its own but very minimally and slowly. She is able to move her head now to center and slowly strenghtening that process. She can also track her eyes from left to right again, but when shes tired they stay to the left.
Pool therapy continues to be a huge success, as the tone is almost all gone when we lay her out in the heated pool. She is experiencing gains in her leg movements steadily, and starting to move her left leg more, while her right leg is increasing its range of purposeful movement. We are changing the location and construction around our hot tub at home to facilitate more of this type of activity especially sitting in the pool.
We lost the MyTobii computer for a while(it was a two week trial) but the process is in the works to get a newer one with more bells and whistles, this time for keeps! A lot of research has to be done to make sure this is a good fit for Shawna and that she will have lots of room to expand her abilities.
We continue to be thankful for the blessings we have recieved from Gods hand and contiue to be strenghtened by your prayers and support......Thanks Al, Deb, Shawna, and family

1 year + 1 month

Good evening all. Shawna continues to increase slightly with gains to physical movements. The tone in her left side has been slowly decreasing. We have decided to wait for making a decision about a shunt insertion until the aspect of tone medication has been explored fully with the assistance of Dr. Gillette. Shawna has experienced a few changes of late with respect to her personal support worker. Her PSW Sharon Kingma had to take some time off to become a new mom to Avaia Faith. Shawna was able to hold the baby and stare intently at her for a few minutes today. It was a beautiful moment. Today another important development in her treatment was tried. She had pool therapy! We tried first in the cooler pool to do assited walking but that was not too successful we decided to move her to the warmer pool and have her float and try having her initiate leg and arm movements. That part was succesful as she floated on her back with her new pfd-a. Her physiotherapist breathed a huge sigh of relief as everything went according to plan and her life vest proved to be very effective in preventing her from turning over and protected her airway completely. In the heated pool (91F) the tone was almost completely gone and she relaxed almost to the point of falling asleep as she floated. Travelling home she was exhausted and promptly fell asleep. Tonight when we make swimming motions and talk about her pool therapy she breaks out in spontaneous laughter, because she enjoyed it sooooo much. Heated pools here we come!
Another fantastic development in her treatment which was alluded to by Mrs. Vanyken in the last blog coments was a loaner "all in one"computer which is set up for touch screen and eye-gazing. The eye gaze portion of the computer has two cameras which watch Shawnas eyes to move the "mouse" and when she holds it long enough in one position clicks the mose to activate the programs or icons. It is completely set up for her to type messages that way and email or talk to friends online once she becomes more precise with her eyes. She demonstrates quite readily that she can read and regularly clears the screens playing memory games. The computer has an associated speech sytem which will speak the sentence she types out or the command she has enacted right down to saying what she would like to wear that day or have a drink etc. Right now we only have the computer for a two week evaluation but i'm pretty sure the therapists will recommend this device to enact a major breakthrough in commuication. The therapists were so enthusiastic the first time they brought the unit here when Shawna demonstrated she knew exactly what it was for and promptly sounded the alarm page and turned it off again and again for 4 times. Each cycle required three processes with eye movements to different quadrants of the screen. Very exciting..hopefully...considering one of the therapists questioned if Shawna could even do it since she herself couldn't.
Shawna also enjoys the new sunroom/exercise room which has been added to our home. A beautiful well lit and warm room to enjoy even on the coldest of days. Again we are experiencing the riches of God's grace as he continues to show us he cares for us and all is in His control. Thank you for your prayers and support. Al, Deb, Shawna and family

