28 July, 2010

Will Chan Chea walk again??

Recently, we met 25 year old Chan Chea, out in one of the villages in Kandal Province, not far from Takhmao. Chan Chea become unwell 4 years ago, when she was 21 years old, and since then, has not walked. From the history given, it seems she had encephalitis. It resulted in her muscles changing, becoming very weak and developing some spasticity. When we met Chan Chea, just 3 weeks ago, she was unable to stand on her own. She could hold herself up in parallel bars for a very short period of time, before the pain from standing on deformed feet got too much. Chan Chea showed promise. She had some power in her muscles, and it seemed that if we could help change the position of her feet, and give her a good base to stand on, then with strengthening, could we get her standing and walking again?? So with great casting handywork from physios Sokny and Hoeurn, we started the process of serial casting Chan Chea's feet, aiming to gradually gain a better position. It is highly likely that Chan Chea will also require surgery, which we try to have arranged as soon as possible after her feet are more mobile. Below you can see photos and videos of the procedure over the last couple of weeks. The casting was commenced on Thursday 8th July, with regular casts changes since. Today, July 28th, Chan Chea had her 4th lot of casts applied in the 3 weeks. Chan Chea was also shown strengthening activities to continue at home, and last week was encouraged to practice standing in her casts. Her feet were still not at a neutral position for standing, Sokny's handywork with 'flip flop' shoes to create wedges to place under the heels of the cast meant she could stand in her casts. This was fabulous progress. But today was the day where I really saw that Chan Chea might actually walk again. Today she was so brave. Before changing her casts, assisted by 2 of us, Chan Chea walked about 2 metres in her casts. The look on both Chan Chea's face, and her mother's was of complete joy, and almost shock, that she was actually doing it. Sokny then assisted Chan Chea back to sit down with her Mum, teaching her how to help her to walk safely. Chan Chea's aim is to be able to work and integrate into society. With her disability, she cannot work, and her mother can not work, as she has to look after her. So the family has 2 less incomes, a huge impact on the family. Can we help Chan Chea to achieve this aim? If today is anything to go by, then it's highly possible. She will, however, still require significant foot surgery to further correct the foot, but the casting has provided a great start and enabled her to start strengthening activities and assisted walking in her casts. With discussions underway with surgeons, the procedures will be determined and surgery will occur as soon as possible.

Watching on intently

Visit to do third lot of casts

Just prior to removing second casts,4 days later

click to view video introducing Chan Chea

Removing the casts

The third lot

Heel raise being made by Sokny, to allow Chan Chea
to practice standing (need to have a 90 degree angle with the ground)


Below are the pictures taken at the beginning of today's visit, 28th July. Prior to removing Chan Chea's 3rd lot of casts, we practiced walking with her. She required assistance, as her muscles are very weak and the casts are very heavy. Her balance also needs improvement, understandably. She did so well! Her mother has been shown activities to help Chan Chea continue on with at home, to improve her strength.

After the 3rd casts were removed, Sokny assesses her foot

Very helpful chickens out in the community :)

Getting a better position, 4th casts

(28th July)

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