The Physical Side of Rehab

On Wednesday someone from every department visited me—medical, psychology, speech therapy, occupational therapy, and physical therapy. Each had forms, questions, and things they wanted me to do while they observed. By the afternoon I was ready go downstairs for the scheduled rehab sessions. Each morning and afternoon I was provided with 1-1/2 hours of therapy divided between Occupational Therapy (OT), where the person is taken to the maximum level of independence within the level of functionality they had achieved, and Physical Therapy (PT), where work is done to attempt to improve the functionality.

Since I was using a walker, OT meant learning how to use a walker safely. For instance, I had to get around a kitchen doing various tasks while using one. In PT, I was getting off the walker onto some parallel bars to work on balance, improving the use of my right leg, and other activities. This proceeded through Thursday. In parallel with this, Susanne was in discussion with the Social Worker about the future. Indication from the insurance company was that they would cover me staying for about a week and then reassess my progress. The staff felt they could get me functional with a walker by that time.

Susanne produced a document for the staff with extensive photographs of our house and attended one of the OT and a PT therapy sessions. I was very clear that she was getting disturbed about the prospects of me in a walker in our house, which has many sets of stairs and uneven surfaces. I resolved to do everything I could to get off the walker. By this point I was beginning to get well grounded in the implications of the Fact-Based Spirit-Guided Path and it was clear that, if you need facts, then ask the right questions and keep asking until you get what you need. I showed a therapist the pictures and asked for her thoughts on how someone using a walker might function. I could get see her eyes bugging out of her head. She made suggestions about removing throw rugs, etc. I then said, “As far as I’m concerned it’s out of the question for that to be my state when I’m discharged. I request that we shift our focus such that, if I’m not fully ambulatory at discharge, that I require only a cane.”

The other insight I had was that, on occasion, I had to politely guide my own treatment. She said to me, “OK. Please get up on your walker and I’m going to carefully observe what happens when you walk.” I did so and within a minute or so she said, “What you appear to have is a condition called Drop Foot. What that means is your Anterior Tibialis muscle (Front Shin Muscle) is not working.” Hallelujah….a FACT. She then used a length of gauze to create a makeshift support for my lower right leg and asked me to walk. World of difference. She explained that she was simulating a working Front Shin Muscle to prove her hypothesis. We proceeded, without the walker, to see how I well I could do out in the hall. A little shaky but wonderful. She was right there guiding me as was appropriate. We then successfully tried the stairs! When Susanne arrived for lunch I excitedly shared the progress. She agreed that it sounded wonderful, but I could tell it did not remove the WALKER image from her mind. I returned to OT in the afternoon and requested to work with the same person. We went to a table and she pulled out the stuff she’d brought from home…Velcro, webbed strips, etc.…the therapist’s office version of creating something with spit and bailing wire [this is an obscure expression that may not mean much to some folks] and went to work with scissors. She attached some pieces around the bottom shoelaces, taped a band around my shin and connected the two with the webbed strips. It was very clear what she was doing. Once she had it in place we had a wonderful time walking around with a cane. The PT person I then worked with had me using the parallel bars and asked me to move my left and right feet in a certain order as I walked sideways…I immediately recognized the steps of the dance Hava Nagila…complete with the dips and bounces. I was elated and couldn’t wait to share my triumph with Susanne.

I attended a very nice chair Tai Chi class the next morning (Sunday) and had one PT session in the afternoon with strengthening exercises. On Monday, the physical therapist found an ASO (Ankle-Shin Orthosis) brace to insert it in my shoe to replace the makeshift brace from the weekend. I was fully ambulatory with it and a cane. The department heads all met Monday to review my progress, so right after the meeting 5 ladies in white jackets came walking into my room to speak with my wife and me. Each reported in on their disciplines and identified what was remaining before I was safe to be discharged. The conclusion was that I could be discharged Tuesday or Wednesday to home. We chose Tuesday. That afternoon, I then worked on the necessary skills and chair for showering.

I then I fell into a wicked trap. I somehow made up that I had progressed as far as I could, and I began in my mind to develop a whole new persona, to go along with the transformed inner me, that had a certain flare around the cane. I figured I’d have a good time picking out just the right customized cane. As Susanne came into my room later on she overheard me waxing eloquent with a business colleague about the quest for just the right cane for the new me. As I hung up, our friend Elinore arrived to provide another Jin Shin Jitysu accupressure treatment, which she and Susanne did together. While she was working on me, Susanne asked about the cane comments and asked what medical person had told me that my condition would be permanent and told me I had made up a story. I closed my eyes and told her I didn’t want to talk about it. Inside I went “You fool. You just extrapolated an incredible fantasy based on NO FACTS.” When Elinore left, we headed out to the gardens for our evening sojourn. On the way I said, “I really want to thank for spotting and popping the trap I fell into. Of course I’ll do all I can to get that muscle back and get rid of the brace and cane. Thank you so much.” All I had the next morning was an early PT session where I was issued my own cane and provided with an elastic band and exercises to do.

Once the discharge paperwork was in order, I made my joyous exit, Susanne drove me down the street to register for Out Patient Rehab, we stopped at the drugstore to fill prescriptions, and we went home. I can’t tell how wonderful it felt, after 2-1/2 weeks in 2 different sterile hospitals, to walk into our sensory-rich and inviting home.