Earlier today I posted an entry for Dec 23-25. Please scroll down for that.



Dec 26, 2006

A reiteration of the goals Gary had going into Day Program and how he/we fared:

Goal: Raised toilet seat – how to transfer onto it and how to use it for the bowel program

Result: Gary has the basic technique down. He will need to practice the transfers with me for a while until we are comfortable with him doing them by himself – and first, we need to get a proper-height piece of equipment, because we discovered on coming home that the raised toilet seat they gave us is much too high! So, we haven’t yet had the chance for him to actually get on it at home; in particular, we haven’t been able to see if looping his chain loops (which are normally used to assist him in stretching) over the grab bar in the shower and then hanging onto a loop while he leans over to do his bowel program is going to work for him – it seemed a little scary for him to do so to me, the grab bar being so far away. If that doesn’t work we’ll have to figure something else out, maybe installing a floor-mounted grab bar.

Goal: Work on Transfers from wheelchair to the following and from the following back to the wheelchair:

raised toilet seat (Result: see above)
floor (Result: We got the techniques down, both the technique of bumping up into the chair backwards using an aid like a step and that of going directly into the chair frontwards, both ways requiring assistance from me at this point in time)
our car (by himself and possibly without use of transfer board) (Result: he still needs assistance and we still need the transfer board and we decided the way we had made up was better than the “official ways” being taught to us, because by going from the car into the wheelchair backwards Gary doesn’t have to worry about banging his butt on the frame of the car.)
an SUV like Michel’s, which has a seat so much higher than our chair (Result: Gary learned the technique and got it down, with assistance of course.)
shower bench (Result: an alternate way was suggested, that of transferring from the raised toilet seat to the shower bench, which would eliminate the problem of not being able to get the wheelchair at an advantageous angle to the shower bench. We haven’t tried this at home yet.)
low to high transfers in general (Result: Gary can do these much better than at previous Day Program; requires assistance at this point in time)

Goal: Dressing while in the wheelchair, trousers especially (so he doesn’t have to get back into bed to dress himself)

Result: he has the techniques; it will just require practice to be successful – he hasn’t been able to get the very last part of getting his pants on over his butt without assistance. So far, he hasn’t been eager to practice this at home, sticking to dressing in the bed.

Goal: Decreasing the number of ICs to four (though that may be a problem because at this point it would mean he would have to get himself out of the prone position at midnight and lay on his side to do the IC, and he would then have to wake up an extra time during the night because he’s not allowed to stay on his side for more than six hours and he isn’t comfortable staying on his side for even that long – and he doesn’t want to wake up an extra time!)

Result: because of the aforementioned problem, no change was made.

Goal: Curbs and wheelies

Results: able to do four-inch curbs about fifty percent of the time, less able to do six-inch curbs; therefore, he will in neither case be doing these on his own yet as we don’t want him tipping over backwards, even if he now knows how to get the chair upright, him in it, should that happen (assuming he isn’t too dazed to even try); he can do these curbs with assistance, however.

Goal: “Regular bed techniques” – in other words, now he does everything in a hospital bed, which has those nice electronic controls and rails to aid him. Since he eventually wants to travel, he wants to be able to do his maintenance tasks in a regular bed, so he needs to “re-learn” how to pad and position himself, and turn from side to side, and do his bowel and bladder stuff, etc., in a regular bed. Also, he wants to learn how to prone himself, because he is definitely dependent on me for that.

Result: This didn’t turn out to be as big a problem as he thought it might be. He can do his bowel and bladder care, and turn from side to side, and pad himself while on his side with no problem. As for proning, he can get padded off and in the prone position, but at this point I still need to check that his pillows have ended up correctly above and below his knees to make sure there is no pressure on his knees. We also had a tradition of a “thank you very much pillow,” which is the pillow he puts under the side of his face while he is lying in the prone (face-down) position, and is the last pillow that is put into place for the night. Our tradition was that I would throw this pillow with some force on top of the back of his head every night, at which he would say, “Thank you very much” and then put the pillow under his cheek. Hey, we have to have our fun. We missed our tradition when he was putting that pillow in place himself, so we went back to me smacking him with it.

He hasn’t practiced in a double bed at home. First we have to figure out what to do about a bed for him. I am going to try sleeping in the hospital bed at least one night – and Gary will have to make the high transfer into my double bed. If we like the results, we have to figure out if we are going to move my bed into his room and the hospital bed into mine, or move both beds into mine and shop for a double bed for him. The hospital bed is rented, and we have it for a total of six months, we think.

Goal: Find out if there’s anything else he should be doing for the “leaking problem,” see what the possible solutions to it are and what their long-range effects would be

Result: He was discovered to have a UTI. We wonder if he may have a near-constant low-level one, which may be causing the leaking. He is going to incorporate cranberry juice in his diet. He is also going to speak with a local urologist about the problem.

Goal: Grease his flap himself

Result: success

Goal: Do his own skin checks of his butt and back

Result: We think he will be successful with this when we get a long horizontal mirror hung on the wall next to his bed.

Goal: Get another wheelchair evaluation – it’s possible the wheels on this could be brought in to make the chair narrower; also, we want to see if his tip bars could be raised and if the footplate is in the proper position (I had to fool around with it from what it was when his new chair came, because he couldn’t roll under the kitchen sink – the position of the footplate made his knees to high – only now, in the position the plate is in his heels don’t rest on the plate). A minor goal is to learn to breakdown and assemble the chair himself, but he doesn’t really see himself doing that, like to get it in a car – it’s too heavy for him. He won’t need to do that when he gets his van, cuz he’ll be able to roll the chair right in; and if he’s a passenger in someone else’s car he’ll depend on them to get the chair in and out for him.

Result: he didn’t bother with the breaking down and assembling of his own chair. All the changes to the chair mentioned above were made, and in addition the back of the chair was raised. He is quite pleased with the changes, and especially the fact that his back no longer aches as it had been doing in the new chair – there is still discomfort there, but it is like it had been before getting the new chair.

Goal: He also hoped to persuade the recreational therapist that a good goal to have would be for he and I to go to the Atlanta symphony Christmas concert next week. The catch is that we’d want permission to not have anything scheduled until 10 am the next day, as it would be a later night for us than usual – otherwise we wouldn’t need to mention this to them as a goal!

Result: We went and had a good time ;-)

Goal: Other rec therapy goals: they may get him in the pool; they are putting him in the standing frame; they may go over a weight training program with him that he would be able to use at our university gym.

Result: He got in the standing frame a couple of times and in the Easystand in the gym with me a few times; the OT gave him a home exercise program; he went swimming twice, the first time being a very emotional experience as he felt the freedom of being able to move his body about in the water easily. It takes so long to shower and dress afterwards, however, that he is not at this point inclined to make swimming a regular thing. Come to think of it, I’m not sure how the university would handle me needing to be in the changing room with him, but we don’t have to worry about that at this point.

Other things that happened on Day Program not on this list:

He learned the technique for getting his wheelchair upright should it fall over backwards – this the two of us were able to do with no problem.

He learned how to bump up and down stairways. We can do this together, though he isn’t eager to be doing a lot of this ;-).

He learned how to go down the stairs backwards in his wheelchair using one or two handrails, with my help – he said he wished he had known how much effort I had been putting into it, because he found it easy and he would have liked to have known if it was all right with the therapist if I didn’t help so much with it.

He learned how to manipulate a knapsack on the back of his wheelchair.

He learned how what tools to use so that he could sweep better (so that when I follow up with the mop, I’m not just smearing the dirt he hasn’t picked up;-)).

He learned about using a velcro strap so that he can hold the oven door open in a way that allows him to balance better.

Finally, we are supposed to be getting a referral to a speech therapist to see if there is something that can be done about his coughing problem (or rather, my problem with his coughing ;-)).

