June 20, 2006
When I got on the elevator this morning, another guy managed to get on just before the doors closed. He pushed “1." The elevator doors opened wide. “Uh, we’re on 1,” I told him. “If that’s the floor you want, you just step off here.” He laughed and pushed “B.” The up arrow had been lit all this time, and I had already pushed “3.” “I guess you’re taking the scenic route,” I told him. He laughed again, embarrassedly but with good humor, kind of shuffling and mumbling – I got the strong impression he didn’t know what floor he wanted to go to. “Too early in the morning, huh?” I said. He agreed.
The OT arrived at Gary’s the same time I did, and she put Gary on his stomach to do some exercises for his back – his back muscles are obviously his weakest ones (and not just because of the accident). So she had him doing rowing motions, lifts out to the side and to the rear, all without weights, making sure to shrug his shoulder blades together. While he was exercising, she left for a moment to get a mirror, as he was going to practice skin checks next. She had me stay next to the bed to make sure he didn’t fall out, as he was way over on the edge. As I watched him exercise, I could see he definitely had more muscles in his arms, and I told him I could see tricep development. Coincidentally, when the OT returned, she also commented on his muscle development. “Yeah, I’ve got triceps now,” Gary said. “I never had them before.”
To do the skin check she gave him a mirror attached to long arm – think of one of those mirrors the dentist sticks in your mouth to look around in there, only this one made for a giant dentist (for use on a client with a giant-sized mouth, one would hope). For Gary to try to see his backside, he had to lay on his side, fold his body up a bit (though he is not allowed to fold too far because of the skin flap) and get up on one elbow and use the other arm to hold the mirror. Again, balance came in to play, but so did his flexibility – or rather, his lack of it in his neck, shoulders, and hips (he’s never had much physical flexibility – he said even when he was a kid he could never touch his toes with his legs straight). The OT said she could see that I was going to have to do the skin checks “back there” and probably also on his feet.
Next Gary practiced getting his pants up – nontrivial when laying down and without being able to move or have the use of anything below your chest. He did that successfully, with a lot of turning from side to side. I’ll probably have to put on his socks and shoes for him, though, not only because he won’t be allowed to bend over far enough to do it himself for six months to a year after the flap surgery but also because he may not have the flexibility – I’m going to encourage him to work on his stretching ;-) This discussion brought up a major concern. Gary asked if he was going to be able to turn himself and pad himself during the night, saying he didn’t want to have to wake me once a night to do this as I had enough trouble getting a good night’s sleep as it was. Whether he’ll be able to do this is still up in the air. He can prone for about five hours, but he feels he may not be able to extend that because it gets uncomfortable after a point. So he would have to turn onto a side, which should be no problem, but the problem comes in getting the pillows placed properly for that position. One would go between his thighs, and that should be doable for him, but others are supposed to under and between his ankles, and he may not be allowed to bend enough for him to do that (because of the flap), even assuming he is flexible enough. I wonder if we can train the cats to position the pillows for him.
After the OT left, the PT dropped by bearing gifts – elbow pads, for when he is doing stuff on the exercise mat; a gait belt, for when he is practicing transfers – she said should he lose his balance, it will be better to grab him by this belt rather than grab him by his pants and give him a wedgie; a gel pad, for putting over the wheel of his chair when he transfers out of it, so he doesn’t scrape himself along the wheel; and a couple of transfer boards, the shorter one for most transfers, the longer one for transferring in and out of cars. She told him she’d sign him up for the class where he’ll learn about vans and practice getting in and out of them. She said she didn’t recommend he get a car or van where he would have to pick up his chair and get it in and out, that that was okay for a twenty-something, but with his arthritic shoulder, he needed to be thinking of preserving the strength of his shoulders for as long as possible. He told her we’d already decided we’d get a van with a lift or one where he can wheel into it and lock the chair into the driver’s position. She said if we wanted the latter, to be sure they knew that at his wheelchair clinics, because not all chairs had that EZ lock feature. She said he also should think if he wanted any power features on his chair. If he intends to do a lot of movement around campus or out in the community, he might want a chair that, while not a fully powered chair, had wheels that had some power features, easier to push than a purely manual chair. The PT left, and I asked Gary what he’d thought about what she said about the chair. He said he’d decide more about that when he got further into the rehab and got more of a feel for what it would be like to push himself around on a daily basis.
