REHABILITATION INSTITUTE OF MICHIGAN (RIM)
The day has finally arrived!


Josh and I (Sue) went to Detroit today for an evaluation at the Rehabilitation Institute of Michigan (RIM). Josh IS a candidate for their type of therapy. Their therapy is the next step after traditional therapy (which gets you efficient with the condition you are in. In Josh's case, Mary Free Bed got Josh efficient in a wheelchair). But now it is time for that next step - WALKING!!!

This therapy allows the therapist to work Josh's leg muscles so that new nerve pathways are created where the old ones have ceased to work. They call this "reorganizing" nerve pathways. Our bodies, brains, and nervous systems are quite amazing. They are capable of much more than anyone thought and these doctors and therapist are taking advantage of the body's untapped resources to help people to regain lost functions. This will not be a quick fix. This type of therapy takes lots of hard continuous work. Traditional therapy sessions are about 45-60 minutes long, two or three times a week. This therapy is three hours long, three to five times a week. It takes a major commitment. We will have to work something out with his school since he would have to go during school hours. Most likely he will have therapy in the afternoons (1-4 pm). And as I have mentioned before, the Institute has recently opened a branch in Rockford (just 20 minutes north of Grand Rapids) which provides a much closer facility for us to access.

Josh most likely won't start until January or later. He is on the waiting list. As soon as they hire more therapists, they will be able to get these patients off the waiting list and into therapy!

Josh wasn't shy and asked if he could try out this piece of equipment. It suspends Josh so that his legs don't have to support him. Then the therapist helped him move his legs in a "normal" walking fashion which would help reorganize his nerve pathways. In a regular therapy session Josh would be wearing leg braces. Josh has leg braces and a walker that he has used in therapy, but RIM has more hi-tech leg braces that actually "unlock" the knees when you would normally bend your knee during normal walking. Josh's braces stay locked at the knee until he is ready to sit down. We need a pair of those "expensive" hi-tech braces. They would be a better fit for "normal" walking. That has been Josh's goal from the beginning. He feels like someone is finally listening to him and letting him do the kind of therapy that he wants.

A therapist helping Josh. 

A therapist helping to move Josh's leg as he tries to "walk". 

Our medical case manager is trying out the Glider. It takes you from a sitting position up to a standing position. It allows you to move your legs in a normal walking pattern while the "knee holders" keep the knees from collapsing. I don't know all the correct technical terms, as you can see. 

The glider in the standing position. In this position your hands can push back and forth and your legs will move with it. This also helps to reorganize those nerve pathways.

This nifty machine will get Josh's muscles moving to help reorganize nerve pathways to get him walking again. The patient lays on his back and then reaches hands and feet up. The feet are strapped onto the pedals. As the hands pedal, the feet move as well. Interesting!

This piece of equipment suspends the paralyzed person and allows a therapist to help them simulate walking to get the legs moving in a normal fashion. Doing this over a period of time can help reorganize the nerve pathways and help the person to walk again. 

We met with Dr. Hinderer and Brian Sheridan (shown here with Josh). Another piece of equipment (behind) that Josh will most likely be using for therapy. 

The "Total Gym" is one piece of equipment Josh will probably be using during therapy.

Basketball
Josh had basketball games in Fort Wayne, Indiana this past weekend. The Jr. Pacers won two and lost one game. I saw great improvement in Josh's playing. He was getting into position quicker and started getting the hang of dribbling and pushing his wheelchair all at the same time. That is quite a task! He was playing a much more aggressive game than before. He is really enjoying being on the Jr. Pacers Varsity basketball team. It keeps him busy and physically active.

RIM Evaluation
Josh's evaluation will take place at the Rehab Institute of MI in Detroit on Thursday, Dec. 22, 2005. He will go through the evaluation to see if he is eligible, which he most likely is, and then they will devise a plan of therapy for him. Once that is done our physiatrist will look over the plan and give her approval (or disapproval) on all or some of it. Then once therapy starts, it will take place in Rockford. It most likely won't start until after the first of the year. We'll keep you posted!