Okay, enough of him for a while. Now I need to get back to my novel and wrestle with my characters ;-)

Dec 23-24-25, 2006

Tigger was happy to have us home. He followed me around for the rest of the day on the twenty-second, demanding lots of petting. Blackjack was just happy to have someone to yell at when he wanted food.

We looked through the mail that had been sent to us over the past couple weeks. Found some nice fat checks from my mom and Gary’s mom ;-) and some lovely Christmas cards. Debra Talley had done a watercolor of a bundled-up little girl with up-turned face greeting the swirling snow, and the print of it was marvelous.

We called my little sister, and I listened in when Gary talked to her about Day Program and such. He told her they had him doing things he’d never thought he’d be able to do but that he could on account of not only the techniques they showed him but their encouragement. In particular he mentioned getting the wheelchair back upright if he falls over backwards in it (and let’s hope that never actually happens). He told Di that he was stronger in his upper body than he’s ever been before – and I note that he’s certainly got muscles like he never had before!

She must have asked him something like if he ever got depressed, because he said somehow he never did, that he always focused on what they said, that he would, in time, be fully independent. He said that his “support group,” headed by me and including his family and friends, helped in that regard. He noted that lots of people with SCIs do experience depression, that one of the workers at Shepherd had told a group of us that she’d been depressed for two years after her accident.( On Christmas, we talked to my mom, and the topic must have come up again, for he said much the same thing, in particular how grateful he was to my brother Joe for taking time out of his life and coming to work on our home and to the math department people who devoted time to the project, helping Joe out.)

Di asked about his job, and he talked a little about that, saying that it would have been very difficult to return to a nine-to-five job, but that he was fortunate not to have time commitments in that way.

When I was on the phone with her, Di told me a funny-but-not-funny story of how she is supposed to be cat-sitting for a friend and the cat, an “outdoor cat,” has run away. Fortunately, through the humane society the cat has been located – it is staying about two blocks away from Di, being fed by a woman who noticed it hanging around her house. Now all Di had to do is catch it by this coming Wednesday.

We went to Kroger in the afternoon, getting back into our routine – including the stop at the ice cream parlor afterwards. Joe and Dolores had said that for Christmas one thing that we should do as our gift from them was to buy or do something special for ourselves. They suggested Gary get a gallon of ice cream “with his name on it.” I told him we were getting that gallon scoop by scoop. (As their gift to me, I intend to buy myself a copy of the soon-to-appear book on the Remington Steele series.)

One thing that was not routine in the day was that we were going to a Christmas party in the evening – this was Gary’s first outing to someone else’s home. Gary called the Stuckwisch’s to make sure he could get into the house. They told him he could come in through the garage door so as to avoid the sunken living room – because Frances didn’t want him doing wheelies in her house in order to get out of the living room and into the rooms where the food was ;-). The garage door led into the kitchen – where the rice and beans and chili would be kept – so Gary didn’t mind that at all, since he tends to gravitate to the kitchen at parties, he says. Through the kitchen he could also get into the dining room, and on the dining table there was a big spread of food as well. This was just fine with Gary. We stayed a couple of hours – probably a lifetime record for me ;-) (parties make me anxious) – and then we left so Gary could start his evening routine. The only “problems” we ran into was that in getting to the Stuckwisch’s we couldn’t see the names on the posts they use as street signs down here, and I had to keep on getting out of the car to see if the cross street was the one I wanted to turn on; also, at their house the outside was very dark which made it harder for me to put Gary’s wheelchair together – but since I’ve done it often enough, I could essentially do it by feel.

Sunday I spent much of the time catching up the blog. I also composed a Christmas letter for Gary. On Christmas morning we started off the holiday by reading each other’s cards and crying over them. We are sentimental saps ;-). Then it was present time! Joe and Dolores had made a donation to the Christopher Reeve Foundation in our names, and they bought us “Superman” and “Superwoman” tags to wear and said they bought some for themselves too. We had made a donation to Toys for Tots in their names. Janet and John sent us a four-foot LED Fiber Optic hanging Christmas tree so we would have some Christmasy decoration. Since it was morning, we couldn’t get the effect, but in the evening we turned the lights out and plugged in the tree and were treated to quite a show! We gave them gift certificates to amazon.com. And that is what I also gave my little sister Di and her two boys. From Di I got some mystery books and Gary got the book “The Last Three Minutes,” conjectures about the ultimate fate of the universe, and I also got some loungewear. For some strange reason ;-) Gary’s side of the family decided Christmas was about kids, and so it was our nephews an nieces that made out with the goods, though Bob did send Gary a St. Louis Cardinals World Series Champions T-shirt. Oddly, I forgot to give Gary the presents that had already come in the mail, only remembering to do so in the evening. I joked that I was getting him a rickshaw weight machine too, but he didn’t seem to think that was very funny.

We made calls to or received calls from the various family members, though we didn’t get in contact with Joe and Dolores until Tuesday morning. My mom, as usual ;-), has been keeping busy going to party after party. Joe and Dolores are coping with 23" of snow in a town in Colorado that, as may surprise you, is not prepared to deal with that amount of snow – the main streets are plowed, but not the others. Usually the snow there doesn’t stay very long, sublimated from solid to gas by the dry air and the intense sun they get there in the winter time. Joe and Dolores sent us pictures of the results of the blizzard. Their dogs seem shorter than the drifts, though Joe says they get along all right by leaping from footprint to footprint.

Gary and I had fun making our typical holiday meal – yes, nearly identical to the Thanksgiving meal I described. I think the only differences were the type of bread used in the stuffing, the fact that asparagus was had instead of broccoli, and that I added cranberry juice to the maple syrup that was poured over the sweet potatoes. The juice we had on hand because we are going to incorporate that in Gary’s diet as a preventative for UTIs.

Gary had intended on Christmas morning to try out the raised toilet seat, which evidently is the correct name for what I had been terming “the commode chair” (evidently a commode chair is a different piece of equipment, similar to a shower wheelchair, and in fact can double as a shower chair). I told Gary “raised toilet seat” just sounds like some man forgot to put the toilet seat down, and he said he was sorry but that was the official name for it. At any rate, the chair turned out to be much higher and much smaller than the one Gary had used at Shepherd, and neither of us were comfortable with him making such a high transfer onto something he would essentially have nothing to hang onto, not to mention leaning over sideways on it and being half a foot higher from the floor than what he’d practiced on. So, we skipped that. Gary called the company on Tuesday and it turns out he got an old model, so he is trying to get our vendor to replace it with the new model. Dealing with vendors tends to be a little like pulling teeth, we’ve found.

So, now I’ve pretty much caught up on our doings, except in the next entry I want to make a bit of a summary of Gary’s achievements at Day Program and what we are incorporating of what we learned.

This is my second post of the day, so if you missed the one pertaining to Dec. 21, scroll down.

December 22, 2006

As figures, I woke up at 3:30 and couldn’t go back to sleep. I got up when I heard Gary stirring – he had set his alarm for a half hour earlier than usual (5:30) to give me more time to throw stuff in the car before Day Program. So, while he was doing his thing and in between doing what I needed to do for him I packed up the stuff as it became “available” to be packed, and loaded the car, and did more cleaning, and laundered the sheets and towels like they said I was supposed to do before vacating the apartment. There was just enough time to get it all in before we needed to leave for Day Program, and I was glad I didn’t have to miss any of his last day. While we were still in the apartment and Gary was helping me fold the towels, he said, “I am impressed with the job you’re doing this morning.” I said, “Oh, you mean the way I pulled the sheet out from under you while you were in the middle of your bowel program so I could wash it?” (which did happen). He laughed and said, “Yeah, and the way you demanded the peel from the banana I was eating for breakfast so you could throw all the trash in the dumpster.” (which also happened).

