Equipping People To Make Sense Of What They Are Told
Family History.
Non Relevant for M.S.
Past Medical History
Apart from symptoms of M.S. There is no relevant medical history, However it should
be noted that this person is an honours graduate in French language, horse rider
and has travelled extensively in France. This may be relevant to a possible link
with Borreliosis (Lyme)
Symptoms
In 1995 she developed paraesthesiae in her toes as her first symptom of a rapid primary
progressive form of M.S. Diagnosed by a neurologist and MRI scan, which demonstrated
numerous plaques.
When seen on 8 May 06, she had marked spasticity and spasms in the lower limbs, which
produced ulcerated heels. She had athetoid movements of the arms on the slightest
touch. She was unable to turn her head to the left.
There was uncontrolled nystagmus. Colour vision was impaired through the whole range.
She had swallowing difficulty, loss of intellectual capacity (though a graduate in
the French language she could no longer speak or translate English/French or French/English).
A series of independent reports from Patricia Shelley MCSP. HT. HPC. Registered
IBITA. Senior Bobath Tutor
12 July 06
The patient and her parents have requested that I write you a small report as to
the observational effects that I have seen from the goat serum. I saw xxxxx on 12
June. Her whole appearance had improved in that she had more neck extension, she
looked more alert, her ataxia in her head and neck had decreased about 20%. Her breathing
was calming and the overall excitation of her nervous system was improved.
From a handling perspective, I could touch xxxxx arms and treat her upper limbs with
ease. This is a tremendous breakthrough for me as a physiotherapist. It would appear
that the hypersensitivity of the skin was greatly reduced. Due to this fact alone,
I could work towards head and neck and upper limb alignment without xxxxxx complaining
of pain.
I saw xxxxx again on 3 July. This time there was a huge difference in the lack of
swelling in xxxxxx face. Again she was more alert, it would also appear that her
vision had improved as she commented about the cat picture on the wall. This she
has never done before. On this occasion, I was able to release the muscle spasm in
her arms and was able to get her arm more comfortable on the wheelchair arm rest.
At the end of the session I managed to get xxxxx arms down by the side of the wheelchair
with no pain. Her head and neck were straighter. She had an increase of range of
movement in the upper limbs, albeit very small but there was no pain until 40% of
flexion in the right upper limb.
2 Jan 07
Since I last wrote to you xxxxxx is now having weekly physiotherapy at home as well
as coming to me as and when she can. She has just had two weeks at home where mum
and dad have been doing lots of arm exercises and it would appear that this has been
very beneficial as both arms can now come down by the side of the wheelchair which
we haven’t been able to do for over eighteen months. The ataxia when we take the
arms out to the side is initially worse but then settles off and xxxxx is in much
less pain. Her legs can also be straightened out easier and all in all things are
on the upward scale and she she is doing reasonably well.
Her head and neck movements are much improved in that she can turn both left and
right without her head and neck shaking too much.
I hope that perhaps we can start to do some dual sessions with the other physiotherapist
so that we can actually think about sitting her on the side of the bed and start
to get some better sitting balance now that this right shoulder is less painful.
I have seen xxxxxx on three more occasions since I last wrote to you. There have
been some more positive changes in that I can definitely do far more in an hour than
I was able to do before the treatment started from you. I have been concentrating
very much on trying to get head, neck and shoulder girdle alignment.
The head stays longer in the midline, her facial muscles are more symmetrical, jaw
opening and closing has more symmetry, although the temporo-mandibular joints on
both sides are still not in the true plane. The head ataxia is stopped very easily
now with pressure on the forehead towards the occiput which gives more length posteriorly
in her neck and trunk musculature. This has resulted with increased alignment in
the coronal plane of her head and shoulder girdle which is very important for her
breathing and swallowing maintenance.
Breathing is more symmetrical and she now has increased air entry in both apical
lobes at the end of the the session today. In respect of active movement in her head
and neck she is now able to tuck her chin in by herself and this gives her more control
of her head going backwards.
It would appear that we are therefore, progressing with increasing her posture and
extension. Selective movement in her head and neck is definitively positive and the
pain in her upper limbs is reduced at rest although there is still pain with therapy
albeit greatly reduced and tolerable for xxxxxx.
10 June 07
Since her Baclofen pump has stopped she still has no pain at rest in her limbs. However,
on movements, when at the end of her range then xxxxx response is very definite.
Her legs are a little stiffer than they were but still relatively easy to straighten
and certainly in the wheelchair she has no spasms, which is obviously for us all
to manage. On a positive note her voice is louder and she is able to hum for a few
seconds, her ataxia in her head and neck is greatly reduced at rest with almost no
shakes. However, on movement there is still difficulty although frequency and range
of tremor is much less.
xxxxxx can now hold her head off the back rest for a short time.
Her responses to questions are much quicker. She has been going out with a carer
and so stimulation has been improved. She can now lift her arms up albeit they are
shaky and her eyes are less mobile. I am still concentrating on the head and neck
and breathing difficulties. On handling xxxxxx there is a very strong deep pull to
the left which I have to work very slowly to decrease. The carry over here is very
difficult. I am hoping to visit xxxxx at home later this month and do a joint session
with the physiotherapist in order to ascertain future