This reminded him to tell me that he had talked to his (rehab) doctor (the one primarily responsible for his care here), explaining things to the doctor along the lines that I’d told him I thought he should. Gary had started out their conversation by saying that he knew the doctor had some reservations about him returning to his job so early, but . . . Then he explained how supportive the math department was being, what his job in the fall would entail. The doctor stopped him at one point and said he was convinced. Gary said the doctor then became encouraging, saying there was no medical reason Gary couldn’t return to work this fall. This was a great relief to Gary, since he’d found it disheartening when his doctor, someone with a similar injury to his, had been so negative about him being able to return to work that quickly.
His primary nurse came, and I hoisted Gary into his chair. Then it was my turn to do an I.C. on him. The nurse said I did great.
Later in the afternoon, when I passed by the case manager’s office, she yelled out, “Peg, congratulations!” “For what?” I asked. “You got the I.C. checked off,” she explained. “Yeah, one down, fifty more things to go,” I joked. I joined Gary in front of the elevators, where he was supposed to meet for push group, where he and a bunch of other people would practice pushing their wheelchairs over different surfaces. No one else was there. I looked at the schedule, and checked in the gym, and he was where he was supposed to be; they said the previous group might be running late. Ten minutes later, we were still alone. The leader finally showed up and said they were waiting on another person – evidently it was a group of two; she went off to find the other guy. Gary thought maybe he should get a start on his protein drink of the afternoon – he is having to adjust his liquid intake so that the ICs stay in the right range – so I went back to his room to mix it. While there, my cell phone rang, and it was his family physician’s office. He’d called her office earlier today because Shepherd requires that before he leave here he name a hometown primary physician willing to work with him now that he has an SCI. The only doctor he’s regularly seen in the past thirty years is close to retirement, so he didn’t know if she would think it better in the long run to now turn him over to someone else, and if so, who, and that is what he wanted to talk to her about.
So, with his protein powder and three paper cups in hand, I ran back down the hall to the elevators and gave him the phone. Then I went into the nearby bathroom to mix his drink. I came out with one of the cups; Gary said he was keeping the cell phone because the doctor was going to call back (she did, but somehow he didn’t hear it, and when I told him later when he handed the phone back that there was a voice message on it from her and he called her back, he didn’t get her; he left a message, but they never connected the rest of the day). He then said he didn’t want the drink now because he had to go on his “push group” right then ( it was a group of one – him – I never found out what happened to the other guy). I said I was coming with, to let me put his drinks back in his room, but the leader, who we hadn’t met before, said I couldn’t come because I’d be a distraction. Frankly, this p’d me off. He rolled away; I went into the bathroom, collected the other two cups of the protein drink I’d just made up, went back to his room, and worked on the blog. About an hour later, I left for my gym appointment.
The person showed me how to operate a few of the cardio machines – she didn’t think the treadmill would be good for my back, but suggested I use the bike or the Nu Step, which you operate with hands and feet. She had me try them; I did, and she told me to peddle faster. I turned the resistance down from where she had it and complied briefly, but I didn’t want to do a lot. Even though she knows I have CFS, I don’t trust that she really knows what that means in terms of how exercise affects me. (The last time someone claiming to know about CFS tried to set me up with an exercise program at a gym, I did one day of it, a program that had seemed easy, went home, and crashed for a week; I didn’t return.) She then showed me a few weight exercises she thought would be good – lat pulldowns, flies, and reverse flies (but if I do them, the latter two I’ll do with free weights, not on the machines as she showed me – most exercise machines aren’t made for small bodies). Again, I kept telling her to put less weight on the machines than she had on there, and I only did a few reps.
