July 1, 2006
No rest for the weary: Gary had a therapy session scheduled for today (Sat), from 10-11am. His regularly scheduled therapists take off each weekend, but the therapist assigned to him for today had worked with him before, so was familiar with his case. She is one of the few therapists here, it seems to us, who has long-time experience – over twenty years. Most, if not all, of the other therapists we see in the gyms seem pretty young; Gary’s PT, for instance, has only been working as a therapist a little over two years. We were amazed at that, because she seems very good, as is his OT, of a similar age. But today’s person’s greater experience was very evident. (I suppose there aren’t many long-time PTs because the pay probably isn’t that great. This person told us she only works on weekends so I would assume she is not dependent on this job for her main source of income.)
Maybe because of it being so close to July 4th and staff taking off for the holiday, there was an over-scheduling of patients to therapists. Consequently, during the hour the therapist was supposed to be working with Gary, she would give him a task and then go off to help other patients, coming by occasionally to ask us how things were going. She started Gary off on the rickshaw. After that, she helped him with his transfer to the mat and then brought him dumbbells and told him which exercises she wanted him to do. I mostly oversaw him, making sure he didn’t cheat ;-) (by the way, mom, since you are new at email, that symbol I just typed, the colon followed by a dash then a parenthesis (here it is again ;-) ) is a wink (look at it sideways – the semicolon is the eyes, one eye winking; the dash is the nose; the parenthesis is the mouth, smiling. The symbol :-) is a smile (again, look at it sideways) ). At one point, though, since Gary was safely in the center of the mat, I stopped my overseeing of his weight program and went over to another mat to practice the rolling from back to side that he has so much trouble with. I’d never tried such a roll before, and I was hoping that in doing it myself I could figure out something about it that might help him. I kept my body “dead” from chest down and tried to roll from my back to my side in the way they taught. I noticed one thing immediately. If I wanted to roll to the left from a supine position I first swung my arms to the right (chest and head following) as he did, but then I automatically arced them up to the left over my head. If my memory was correct, he always swung straight across. I tried it that way and found that my arms essentially got in my way and stopped me from being able to roll over. I went to his mat, told him my findings, and after he finished the set he was on, he watched me do a roll swinging my arms upward. “But that’s the opposite of what they told me to do,” he said. I told him no, it wasn’t – his OT had told him he could swing his arms upward if he found that easier. He told me he didn’t remember that, and in fact had been swinging his arms downward. So, as he watched me, I tried it that way. I stated the obvious result: “Well, that completely stops me – I can’t get over at all. My arms get in the way.” He gave an ironic laugh and said maybe that was why he couldn’t get over, that maybe the times he’d successfully gotten over were the times he’d forgotten to swing down. He decided to try my way before the end of this therapy session. He finished his weights and then went into his stretching routine. I helped, supplying a tiny bit more of a stretch than he can get on his own, as his OT had suggested I do – Gary’s flexibility is so poor and it’s so important now that he get as flexible as possible, I figure he needs all the help in developing greater flexibility that he can get. After we finished the stretching, he tried my rolling tip, and he got right over (well, on the count of three swings, I mean). He tried the roll a couple more times, and each time he got over. I felt proud that I was able to contribute something to help him in another area he’d been having a bit of trouble with.
We had already run over our hour (the most recent time the therapist had walked by she’d told me that she was glad I was there and that I should get a pay raise; I asked her what kind of raise I would get from $0; she said she’d double it; I told her that having a Ph. D in math, I knew what that was), and Gary was ready – a bit eager, actually – to leave. But the therapist came over, her other patients now gone. She said they needed to work on his rolling. She said she’d noted when he first got on the mat and did a roll that he needed to swing his arms up at the end of his swing. I felt validated. Then she told him he needed to tuck his head and chin more as he swung over, and to punch hard at the end. All this he had been told before, but then she did something that really brought this home. After he got himself rolled over by using the arms swinging upward technique, she had him stay on his side and told him “Don’t let me push you back.” She then pushed him at the hip as if to roll him onto his back while he fought to stay on his side. Sure enough, his natural reaction was to strain upward with his top arm (there being nothing to grab onto – I’m sure he wouldn’t have tried for HER butt, as he had mine) and to tuck his head and chin in. That little practical demonstration made a world of difference to him. He practiced a few more rolls and they were done so much more easily. I’d venture that if he does a few more practice sessions at it, they will be completely automatic.