Sue

GOOD NEWS
We saw Josh's Physiatrist (rehab Dr.) today and she gave permission for Josh to try the therapy that the Rehab Institute of MI has to offer. The evaluation will have to take place in Detroit, but he should be able to have his therapy sessions in their new branch in Rockford. Now we just have to send in the application and set up a 3-hour evaluation appointment and then we are on our way. We are so excited. This kind of therapy has been our goal since the beginning. It is finally going to happen. The therapists will work Josh's muscles that are paralyzed so that new nerve pathways will be made to replace the ones that were damaged. It makes so much sense.

We thank everyone who has prayed for this with us. The power of prayer is so awesome!!! We didn't know for sure what our doctor would say today since she has always said "no" when we have repeatedly asked for this therapy. So, I know your prayers made the difference.

From a very excited Holt household tonight, we say thank you for being there for us (in many different ways) through all of this. We covet your prayers and friendship.

Susan Holt

NEW THERAPY
We are hoping to get permission from Josh's doctor to start some new therapy. We meet with the doctor December 1st. The Rehab Institute of Michigan (RIM) is located in the Detroit area, but will be opening another branch here in the Grand Rapids area soon. This therapy trains paralyzed people to walk again. They work the leg muscles so that new nerve pathways are created to get messages back up through the spinal cord and to the brain. We have been asking the doctor from the very beginning to try this kind of therapy, but she hasn't given the okay yet. After reviewing Josh's biofeedback results we are hoping she will see that this therapy could help strengthen the muscles that were detected during biofeedback. We are very impressed with the results people are getting at the Institute. Josh has to get the chance to see if it will work for him.

BIOFEEDBACK
9-19-05
Josh had his last session with the biofeedback today. They were trying to get a baseline of the different muscle groups in his legs and back. Today's session was especially exciting. They tested areas up an down Josh's back. Since that is the closest places to the area of spinal nerve loss, they had the most activity. He now has to work on strengthening his lower back muscles and then work his way down his legs. It will be a lot of HARD work!!! Now we need to get the exercise equipment in his exercise room and he can get started.

Josh will most likely go back in 6-12 months to see if there is improvement. It would be so nice if we could have the biofeedback equipment at home to see the improvement, but that would be too costly. It would be nice though.

Now let the hard work begin! Josh can do it!!!

Sue

MORE BIOFEEDBACK

Josh went for more biofeedback today. Instead of trying to flex his muscles while sitting, he stood up with his leg braces and walker. He did even better than the last time. We set up three more sessions and will set up more because he is doing so well. Josh has been doing exercises to strengthen his upper body and working his abs. There has been much atrophy in the ab and hip areas, but his abs are beginning to get some tone back. The hips need a lot more work though. We were so encouraged after today's session. Excitement is in the air!!!

Sue

BIO-FEEDBACK (8-24-05)

Josh had his bio-feedback session today. They hooked electrodes to different parts of his hips and legs and asked him to move those muscles under the electrodes. The computer would show whether or not he was moving those muscles and how much. We are excited about the results. He was able to show movement in his hips and a little in his upper legs. Nothing moved as they worked further down towards his feet. That is normal since muscle movement nearest the spinal cord would come back first.

We go back next Friday so they can see if there is better movement when he stands using his leg braces and walker. Josh is going to start doing some suggested exercises to build up more strength and muscle movement in the hip area. He has to start working on the areas that show some movement.

Today was very exciting and we are hoping and praying that things will only progress forward.

Sue

CHECK OUT THESE SITES

Here are some other sites to check out. These people are among the first in the world to have this special stem cell surgery (using their own stem cells from in their nose). They are also among the first to take part in a very intensive therapy program in Detroit, MI that has shown great promise for paralyzed people. You can see for yourself how it has helped these people. Also, here is the site for the Rehab Institute of Michigan (RIM) so you can keep updated on the cutting-edge research.

Sam Wassink: www.prayers4sam.blogspot.com
Eric Chase: www.ericchase22.blogspot.com
Jason Feasal: www.feaz81.com
RIM: www.rimrehab.org

This is the Holt family. Our oldest is in the Navy. Pretty impressive uniform, Caleb. The family photo was taken about 4 months after Josh's injury (Fall 2004)

Josh Holt 2003