His first hour at Day Program he was in the standing frame, and as balance exercises the PT played catch with him, first with a tennis ball, then with what I guess was a soccer ball – at least, it was about that size though it was on the heavy side and didn’t bounce very well. She threw the tennis ball to both his left and right sides and he was supposed to use each of his hands to catch it. While they were throwing, she asked him if he was sore from all he’d done yesterday. He said he had been sore yesterday afternoon and evening, but wasn’t now. They changed to the larger ball, and he was supposed to use two hands to catch it (he first asked her if there was any danger of him falling out of the standing frame if he leaned too far to one side to get the ball, and she assured him there wasn’t). All of a sudden while they were throwing the ball back and forth, Gary whips it in my direction (I was off to the side of them). He hadn’t looked at me beforehand, and not only wasn’t I prepared for the throw, but I was just finishing putting my notebook back in my pocket, having just written that they were now using the larger ball. Fortunately I got my hands up in time to catch the ball. Gary laughed and said it was an amazing catch. I am not sure why he thought I should think him funny, seeing that if I hadn’t gotten my hands up I would have gotten hit in the face. Must be some obscure Gruenhage humor ;-).

So then the three of us played catch for a while, at good speed and in no particular order – kept us all on our toes. Then the PT got some ping-pong paddles and we tried to play ping-pong with the tennis ball. The PT soon left me and Gary to do this ourselves. This is not my game anyway, but it was definitely not my game under these circumstances – there was only a limited amount of area that I could hit it to for Gary to be able to hit it back, and my aim wasn’t that great. I got more exercise than he did, what with me running around the gym to retrieve the ball. We did a lot of laughing, though.

The next hour we went on a push, but it wasn’t a very lively one. There was only one other person on it, and she was fairly newly injured and didn’t have anywhere near the skills, strength, or endurance Gary had. We went out to the door to the parking garage, near the elevators, and the therapist had Gary open the door. Of course, he’s had practice opening doors for the past four months, so he did it easily. Then it was the young woman’s turn. Not only was this the first time she had tried to open a door, but on account of her injury – C6-7, incomplete – she didn’t have full functionality of her hands. Gary, myself, and the therapist stood watching her attempts, and at this time another woman entered the area to use the elevators. She punched the button for the elevator and it came almost immediately, but it was then that she became aware of the woman in the wheelchair trying to get back in through the door from the parking area. “Does she need help?” she cried. “Is she stuck?” She moved toward the wheelchair person, but I assured her that this was a practice session. The woman then said, “Oh,” and left, taking the elevator. I then said to the closed elevator door, “Yes, she was stuck. The three of us are just cruel people, standing around watching her struggle to get in the door.” We all started laughing, and then we shared what had happened with the young woman who had finally made it in through the door. Next came more door practice, and the woman was amazed how easily Gary could do it. I assured her that Gary had been practicing it for four months and that she would be able to do it in time. We then headed toward the tunnel that led to Piedmont Hospital so that Gary and the other person could attempt the dreaded Blue Carpet – you might remember that is a carpeted long and steep incline. But on the way, the therapist disappeared (Gary and I were way ahead of the others). The other person in the wheelchair pulled up, and she said she had no idea what happened to the therapist, that she didn’t realize the woman wasn’t with her. I thought maybe she’d gone to the bathroom. After several minutes, Gary said he was going to check his email in the library, which was close by. I waited with the young woman, who I guess to be in her late teens, early twenties. She asked how Gary got injured, and I told her about his accident. She said she had been in a car accident too, that she’d been a passenger in a car driven by a drunk driver, and that he’d slammed into a parked car at 105 mph. Nothing happened to him – she said he was still out playing baseball and driving drunk. I couldn’t help having the thought that while it is inexcusable to drive drunk, it also isn’t wise to get in the car with a drunk driver.

The therapist showed up with some strange excuse about having to buy the pecans that were being sold in the passageway because they were going to run out, and that there had been a long line. They have been selling those pecans ever since we arrived, so I didn’t “get” her excuse. Anyway, Gary came wheeling out of the library at this time, and we headed toward the Blue Carpet. He made it “the easy way,” which has a smaller and shorter incline at the end, with little difficulty, and then after a rest it was time to tackle the hard direction. His record last August was to get up this incline with three rests. He made it in one shot! It still wasn’t easy for him, but he did it. The young woman needed lots and lots of rest breaks to get up it, gasping away, the therapist hanging onto her chair so she wouldn’t go backwards. Reminded me of the first time Gary was in the chair and he needed rest breaks to even go for a relatively short distance on a level floor.

We then headed back toward the parking garage, and Gary and I thought the therapist was going to have them go up the parking ramps, like they did the one other time Gary was on a push like this. But we didn’t go there, instead turning into the Marcus building and taking the elevator back to the third floor. I thought maybe it was because the parking ramps would have been too much for the young woman, though the therapist said it was because it was wet out.

Last on Gary's schedule was a group exercise session, the group being the same four of us (me, Gary, the young woman, and the therapist). After that was Gary’s graduation ceremony. His therapists and me and others in the gym cheered as Gary received his certificates. His special award this time was for being “Most Improved since last Day Program.” I had thought they might make it a funny award, one referring to his split lip. They then gave him a nice send-off – they sang the Shepherd Graduation Song, and he went wheeling out of the gym, giving them a regal wave as he left.

So, the Day Program this time around was a very satisfactory experience – Gary was very, very pleased, thought it was very worthwhile, said he’d learned to do some things he’d never thought he’d be able to do even with me giving some help. As for me, he astonished me in a number of ways. I knew he was stronger (though it never occurred to me he would be able to use four-and-a-half times as much weight on the rickshaw than he did last August) and had better balance, but this was concrete evidence of how he’s not only improved on so many tasks, but can do things like floor-to-wheelchair transfers that were simply impossible for us to do last summer. I think he astounded his Day Program team, too, seeing that the first day we were there they told him he’d need a month to accomplish his goals, and then he goes and essentially gets through those goals, and more, in two weeks.

But we were not quite through with Shepherd. We went to the room with the “bummed-out patient.” The man didn’t seem out-and-out depressed, but he did question his ability to learn to “move all this deadweight around.” He said he’d watched Gary in the gym and had been amazed at what Gary could do, and that he himself couldn’t even imagine being able to get himself into a car. Gary said that still wasn’t the easiest thing in the world for him to do, and that when he first came here, he certainly couldn’t do the things he can do now, but that the therapists here were very good and in time the man would learn how to do them too. The man still seemed a little skeptical, saying he weighed a lot more than Gary does, but Gary insisted that in time he would develop the strength and techniques.

Anyway, the guy said he appreciated Gary coming around to talk to him, that it was good to talk to someone in much the same boat (they also shared experiences of how much they had hated being intubated – the man was still being weaned off his trache tube). The man said that Gary seemed to have adjusted well, and Gary said he had. The man said he hoped that he would adjust that well, and then we said our goodbyes.

So now we were through with Shepherd. Traffic was thick all the way from Atlanta to home, I guess it being the weekend before Christmas. We stopped at the Target a few exits before our own, in order to look for a few things that Gary wanted to get based on the ideas that had come up at Shepherd. So, as Christmas presents I got him a knapsack and an exercise mat for when we practice floor transfers. I thought we’d find some crocs there, but we didn’t, so I will get them elsewhere. I will also buy him some Jobst socks, which are supposed to be not only better but more stylish than the t.e.d. hose, according to the “Been there done that” guy. I’m also getting him wheelchair gloves, and will take him to the movie of his choice. Oh, and I also already bought him a cashmere V-neck sweater and a knit polo shirt.

We were both pretty exhausted by this time, and I still had the car unloading to do. Ycchh. I had to put the bed warmer back on my own bed, and while I was doing that, Gary rolled by. “There’s Peg, making a bed, as usual,” he joked. I swear I’ve made more beds in the past two weeks than I have in my life. Gary was too tired to make anything for himself for dinner, so he decided to have the peanut butter and jelly sandwich he had made for his lunch (I had stopped at Fresh Market and gotten him an Italian panini sandwich for his lunch) and also have some Amy’s organic soup. I made my zukes and rice. There were still two hours to go before bedtime, and I spent the time pretty much just wishing the time would pass more quickly, too tired to do anything. I couldn’t go to bed early, because Gary had to keep to his routine and there were things I had to help him with.