1 year + 2 weeks

Good morning all. As we continue on the path chosen for us we've come to a small hurdle. The meeting with the neurosurgeon did not give us any concrete answers. When he examined the CT scan he explained to us that brain surgery is not an exact science there are still many unknowns. He could not tell from the pictures if the right ventical enlargement was a result of pressure or the natural enlargement as the water pressure tries to equalize toward the area where the damaged brain tissue has dissintigrated. For the actual shunt insertion there is a 10% risk from the operation from infection, bleeding, wrong area insertion etc. The reults are varied 30% chance of immediate results, 30% chance of limited result and the remainder no change. There also is a danger Shawna may lose more brain function from the shunt insertion as it passes through the brain into the ventrical and if there is bleeding and an infection. It is left completely up to us. Shawna is included in the term us as Dr. Wells made a point of explaining the whole operation and possible complications to her after she demonstrated to him she could respond to his commands to blink and give a thumbs up. We decided to wait as there is only a two week wait for the proceedure and we are going to be in the middle of another treatment to try to eliminate the thrush in her mouth. Shawna is going to an oral surgeon who will put her to sleep to completely examine and clean her mouth and teeth. After that she will have an additional diet of antioxidants and some special oils to internally combat this infection as well as a new toothbrush for each cleaning and everyone who contacts her must wash hands thouroughly before and after contact. Since that meeting almost two weeks ago Shawna had an increase in the tone immediately following the meeting. We could not get definite answers if she wanted the operation or if she had headaches or pressure. Thankfully that excess tone dissapeared quickly and mustve been brought on by stress. Since then there has been a large reduction in left side body tone. Shawna has been able to center her head and track her eyes to the right and move her left arm more. There has also been less side curvature as her left back and side muscles have relaxed. We've also been able to stand her again with minimal effort against the tone. We're slowly getting back to where we were a couple of months ago. The rest of her therapy continues to be successfull as Shawna is able to stay awake now for most of the day and participates in all the sessions. We have been blessed again with this progress as the shunt idea seems less of an immediate concern. This process though is an up and down thing and we may still have a large uphill battle looming against the tone issue. We are thankfull at those times that we can lay those needs before our Heavenly Father and he continues to provide what we have need of daily. Thankyou again for your continued prayers and support. Al, Deb, Shawna and family.

1 year

Good morning all. Today will most likely be a day of reflection, as we celebrate life. A life given back to Shawna by our gracious Father. Yes the events of this day remain a vivid picture in our minds but we hold fast to the riches we were given during that time of need. We continue to be supported by the communion of saints and our family and friends to the effect that we truly know we belong to our faithful Saviour.
Some fantastic things have happened to Shawna in the past two weeks. Shawna enjoyed 9 full teaspoons of applesauce in one setting. Her tongue is starting to work better as she swished the applesauce around in her mouth and swallowed successfully. She agreed to each teaspoonfull and opened her mouth to receive it. This was a huge success and Shawna was very excited about it. Another important development was getting Shawna onto her facebook page. She was very excited as she began to read her messages on her wall and inbox. It takes a great deal of effort for everyone who assists her with this to make sure her wishes are followed.
Its been quite cold lately and as a result we have not been taking her out anywhere except appointments. She already went through a bout with stomach flu. With round the clock monitoring she pulled through that episode. On this Wednesday she has an appointment with the neurosurgeon Dr. Wells to see if anything needs to be done regarding the right ventrical enlargement in Shawnas brain. He may want another CT scan done as the last one is now two months old. At least we are started on a pathway to explore why her tone on the left side is so intense.
We've been trying new physio things with Shawna. One that she has been successful with is getting her to initiate rising from her chair or bed and sitting back down again. We bend her forward and give her our arms for her to pull herself to standing and then hold her shoulders as she breaks tone in her knees to sit. She has been getting faster and faster at this and it makes transferring her a lot easier. Another thing we did was have her on her stomach an try to have her in a crawling position. This was not very successful as Shawnas face was pressed into the mattress and she was not comfortable with that position. Later she (5 hrs later) she became sick from that exercise. We will have to wait for more equipment to facilitate this procedure. All in all we continue to receive many blessings from the hand of our Heavenly Father as we continue on the path he has chosen for us. Thanking you again for you prayers and support. Al, Deb, Shawna and family

