Discharged from OT

I was discharged today from Occupational Therapy, ordered by my primary care doctor to treat my sore shoulders which were suffering from overuse. They basically hurt all the time. First we treated them with ultrasound and diathermy, which uses electro-magnetic currents, and with resting from walking or NuStep. Putting on my AFO’s strains the shoulders from hauling and manipulating the legs into proper position, and walking strains the shoulders with pressure while using the walker (because it’s hard not to hang on for dear life). And of course, I use my arms to roll around in my wheelchair Phoebe.

After that, I did a bunch of things: stretching on the mat using a roller or little circle things. Weight bars to do curls, extensions, swings, and other exercises. Using the pulley weights. The arm bike with increasing tension. Best of all was a quick massage with BioFreeze to finish the session.

The arm muscles are better but the right shoulder still aches at the end of the day and sometimes at night, interfering with sleep. I’ve been using a muscle relaxant and a heating pad at the end of the day, which help. But if I wake up and it still hurts, I’ve learned to just relax and rest it for a day. That means no walking. So far one day of that seems to do the trick.

In any case, this round of OT is over. I invested in a set of weight bars to use at home to replicate my therapy exercises. You can do more with them than with a set of hand weights and I have them in the living room where they’re easy to grab. I’ll continue to use the heating pad and rest when needed. And if things flare up again and I need more help, I know I can go back with just a call to my doctor.

First Solo Shower

I’m clean! I’m clean! Today I took my first solo shower in five months and it was WONDERFUL! I’d practiced with occupational therapy, figuring out where towels needed to be, and how to manage the actual washing, and standing up. That was a kind of risky part, but it worked and the legs stayed steady. What we hadn’t quite planned was that I would need three towels for this project – one for the wheelchair, one to dry off with, and one to mop up the water that got on the floor. To keep that from happening, I think I need to get a new shower curtain liner, and to rethink where the towels during the shower itself. No reason why they couldn’t get piled into the wheelchair instead of threaded through the grab bar. I’ll try that next time. Maybe tomorrow?

Some progress, some not

1. OT is coming tomorrow afternoon and we’ll practice me giving myself a shower. Words can’t express how happy this makes me!
   
2. PT is coming tomorrow morning. At least they’re not overlapping visits. There’s something wrong with my right big toe, very painful, maybe corns?, so it should be fun walking. Maybe Harry can take a look and tell me what to do for it. It’s unhappy most of the time anyway with nerves waking up, what’s a little more owie-ness? Except that would be bad.
   
3. Foot doctor’s office is sending me an Rx for a left foot AFO to go with my right one. PT tells me these run about $1800 each. So far this is a very expensive year.
   
4. Brickstreet Pharmacy will take back the unuseable blue wheelchair and give me a refund, but they don’t have any chairs that I need in stock and don’t seem interested in finding me one. So tomorrow I start making phone calls to other places. At least I know very precisely what it is I’m looking for now. I’m hoping that some of the places that may not usually have them would order for me if I give them exact specs. Apparently the wheelchair people don’t want to take orders directly from the folks who actually need to use them.

I need a shower

It’s been two weeks, and I feel horribly grubby. Oh, it’s not as bad as when I first went to rehab (that was a 3 week wait), because I’ve been giving myself sponge baths and washing my hair in the kitchen sink. But my aide had some medical issues to deal with and hasn’t been here, and now her schedule is changing again. I am not her priority, nor should I be, but it’s hard to work out something else when there’s so much I don’t know.

The plan was to work with Occupational Therapy last Friday on how to give myself a shower. I could figure out how to get in and get clean, but getting dry, out, and back in the chair was the challenge. But last Friday, an hour before the OT was scheduled to arrive, we got word that water was cut off to all of Meadow Lake. No water, no shower. We did strategize how to make it work but never got the chance to actually try it out. And ha, still no shower. I promised that I won’t try to do it when I’m completely on my own because I’m a major fall risk until we know for sure that our plan will work. Even then, I may need to have someone here while I shower, just in case. I’ll cross that bridge when I get there.

I’m hoping that will change sometime early this week. I’m tired of feeling grubby and smelly, though I probably feel those more than actually are real. Monday I’m calling about the wheelchair and will call the foot doctor AGAIN (after leaving a message on the portal last week for a promised 48 hour turn around that never happened). Except wait, it’s MLK Day so maybe they will all be closed. Ah well, I can still try and see what happens.

One good thing is that a small but very, very heavy box of genealogy reference books will be picked up tomorrow by the East Texas Genealogical Society to sell, donate, or give away as works best for them. They’re good books, I just no longer need them. They were in my car to go to the Tyler Public Library when I moved and then, well, never got there.

Image credit: Photo 83347015 © Anton Shevialiukhin | Dreamstime.com

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.