July 26, 2006 (Two entries are being posted today, so if you want to see the journal entry for the 25th first, scroll down.)

I am sore, but no other noticeably ill effects from the exercise. I’m usually worse the second day after it, so we’ll see how I feel tomorrow.

Today was a rather light day, which Gary didn’t seem to mind (he is a little worried about his shoulders, and we have been icing them several times a day). First up was the therapy tech, and today’s work was done on the queen-sized bed in the gym. He transferred onto the bed and then, sitting along its edge, did hops up and down the side. I asked if he wouldn’t get more lift if he bent more, and he said he probably would but he was afraid of falling off the bed. The tech was right in front of him and promised him she wouldn’t let that happen, so he tried it and did noticeably better scoots.

Next he got his legs up on the bed with a little help from the tech, and by himself got to the middle of it and sat up (a seemingly impossible goal when he first came here). With his legs straight out in front of him on the bed, he practiced the hops again, first to one side, then the other. I pointed out that while he was getting his head down the opposite way of travel, he wasn’t much allowing his body to follow it – only his head was dipping. So he tried to use his body more, and again the difference was noticeable. He called it “using the trampoline effect.”

Next he was to practice going from a prone to a side-lying position and then getting the pillow from under his legs to between them – the goal being not to wake Peg every single morning at 4am to do this for him ;-). The tech said she had to go get a pillow and told Gary not to move. “Don’t worry,” he told her. “I won’t run away.”

He remembered the OTs tips about getting on his side and “walking” on his elbow into a curled position, and he got the pillow put in the proper place with no problem.

His final task was to sit himself up and get himself back onto the edge of the bed for the transfer to the chair. The tech gave him only a little help with his legs.

We went back to his room, and since Gary was to go to the Braves game this evening, his flap dressing had to be changed sometime during the day while I was there, so since he had an hour’s break before seeing the OT, we did it then. The PT came around during this time to tell us that in their team meeting this morning, it had been decided he didn’t need a special mattress – or even a hospital bed – when he goes home. The PT confided to us that she and the OT wished they had known that before now, that there would have been more practice on a regular bed. But Gary and I thought it would be best if he starts out with the hospital bed anyway. It is what he is used to, and throwing in a new factor at this stage of the game makes us uncomfortable. The PT said she’d also thought it best for him to start with the hospital bed. She said he could practice using the rails on it less and less, and whenever he was comfortable with the notion, he could sleep on a “regular” bed.

The good news about this is that it means the medical staff agrees his flap is healing well, that it no longer requires he sleep in a special bed. I know from dressing the wound that it is looking so much better lately – there are just two tiny holes that haven’t quite healed up, both at the junction of two seams.

Though the PT had previously demonstrated to us how to “break down” Gary’s wheelchair for its transportation, we’d actually never done that, so when the OT asked Gary what he wanted to do during her session, he suggested that. The task is slightly more than he can handle independently, but for now the important thing is we have hands-on experience doing it so we can get his chair in the car!

She next wanted him to transfer entirely without help from the mat to his chair. He gave me a nervous grin. I told him he could do it. He said to the two of us, “And you’ll catch me if I fall, right?” and we assured him we would, the OT adding that she was sure he wouldn’t need any assistance, that he could do this himself.

It took him a while to psyche himself up, and then he tried the transfer – but he landed on the tire (very bad for the flap) and the OT had to help him over. He then made the transfer back (the downhill direction, and therefore easier), the OT saying it had been on his own (though I noticed she’d kept hold of his pants this time). She commented that it hadn’t been a very high depression transfer, however, and she said that she was learning how much help I’d been giving him, that I was stronger than I looked. She asked me how much lift I thought I’d been supplying him with, and I said it varied, that sometimes he seemed to get tremendous lift on his own, but sometimes little, that he wasn’t consistent (depending on how tired he was, etc.). I didn’t admit, but maybe I should have, that I never acted purely as a guide – I’m too scared to not give him a little lift, as I want to make sure he lands where he’s supposed to. But maybe that’s made the OT think he is better at it than he is.