day 352

Good morning all. When you look at the days gone by it seems like passing by in a high speed train. I can hardly believe that in two weeks we will be 1 year to the date of Shawna's accident. I must say that there has been no shortage of emotional and physical help from Family, Friends and the Communion of Saints, without which we would most assuredly have been swept away. God is an awesome God. He continues to bless us with continued healing and strengthening. Shawna continues to struggle to make consistent sounds. Some days are better than others and some events trigger louder responses. She definitely has a good sense of humour and laughs easily when her brothers clown around with her or themselves in front of her. When she's watching a show she will become deeply involved and will also laugh almost instantaneously at the punchlines. One thing that has been a good investment has been getting the wii system for her therapy. Although the others(myself included) would like to play we first have to do some hand over hand sessions with her. She is very intense, and esp her right hand is right on time and tenses to hit baseballs, tennis balls, music chimes, and especially boxing which she laughs continuously as we decimate her opponents.( thats probably why I'm late on blogging) She enjoyed her birthday with many visitors, cards, and well wishes. I won't lie that she enjoyed it tremendously because the days after she was quite downcast, and pretend sleepy when the therapsits came. This may have been because she remembers her other birthdays and the realization of her limitations at this time in respect to them. We seem to have crossed that bridge again though and she's back to her "old" self. The occupational therapist as well was quite excited to have the wii accessible for her and they use it often for her therapy(I think they just like to play too). Shawna is starting to point with a pointer to smaller items and this is very encouraging for her as the link to communicating becomes stronger. For physical therapy shawna continues to bike, although the tone continues to make a mess of it. We continue to stand and sit her. A new thing we do with her is having her sit and holding her arms in front of her to help her to rise to standing. We wait quite a while for her to pull on our arms and she straightens her legs on her own. This is just another small step in relearning how to stand up. We finally recieved the results of the CT scan done in early December because of the increase in left side tone. Although I have personally not recieved a copy yet, we have made short work of arranging appointments to deal with those results. Its frustrating that it takes so long for results to come to anyone when they are on an outpatient basis. If Shawna was still in the hospital they would have been deeply involved in a plan of action the same day the CT scan was done. According to what has been read to me by our family doctor and the physiotherapist the main findings of the CT scan was that the left ventrical has decreased in size but the right ventrical has increased. We would have expected a decrease in size at the year mark because thats how long it takes. The increase in the right poses a problem. That is most likely the cause of the marked increase in left side tone as the right side of the brain would be under pressure, which is the side that controls the left side of the body. A referral has been made to Dr. Wells at the General to see if anything should be done about this. He may suggest that a shunt be placed in the ventrical to drain it as the normal drain may have been damaged by scarring. Although it is a scary thing to think Shawna may have to have another brain operation, we realize that all things are not in our hands but remain in the hands of our Heavenly Father who sustains and provides us with all things necessary for body and soul. Thanking you again for your support and prayers. Al, Deb, Shawna, and family

(Day 334)

Good day all. Shawna has continued to make good advances in communication. She is definitely good with pointing at pictures and words using a drum stick. She even named her puppy using this form of communication. We received a gift of a beautiful white male shnauser mini mix. His name is Q-tip. He's 5 weeks old and hopefully Deb and Jessica are not alergic to him as Shawna and the family are already quite attached to him. He sits and sleeps very sedately on Shawnas lap while she carefully pets him. Its an amazing form of therapy. There isn't much therapy for the next couple of weeks but we have our hands full with visits and therapy we can do with her. Not includng the puppy training. The doctors still haven't given any instructions for the increase in tone but the physiotherapist has given us a stimulation machine where we attach probes to her right back muscle to make the left side release. This has proven to be very effective in reducing the amount of tone that is present in her left side. We hit a bad spot with the biking as Sawnas tone increased to the point she couldn't do it by herself anymore. Weve changed the way that we do the range of motion exercizes involving her legs and she has again been putting in some very good days on the bike. We remain thankfull to our Heavenly Father for what he has given and continue to thank you for your prayers and support. We would also like to take the opportunity to wish you all a blessed Christmas celebration and God's continued blessing for 2009. Al, Deb, Shawna, and family

(day 320)

Good morning all. Things are still progressing slowly.....but its still progress! We had a team meeting with all the therapists and care givers to go over the past 3 months of Shawnas care and to determine the new goals. The main jist of the conversation was that Shawna has progressed considerably with respect to amount of time she can focus before zoning out. She's gone from 1 hour to 3 hrs with a couple cat naps. Her communication is improving and her comprehension is very evident. The therapists main concern is that the sessions not overlap so she can rest and have all phsio activities occur only after the language and fine motor skills. The phsio sessions completely drain her for hours. The muscle tone in her left side is beginning to complicate the therapy. Shawna has been for a CT scan to see if there are any brain pressures contributing to this. She also had some bloodwork done to check for infections. The next thing will be for her doctor to determine if drugs are required to control the tone until Shawnas brain can adjust and be able to turn off the muscles that she can now turn on. Shawna has been out to a couple of functions and enjoys it tremendously with lots of vocalization to show her appreciation. Vocalization seems to be improving a lot especially when combined with laughter and spontanaity. When she tries to talk though it stops when she concentrates. We look forward to spending a lot of time together with family and friends during the upcoming holidays. Our contractor has been busy with the addition. The walls are up and the front of our house has been stripped to the bones to make good to the new roofline (quite a sight). We continue to realize our dependance on our Father for his goodness and guidance as we continue on the path He has chosen for us. Thanks for your prayers and support. Al, Deb, Shawna, and family