I was very happy to hit the pillow that night.

Merry Christmas! Thanks to those who sent holiday cards, email or otherwise. And special thanks to those of you who have kept in touch over the months, lending your moral support. It means a great deal to us. As well, thanks to those who are more silent about it but read the blog :-).

December 21, 2006

Shoot, there’s another thing I forgot to tell you about the floor-to-wheelchair transfer – namely, how to do the reverse, that is, how to intentionally and directly go from the wheelchair to the floor. For that, Gary locks the brakes, puts his feet forward off the footplate, puts one hand on the chair leg, the other on the floor, and then walks his hands forward QUICKLY so that his body follows and ends up straight out on the floor (do you remember “wheelbarrow” races from when you were a kid?). As spotter, I kneel next to him and hang onto a belt loop (or belt, if he wears one) with one hand, while the other hand I put under his chest to keep him from falling on his face. After the first couple arm movements he makes, however, he goes too fast for me to keep up with him (scrambling along on upright knees), so the rest is up to him. In our practice, that went fine.

As we moseyed toward the third-floor gym on Thursday morning, we ran into Gary’s doctor. He asked Gary if he would talk to a recently admitted patient, someone in the senior group, as Gary had been. The guy’s level of injury is a bit lower than Gary’s (T9, complete), but fairly comparable. The doctor said the guy is bummed out, and the doctor thought Gary would be a good person to talk to him, so that the guy can talk to someone who’s been through therapy, been home, and has seen improvements in his capabilities over the months with therapy. Gary said sure, he’d do that, though looking over his schedule, he and I thought he’d probably wait until tomorrow after he was all through with therapy (and Day Program!).

We then passed by the PT, who commented on the scabs Gary now had on his lips. She said she was sorry that had happened, but he said it would serve as a reminder to get his hands up on the wheels when doing the floor-to-wheelchair transfer.

First on the agenda was a meeting with the case manager, who filled out Gary’s discharge papers (though she jokingly reminded us we couldn’t skip out until tomorrow). She commented that both Gary and I had a calm, confident look about us, that even if we are not quite there on some things, we know we *will* be there. I was wondering if she was contrasting our look to when she first saw us enter Day Program last July. We (and probably especially I) were frazzled and distraught on account of the whole new crop of problems that had arisen over the weekend (that’s when his leaking problem started and also his flap suddenly looked worse) on top of the getting used to doing the whole shebang of his care on our own.

At any rate, she is exactly right. Gary (with some help from yours truly) has accomplished more in this session of Day Program than he thought himself capable of. And the things he is not quite there on, for example getting those damn pants on while in the chair, we know is just a matter of practice – he has the techniques.

The next hour was spent (wasted ;-) on doing that ASIA test again – the “touch tests.” It seems rather silly to have it done ten days after the last time he had it done, especially seeing that nothing had changed from last August to Dec.11 when they tested him. But evidently it is somebody’s requirement that he be so tested.

The next hour we met with yesterday’s OT. She had a broom for us to buy and also had made Gary a velcro strap for the oven, so he tried those out in the practice kitchen. Then we went back to the third-floor gym and Gary practiced dressing again. He picked up another tip – to try leaning straight forward in the chair as far as possible in order to get the pants up in back. Since his balance is so much better, he is more confident of making such a lean. (And now he knows that if he should overbalance and can’t catch himself, he can walk forward on his hands as in the chair-to-floor technique.) The OT also suggested we could sew loops inside Gary’s pants so he has something to hang onto when he is pulling them up. I’m not sure we’ll do that, but it’s something else to have as a possibility.

Next came IC and lunch. After that we met with the therapist who had gone over curbs with us, only this time it was for more bump-up practice from the low mat to the high mat – this is where he has the J-pad strapped under his bottom, has his back to the upper mat, and “on three” throws his head down and pushes with his arms to get his butt up and back over the higher mat. I assume this practice was in preparation for the next hour when Gary would be bumping up the stairs. I think the PT had been giving him a not insignificant amount (which is somehow different than a significant amount ;-)) of help last time when he did these, because he was not able to do them without the therapist and/or I guiding him back over the top mat – he got his butt up, but not back. He did a bit better at them when I suggested he sit cross-legged instead of frog-legged, since he could get his head down lower that way. He made a couple of those with minimal help. BUT, he didn’t want to overpractice because these are tiring, and he knew going up the stairs was coming next. Before that happened, however, a little performance took place. A teen-aged girl who had been recently admitted had apparently been taking dance classes. A couple friends of hers put on a little dance performance. I guess that girl is braver than me – had I been a dancer and could no longer dance, the last thing I would want to see so soon after my injury would be a performance put on by my dance friends.

So, in the stairwell, the PT first had Gary do a transfer from his chair to a stair – this was a different kind of transfer than he’d done before, and he did a good one. Then a belt was tied above his knees to keep his legs together and in good position. The actual bumping up (and down) the stairs Gary said was scarier than the other bump-ups – because “on three” he was throwing his head downward toward a flight of stairs. First I spotted him from in front and the PT from behind, then the PT and I switched places, and finally, I spotted him all by myself. When spotting him by myself while he was going up the stairs, I had to switch positions from being in front of him to behind him, depending on what stage of the process he was in. When he is doing the actual bumping up a stair, I am seated two stairs above where he starts, and I hang onto his J-pad and make sure he lands on the next stair (he did these better than the mat transfers we had just done because his legs are in a better position to help him). Then I continue to hang onto him as he does little depressions wiggling first one hip back then the other until he is fully on the stair (the PT said that that is the most dangerous part of the maneuver and for me to hold on good). Now his legs are two stairs ahead of him and he needs to get them to the stair just below him. At this stage I go in front of him and put my hands on him to make sure that while he is moving his legs up to the next stair he doesn’t lose his balance and go tumbling down.

Getting back down the stairs I hang onto the J-pad from behind as he lowers himself down to make sure he goes down gently, then come to the front to spot him while he repositions his legs on the stair two away from his butt.

The PT said we had now basically met all the goals Gary had when he came here, that now it was a matter of practicing what he/we had learned, and that because of that, and because there was still some time left in our hour with her, she was going to go through with us an advanced technique she hadn’t expected to get to with him: how to get his chair upright, him in it, if he should go over backwards in it. The first thing he should do if his chair is going over backwards is to put his right hand behind his head (to protect it) while tucking his chin and put his left hand on his right knee, to prevent his legs from coming up and smacking him in the face. Now, instinctively Gary wants to instead bend and reach forward with both hands to try to counteract the fall – but that ain’t going to work if the chair’s momentum is backwards.

Once he is on the ground, he puts the brakes on and pulls on the tires so his hips are firmly in the chair, then he snugs his seat belt. At this point the PT looked down at Gary and said, “Now you have to get up from there.” There was a pause, and then she said, “Why are you looking at me like I’m crazy?” He said, “Because you are.”

His next step was to push up on his right elbow and get his right hand on the ground, then to reach with his left arm over and up to the right top side of the wheelchair’s seat frame. Then he pushes with his right hand and the idea is the chair rotates around the fixed tire and into an upright position. Now, supposedly when he is advanced enough he’ll be able to do this entirely by himself, but how we did it at this time is that I am holding his push handles while he is on the ground and at the time he starts to push with his right hand, I push upward on the handles to help raise the chair. But, I wasn’t using much force at all to do this – it was mostly Gary. In fact, for both of us it was less effort to get him upright in the chair this way than it was to get him in the chair doing the floor-to-chair transfer. I half-joked that if he ever fell out of the chair we should get him back in it this way, but of course if we tried that there is the problem of getting him in that initial position of being seated in the chair.

The PT now asked Gary if he still thought she was crazy. "That I can do this myself? Yes," he replied.

