Therapy Then and Now

In the last three months, I’ve had three phases of therapy. I thought it was worth making some notes about how they are the same and how they’re different.

Phase 1 – Intensive Therapy at the Olympic Center (three weeks)

This is where I started when I left the hospital. They have a well-deserved reputation for success and for working patients hard, and it was the best possible place for me to start. I had a physical therapist (Veronica) and occupational therapist (Susan) and worked with each of them for 90 minutes a day, usually in the mornings. Therapy was one-on-one during that time, often with the assistance of one or more other therapists to help make sure I was supported and didn’t fall. I was in fragile shape emotionally, unable to control my body or know what it was going to do. I wore Depends or diapers because no one yet knew if I was incontinent or had bladder and bowel control. It took two people to do almost anything – get me out of bed, transfer to the bedside commode, stand up, everything. I didn’t think I would be able to walk again and was isolated and felt very alone.

Everything Veronica and Susan asked me to do was hard, and we did one more, then one more, then did it again when I thought it was impossible to do another. They were kind and supportive but also insistent and persistent, teaching me how to do these difficult things and breaking them down into steps I could remember and still often say to myself. Susan taught me how to dress myself and manage the toilet as well as how to build up upper arm strength using weights and the arm bike. Veronica taught me how to strengthen and move my body for wheelchair mobility, bed mobility, transfers, and walking. We used the Kinetron and NuStep, the parallel bars, and lots of wheelchair and walker work. I went from barely standing up to walking 100 feet in three weeks.

Phase 2 – Residential Therapy (six weeks)

I lived in the Meadow Lake Health Center for residential rehab for almost six weeks. I continued to have daily therapy but it changed from 3 hours a day to about 90 minutes split between physical therapy and occupational therapy, usually with PT in the morning and OT after lunch to break up the day. Each therapist sees several patients at the same time and we worked in much smaller space with more limited resources. There were often gaps during therapy time when I finished one task and was waiting for instructions on another. All of us used the OmniCycle for upper and body work, and most of us used the parallel bar to do standing leg exercises and/or OT work with endurance standing and side movements. We also used weights – the kind that we strapped on arms or legs, weighted bars, or dumbbells. And there was great emphasis on walking.

My physical therapist usually called me “Lovebug” which really annoyed me, and I often felt that I was going through the motions without her paying much attention to what I was doing or getting corrected or challenged to do more. I suspect this was because I could do more independently at that point, but I still felt I had much to learn and improve and didn’t get pushed to make those changes. I was able to walk 300 feet/day when I left but didn’t feel confident doing so. I never did learn how to put my shoes on myself.

Phase 3 – Out-patient Therapy (three weeks and ongoing)

Now that I’m an out patient, I have physical therapy three days a week for an hour at a time instead of daily, and there is no occupational therapy, though I suspect that were I to raise a question or problem about how to do something in daily living, I could get help. I changed therapists when I switched to this schedule because I liked the style and approach of one of the others I watched while I worked with my own therapist as a resident. Our appointments rarely involve walking, but do involve electrical stimulation to wake up the leg muscles at almost every session as well as exercises on the mat. I am challenged to change position or do another set and am corrected when I get sloppy or lose focus. This reminds me of the therapy I started with, and although I could always use more time than I have, I think we use it well.

I am supposed to be walking on my own here at home, but to be honest, that’s not happening a lot because I hate the AFOs which don’t stay up well on one foot anyway, and I’m not supposed to be walking without my shoes one. I’m comfortable in the chair and there are things I can do from the wheelchair that I can’t do as well with the walker, such as feed the cats. I do not feel confident walking on my own, especially after almost falling the other day, but know that I have to work harder to build that back and to do my leg exercises on days when I don’t go to therapy. I have to own this for myself and not wait for others to push me into it.

I have no idea how long I will have physical therapy but know I will lose muscle strength and tone if I don’t work hard on my own.