"…to the praise of the glory of His grace…" Ephesians 1:6

Rehab Update

We had a flurry of activity in our rehab center over the last few months and have now officially closed the center until the end of the summer.  This week our team is devoted to making final preparations for the camps for adults and children with disabilities that begin next Tuesday.  After camps, all of our staff has vacation time before we resume rehab at the end of August.  We had many new patients find our center in recent months and the therapists tried to conduct as many evaluations and consultations as possible.  Our current rehab patients all received detailed home programs to work on during the break and we look forward to seeing many of them at camp!
Our children’s room has been blessed with many new toys and rehab items, some that we ordered and some that arrived in a humanitarian shipment to the church.  My personal favorite is the basketball goal!  Here are some of our kiddos (unfortunately, we didn’t manage to get pictures of several of our newest kids):

Ilya on our skateboard-turned-scooter

Anna- Maria working on her hoops skills

Mark loves to draw and play “guess that picture”

Maxim and Sveta working on the stairs 
Ivanka using another makeshift scooter

On the adult side, we have several new faces:



Vasya’s spinal cord injury was 2 years ago and he started rehab about a month ago.  His brother drove him almost 2 hours one-way for rehab twice a week.  Expensive, but profitable trips as Vasya has made good progress.  We are particularly excited that Vasya has agreed to come to camp!  Please join us in praying for his repentance.  


Miroslava came for a consultation last fall due to progressive weakness in her legs leading to falls and difficulty walking.  We ended up referring her to a neurosurgeon who discovered a tumor on her spine.  She had the tumor removed and returned to us about a month ago to work on her walking.  She is a joyful and kind lady and she’s so tiny that she gets to use the pediatric crutches! We are thankful for the progress she made in a short amount of time and look forward to seeing her again in the fall. 

Being able to help new patients is great, but it also presents challenges.  During this last month, it meant that our therapists had to have difficult conversations with some of our long-standing patients who have maximized their potential.  Unlike in America, we no insurance regulations that determine the length of rehab services for each patient, no physician who oversees patient care at our center, and no multidisciplinary teams to discuss and determine each patient’s plan.  Sometimes the absence of those things is a pro, but often it’s a con. 

You see, most, if not all, of our patients with spinal cord injuries arrived at our center with no realistic understanding of their prognosis.  It has been our experience that physicians in our region are not clear with them about their potential after their injury.  They either tell them exactly what they want to hear…”You will walk,” or they fail to tell them the information that we find later in their documentation…that the patient’s injury is classified as the most severe, indicating no potential for walking.  As our therapists conduct their evaluations and begin educating patients about the results and the goals for rehab, they often find themselves to be the first voice of reality and “negativity.”  They break the news that the patient’s leg movements are caused by spasticity and they actually exhibit no voluntary muscle control over their legs.  They have the challenging discussion about the patient’s goal of walking and how it is not realistic at this time and may never be, so we will start with simpler, more achievable goals.  Over time, patients often come to understand their prognosis and work hard to progress toward these other goals of rolling, sitting, transferring, and propelling their wheelchair. 

Some of our patients with spinal cord injuries have had rehab for years to achieve their maximum potential and some maximized it in months.  Either way, the topic of discharge is always difficult.  First of all, our therapists have to acknowledge that we don’t see more potential, that we can’t write any more achievable goals for this patient…that’s tough.  Then it can be even more difficult to face the patient and state the honest truth that their rehab potential has been maximized, that their current functional state is probably the best they can expect, and that we are discharging them.  It’s hard to be the bearers of this news.  And it’s harder still for those patients whose physicians and surgeons have been telling them the opposite.  God was faithful to give our therapists wisdom as they had these conversations recently and He answered the prayer that patients and their families would be understanding and accepting. 

Thankfully for us and our patients, discharge from rehab does not have to mean complete discharge from our center.  This is one pro to being on our own with no insurance regulations.  We have two categories of patients at our center: patients who receive rehab services and patients who receive prophylactic services.  Those who receive rehab services are progressing, continue to have achievable goals, and come 2-3 times a week.  Those who receive prophylactic services are those who have maximized their rehab potential and come 1 time per month.  We have this prophylactic category for several reasons.  First, our center is part of a ministry and our first goal is for our patients to know Christ.  We want to stay in their lives to show them more of Christ.  Second, many of their families cannot or do not perform physical tasks for them like range of motion of their legs or transfers to a wheelchair.  Bringing them to the center lets us keep an eye on their physical status.  And third, it give them an opportunities for activity and fellowship with people outside their home, something that can be very infrequent for some of them. 

Anya continues her rehab

Kolya comes for prophylactic services
Anya was discharged and will receive prophylactic services if she chooses

Anya, in the last picture, was a particularly difficult person to discharge.  I have mentioned her before – she had corrective surgery of her scoliosis and is now a paraplegic.  Her surgeon was telling she and her family exactly the opposite information we were about her prognosis.  Unfortunately, more than 8 months after her surgery she continues to show no signs of muscle activation in her lower body.  She is very independent in a wheelchair and in answer to prayer she and her father accepted the news of her discharge with understanding.  But please continue to pray for Anya, who is only 14 years old.  Pray that her therapists will be able to stay in contact with her and that God would work in her life.

Lastly, please pray for these folks:

With the exception of my mom and the addition of a couple of others, this is our core ministry team.  Please pray as we head into 3 weeks of camp: for love, joy, wisdom, endurance, and the truth of the gospel to go out.  Pray for those attending the camps, helping in the camps, and all the logistics involved when 150+ people are in camp, many of whom have disabilities.  Pray for God’s Word to be spoken clearly and for the Holy Spirit’s work in people’s hearts.

I hope you are all having a wonderful summer and I look forward to telling you all about camps!

via: Rehab Update“>Advancing with a Limp