July 17, 2006

First let me say Gary seems to be all right. Second let me say I could have done without today’s excitement. Before his afternoon session with the tech, Gary decided to practice wheelies like he’d been doing with the OT in the morning, only, doing it with the tip bars on instead of off as he had with her (as I’ve said, this skill is used for going up curbs, over uneven surfaces, down ramps). I felt uneasy, because I hated seeing him tip back even though the tip bars were supposed to prevent him from falling over backwards – I just didn’t trust those tip bars. I decided to move behind his chair even though I figured he’d think I was being overprotective. I’m sure you can guess what happened. Just as I made my move, his chair tipped over backward. It was so awful, rushing over to him knowing there was absolutely no way I could stop what was going to happen, seeing the look of horror on his face, hearing the clunk as the back of his head smacked the floor, seeing the look of pain on his face. I fell to the floor next to him, afraid to move his head but wanting to cushion it from the floor, wanting to hold him. People came running. One of his first thoughts must have been about his flap, because he held his legs above the knees to keep his legs from falling toward his face (and thus preventing his body from bending too much). A PT told him she’d hold his legs in place for him. Two nurses arrived, and ran through various things one checks for with a head injury: whether he’d lost consciousness, if he felt nauseous, if he had a headache, if he had blurred vision; the only one he said “yes” to was the headache; he also said he had tingling in his fingers (that went away shortly afterwards). They said they’d bring some Tylenol and an ice pack and that the doctor was coming to check him out. They also took his temperature (normal) and his blood pressure (high). They asked him what happened, and he told them he’d just been trying to practice the wheelies. They first assumed he’d tried it without tip bars, but he said he’d had them on; then they said he must have done a particularly vigorous one, and he said no to that as well. They were perplexed, but the PT examining the tip bars said they were back too far. Turned out Gary’s OT hadn’t known the tip bars had two positions, and after the morning’s session she hadn’t put them back on what we’d been told was the correct position.

Various staff and fellow patients came by to ask how Gary was doing as he lay there on the floor. He said he was fine except for the headache. Me, I was more of a mess, trying not quite successfully to hold back tears, frightened that now he would have a brain injury, feeling guilty because I hadn’t been behind him, hadn’t acted on my intuition quickly enough. Once again I felt like turning him into “The Boy in the Plastic Bubble” so no harm would come to him. The resident doctor came and asked Gary the same questions the nurses had, then said he didn’t think a head scan was necessary but that if any of those other symptoms should arise, to let the nurses know immediately and they’d get him scanned. The two nurses and two of the therapists lifted his chair up (him still strapped into it), and we discovered that he’d broken skin on the back of his head and it was bleeding a little. They shaved the area, then gave him ice (tied up in an examination glove) to put on it. They said the doctor said he was free to do whatever he wanted to do. He looked at the clock, saw there was half an hour left to his therapy session, and asked his tech, who was right there, what he was supposed to do during his session. She said “the terrible threes.” He said he thought that would be all right to do, since he’d be prone and he was fine except for a headache. The tech and I looked at each other. We suggested to Gary that he go back to his room and rest – I tried to make light of it, saying I knew that I was always willing for him to do more in his therapy sessions, but today I thought I’d cut him a break. He agreed to go back to his room. The therapy tech and I got him into his bed and proned so that we could put ice on the back of his head. Other people came to check on him – his nursing tech, his OT and PT, the psychologist (Gary said he was fine, though admitted he’d been scared, especially when all the people had surrounded him in concern; he told the psychologist that maybe she should talk to me, since I was more traumatized by it than he was – he was right; I even felt guilty about that, since it took the attention away from him and put it on me. I told the psychologist I felt guilty for not having prevented the accident; she and Gary assured me it was in no way my fault; part of me didn’t believe them.)

The ice on his head made him cold, so I brought him hot cocoa and later hot herbal tea. I told him I’d read the mail to him, as it had just arrived. One item was a card from my mom, and I started crying while reading it aloud and at one point I couldn’t go on – the afternoon’s stress had gotten to me. Gary tried to comfort me, again assured me he was all right and that it was in no way my fault. I said I intellectually understood that now, but overriding all that was the plain fact that I didn’t like seeing him hurt. He smiled ironically and said that he didn’t like being hurt, either. Janet and Jack Roger’s package containing a couple “Clueless George” books (take-offs on “Curious George,” satirizing you-know-who) was the other item we’d gotten in today’s mail, and I read the books to Gary – they were just what I needed to help calm me down.

After I read him the books, Gary took a nap for about two hours. I stayed right there, wanting to make sure no afteraffects from the fall arose. He wanted to change his head position a couple of times, so I would take the ice off his head then reapply it. I was glad he woke up these times, so I could make sure of there wasn’t any disorientation or any other mental sign of concussion – had he not woken up, I would have woken him myself. After his nap, he wanted to get back in his chair. We “cheated,” me giving him a lot more help than I normally would in getting him upright and in doing the actual transfer – he said he felt fine, but he would take the extra help just to be sure nothing weird happened. After he got into the chair, he told me to go to the hotel and take care of myself – I don’t know how much of it he could see, but I felt really wiped out. As I collected my things to go, he wheeled outside the curtain. “Where are you going?” I said. I must have sounded anxious, because he said in an reassuring voice, “Just to open the curtain.” As he did so, he joked, “Then I thought I’d practice some wheelies, then go outside and try some curbs. Would that be all right?” I gave him a look. He said, “Don’t worry, I’ll be a reluctant wheelie-er for the next while. I’d rather do a hundred pushups.” I didn’t tell him that the OT had come in while he was asleep and told me that the next time she saw him (which although she usually sees him everyday, this week won’t be until Thursday), she would do wheelies with him, a “back in the saddle kind of thing.” I’ll probably be having an anxiety attack during the session – assuming she can convince Gary to do it.

