Here's a snippet from the Botox assessment. This is what Dr L wrote in his notes about Isla - full of lots of technical stuff, all of which is completely lost on me, but some others may find it useful. I thought I should pop it on here, given that I will no doubt lose the actual piece of paper it's written on. I haven't received a letter like this before, so it's interesting to read all of this, even if I don't understand it ;)

Isla's OT reported that with her Peabody Developmental Motor Scales assessment of her fine motor skills, Isla scored well within normal range. Isla has not yet developed hand preference but prefers to use her right more than her left. There has been a significant decrease in mirroring of her hand movements and there is less tremor.

Michael has also been seeing her privately. He notices internal rotation, particularly of the right leg with the need to circumduct the right leg for clearance of the left. This improved after serial casting to her right leg for 2 weeks in early February 2009. Her mother also agrees that Isla was walking much straighter but the effect of this was not sustained.

Indeed today when Isla walked, she was leading with her right pelvis so the left pelvis was retracted. Her foot progression angles were + 20 degrees on the left and - 40 degrees on the right. Initial contact was with the right forefoot but she did achieve heel contact on the right in mid-stance. At times, she had left forefoot contact initally as well. She had circumduction of the right lef to assist with clearance. Isla was slightly crouched by up to 10 degrees at the knees during mid-stance.

Isla was demonstrating increased tone in the right gracilis. Passive hip abduction in flexion was approximately 45 degrees on the right and 50 degrees on the left, and in extension approximately 25 degrees on the right and 30 degrees on the left. There was internal rotation bias at the hips in extension to approximately 80 degrees on the right and 60 degrees on the left, with external rotation being approximately 30 degrees on the right and 40 degrees on the left. there was no excessive tibial torsion. Foot-thigh angles were + 20 degrees. Gastrocnemius length bilaterally was approximately + 15 degrees with the initial catch at - 15 degrees on the right and - 10 degrees on the left. Soleus length was + 25 degrees with initial catch at +5 degrees on the right and + 10 degrees on the left. There was sustained clonus bilaterally. Popliteal angles were approximately 20 degrees with no catch.

Isla's kindy sent home a really interesting hand-out this week about school readiness. I've never really thought twice about not sending her to school once she reached the age where she could start. Now I'm reconsidering.

I'll share it with you..It's called "Am I Ready for School?"

Dear Mum and Dad,

I was born after March so please carefully consider my readiness for school
next year before enrolling me.
Remember that the legal starting age for school is 6 years of age.
Remember that I may be a whole year younger than children who will start
next year, and I may not have the social and academic skills necessary to
compete with these children.
These things may not show up until the later years of schooling and the
decision you make will affect my entire life and attitude to learning. Please
give this matter some serious thought.
To cope with school I need to be self-confident and have a positive self
image, not just at home where everything is familiar, but also in a large group
situation.
I need to be able to communicate freely and be verbally understood. I also
need to be able to follow complex directions.
I have to be able to concentrate on any activity for a set amount of time
to complete a task.
I have to be independent and able to care for myself - toileting, dressing,
and taking care of my belongings.
I also have to have social skills - being able to deal with frustration,
anger, being able to co-operate, respect others and their belongings and to
share.

Mum and Dad...being able to write my name, know my ABC and how to rote
count are not so important. If you are going to teach me these things, please
make sure:
Writing should be taught in the NSW foundation style. It has special letter
formation and the direction of the hand movements to form the letters is most
important. It is very confusing for a child to be taught one way at home and
another way at school. Please put a capital letter at the start of my name only
eg: Kylie not kylie.
Knowing my ABC does not really help me read. It is more important for you
to read to me, listen to me and talk with me.
In order to be ready for school, I need to have developed my:

• Fine Motor Skills - hold pencil and brushes, thread items, manipulate
  dough.
• Eye-Hand Co-Ordination - Threading, cutting
• Gross Motor - active play, climbing, throwing, catching, running
• Concentration - ability to participate in group discussions and
  activities.
• Social Skills - able to cope with emotions, have ability to take
  turns.

The 50 most important skills for children commencing school:

1. Use the toilet independently.
2. Follow verbal instructions
3. Dress & Undress
4. Identify/recognise own name in print
5. Look after own belongings
6. Share with peers
7. Express/indicate needs/wants
8. Hold pencil to make marks on paper
9. Keep still for short periods of time
10. Separate from parents at school
11. Take turns
12. Speak clearly
13. Identify own school bag and belongings
14. Open lunch box
15. Use tissues
16. Say their name
17. Know to/how to wash hands after toileting
18. Play with peers appropriately
19. Respond to their own name
20. Communicate with peers and teachers
21. Ask and answer simple questions
22. Use scissors
23. Tie shoelaces (at least practice this lots)
24. Write their own name in lower case letters
25. Listen to a story
26. Put things away after use
27. Know common colours, shapes and numbers
28. Listen to instructions
29. Eat independently
30. Participate in group activities
31. Know own name
32. Speak in complete sentences
33. Adequate concentration span
34. Listen to others speak in a group
35. Awareness of why they are at school/keenness to learn
36. Count to 10
37. Show an interest in books
38. Acceptable behaviour for school
39. Show respect to teachers/adults and manners
40. Ask for help
41. Hold book and turn pages correctly
42. Eye contact
43. Share an adults attention with other children
44. Recite nursery rhymes/simple songs
45. Know address and phone number
46. Be familiar with/use pencils. scissors, glue, paintbrushes
47. Attempt drawing
48. Fine motor skills
49. Walk up & down stairs safely
50. Accept correction/follow request appropriately

So there you have it. Interesting.