She then gave him tips on how to get his legs onto and off the mat after and before a transfer – another skill no one else had broken down into steps for him so that he knew precisely what he should do (I just hope that between the two of us we remember how to do it). Then she gave him some tips for getting into a sitting position from his side (on his side is where he ends up after transferring to, and getting his legs on, the mat) – he has always resorted to getting in a prone position and working from there, saying he isn’t strong enough and his shoulders aren’t flexible enough to do it from the side position. She then showed him a way to get to the sitting position from a lying-on-the-back position, but he had similar strength and flexibility issues there. She said she thought he should work on those issues, rather than abandon completely these more efficient ways of getting to a sitting position. One of the first things he needed to do in order to use these more efficient techniques, she said, was strengthen his neck muscles. (We’ve noticed this for a long time, actually – when he is hoyered with the net (which supports him on his backside from mid-thigh to shoulder and lifts him from his bed into the air), he has a hard time holding his head up without using his hand.) She told him that when she saw him again – in two weeks – she wanted to see improvement in his neck strength. She gave her thoughts on what progress she thought he could expect to see by then: that he should pretty well have the rolling down pat, and that the getting into a sitting position using the method he had been using would be easier. She hoped that he could also make some progress in the other methods of getting into a sitting position, but that he would just have to see if his arthritic shoulder prevented him from doing so (so far, nothing he’s been doing has affected that shoulder negatively).
The rest of the day was ours, and we hung out in his room for a while, doing some personal care tasks, having lunch, being on the computer and on the phone. After he talked to his mom about the Alaska flight cancellation, we decided to go out to the garden a while, since he was feeling a little cold. No problem with cold in the garden – we didn’t want to get out of the shade (it was about ninety degrees at the time). In front of where we sat was a thigh-high curved sculpture of a human. The figure was kneeling on its legs, bent forward, head down. “What do you think that sculpture is about?” Gary asked me. I thought only a moment and then titled it: “‘It’s been a tough day at Rehab.’” Gary laughed and said he thought that fit. He said it’d be funny if we taped to the sculpture a sign with that title– he was sure every patient would get a kick out of it. So maybe I will put up a sign ;-)
We left the garden and entered the rec room. I asked if he wanted to shoot some pool. So we played a game where we got whatever balls we could in, no division into solids and stripes. Gary creamed me – I got only two balls in. This is no doubt due to all the helpful techniques he discovered while playing his nephew Justin in pool that second time – and not a reflection on my skill at this game ;-)
Joe called during the game, giving me a brief respite from my humiliation. He gave us another update on the house. He has rethought the pedestal sink scenario and now plans to get wall-hanging sinks. Just before he hung up, I remembered something else we might want done: having a mirror hung over the bed in the master bedroom. “After twenty-five years of marriage you want a mirror over your bed?” Joe asked insinuatingly. “So Gary can see himself when he’s stretching, so he can make sure he’s thrown his chain loop over his foot and so on,” I hastened to clarify. I am not sure Joe was convinced that is the reason.
During my evening visit with Gary we talked to my mom by phone. At one point, when Gary was on the phone with her, he started crying and said, “That’s what my family says too.” He couldn’t talk any more, and he handed me the phone. I had no idea what that was all about but I thought he needed a good hug so I supplied it. After the call was over Gary told me that what she had said was that the whole family was proud of my devotion to his care. He started crying again, and I gave him another hug, saying, “Goodness, every time you tell me something like that you start crying.” He said, as he’s said before, that it was because he was so grateful to me. It feels a bit odd to hear him put it this way, because of the following: my reactions to this situation and how I deal with it have not been thought out, and it seems to me that gratitude implies thanking someone for something they wouldn’t have otherwise done. However, I know that if our situations were reversed, gratitude is what I’d be feeling too.
