Friday, August 28, 2015

A therapy session with Rachel

Hello, my name is Brad Cooper. I am the primary physical therapist working with Rachel in this outpatient setting. Yes, I am the physical therapist who suggested that Rachel increase her treatment sessions to three times per week instead of two. Although Rachel made a face and rolled her eyes a little (because she knew she would be giving up a day of swimming), she did not hesitate. Rachel has been very consistent and compliant with her treatment and exercises and has been progressing well because of her hard work.

A therapy session with Rachel

A physical therapy session.
A physical therapy session.

Hello, my name is Brad Cooper. I am the primary physical therapist working with Rachel in this outpatient setting. I am not writing because I was asked but because—after getting to know Rachel and reading the blog—I feel compelled to do so.

Yes, I am the physical therapist who suggested that Rachel increase her treatment sessions to three times per week instead of two. Although Rachel made a face and rolled her eyes a little (because she knew she would be giving up a day of swimming), she did not hesitate. Rachel has been very consistent and compliant with her treatment and exercises and has been progressing well because of her hard work.

Working with Rachel is all about her laugh and her smile.

Every time you ask her how she is doing, she will say she is tired and then laugh. Every time you ask her to do an exercise or an activity, she will give you the look and then say, "OK" and laugh. Every time we reach a milestone (such as lifting her leg up against gravity), she will proudly say, despite the exhaustion, “Look what I did” and then laugh.

When Rachel is having a bad day and even some pain, she seems to always let it out and then move on and begin to laugh again.

Laughter is good exercise (it uses a lot of different muscles), but it is not the only exercise or activity Rachel does in physical therapy. 

When we started therapy, we worked in and out of the pool for Rachel’s treatment. Most recently, since Rachel is spending so much time in the pool with her swim team, we mostly work on land. 
Presently, she spends about an hour and half, three days a week, at our clinic. We are working on her strength with exercises, on her balance (she is getting very good at this) and her gait as well as her range of motion. At the same time, we are trying to keep her pain down and have a little bit of fun.

And, of course, there is the smiling and the laughing. But we don't have to work on that. It comes naturally. 


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About this blog
Rachel Kovach, 12, is a seventh-grader at Mother Theresa Regional School in Atlantic Highlands, N.J. She lives in Highlands, N.J., near the Sandy Hook national seashore, with her parents, Mari and Kurt Kovach.

Since first grade, Rachel has been swimming with the Monmouth Barracudas, a year-round competitive United States Swimming Club program. She hopes to continue competitive swimming after her cancer treatment; if not, she envisions coaching someday or maybe a career in medicine. Figure skating and jazz dancing have been big parts of her life. One of the things she hates about being in the hospital is missing her dog Cocoa and her many friends.

Rachel's doctors

These are the key physicians overseeing Rachel’s care at Children’s Hospital of Philadelphia:

Naomi BalamuthNaomi Balamuth, pediatric oncologist, specializes in treating pediatric sarcomas, a subset of solid tumors.

 

 

Richard B. WomerRichard B. Womer, pediatric oncologist, led studies of the latest chemotherapy treatment protocol for Ewing’s sarcoma.

 

 

John P. DormansJohn P. Dormans, M.D., chief of orthopaedic surgery, is an international expert in the surgical treatment of musculoskeletal tumors.

 

Timeline of Rachel Kovach’s Treatment

Dec. 3, 2010: Pain in Rachel's right knee is initially diagnosed as tendinitis.

Jan. 20: An MRI reveals a tumor in right leg.

Jan 24: Rachel sees John Dormans, chief of orthopedic surgery at Children's Hospital of Philadelphia.

Jan. 27: A biopsy confirms Ewing's sarcoma.

February to mid-April: Regimens of chemotherapy alternate every other week. The three-drug regimen is given over two days; the two-drug regimen is given over five days.

May 3: Surgery replaces most of the right femur with a prosthesis.

May 5: A Children's Hospital team will help Rachel get out of bed.

May 10 to September: Alternating regimens of chemotherapy are to resume.

Around May 10: Physical therapy will begin in the hospital and continue for at least several months after Rachel goes home.

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