She had him do another transfer both ways, the OT saying that it was “all him” both times (though she’d been hanging onto his pants), but that he wasn’t getting very high. The PT walked by, and the OT said to her the same thing, that she was learning how much help I’d been giving Gary, that I’d been giving him lift. But the PT said that she’d done the transfers often enough with him that she thought that even though he doesn’t always get tremendous lift, he still gets enough to clear the wheel.

So, I’m not absolutely sure he’ll get cleared to do even the mat transfers on his own this week – there’s really only tomorrow to go. He did confide to me after his attempts that he’d been afraid to bend as much as he normally does in the transfers because of his “balance issues”; without the security of having one of us have our hands on his hips he was afraid he might fall. And of course, if he doesn’t bend his upper body as much, his butt doesn’t lift as much – that equal and opposite reaction thing.

After the OT session he had a “group” session (an outing up the block to Chick Filet), but before they took off on their outing, there was a graduation ceremony! He and another patient are being discharged this week, so their teams members had a ceremony for them, while everyone else in the therapy gym clapped and cheered. In the background “Chariots of Fire” played, and the therapists put traditionally styled caps on the two graduates. They both got Shepherd T-shirts, which say, “Outroll, Outmaneuver, Outlast,” and fanny packs (good thing the gift shop hadn’t had any more yesterday). Each of them got a certificate of graduation from Shepherd Inpatient Therapy, and since they’d both completed their course work, they got Super Student Award certificates. The other man also got certificates for Best Tolerance of Stretching (I think that was a joke) and Best Homegrown Tomatoes. Gary got a certificate for Most Likely to Need a Helmet for Doing Wheelies and a “Shiny Hiny” certificate from the skin team, the certificate in the shape of a butt and covered with foil. Then pictures were taken – Gary’s had the members of his Shepherd team in it and me. The pictures came out pretty good, but I don’t have a scanner here, so I guess I can’t put them up on the blog until we get home.

I know it’s silly, but I cried a little during the ceremony.

After the ceremony, Gary told the skin PT, who’d handed him his certificate, that he’d now like to see pictures of his flap. She wasn’t sure they still had any, though. When he and I got on the elevator to go on the group outing, I looked on my cell phone camera and showed him a couple of pictures of the area in question – I’d taken them to make sure I'd know if things “down there” got any worse. One picture was taken at the end of June, before his flap surgery, and the other taken after the surgery. He said he was glad he hadn’t looked at them at the time.

Next came the “group push” to Chick Filet. Gary’s task was to check out the men’s room for accessibility. The PT assigned to him (not one who has worked with him) commented as she watched him maneuver to get through the door, “He never gives up, does he?” I agreed he doesn’t.

The members of the group ate their ice cream or drank their shakes, which someone else had had the task of ordering (Gary only had a little of his shake because he was worried about the effects on his IC levels), and then the Shepherd leader of the outing gave Gary the task of handing back change to four members of the group (everyone had given a few bucks to cover what they thought they’d be buying). Gary’s PT joked that since he was a mathematician, he ought to be qualified for the task. The leader gave Gary the receipt, and she started explaining to him how to make change! (So-and-so has given five dollars, and his shake cost $2.79, so you need to subtract – ) I couldn’t help it – I said, “I think he knows how to do that.” And yes, he lived up to my expectations.

On the way back, he still couldn’t make it up his nemesis curb cut, but other than that, things went smoothly. The PT assigned to him gave him help up the Blue Carpet instead of making him do it himself because she said he would be doing a lot of pushing at the Braves game tonight and she didn’t want him to tire himself out beforehand.

After he got back to his room, he and I got him transferred into bed so he could have a little rest before his Braves outing – and to get his feet up for the benefits to the IC.

So, that’s where I left him today. I went off to the chiropractor then went to the hotel and used the time I’d normally be spending with him tonight to catch up on the blog. I’ll let you know tomorrow how things went at the game!

All for now. (Except, yikes, I’ve just noticed how much sorer I am now than I was earlier today!)