I know he sometimes feels badly that I have to deal with this. When I told him my dream about not being able to check out of a hotel and that it turned out that everyone who checked in was soon executed, he said he had a possible interpretation: that the situation we now find ourselves in is the hotel I’ve checked into and I’m feeling trapped into it, like it is ending my life.
After he said this, he started crying. I hugged him and said that I didn’t like that interpretation and that it would have never occurred to me – sure, the situation was one I’d prefer not to be in, but I wasn’t feeling that beleaguered. After he calmed a bit, he said he’d like to check out of this situation, too, and go back to the way things were.
I know that he doesn’t long entertain such thoughts – in fact, I think he is remarkable in how well he has accepted the situation and makes the best of it – but I don’t think he would be human if he didn’t have such thoughts at all.
Well, I sort of wandered off track there . . . Back to my mom’s call. Something she said reminded me of another person I should thank – my sister-in-law Dolores, for letting Joe stay away from home for this length of time and delaying their own clients so he can work at our home. So, thanks, Dolores! (When my mom talked to Joe recently and said to him, “Poor Dolores,” having not yet explained that she meant it must be hard on Dolores to have Joe gone all this time and that it was so good of her to let him do this, my mom said Joe exclaimed something along the lines of, “What do you mean, ‘Poor Dolores’? She’s got our dogs. What do I have here? Cats! When they even deign to turn up.”
Well, I can certainly sympathize with Joe missing his wife and his dogs. We miss our kitties, and I always hated it when Gary would go off for a semester on sabbatical. Nighttime was the worst.
And I know Joe is making a great substitute “papa” for our “boys.” He still hasn’t put up a cat barrier to keep the cats out of his sleeping room, thus letting Tigger wake him at 5:15 am to demand breakfast. He’s been something of a pushover with them ;-), as he knows they have not been getting their usual quota of attention – they are used to me being constantly around the house.
But, when Gary and I get home, we are definitely erecting that cat barrier, and there will be no giving in to whining for Fancy Feast.
I think.)
All for now.
No rest for the weary: Gary had a therapy session scheduled for today (Sat), from 10-11am. His regularly scheduled therapists take off each weekend, but the therapist assigned to him for today had worked with him before, so was familiar with his case. She is one of the few therapists here, it seems to us, who has long-time experience – over twenty years. Most, if not all, of the other therapists we see in the gyms seem pretty young; Gary’s PT, for instance, has only been working as a therapist a little over two years. We were amazed at that, because she seems very good, as is his OT, of a similar age. But today’s person’s greater experience was very evident. (I suppose there aren’t many long-time PTs because the pay probably isn’t that great. This person told us she only works on weekends so I would assume she is not dependent on this job for her main source of income.)
Maybe because of it being so close to July 4th and staff taking off for the holiday, there was an over-scheduling of patients to therapists. Consequently, during the hour the therapist was supposed to be working with Gary, she would give him a task and then go off to help other patients, coming by occasionally to ask us how things were going. She started Gary off on the rickshaw. After that, she helped him with his transfer to the mat and then brought him dumbbells and told him which exercises she wanted him to do. I mostly oversaw him, making sure he didn’t cheat ;-) (by the way, mom, since you are new at email, that symbol I just typed, the colon followed by a dash then a parenthesis (here it is again ;-) ) is a wink (look at it sideways – the semicolon is the eyes, one eye winking; the dash is the nose; the parenthesis is the mouth, smiling. The symbol :-) is a smile (again, look at it sideways) ). At one point, though, since Gary was safely in the center of the mat, I stopped my overseeing of his weight program and went over to another mat to practice the rolling from back to side that he has so much trouble with. I’d never tried such a roll before, and I was hoping that in doing it myself I could figure out something about it that might help him. I kept my body “dead” from chest down and tried to roll from my back to my side in the way they taught. I noticed one thing immediately. If I wanted to roll to the left from a supine position I first swung my arms to the right (chest and head following) as he did, but then I automatically arced them up to the left over my head. If my memory was correct, he always swung straight across. I tried it that way and found that my arms essentially got in my way and stopped me from being able to roll over. I went to his mat, told him my findings, and after he finished the set he was on, he watched me do a roll swinging my arms upward. “But that’s the opposite of what they told me to do,” he said. I told him no, it wasn’t – his OT had told him he could swing his arms upward if he found that easier. He told me he didn’t remember that, and in fact had been swinging his arms downward. So, as he watched me, I tried it that way. I stated the obvious result: “Well, that completely stops me – I can’t get over at all. My arms get in the way.” He gave an ironic laugh and said maybe that was why he couldn’t get over, that maybe the times he’d successfully gotten over were the times he’d forgotten to swing down. He decided to try my way before the end of this therapy session. He finished his weights and then went into his stretching routine. I helped, supplying a tiny bit more of a stretch than he can get on his own, as his OT had suggested I do – Gary’s flexibility is so poor and it’s so important now that he get as flexible as possible, I figure he needs all the help in developing greater flexibility that he can get. After we finished the stretching, he tried my rolling tip, and he got right over (well, on the count of three swings, I mean). He tried the roll a couple more times, and each time he got over. I felt proud that I was able to contribute something to help him in another area he’d been having a bit of trouble with.