The PT then left, that being the end of the session. Gary was obviously thrilled we could do this advanced technique with no problem. He started to say to me that this particular PT was really good – and he became so overwhelmed he started crying. He finished his statement, saying that the PT really had a way of instilling confidence in him, that he can do things with her that he never thought he’d be able to do.

The day finished with a group exercise session, led by a different therapist than usual. She had a good tip about balance in the chair – that in reaching forward it is good to have the large part of the castor wheel pointing forward because that gives greater stability to the chair. She was really into breathing (“Now hold the position and breathe and breathe an breathe”), and as the session went on she revealed she taught yoga classes to those in wheelchairs. I’m afraid I had all I could do to keep from laughing at her manner, though. She spoke in a dramatic tone as if she were addressing a large group of people rather than five of us, and she reminded me of one of the instructors at "Freidlich Sensitivity Spa" in the episode, “Sensitive Steele,” a reference that only a very few of you will appreciate, to your loss ;-).

On our way out of the building I made a mistake and held the door open for Gary. I joked that we had to go back inside so he could open it himself.

The rest of the afternoon and evening I spent much of the time packing up as much as possible, loading the car, and cleaning the apartment. I should have skipped the stupid vacuuming though – my back and leg hurt when I was done.

Gary wanted fish for dinner, and for some reason the oven started smoking while the fish was cooking. That set off the fire alarm. I couldn’t figure out how to shut it off, so I opened the door to the apartment to let any smoke out and stood on a chair fanning the fire alarm. That shut it off, fortunately!

Okay, I already posted something earlier today, so if you missed it, scroll down to the next entry.

December 20, 2006

Oops, I forgot to put in another the thing Gary learned yesterday. After we did the floor-to-wheelchair transfer, the PT took us outside to the garden area where there is a flight of steps, and Gary learned how to go down them backwards while in his chair. The stairs had rails on both sides, and the technique was for Gary to hang onto both rails, lean way forward, “nose to his knees” (not quite physically possible for him), and slowly back down. I was to stay behind him, hanging onto his push handles, one leg on the stair below the one where his wheel would next go (so he wouldn’t run into me), the other leg on the step below that, my hip to his chair to help support it as it came down. I don’t know how much help I was supposed to give, but I was in “better safe than sorry mode” and I hung onto that chair for dear life, supported the weight of the chair on my hip, and guided the chair down slowly.

Wednesday morning began with the group fitness class, which went much as it always does ;-). The next hour was more swimming! The Shepherd pool was ideal for the pool exercises the rec therapist went through with Gary – in fact, I’ve never seen another pool that has an underwater ledge along the side that you can sit on and be about waist-deep in water. In a more typical pool, Gary would either have to sit on a step to do these exercises, or, the therapist suggested, stack some pool aerobic steps (assuming the pool has water aerobics classes). He would need to stick a towel under his bottom so he doesn’t scrape it on the pool floor, and, in case I forgot to mention it before, he should always wear pool shoes so his feet don’t scrape on the pool floor.

She gave him a pair of “resistance paddles” – they are about fifteen inches long, have a bar in the middle that you hold onto, and have paddles on each end with little holes in them, the paddles providing resistance as you push them through the water. For something similar to what he was using, see http://www.waterworkout.com/products.amp?product=pp.

She took him through a series of exercises, doing twenty reps of each. I sat behind him on the ledge and held him under the armpits to help him keep his balance. Indee, he said that the exercises mainly worked his balance, not finding them difficult in the strength sense. I wasn’t sure how much support he would need, so tried to give as little as possible, but I did find I had to put forth effort – he definitely needed my support and it was a little bit awkward and tiring for me to stay in that position behind him holding him upright the entire time.

He started with his arms out to the sides at shoulder height and pushed the paddles down to his thighs. Next he held his arms out front and pushed them down to his knees. Next were one-armed biceps curls. Next he held his arms out in front at shoulder level and gave big sideways sweeps to the back and then to the front, one arm at a time. Next he did stirring motions with the paddles, one arm at a time, clockwise, then counterclockwise. Finally he did punches, one arm at a time.

I asked her if they ever taught a type of “drown proofing.” I had meant like what is taught in swimming lessons, a method for surviving in water disaster scenarios: you float vertically (assuming you are not one of those relatively few people with negative buoyancy), making minimal movement, face-down in the water; when you need a breath, you gently push down on the water, exerting just enough effort to clear your mouth from the water to take a breath, and then relax.

But she misunderstood me and told him that if he is ever near water in his chair (on a boat or a dock) that he doesn’t want to have his seat belt on – if he falls in the water, he doesn’t want his chair attached to him. I wish I had pursued my question, but I didn’t. I want him to try the drown proofing method next time he is in the water, though.

After he finished with these six water exercises, we swam a couple laps, him on his back, the therapist and I swimming along. I asked the therapist if he’d be able to do the crawl stroke, and she said first she would want to teach him how to breathe by rolling over onto his back in case he wasn’t able to catch a breath the normal way one does while swimming the crawl. This was more like what I had been trying to get at with my question of drown proofing. So, anyway, she taught him how to do that. If he couldn’t clear his mouth for a breath while doing the crawl, he was supposed to put his arms in “Indian chief position,” to use a politically incorrect description (one arm folded on top of the other), then since he breathes to his right side, he was to punch up with his right elbow while pushing down with his left hand against the water and, at the same time, attempt to roll over to his left side and onto his back. So he practiced this a couple of times, and then he tried to crawl stroke. He said it felt very different, not using his legs. The therapist was holding onto his waist as he did this, walking along the pool bottom with him as he swam along. I do not know how much support she was giving him – since his legs don’t float, but rather would drop down, and he couldn’t use them for any stability in the water, I suspect her help was not insignificant. She didn’t have me try it with him, and I regret not asking to do so. So, we will have to try it on our own the next time he is in the water. Or, maybe the next time he’ll be in the water is with the therapists, because he wants to go to the Adventure Skills Outing on Lake Martin that Shepherd holds annually, and he can try it again at that time.

The therapists called the pool at the university for Gary, and they found out that there is no pool lift chair, like Shepherd has, but they do have a wheelchair ramp down into the pool. I assume this means they would have a pool wheelchair for him to use to get into the water. If not, he could bump out of his chair as he’s just recently been learning, though he would have to be very careful of his bottom on the rough surface of the pool deck and the pool – maybe we’d have to get some pad to put under him. Anyway, we’ll just have to see.

After this session we lingered in the hot showers and then we were supposed to do “Dressing with Caretaker.” I don’t know if they had wanted Gary to practice dressing in the chair, but by the time we were out of the shower it was 11:30, and there wasn’t enough time for him to practice dressing in the chair, do his IC, and have lunch, if we were to make the 1pm session. So, he dressed on the mat in the men’s restroom instead, and of course I was with him, helping him with the transfer out of the shower chair that he had transferred into at poolside and getting our clothes out of the locker and helping him with his pants in the interests of time.

The first session of the afternoon was with the PT, and she told us to do the floor-to-wheelchair transfer; she wasn’t going to help at all, and I was supposed to give minimal help. Gary got a battle wound this time – he cut his lip during the process. The PT said he could say I gave him the fat lip, but he said he was going to tell people he got it because he didn’t do what his PT told him to do – which is true, but perhaps not in the way people might take that. What happened is he didn’t put his hands on the wheels during the second push up when he was trying to get his chest on the back of his chair. He had his hands too far back, on the legs of the chair, and he ended up scraping his face along the back of the chair.

The next task was to go backwards down the stairs in the wheelchair while using just one rail, since most stairways don’t have two. He said this was actually easier on his shoulders. The only “problem” was that he forgot to communicate with me and nearly ran me over, taking the next step before I had backed down another step. He said he didn’t realize I was back there doing anything. I didn’t let him try it by himself so he could tell what help I was giving. ;-) We had an audience of Nurse Mark, one of our favorite people here. Mark gave Gary the thumbs up and applause, and was suitably impressed that we had mastered the floor-to-wheelchair transfer.

