My advice for other families is to never give up. It can be a lot and you’re always trying to find the right answer or solution, so be persistent and keep going,
Managing Hypertonia of the Lower Extremity
Elsa Lopez was overjoyed to welcome her twins, Gabby and Joel, into the world in December of 2011. They were two healthy and happy babies. It wasn’t until months later when Elsa noticed that Gabby was not making any strides to crawl or take her first steps. She took her to be evaluated at a local children’s hospital, where it was discovered that Gabby had hypertonia of the lower extremity, which made it difficult for her to crawl or walk. “Her left leg goes inward and almost on a tip toe, like a ballerina position,” said Elsa. “When she was younger, it also used to affect her arms, but luckily it stopped when she was in the first grade.”
After her diagnosis, Gabby was still not walking or crawling and needed to begin physical therapy to help her leg adjust. However, it was a difficult time for therapy as Gabby was so young. “She wasn’t tolerating activities at first. It was hard for her and she would cry a lot, so we took a break and decided to come back when she was a little bit older,” noted Elsa. She started coming to Children’s Specialized Hospital’s Mountainside facility when she was 18 months old. After much progress in physical therapy and her first procedure of Botox injections with a serial casting, Gabby took her first step when she was 2 and a half years old.
Physical Therapy Journey
Gabby, now 11 years old, continues to go to physical therapy at our Union location where she works with Clinical Lead, Physical Therapist, Laura Higgins.
“During therapy, I work on many things, like jumping and stepping on blocks,” said Gabby. “Laura is really nice and whatever we do, even if it’s a small activity, she always asks for my opinion and lets me pick the game, which I love!” Jumping was a difficult task for Gabby at first, but now she enjoys it and is able to jump on the trampoline during therapy sessions.
Throughout the years, Gabby has gone through several procedures to help her with mobility in her left leg. “She has gotten Botox and serial casting, worn braces and tried swimming therapy,” explains Elsa. “The Botox injection helps to relax her leg muscles as her muscles are very tense and do not stretch.” After the injection, her leg can now easily extend, which allows Gabby to undergo serial casting. Serial casting helps to improve the function in her leg. She gets this done every 1-2 years. Gabby also puts a lift in her shoe to help her foot touch the ground, making it easier to walk.
“It’s great to see all the progress that Gabby has made. We love working with Laura as she has built a relationship with my daughter. She makes sure she really works in therapy and that’s exactly what she needs,” adds Elsa.
“I have had the pleasure to work with Gabby and her family for a number of episodes of care over the years! For her most recent episode of care, Gabby really advocated for herself and identified her goals. This included improving her ability to complete cheer-based jumps and skills, since cheer is what she and her friends often did during recess,” said Laura.
Overcoming Obstacles
Gabby has come a long way with the help of physical therapy. “She has gone from crawling everywhere to walking great,” shares Elsa. “We do not restrict her from any physical activity. She’s able to do everything!”
“I love musical theater and moving around the stage,” adds Gabby. “I also do gymnastics with my friends. It’s a little hard, but my friends help me a lot.” Gabby also loves going shopping with friends and hanging out with her two older sisters, older brother and twin brother.
“Gabby has worked really hard and demonstrated not only the ability to complete various cheer jumps, but also improve her symmetry in completing a jump leading with one leg versus the other. She is able to complete various jumps in succession, which is really amazing and such a testament to what can be accomplished with patient led goals,” added Laura.
When asked what her greatest hope is for Gabby, Elsa said “I hope one day she will no longer need to get procedures done since it’s a lot for her to go through. We’re hopeful that when she stops growing, the muscle may not need to be as stretched and it will make a big difference.”
“My advice for other families is to never give up. It can be a lot and you’re always trying to find the right answer or solution, so be persistent and keep going,” Elsa added. “There’re always new medical things coming out, so make sure to stay informed. This can be done by asking your therapist for more information and if there are other things to try. Lastly, go to all the appointments because it’s worth it and eventually you will see results.”