We had already run over our hour (the most recent time the therapist had walked by she’d told me that she was glad I was there and that I should get a pay raise; I asked her what kind of raise I would get from $0; she said she’d double it; I told her that having a Ph. D in math, I knew what that was), and Gary was ready – a bit eager, actually – to leave. But the therapist came over, her other patients now gone. She said they needed to work on his rolling. She said she’d noted when he first got on the mat and did a roll that he needed to swing his arms up at the end of his swing. I felt validated. Then she told him he needed to tuck his head and chin more as he swung over, and to punch hard at the end. All this he had been told before, but then she did something that really brought this home. After he got himself rolled over by using the arms swinging upward technique, she had him stay on his side and told him “Don’t let me push you back.” She then pushed him at the hip as if to roll him onto his back while he fought to stay on his side. Sure enough, his natural reaction was to strain upward with his top arm (there being nothing to grab onto – I’m sure he wouldn’t have tried for HER butt, as he had mine) and to tuck his head and chin in. That little practical demonstration made a world of difference to him. He practiced a few more rolls and they were done so much more easily. I’d venture that if he does a few more practice sessions at it, they will be completely automatic.
She then gave him tips on how to get his legs onto and off the mat after and before a transfer – another skill no one else had broken down into steps for him so that he knew precisely what he should do (I just hope that between the two of us we remember how to do it). Then she gave him some tips for getting into a sitting position from his side (on his side is where he ends up after transferring to, and getting his legs on, the mat) – he has always resorted to getting in a prone position and working from there, saying he isn’t strong enough and his shoulders aren’t flexible enough to do it from the side position. She then showed him a way to get to the sitting position from a lying-on-the-back position, but he had similar strength and flexibility issues there. She said she thought he should work on those issues, rather than abandon completely these more efficient ways of getting to a sitting position. One of the first things he needed to do in order to use these more efficient techniques, she said, was strengthen his neck muscles. (We’ve noticed this for a long time, actually – when he is hoyered with the net (which supports him on his backside from mid-thigh to shoulder and lifts him from his bed into the air), he has a hard time holding his head up without using his hand.) She told him that when she saw him again – in two weeks – she wanted to see improvement in his neck strength. She gave her thoughts on what progress she thought he could expect to see by then: that he should pretty well have the rolling down pat, and that the getting into a sitting position using the method he had been using would be easier. She hoped that he could also make some progress in the other methods of getting into a sitting position, but that he would just have to see if his arthritic shoulder prevented him from doing so (so far, nothing he’s been doing has affected that shoulder negatively).