As I left Shepherd, I remembered that I was supposed to have been at a chiropractor appointment over a half hour earlier. I stopped in, apologized, explained what had happened. He has been very understanding and compassionate this whole time, so my being late was no problem. He joked that maybe he should bring a helmet for Gary to wear. I felt like taking him up on it.

In the evening when I returned to Gary’s floor, laden down with baby salad greens, mixed berries, and banana split ice cream, a nurse saw me coming down the hall and called out, “He looks good.” I told her that’s exactly what I’d wanted to hear. Gary was still sitting up in his chair, and said he felt fine, no headache. I had been planning on asking the nurses if they were going to wake him throughout the night to make sure of his neurological status by asking him questions (I knew that this is something that is done after head injuries), but it turned out I didn’t have to – he said that they were going to do so every four hours throughout the night per doctor’s orders. I told him I was sorry I’d gotten more traumatized than him by the situation. He said he understood why that should be, a “first a husband who is paraplegic, now this” feeling. He did hope that the OT wouldn’t get in trouble, as other than this she’s been great.

He had some fruit and then ice cream, and then we went through the evening routine. Before leaving I told him, “Do me a favor and don’t hit your head ever again.” He said he’d try not to. I told him that the chiropractor had said he could borrow his helmet. Gary joked that tomorrow he should go to his therapy sessions wearing it.

Not a bad idea.

Well, now that I started this entry with the middle of the day, I’ll go back to the beginning. First up was the therapy session with the OT. They began with wheelie practice. He started off very jerky, and the OT told him to be zen, to be one with the wheelie. It isn’t possible to stay in the wheelie position (at least, for long) without moving the rear wheels back and forth, but she told him to move his hands only as necessary, relaxed and reactive to the process; the PT who’d first worked with him on this had seemed to be indicating that it was a much more active process, and he did much much better with this new advice (and I think it was the great confidence boost that he got as a result of this session that later led him to practice the wheelies on his own). After having him stay in approximately the same spot, the OT had him do a little traveling while in the wheelie, and then to do 180s. They finished this portion of the session by having him practice “wheelies up a curb,” except that because there wasn’t time to set up the 4"-high wooden platforms they use as curbs, he was to pretend a particular line on the floor was the curb and do a wheelie when he got to it, and then immediately lean forward as he would in order to help the rear wheels get up the curb.

Next she took him to the practice kitchen they have set up for the patients. She pointed out how the kitchen sink had been modified in order to allow a wheelchair to roll under it, but we told her Joe had already taken care of that. She had Gary practice getting stuff out of cupboards with his grabber, pointing out the rather obvious thing that lighter stuff should go on the top shelves. He is scheduled to do a cooking session with her on Thursday, and she told him she’d placed his order for ingredients: spaghetti and garlic bread and broccoli. She also would have gotten him spaghetti sauce, but we’d said no thanks, we’d supply our own, and in fact I picked up some “Mothers” garlic and basil sauce and olive and caper sauce at Fresh Market in the evening.

She mentioned that he should now be starting to practice doing his bowel program on his own. He told her he already was. She said he was the first patient to ever do the bowel program on his own without being told. I held in a smile. Gary later said he should have told her that he was doing it because I’d suggested to the nurses that it was time for him to do so, and that I had an ulterior motive for making the suggestion – not that he blamed me!

Next he went to the ProMotion Gym for a session with the exercise rec therapist. This time she gave him a good work out. She started him on a Schwinn hand cycle for five minutes. Then he went to the Bowflex and did two sets of ten of chest presses, flies, internal and external rotation, one-arm rows, shoulder extensions, and tricep extensions. While he was doing this, I mentioned how he hadn’t been able to do the group weight exercises with dumbbells because of his balance. She said she was going to show him some dumbbell exercises next and give him some tips. We went over to the dumbbell rack, and she told him to pick out his weights. He said he’d start out easy, and picked up some three’s. She told him to put them back – that no way was she going to let him get away with that :-)! So he picked up some fives. She showed him one-armed (bent-armed) side extensions and a couple variations of one-armed biceps curls. She also showed him some more balance exercises he could do: raise his arms out to the side and lean in one direction, then the other; she explained another balance exercise, one where I would sit behind him and give him little pushes in different directions and he would have compensate. I gave an evil grin and said I liked that one (of course now that I write this after the head-bashing occurred, this doesn’t seem very amusing).

During the half-hour break before the next class, I called the adaptive technology guy at Shepherd and asked if there was any way that both Gary and I could get on the internet in his room at the same time. The guy came to Gary’s room later in the afternoon, and now Gary and I won’t have to fight over who gets the ethernet cord.

The next class we attended was Airplane Mobility Class, where they went over what was going to happen at the airport when we go on Wednesday. It will be a long day, from 9-3. The participants will do ticketing, security, take the elevator to the train, take the train to the terminal, go to the gate, then do a transfer into the aisle chair (a big-boned woman asked at this point, “How long we gotta be in that itty bitty chair?”, which made everyone laugh). Then they get rolled into the plane, then get transferred into the airplane seat. On the plane, there will be a presentation about airplane travel for those with SCIs. Next they’ll deplane, and go off to do their ICs. Next comes lunch at the food court, then back to the train or the moving sidewalk, finishing up at baggage claim.

After that class came lunch, and then we went off to the tech session, right before which occurred Gary’s fall. So now we’ve come to the events I’ve already described. It was a long, long time before I got to sleep last night (it is now Tuesday morning), and I shot awake too early. I kept seeing the image of him going down. :-(