We saw Dr L on Tuesday. I love this man. I feel very privileged that we are able to see him at all.

First appointment after lunch, 1pm - we arrived at 12.40pm left at 3.20pm. LONG day with the girls.

Isla has been sick with the 'flu for the last few days, and was particularly bad yesterday. Any smart mother probably would have not taken her out, but with the waiting list so long to see Dr that I just didn't want to cancel. I was pretty surprised when he said, "I haven't seen Isla for almost a year" Surely not?! I really should have waited around in October last year.

So, we're having botox. Still uncertain just how I feel about the whole thing, but that's secondary I guess. Isla doesn't know about it all just yet, and that's for a few reasons. 1. That I have absolutely no idea how to explain it to her. 2. I don't quite know what to expect and 3. It's not until June, I don't want her stressing about things until then.

June 4th we're booked in. Wish us luck. Her right leg is turning in quite a lot, all of us were really shocked to see just how much it tuned on Tuesday, even Ian and I commented to each other that we've never seen it that bad before. Thinking about it now, I think it may have been more obvious because she really wasn't very well. Today it's nowhere near as pronounced.

She'll be having 3 injections in total. 2 in the right leg, one in the left. Then will be in plasters about 3ish weeks afterwards (I think I heard that right). They said something about the gastrocnemius (thanks Google!) muscles. Wiki tells me that's the calf muscles. They're also doing hamstring on the right hand side. I really should learn all these proper terms for the muscles, then I might have some clue what they're talking about.

Only little doses of the Botox, Dr L said we may not see any difference (which makes me think, why bother) but he said better to start out small and increase as she needs it. It'll be interesting.

She'll have the injecitons under sedation, thank god. She'll have the nitrous oxide (laughing gas) and morphine as well. Dr L advises us to get hold of an anaesthetic mask so Isla doesn't freak out with it. Will see if Aunty Kate can hook us up with one of these.

Hip X-rays showed slight migration in the right hip, but nothing to be concerned about. Probably caused by the way her right leg is turning in. There was talk of theratogs, will have to investigate further.

We saw Michael the physio yesterday, and he introduced us to "Dynamic Taping". This funky bandage (fabrifoam) which is smooth one one side and grippy yet foamy on the other, which we wind around her leg, which helps to pull it out. It's awesome. Michael strapped her up yesterday over her orthotic and when Isla ran her leg was straight! Still pulled in a little when she walked, but a massive improvement. I showed Ian how to put it on last night and he was surprised by how well it worked. Will definitely have to stick with this!

Haven't taken photo's for a while. Will strap her up and take some pics today hopefully!

I have been SO very slack. I do genuinely come online to update Isla's blog but get distracted by Twitter *hides*

Amanda from Swish and Swanky sent this beautiful gift to Isla, out of the kindness of her heart. Amanda is such a gorgeous lady, thank-you SO much! Bella, as Isla has named her, hasn't left her side since she arrived yesterday, she even came to swimming lessons and to the physio today!

The ballerina was knitted by Rachel from Knitwish on Etsy - you MUST buy one of her creations, they are so beautifully made.

Thank-you, thank-you, thank-you Amanda!

Isla started swimming lessons yesterday. She was freaking out before we got there, saying she didn't want to go in deep, and she didn't want to put her head under the water. She has been terribly afraid of water since NYD 08 when she was in an inflatable backyard pool at the IL's place.

I was down the back taking photo's of my niece and nephew, FIL & Ian were in the pool with her. Both boys got out of the pool and left Isla in there, thinking she was holding on to the side, she tried to walk across the pool (the water came up to her armpits) and she slipped. I came up from the back and saw her completely under the water, on her own and trying to get up. I didn't know how long she'd been under, single-handedly the scariest moment of my life.

Putting Isla into swimming lessons is something I'd been meaning to do for the longest time, but I finally decided that we've wasted enough time and made an enquiry at the local swim school. As luck would have it, there is another girl at the pool having lessons who has Spastic Diplegia too, and her mother agreed to Isla joining the lesson (which saved her $35 a lesson!). The other little girl, Sarah, is gorgeous. She is 6 and can swim freestyle and can almost do breaststroke. So great to see another person with the same condition as Isla, it gives me great confidence in what Isla will be able to do.

Isla loved the lesson by the time it was over, she was scared when she first went in and kept calling out, "Mama, I need you!" in a very high-pitched screetching voice! The instructor, Nicole, had no chance getting Isla to blow bubbles, and I thought we were going to be in for a loooong lesson when Isla asked me to give her a towel and wipe her face because it was a tiny bit wet!

But, once the teacher took Sarah for a little paddle, Isla very slowly put her face in the water and started blowing bubbles! And the rest, as they say, is history! She was floating on her back with the instructor, and even tried diving in!

When the lesson was over and she was out of the pool, little teeth chattering away, she said "I want to go back in the pool" LOL

She even insisted on wearing her swimming cap home and plans on taking it to show Michael her physio this afternoon!

I have some video of her using the kickboard too, will upload it shortly. I am so proud of her, she was so incredibly scared at the start of the lesson, and now she can't wait to go back!