The rest of the day was ours, and we hung out in his room for a while, doing some personal care tasks, having lunch, being on the computer and on the phone. After he talked to his mom about the Alaska flight cancellation, we decided to go out to the garden a while, since he was feeling a little cold. No problem with cold in the garden – we didn’t want to get out of the shade (it was about ninety degrees at the time). In front of where we sat was a thigh-high curved sculpture of a human. The figure was kneeling on its legs, bent forward, head down. “What do you think that sculpture is about?” Gary asked me. I thought only a moment and then titled it: “‘It’s been a tough day at Rehab.’” Gary laughed and said he thought that fit. He said it’d be funny if we taped to the sculpture a sign with that title– he was sure every patient would get a kick out of it. So maybe I will put up a sign ;-)
We left the garden and entered the rec room. I asked if he wanted to shoot some pool. So we played a game where we got whatever balls we could in, no division into solids and stripes. Gary creamed me – I got only two balls in. This is no doubt due to all the helpful techniques he discovered while playing his nephew Justin in pool that second time – and not a reflection on my skill at this game ;-)
Joe called during the game, giving me a brief respite from my humiliation. He gave us another update on the house. He has rethought the pedestal sink scenario and now plans to get wall-hanging sinks. Just before he hung up, I remembered something else we might want done: having a mirror hung over the bed in the master bedroom. “After twenty-five years of marriage you want a mirror over your bed?” Joe asked insinuatingly. “So Gary can see himself when he’s stretching, so he can make sure he’s thrown his chain loop over his foot and so on,” I hastened to clarify. I am not sure Joe was convinced that is the reason.
During my evening visit with Gary we talked to my mom by phone. At one point, when Gary was on the phone with her, he started crying and said, “That’s what my family says too.” He couldn’t talk any more, and he handed me the phone. I had no idea what that was all about but I thought he needed a good hug so I supplied it. After the call was over Gary told me that what she had said was that the whole family was proud of my devotion to his care. He started crying again, and I gave him another hug, saying, “Goodness, every time you tell me something like that you start crying.” He said, as he’s said before, that it was because he was so grateful to me. It feels a bit odd to hear him put it this way, because of the following: my reactions to this situation and how I deal with it have not been thought out, and it seems to me that gratitude implies thanking someone for something they wouldn’t have otherwise done. However, I know that if our situations were reversed, gratitude is what I’d be feeling too.
I know he sometimes feels badly that I have to deal with this. When I told him my dream about not being able to check out of a hotel and that it turned out that everyone who checked in was soon executed, he said he had a possible interpretation: that the situation we now find ourselves in is the hotel I’ve checked into and I’m feeling trapped into it, like it is ending my life.
After he said this, he started crying. I hugged him and said that I didn’t like that interpretation and that it would have never occurred to me – sure, the situation was one I’d prefer not to be in, but I wasn’t feeling that beleaguered. After he calmed a bit, he said he’d like to check out of this situation, too, and go back to the way things were.
I know that he doesn’t long entertain such thoughts – in fact, I think he is remarkable in how well he has accepted the situation and makes the best of it – but I don’t think he would be human if he didn’t have such thoughts at all.
Well, I sort of wandered off track there . . . Back to my mom’s call. Something she said reminded me of another person I should thank – my sister-in-law Dolores, for letting Joe stay away from home for this length of time and delaying their own clients so he can work at our home. So, thanks, Dolores! (When my mom talked to Joe recently and said to him, “Poor Dolores,” having not yet explained that she meant it must be hard on Dolores to have Joe gone all this time and that it was so good of her to let him do this, my mom said Joe exclaimed something along the lines of, “What do you mean, ‘Poor Dolores’? She’s got our dogs. What do I have here? Cats! When they even deign to turn up.”
Well, I can certainly sympathize with Joe missing his wife and his dogs. We miss our kitties, and I always hated it when Gary would go off for a semester on sabbatical. Nighttime was the worst.
And I know Joe is making a great substitute “papa” for our “boys.” He still hasn’t put up a cat barrier to keep the cats out of his sleeping room, thus letting Tigger wake him at 5:15 am to demand breakfast. He’s been something of a pushover with them ;-), as he knows they have not been getting their usual quota of attention – they are used to me being constantly around the house.
But, when Gary and I get home, we are definitely erecting that cat barrier, and there will be no giving in to whining for Fancy Feast.
I think.)
All for now.
posted by Peg Daniels at 9:07 PM
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