She repeatedly told me what she really thought would be good for me would be the swimming pool. She may be right, but you already know I am not eager to get back into the pool. Sigh. Maybe I should, if that’s what would help my back. Shoot. That would mean I would have to see myself in a swimsuit. Maybe I can avoid looking in a mirror or at my reflection. I weigh about the same as I did in my swimming days, but all that swimming and weight-training muscle has turned into excess thighs and butt. One more thing I’d rather leave behind me.
(Yes, that was intentional, as well as true, though I know that would be a silly reason not to get into the pool again.)
Anyway, the afternoon’s events left me in a not-so-good mood, not helped by the fact that I was on the tired side. Even though the motel seems all right now, I don’t sleep as well there as I did at the apartment. Maybe I should try a different motel. Maybe the results would be the same. I want my own home and my own bed! Five more weeks to go, if all goes according to plan.
I got to Gary’s room and I’m afraid I let him see my bad mood and told him the reasons for it. Later I resolved not to let this kind of stuff get me down so or at least not to lay it on him – it’s rather trivial in light of his circumstances.
He said he hadn’t heard the push group leader say I would be a distraction. He said he didn’t see why I couldn’t have come, so maybe if he does it again I will protest if they say I can’t come. What he did was practice pushing over different surfaces. First they went down to the carpeted tunnel I had taken from the Shepherd Center to the Peachtree Orthopedic clinic. I told him I remembered thinking as I walked back from that clinic that it was surprising they had such a steep incline on that tunnel, that it must be hard for someone to get up it in a wheelchair, especially with the carpeting. Gary said he did it, though he had to stop and take a few rest breaks.
They then went outside and he practiced wheeling over grass, which he said was harder than the carpeting. Then they went to the parking garage, and first he practiced opening the heavy door there, and then they went up and down parking ramps. He said he could do it all, but that it was a very good workout!
Towards the end of my evening visit with Gary, Joe called and filled us in on how the house is coming along. Sounds good!
To finish this entry, I will tell you a new expression I learned tonight. Gary’s roommate wheeled by our section of the room and called out, “How are you doing, Peg?” “Fine,” I lied (this was when I’d first come into Gary’s room). “How are you?” I asked. “Fine as frog hair,” he told me.
When I got on the elevator this morning, another guy managed to get on just before the doors closed. He pushed “1." The elevator doors opened wide. “Uh, we’re on 1,” I told him. “If that’s the floor you want, you just step off here.” He laughed and pushed “B.” The up arrow had been lit all this time, and I had already pushed “3.” “I guess you’re taking the scenic route,” I told him. He laughed again, embarrassedly but with good humor, kind of shuffling and mumbling – I got the strong impression he didn’t know what floor he wanted to go to. “Too early in the morning, huh?” I said. He agreed.
The OT arrived at Gary’s the same time I did, and she put Gary on his stomach to do some exercises for his back – his back muscles are obviously his weakest ones (and not just because of the accident). So she had him doing rowing motions, lifts out to the side and to the rear, all without weights, making sure to shrug his shoulder blades together. While he was exercising, she left for a moment to get a mirror, as he was going to practice skin checks next. She had me stay next to the bed to make sure he didn’t fall out, as he was way over on the edge. As I watched him exercise, I could see he definitely had more muscles in his arms, and I told him I could see tricep development. Coincidentally, when the OT returned, she also commented on his muscle development. “Yeah, I’ve got triceps now,” Gary said. “I never had them before.”
To do the skin check she gave him a mirror attached to long arm – think of one of those mirrors the dentist sticks in your mouth to look around in there, only this one made for a giant dentist (for use on a client with a giant-sized mouth, one would hope). For Gary to try to see his backside, he had to lay on his side, fold his body up a bit (though he is not allowed to fold too far because of the skin flap) and get up on one elbow and use the other arm to hold the mirror. Again, balance came in to play, but so did his flexibility – or rather, his lack of it in his neck, shoulders, and hips (he’s never had much physical flexibility – he said even when he was a kid he could never touch his toes with his legs straight). The OT said she could see that I was going to have to do the skin checks “back there” and probably also on his feet.