Next we went back into Shepherd to practice a “low sofa to wheelchair” transfer. We passed through the rec room where a Christmas party was going on. A quadriplegic was singing a blues song – he was very good. It was all the more impressive because he had only recently gotten off a trache tube, and I’m sure his lung capacity had been diminished.

At the sofa, the PT told us that if Gary had to make such a low transfer, he could, if he wanted, stack the sofa cushions on top of each other to make the surfaces more equal in height – though that might make the surface of the couch squishier, which would affect his transfer. He could also stack blankets, or if it was to a surface in our home that he would regularly use, he could put a piece of thick plywood under the cushions. She did the transfer with him, and then it was my turn to do it with him. I had to give him a bit of lift, but not a huge amount.

Next we had a session with an OT, a different one than we have been having (that one left for the holidays). First on the agenda was, again, dressing in the chair. This person also had a useful tip for Gary – to lean on one hand and push up on it to get the opposite hip to raise up for getting the pants over his hips and butt. It now just seems a matter of practice. He has had various people give him various tips, and he will just have to practice to see what works for him. We should hold a celebration the first time he gets his pants on entirely on his own while in the chair ;-). Since at this stage it takes so much more time than dressing in the bed, he doesn’t seem eager to practice it at home.

Next we headed for the “practice kitchen” on the second floor of the building. On our way we passed a sight that gave my heart a wrench – a newly injured young girl, maybe around eight (I didn’t get a look at her face-on), in a wheelchair.

In the kitchen the OT showed Gary a short-handled broom that many patients seemed to like. Gary had told her the story that he had tried to sweep the floors before my sister Janet and brother-in-law came to visit and that I hadn’t been impressed with the results :-). He liked this broom – it was easy to handle and had a broad sweeping surface. The therapist said another one of the therapists had been selling them and she’d look into seeing if there was one Gary could buy. She then showed him a short-handled dust pan that “closed up” when the handle was lifted. Gary liked that too, saying he found it impossible to sweep into a regular dustpan. (He hadn’t told me this and had evidently been sweeping the stuff into a pile and then putting it into the trash by hand – ewww!) She said they had picked theirs up at a Dollar Store, but maybe we could find one in a place like “Bed, Bath, and Beyond.” (Not that our town has one of those.) She also pointed out the mirror they have on the stove so that one can see how the cooking is going in the back pots. Gary told her he got such a mirror (which either I didn’t know or simply don’t remember) but hasn’t figured out how to attach it to the back of our stove.

For another "kitchen problem" Gary has, she showed him the velcro strap they have on their oven, and Gary thought that was something he’d find useful. Our stove door tends to slam shut if you don’t pull it down all the way, but if he pulls it down all the way he can’t get anything in or out of it because he can’t get the wheelchair close enough. So he says it’s been a hassle trying to hold the door partway open with one hand and reach in with the other – a challenge to his balance and on the dangerous side, but he never told me about this problem before.

Next on the agenda was “Gym with caregiver,” so we headed there and got Gary strapped into the Easystand. A Latino woman came up to us and started talking to us about it. The young man with her, who didn’t speak much English, was very excited to see Gary in this piece of exercise equipment and wanted to know how he got to do it. So we told them that Gary had done the standing frame a few times first, and because he didn’t have a great deal of problems with dizziness, they then let him use the Easystand, with me supervising. (Neither of us knew how it would be for him, using this equipment after not having stood for several months, but he has had little problem with it, just once complaining of not feeling good, a feeling which soon passed.)

We skipped out of the gym about fifteen minutes early because we had things to do before going to the concert tonight – we wanted to have everything ready so that when we got home from it Gary could pretty much just “hop” into bed and do the things he needed to do before sleep (undress, skin check, greasing flap, IC, getting into prone position – skipping the bed bath because he had showered at the pool).

At the Woodruff Art Center, we parked in the parking garage and took an elevator that disgorged us on a patio-like area from where we could enter the Art Center. We had to go to the box office to pick up our tickets. The signs to the box office were strangely marked – it turned out we made a complete circle of the building (or actually, a square) and ended up almost at the point where we had entered the building. We joked that if the arrow on the sign had pointed in almost any other direction than what it did, we would have found the box office quicker. After getting the tickets we had to cross to the other side of the building – it was like an obstacle course for Gary, trying to pick out a path to go, what with the crush of people.

In the auditorium the wheelchair seating was in the second-to-last “row,” which consisted of spaces for wheelchairs to pull up into and plush folding chairs for the people accompanying those in wheelchairs. We had a good view of the stage, better than if Gary had taken an aisle seat, which would have been our only other option.

The guest conductor was Michael Krajewski, who had also been the conductor the last time we were here, last Christmas time. He likes to liven up the performance with the occasional (bad) joke. After the introductory piece of “Winter Wonderland,” he turned to give his opening remarks. At that moment a family with several children was causing a bit of a disturbance, moving down one of the first few rows all the way from the aisle to the middle seats (there is no middle aisle at this facility). So Michael made some cracks about that, saying something along the lines like, “Children, when mommy says to hurry up or you’re going to be late, she means it.” Somewhere in his introductory remarks he talked about how in getting here he had been going through the airport and had noticed that they had hung mistletoe over the baggage check-ins. He had thought that strange, so he asked the airport personnel the reason for that. The reply was, “So you can kiss your bags goodbye.” You saw that coming, didn’t you?

After the “March of the Toys” was played, Krajewski introduced the featured artists, the Von Trapp Children – these are four children from ages twelve to eighteen who are the great-great grandchildren of Captain von Trapp and Maria, of “Sound of Music” fame. After the von Trapps came to America, they earned their living as a singing act. These descendants revived that tradition. They were very good, not just living off their name. They sang a few songs from “Sound of Music” – “Do Re Mi,” “My Favorite Things,” and, as you might guess, “Sound of Music” (which reminded me that when I was a kid we had to sing this in glee club, and as a joke one day, we all screamed in mock fright after singing the first few words, “The hills are alive.” I decided not to recreate this experience for those in the audience this night.) My favorite songs they sung were: “Carol of the Bells” (one of my favorite Christmas songs), “Do You Hear What I Hear,” and what might seem an odd thing to include, “Anything You Can Do” from “Annie Get Your Gun.” It was sung by one of the girls and the twelve-year old boy. My favorite part was their duel, “Anything you can sing, I can sing higher.” The twelve-year-old boy “won.” I guess they’re going to have to delete that selection when the kid’s voice changes in a few years.

We left after intermission because we didn’t want to make too late a night of it, but I was very glad Gary had suggested we do this – it was a lot of fun. We had a slight problem coming out of the building – we couldn’t remember in which direction to go to get the elevator. We made the wrong choice and ended up wandering around for a while.

We got home and got to bed about a half-hour later than usual. But, we would get to sleep in about an hour because the rec therapist had conspired to make her the first thing on the schedule for Thursday, with the understanding that we would not show up for it because we had done a “rec therapy outing” on our own by going to the concert.

And that ended Wednesday!

December 19, 2006

This morning (Tuesday) I was frantic, for a reason that had nothing to do with Day Program. I realized when I woke up that the changes I had made to my novel on Sunday I had saved to my USB drive but had forgotten to save them to the computer. (I like to save documents to at least two separate places, in case “something happens” to one of them.) So while Gary was getting ready for Day Program and in between doing things I needed to do for him (I do a little more for him on Day Program than I now normally would at home, just so we don’t have to get up so early while on the program) I tried to open the WordPerfect file that my story was written on, and it wouldn’t open! The file had somehow become corrupted. This has happened before, but I had always been able to use a “trick” I picked up on the Corel WordPerfect newsgroup to get the file to open and then with some work (usually a few hours!) “fix” the corrupted part of the document. Well, the trick wouldn’t work. I was trying to get to about page 275, and the document wouldn’t let me get there – I couldn’t scroll to it, couldn’t use the “Go to” dialogue box, nothing. The program kept shutting me down. So then I thought I better try to remember the changes I made. I went to the most recent document I had before that – I have learned from the past that I need to save a separate copy of each day’s changes, so if I lose a document, I “only” lose a day’s work – and tried to write what I remembered. But it was time to go to Day Program.

