Neurological Follow-Up Complete

This morning Raquel saw Dr. Mower for her neurological follow-up appointment. He continues to be optimistic about how things are progressing. He was a little irritated about the lack of therapy she has been receiving by the school district and gave me a Doctor's Orders note to give them which basically states that "Raquel REQUIRES speech and OT therapy as mandated by her IEP" and to provide for these services. He also told us that this is a legal matter, that they are obligated to provide therapy and can be taken to court for failing to do so.

The reason for his displeasure with her not receiving therapy is that he was not able to effectively track her progress. Depakote and speech therapy work hand in hand and he wanted to observe Raquel for 6 months on the medication with regular therapy to see if he feels it is working. If after the 6 months she continues to be non-verbal, he'd begin to start modifying her treatment.

I also gave him the phone number to my HMO Group so he can sign the paperwork authorizing services outside of the district setting. I want to get these going as soon as possible. And my reality about the district therapy is this: how will I ever know it's being done? Raquel can't tell me, I'm not allowed to be there when it takes place, and the only reason I even found out it wasn't being done in the first place was by drilling the teachers and bus drivers and asking tons and tons of questions. By doing therapy through my own private insurance, I will be allowed to screen them and find one that I feel is a good match. Speech therapy right now is critical and we need to have a therapist who is up for a challenge and will work at developing a special connection with Raquel and not just showing up for "work". It's also very important that I find one that deals primarily with preschool kids and not middle school ones.

Dr. Mower wants to see Raquel again in another 6 months and at that point we'll discuss possibly adding another medication if her speech has not improved. No 24-hour EEG for at least another 6-9 months. He gave us the blood work request so he can check not only the Depakote levels but also her liver functioning. I'll do this later this week.