In January 2006, she started using the Vest airway clearance system at home 2 times per day at 20 minute intervals which helps to loosen a lot of her secretions in her upper chest. Additionally, she is getting 4 times per day treatments of Albuterol and Duonab nebulizer used with an IPPB machine to open her airways and dry secretions. This has added a lot to her health and quality of life. Her weight is around 70 lbs. and she still has much strength in her upper body and legs. Moves around quite a bit still. June 2006, she graduated 8th grade at City Hill Middle School in Naugatuck. Her name was posted in the local paper as being given "Highest honors." She always works hard at school with the tasks she is given. She also attended her first semi-formal dance just before graduation and was asked to dance by a boy from her school which she enjoyed. Her speech is rare these days. She often says I Love You to Mom and Izabela (her medical aide) with a lot of difficulty. She still smiles her beautiful smile on most days. Often her cough wakes her up during the night, but she gets a lot more sleep due to the nebulizer and vest treatments she is on. Her dystonia is setting in on her arms, but mostly in her feet. The muscles in her feet are tightening and making it very difficult to walk. The use of the AFO leg and foot brace is becoming more necessary now. She no longer remembers how to tie her shoes and sometimes forgets how to stand, needing more and more reminders. She enjoys the company of her many friends and is getting lots of love. March 2005: Rides special need bike at school for exercise, uses walker with AFO braces on legs. Uses wheelchair more at school. Bryanna really enjoys Middle School of Plainville. She can no longer walk across her own bedroom on her own. She crawls or uses her new small walker to get around at home. Speech is diminishing now. She may be somewhat verbal some days and most other days - nothing at all, just a lot of hand signals with some sign language or shaking head yes or no. Still smiles regularly. October 2004: Difficulty in handling secretions in mouth. Chronic cough and much phlegm accumulating. Sneezing is chronic also. Strong cough keeps her free of pneumonia by clearing her lungs on regular basis. Compressions on back, use of pulmonary methods more often - albuterol inhaler, accapella, allergy relief nasal sprays, steroid meds off and on. Around this time, a wonderful program through the Connecticut VNA: Hospice/Palliative Care (Pedi-Pals) became part of our lives. Bryanna begins having a weekly visit from the VNA nurse at home. Social worker and Nurse case manager involved in Pedi Pals provides support of our entire family. Connecticut DMR also approves a case Manager for assistance with Bryanna's needs. Additionally, we begin using home health care aides from Euro Home Care in Southington, Ct. to assist with after school care for Bryanna. September 2004: Nothing now can be given by mouth due to choking and aspiration danger. She has now become completely tube fed. Aggression and frustration began. Began using Prozac and Valium to fight aggressive behavior and has helped. October 2003: A GI Feeding tube followed by a Mic-Key button was placed in her abdomen due to swallowing difficulties. This was used as a supplement to her feedings, yet was still able to drink thickened liquids and take some foods by mouth. More and more difficulty in eye movement. Fingers and hands start to turn in occasionally and get stiff. Begins to use wheelchair at school sometimes when tired. Still uses her walker. November 2001: Bryanna uses a walker at school to help control her awkward gait. Walks with mom with hand assistance. Completely incontinent. Needs some assistance in bathroom and getting from room to room, bathing, dressing. She can still tie her shoes. One day at school she cried to her aide "Why do I have to be so different?" Since that time, Bryanna seems to have adjusted to the fact that she will have to live with her progression and to just try her best at anything she can despite set backs. She doesn't seem to dwell on it anymore, but has this great smile most of the time.