First up for him was practicing curbs, and he and a therapist started with the four-inch-high wooden platform in the gym that they use for that, the tip bars on his chair taken off. I was so upset about my file that I fired up my laptop right there in the gym and started typing the changes I could remember, stopping each time Gary approached the “curb” so I could cheer him on – talk about your divided attention. I thought I was able to pretty much reconstruct Sunday’s work (it is amazing how much time I can spend thinking about how to write something and have so little to show for it), though I knew I had said some things in a way I liked better on Sunday. Meanwhile, Gary was doing great at the curb practice. I was astonished, seeing that we haven’t practiced curbs at home at all. But as he told me, he’s much stronger now, plus, the technique is greatly a matter of timing (push on the wheels, push on the wheels, push on the wheels, pop the wheelie to get the small front castor wheels up the curb, immediately lean forward and push hard on the big wheels to get them over the curb as well), and he has had some practice at that even in getting up the small rise at the entrance to our house. So he got to the point in the gym where he was making the four-inch curbs about fifty percent of the time. Obviously that means he’s not at the point where he would do them by himself – that other fifty percent of the time he could land on his head – so the next step was for me to learn how to spot/help him with these. So I took the place of the therapist. I had my hands lightly on the push handles (the handles on the back of his chair), the idea being not to help him if he didn’t need it. We did a couple that way, and I wasn’t providing any lift at all!

Next came six-inch curb practice, and that was harder for him, using his momentum to get those back wheels up that height. He only made a couple of those, with help from the therapist. She didn’t have me try any of those with him. She also reminded him that when he went down something of that height, at the time his large wheels went off the curb and were on street level he should stop his chair and make sure that he and the chair were balanced – if he just continued to push, that momentum he had going backwards might cause the chair to flip if he didn’t have his weight forward enough.

Next he was to go outside and practice on a “real curb.” So I shut down the computer and followed him (I was confident that I had at least recovered most of what I had written). Unfortunately, a van was parked where they usually practice curbs of about four-inch height, but we found a curb nearby of approximately six inches, and Gary did a couple attempts at those with the therapist. Again, he would not be doing those on his own, and in fact at this point he wouldn’t even attempt to take them in a wheelie *with* me helping. Fortunately he never has to do curbs around the university or when he eats at the places around there, but so that he is prepared in case he does meet up with some, we reviewed the technique of what I or another person would have to do to assist him. It would essentially doing the above technique, but in “slow motion.” The tip bars would be off, and his chair would be right at the curb (no moving approach for this). I would hold his push handles (firmly!). I would tell him I was ready, and he would push on his wheels to pop up into the wheelie and get his castor wheels up on the curb. The he would wait until I said I was ready, and then he would push on his wheels to get them up on the curb while from the back I would be pushing on the handles to help get him up the curb. To get down the curb, he would be backward to it and would back down it gently while I would hold onto the push handles and have one hip on the back of his chair for it to rest on, both my hands and hip there to make sure the chair was going slow and easy and wasn’t going to go over backwards.

Next we had a session with the OT, and we asked her about how Gary should do his skin checks of his butt and back while traveling. She thought a moment, saying, “I appreciate the thoroughness you two have, but you make me have to think more.” Evidently no one else had ever asked her such a question. She suggested he look into buying some kind of small travel mirror if a hotel mirror couldn’t be used to his advantage and I wasn’t there to check the parts of himself he can’t see.

Next he did more practice at dressing in the chair. One new tip she had for him was to really push the material of the crotch as far under him as possible, "overcompensating," because the hard part is getting that middle material up in the back.

Getting pants on while in the chair is difficult for most paraplegics. (She told us that one of the patients said he was going to look into joining a wheelchair-accessible nudist colony so he could avoid the problem.) The advantage of being able to do so in a reasonable amount of time is that it saves you a couple transfers, i.e., transferring onto the bed to get your pants on, then transferring back into the chair.

While Gary was getting his pants on, the OT asked him how he liked the adjustments that had been made to his chair, and he said they were working out great. His back feels much better now that they have raised the back of his chair.

Next she went over “balance issues.” She said while at home he could work on his balance by sitting on the edge of the bed (me there) and reaching for things on the floor or out to the sides. She suggested that a couple times a week he should sit on the edge of the bed, me behind him to make sure he didn’t fall over backwards, and practice “Tai Chi”– like movements: slowly moving one arm at a time to the front and up and out to the side and back. In fact, she thought it would be good if he took an actual Tai Chi class, that the arm movements would be good for his balance and range of motion – and they’d be relaxing (she said as she told him to relax his shoulders!). If he takes such a class, she told him to sit forward in his chair (me standing behind him to make sure he doesn’t lose his balance) so that he isn’t resting on the chair back.

She left for a moment and I suggested he try some of the balance exercises the therapists were having him do last summer – in particular, pressing his palms together in front of him at chest level with elbow raised to the same height (kind of like the “prayer” position) and then raising his arms keeping his palms together. He was able to do this much better than last summer. In fact, he thought I was holding him, but I just had my hands lightly touching him.

Next on the agenda was a meeting with his doctor, during which Gary had wanted to discuss urinary issues, but the meeting didn’t turn out to be much. The doctor said that the tests had shown Gary does have a urinary tract infection and wrote him a “pre-emptive” prescription for an antibiotic – that is, they hadn’t cultured his sample yet to see what organism they should be fighting, but they wanted him to start on this antibiotic anyway. Gary tried to ask about having a urodynamics study done and about the drugs that people used to stop “leaking” if the leaking was due to bladder spasms, but the doctor didn’t want to talk about that and was curt, saying he wanted to go one step at a side. (This doctor I’m sure is excellent as a rehab doc, but neither Gary nor I have ever been impressed with his bedside manner.) Gary later decided he’d just talk this issue over with a local urologist.

Another thing I had wanted Gary to ask the doctor, which he did, saying “Peg wants to know . . . ” :-), was about all the coughing he does while he is eating or taking pills. He says he feels like there is a “pocket” in his throat where food and pills get stuck. Gary wonders if such a pocket could have been created as a result of the intubation that was done to him in Birmingham soon after the accident. The doctor told the nurse to have one of Shepherd’s speech therapist come and do some tests to see what the problem was. I guess the nurse emailed the therapist, but he or she never came and saw Gary. Supposedly the nurse will now refer him to a speech therapist near home, so I hope she follows up with that; otherwise we’ll have to get on Shepherd about that! I can’t help it – I find the frequent coughing noises he makes during meals a bit irritating. I told him I would never know if he is really choking on something and needs a Heimlich maneuver. He told me that if he was really choking, he’d hold up one finger, then two, then three – like he was taught as a child to do if he was drowning in water. That set us to some black humor laughing.

He was then supposed to practice “bed mobility with care giver,” i.e., with me. About the only thing he really needed practice on in that regard was getting to a sitting position from the supine position without rolling to the side first. He decided he wasn’t going to use that technique much and didn’t really want to spend a whole lot of time on it, so we practiced it a little and then he did his stretches on the mat. Then he went off to do his IC, after which we had lunch.

Oh, perhaps I should mention what is different about using the hospital bed as opposed to a regular bed. In the hospital bed, he can use the hand rails to help him roll from side to side while trying to get his pants on over his butt or for turning himself during the night. He can use the electronic controls to help sit him up for getting his pants on over his lower legs or for bathing himself in the bed (as much as he is able to reach). But he says using the double bed wasn’t nearly as difficult as he’d thought it would be. He can do the turning and sitting up without the use of rails or controls when he has the room of the double bed – it’s just that doing these things is a little easier in the hospital bed. In traveling he wouldn’t have a hospital bed, so he needed to get weaned off it.