Next Gary practiced getting his pants up – nontrivial when laying down and without being able to move or have the use of anything below your chest. He did that successfully, with a lot of turning from side to side. I’ll probably have to put on his socks and shoes for him, though, not only because he won’t be allowed to bend over far enough to do it himself for six months to a year after the flap surgery but also because he may not have the flexibility – I’m going to encourage him to work on his stretching ;-) This discussion brought up a major concern. Gary asked if he was going to be able to turn himself and pad himself during the night, saying he didn’t want to have to wake me once a night to do this as I had enough trouble getting a good night’s sleep as it was. Whether he’ll be able to do this is still up in the air. He can prone for about five hours, but he feels he may not be able to extend that because it gets uncomfortable after a point. So he would have to turn onto a side, which should be no problem, but the problem comes in getting the pillows placed properly for that position. One would go between his thighs, and that should be doable for him, but others are supposed to under and between his ankles, and he may not be allowed to bend enough for him to do that (because of the flap), even assuming he is flexible enough. I wonder if we can train the cats to position the pillows for him.
After the OT left, the PT dropped by bearing gifts – elbow pads, for when he is doing stuff on the exercise mat; a gait belt, for when he is practicing transfers – she said should he lose his balance, it will be better to grab him by this belt rather than grab him by his pants and give him a wedgie; a gel pad, for putting over the wheel of his chair when he transfers out of it, so he doesn’t scrape himself along the wheel; and a couple of transfer boards, the shorter one for most transfers, the longer one for transferring in and out of cars. She told him she’d sign him up for the class where he’ll learn about vans and practice getting in and out of them. She said she didn’t recommend he get a car or van where he would have to pick up his chair and get it in and out, that that was okay for a twenty-something, but with his arthritic shoulder, he needed to be thinking of preserving the strength of his shoulders for as long as possible. He told her we’d already decided we’d get a van with a lift or one where he can wheel into it and lock the chair into the driver’s position. She said if we wanted the latter, to be sure they knew that at his wheelchair clinics, because not all chairs had that EZ lock feature. She said he also should think if he wanted any power features on his chair. If he intends to do a lot of movement around campus or out in the community, he might want a chair that, while not a fully powered chair, had wheels that had some power features, easier to push than a purely manual chair. The PT left, and I asked Gary what he’d thought about what she said about the chair. He said he’d decide more about that when he got further into the rehab and got more of a feel for what it would be like to push himself around on a daily basis.
This reminded him to tell me that he had talked to his (rehab) doctor (the one primarily responsible for his care here), explaining things to the doctor along the lines that I’d told him I thought he should. Gary had started out their conversation by saying that he knew the doctor had some reservations about him returning to his job so early, but . . . Then he explained how supportive the math department was being, what his job in the fall would entail. The doctor stopped him at one point and said he was convinced. Gary said the doctor then became encouraging, saying there was no medical reason Gary couldn’t return to work this fall. This was a great relief to Gary, since he’d found it disheartening when his doctor, someone with a similar injury to his, had been so negative about him being able to return to work that quickly.
His primary nurse came, and I hoisted Gary into his chair. Then it was my turn to do an I.C. on him. The nurse said I did great.
Later in the afternoon, when I passed by the case manager’s office, she yelled out, “Peg, congratulations!” “For what?” I asked. “You got the I.C. checked off,” she explained. “Yeah, one down, fifty more things to go,” I joked. I joined Gary in front of the elevators, where he was supposed to meet for push group, where he and a bunch of other people would practice pushing their wheelchairs over different surfaces. No one else was there. I looked at the schedule, and checked in the gym, and he was where he was supposed to be; they said the previous group might be running late. Ten minutes later, we were still alone. The leader finally showed up and said they were waiting on another person – evidently it was a group of two; she went off to find the other guy. Gary thought maybe he should get a start on his protein drink of the afternoon – he is having to adjust his liquid intake so that the ICs stay in the right range – so I went back to his room to mix it. While there, my cell phone rang, and it was his family physician’s office. He’d called her office earlier today because Shepherd requires that before he leave here he name a hometown primary physician willing to work with him now that he has an SCI. The only doctor he’s regularly seen in the past thirty years is close to retirement, so he didn’t know if she would think it better in the long run to now turn him over to someone else, and if so, who, and that is what he wanted to talk to her about.
