SPIO and SMO

The title of this post sounds like gibberish, right? I would have thought that too, a few short months ago, but now I know what a SPIO vest and SMOs are.

Ryan wearing his SPIO and SMOs

SPIO stands for Stabilizing Pressure Input Orthosis. It basically puts pressure on the body, as a form of sensory input, which helps balance, movement control, stability and posture. It's a vest that Ryan wears and it has velcro straps all around so it's easy to put on and take off (once you get the hang of it). He's wearing it pretty much all day now, with the exception of nap times and if we go outside since it's been so hot. The material is thick but stretchy - almost like a wet suit. We have to strap it on him pretty tight but the material will give with some resistance when you slide your finger underneath and pull it out. It has 2 strips that appear to be plastic on the back of the vest that are on either side of his spine. I believe these strips provide extra input for his posture to keep his back straight. Ryan can wear his spio vest inside or outside his clothes, but since we take it off for naps, I've been putting it on outside his clothes to make it easy.

Back of his SPIO vest so you can see
the plastic strips lining his spine

SMO stands for Supra Malleolar Orthosis (that still sounds like gibberish to me!). The SMO is an ankle stabilizing brace that will assist with alignment - remember how we talked about pronation? - balance, stability, etc. Ryan wears them on his feet/ankles for added support. They're molded plastic and are quite slippery on the bottom, so he has to wear shoes if he's going to be standing while wearing his SMOs. These had a bit of transition/ramp up time. He started out wearing them just 30 minutes a day and has been steadily increasing each day. We were supposed to go by 30 minute increments, but after a few days I quit watching the clock and just took a stab at how long he should keep them on. Now he pretty much wears them all day, with the exception of naps. I have to keep a close eye on his feet and make sure there if there are any red marks, they go away within 15 - 30 minutes of taking the SMOs off. If not, there could be an issue with the fit or the way I'm putting them on. So far so good though.

Close up of his SMO

He has adjusted to wearing both things beautifully. He does't seem to mind and doesn't fuss or put up a fight when we put them on him. He's so laid back and easy going.

We originally though Ryan would also need to get AFOs, which is another type of ankle brace. It goes higher up the leg and attaches around the calf. Ryan proved he didn't need AFOs, however, when he started standing up on his own and bearing his weight on his legs (I say standing "on his own" meaning that he's totally supporting himself, but can't stand totally independently because he doesn't have the balance - we only have to keep him steady but he's bearing all of his own weight). Go Ryan!!

We randomly got the SPIO and SMOs last Monday. I called the provider to see where we were with our order and she told me she'd been meaning to call me, that the order just came in. She said Ryan and I would have to go to her office to get fitted and for me to get educated on them (how they work, how to put them on, how to clean them, etc.) but the only appointment she had for the whole week was about 1.5 hours from that time. Luckily I didn't have any scheduled work meetings and the boys don't have any therapies on Monday afternoons, so I took that slot. I didn't want Ryan to wait longer than he had to! I wrapped a few things up, got the diaper bag ready, snuck into the nursery during nap time (this is a big time NO NO under normal circumstances), grabbed my boy and went to the orthotics office. Our rep there went over everything with me, fitted Ryan's SMOs, gave me paperwork and answered my questions. She also said that his regular shoes wouldn't fit over the SMOs and recommended that we go to Stride Rite to get him fitted. Apparently the Stride Rite people do this all the time and know how to fit the shoes over the SMOs and make sure he gets the right size and the right fit. Since we were out and about and near the mall anyways, as soon as we were done with orthotics, we ran by the Stride Rite and got my little man some new kicks!

These are his new shoes he can wear
over his SMOs

While zooming through the mall, Ryan was wearing his SPIO and his SMOs and I was wondering in the back of my mind whether people would notice and what they would think and if they would wonder why he was wearing them. These thoughts don't upset me or bother me, but they exist in my mind. So when I was briskly strolling through Belk, I saw some ladies looking at Ryan in my arms and right when I walked by them, one said, "he's got the most beautiful eyes!". HUGE SMILE on my face as I thanked them! Of course people will look at Ryan! Not because he has some weird stuff on, but because he's incredibly handsome and his insides are just as beautiful as his outsides. His sweet spirit encompasses the area around him...you can feel it.

Here are a few pictures from the orthotics office last Monday.

 

First time with a SPIO vest

 

Standing up with just a little support from Mama

 

Just chillin'...

 

Getting his SMOs fitted and adjusted

 

Ready to go with my new gear!

Preview! We're getting more gear for Ryan. Ashley (PT) brought in a rep that helps with assistance equipment and he came with a gait trainer for us to try out. As the name suggests, a gait trainer helps with the gait, aka walk. It will put Ryan in a position for standing and walking. When we tried him in it, he was resting and wasn't really bearing his own weight, but once he gets to try it out a little more, I think he'll get the hang of it. So now we've got a gait trainer on order for him and expect to get it in a month or so. We'll have to decide at some point if we want to get a wheelchair/stroller for him. We had a loaner that he was using (remember this?!?!) but due to some strange circumstances, we had to cancel our chair order with that company and had to give the loaner chair back. We're using a different company now to order the gait trainer and any other equipment he might need.

The issue with getting a chair/stroller is that he may not really need it very long. Insurance will only pay for a piece of equipment like this once every 3 years. There's a possibility that Ryan may need a chair that would allow him to propel himself within the next 3 years, but if we already got the wheelchair/stroller for him, we wouldn't be able to get the other kind of wheelchair. We decided to just give it a little time before making any decisions. Hopefully we'll see some really great stuff from having the gait trainer, which could possibly make our decision on which piece of equipment to get next easier. I rely really heavily on Ashley and on the rep to help me make these decisions. They have a lot more experience with this, they have seen how kids progress, they know what types of equipment are good for certain things and they are a lot more knowledgeable. Stay tuned for when we get the gait trainer!

Scott teaching us how to get him strapped in

Checking it out

His brother thought it was pretty cool

Ryan and Ashley