So, with his protein powder and three paper cups in hand, I ran back down the hall to the elevators and gave him the phone. Then I went into the nearby bathroom to mix his drink. I came out with one of the cups; Gary said he was keeping the cell phone because the doctor was going to call back (she did, but somehow he didn’t hear it, and when I told him later when he handed the phone back that there was a voice message on it from her and he called her back, he didn’t get her; he left a message, but they never connected the rest of the day). He then said he didn’t want the drink now because he had to go on his “push group” right then ( it was a group of one – him – I never found out what happened to the other guy). I said I was coming with, to let me put his drinks back in his room, but the leader, who we hadn’t met before, said I couldn’t come because I’d be a distraction. Frankly, this p’d me off. He rolled away; I went into the bathroom, collected the other two cups of the protein drink I’d just made up, went back to his room, and worked on the blog. About an hour later, I left for my gym appointment.
The person showed me how to operate a few of the cardio machines – she didn’t think the treadmill would be good for my back, but suggested I use the bike or the Nu Step, which you operate with hands and feet. She had me try them; I did, and she told me to peddle faster. I turned the resistance down from where she had it and complied briefly, but I didn’t want to do a lot. Even though she knows I have CFS, I don’t trust that she really knows what that means in terms of how exercise affects me. (The last time someone claiming to know about CFS tried to set me up with an exercise program at a gym, I did one day of it, a program that had seemed easy, went home, and crashed for a week; I didn’t return.) She then showed me a few weight exercises she thought would be good – lat pulldowns, flies, and reverse flies (but if I do them, the latter two I’ll do with free weights, not on the machines as she showed me – most exercise machines aren’t made for small bodies). Again, I kept telling her to put less weight on the machines than she had on there, and I only did a few reps.
She repeatedly told me what she really thought would be good for me would be the swimming pool. She may be right, but you already know I am not eager to get back into the pool. Sigh. Maybe I should, if that’s what would help my back. Shoot. That would mean I would have to see myself in a swimsuit. Maybe I can avoid looking in a mirror or at my reflection. I weigh about the same as I did in my swimming days, but all that swimming and weight-training muscle has turned into excess thighs and butt. One more thing I’d rather leave behind me.
(Yes, that was intentional, as well as true, though I know that would be a silly reason not to get into the pool again.)
Anyway, the afternoon’s events left me in a not-so-good mood, not helped by the fact that I was on the tired side. Even though the motel seems all right now, I don’t sleep as well there as I did at the apartment. Maybe I should try a different motel. Maybe the results would be the same. I want my own home and my own bed! Five more weeks to go, if all goes according to plan.
I got to Gary’s room and I’m afraid I let him see my bad mood and told him the reasons for it. Later I resolved not to let this kind of stuff get me down so or at least not to lay it on him – it’s rather trivial in light of his circumstances.
He said he hadn’t heard the push group leader say I would be a distraction. He said he didn’t see why I couldn’t have come, so maybe if he does it again I will protest if they say I can’t come. What he did was practice pushing over different surfaces. First they went down to the carpeted tunnel I had taken from the Shepherd Center to the Peachtree Orthopedic clinic. I told him I remembered thinking as I walked back from that clinic that it was surprising they had such a steep incline on that tunnel, that it must be hard for someone to get up it in a wheelchair, especially with the carpeting. Gary said he did it, though he had to stop and take a few rest breaks.
They then went outside and he practiced wheeling over grass, which he said was harder than the carpeting. Then they went to the parking garage, and first he practiced opening the heavy door there, and then they went up and down parking ramps. He said he could do it all, but that it was a very good workout!
Towards the end of my evening visit with Gary, Joe called and filled us in on how the house is coming along. Sounds good!
To finish this entry, I will tell you a new expression I learned tonight. Gary’s roommate wheeled by our section of the room and called out, “How are you doing, Peg?” “Fine,” I lied (this was when I’d first come into Gary’s room). “How are you?” I asked. “Fine as frog hair,” he told me.
posted by Peg Daniels at 6:02 AM
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