After lunch he was supposed to meet with the case manager for a half hour and then the rickshaw was scheduled in for a half hour. The case manager stuff didn’t take very long. Must not have been too exciting cuz I didn’t take any notes and I can’t remember anything in particular ;-). I then set up the weights on the rickshaw for him. After he finished that exercise (takes at most ten minutes) I suggested various things we could work on – floor transfers, low-to-high transfers. Instead, he made a phone call to the Atlanta Symphony Orchestra to find out about the handicapped parking situation (they said the parking garage was very convenient to the Arts Center where the concert was to be held), and then he went down to the apothecary to get his prescription filled. I let him get away with this sloughing off of his therapy ;-). While he was being lazy, I was back on my laptop still trying to see if I could recover the corrupted file. Gary suggested I try opening the doc in WordPad. That worked, kinda sorta. All the words appeared, but so did a lot of strange symbols, taking the place of punctuation and God knows what else. It seemed a daunting task to figure out where the revisions had been made, but it could be done if I really wanted to spend the time on it – which I would have because I am compulsive that way. But then I recalled another strange trick I had heard about, which was to open the doc in the spreadsheet program Quattro Pro. So I did that, and there were all the words, minus the strange symbols that had appeared in WordPad but without any punctuation. Okay, this was a bit better. I could at least read what had been written without too great a difficulty, and so I could just read it sentence by sentence and compare it to my most recent version of the file before the corrupted one. What I really would have liked to have done, however, was just copy the revised section from Quattro Pro and paste it into the most recent uncorrupted WordPerfect document of my story, but when I copied the “cells” of Quattro Pro and pasted them into WordPerfect (or WordPad), I got one big *vertical* column of words. I then had the thought, what if I pasted it into NotePad, a text editor which strips all formatting and “hidden data”? And this worked! This made it easy to compare the revisions that I had re-composed from memory with the revisions that I had made Sunday (sans punctuation), and I was able to recover everything I had done Sunday. Whew!

Oh, and by the way, it didn’t work to try to open the corrupted document in Notepad without going through Quattro Pro first – I got tons of strange symbols when I did that. I have no idea why it worked to go through Quattro Pro first.

Okay, back to rehab. Next was the major task of getting back into the wheelchair from the floor, whether one has ended up on the floor intentionally or not. First Gary positioned himself sideways in front of the chair with his legs bent so that his knees were slightly to the inside of one of the wheelchair “legs,” (i.e., so that his knees were to the inside the castor wheels, so that when he pushed up to his knees he would be directly in front of the chair). Next he was to push himself up with his right hand on the chair leg closest to him and his left hand on the floor, the goal being for him to end up on his knees with his chest on the seat of the chair to keep him balanced on his knees. While he was doing this pushing up, the spotter (first the therapist, then after he did it a couple times, I was the spotter) keeps her hands on Gary’s waist, either to help lift him or to keep him in place once he was on his knees (since, obviously, he doesn’t have any leg muscles to help keep him on his knees). We did it a few times and I found that it varied how much help I had to give – sometimes very minimal, one time I had to use a bit of effort – but it was never a major effort. Mostly I helped keep him in position so he didn’t slide back to the floor (if he’s not perfectly balanced on his knees, they collapse to one side and his body follows them down). Now, after a rest, from this position (on knees, chest on seat of wheelchair – seat cushion removed to make this transfer easier), Gary was to put his hands on the wheels of his chair and do a (mighty) push up on them, walking his hands up the wheels, keeping his neck extended, the goal being to get his chest on the back of the chair (and not his neck or his face!). The spotter puts her hands under Gary’s knees before he does this push and supplies whatever force he seems to need to accomplish this next stage and also holds him so he doesn’t slide back down while trying to walk up the tires. The PT wanted me to use as little force as necessary – sure, I could have helped heave him up – but she wanted him to do the work (after all, it could happen he could fall out without anyone around to aid him). The amount of force I had to apply again varied, but it was never a huge amount – Gary did the vast majority of the work of the push up, while I mainly held him in place while he walked his hands up the tires.

The last step, after a rest, was for him to take his right hand from the tire and put it on the seat in front of him but to the left side. Then he twisted his head and shoulders to the left, trying to “flip over” to get his right hip on the seat and eventually his butt on the seat. As the spotter I was mainly maintaining the progress he was making, holding him so he wouldn’t slide back down off the seat.

So, as Gary states, it is a difficult maneuver. BUT, he wasn’t at all sure he’d be able to do it at all, even with my help. But we met that goal and are confident that if the need ever arises, the two of us can get him back in the chair this way. The PT told him that if he ever falls out of his chair in public, this is the way she wants him to get back in the chair – not by “cheating” and having two people do a “two-man lift” to get him back in (that is, one person holding him around his chest, the other person holding his legs, and the two of them lifting Gary into his chair). Gary said, “Not even if it’s two big football players?” She said no, but I’m not sure Gary wouldn’t take the easy way out ;-). If there were two people available, she would want one to play the role I was playing, and the other person to stand behind the chair to make sure it didn’t tip over backwards with all the heaving he was doing (if there is only one person, the chair is preferably situated so that that wouldn’t happen, like putting the back of it against a bed or couch, though a wall wouldn’t work because his head ends up behind the chair for a brief time). The second person would also ideally make sure Gary didn't "face plant" (end up with his face on the back of the chair) or end up with his neck on the back of the chair -- this they would do by keeping there hands near his chest. This might happen if, for example, he didn't push up high enough or didn't have his hands in the right position or didn't keep his neck extended.

Anyway, we are delighted we were able to do this. You might remember a therapist tried to teach us to do this last summer, and after our attempt she said, “You’d better just call 911.”

Last on today’s agenda was a scap class – working on the scapula muscle. We all took therabands and did punches, “diagonal pain,” chest flies, external rotation, diagonal punches keeping the elbow at shoulder height, “thumbs-up diagonal pain,” and lat pulls.

Were you worried something had happened? :-) No, just decided not to push things by trying to get the day's happenings down on the blog in a timely manner while on Day Program. So, will be catching up in the next few days.

December 18, 2006

Today was a very full day, and it went very well, with the exception of interaction with the nurse. The first thing she told us what that Gary’s urine sample from last week had been thrown out instead of cultured. She said she would cut into his therapy time before lunch to take another sample. We won’t get the results of it back for forty-eight hours, and it will be too late to schedule him for a urodynamics study here, if that is what the results indicate should be his next step. So he will have to do that at home. He is scheduled to talk with the doctor tomorrow anyway, about possible future steps, but it would have been nice to have the results in hand on which to base our questions.

First on the schedule was the group fitness training. We made it better by proceeding at our own pace, and for some of the exercises I got Gary a theraband I saw lying around for him to do them with. It didn’t make sense to do exercises for traps with dumbbells like they were doing (holding the dumbbells, bringing the elbows back, and squeezing the traps) because that mostly worked the muscles holding up the dumbbells, not the traps. But by holding an exercise band with both hands and doing the same motion the lower traps were targeted.

The next hour was a PT session of practice bumping up into the wheelchair. First she put the “bump-up” chair-like device in front of his wheelchair. It had a sling seat about twelve inches off the floor that he was supposed to bump up onto. He sat with his back to it and put his hands on the handles at his sides (which were about at the seat level), and then on three he threw his head forward and depressed so his butt went up and back. He made it to the sling chair. Next a belt was wrapped around his knees to keep his legs stable underneath him rather than having his knees splay out. This, they said, was key – his weight was partially supported by his legs during the next bump-up, and they could act sort of like a fulcrum. From this position, he put his hands on the next (upper) set of handles on the device, and repeated his movements so that he bumped up to his wheelchair (the seat cushion had been taken off, as that would give him three less inches that he would have to overcome). He did it, and the therapist said, “That was completely too easy.” :-) To get back down, the thing he had to keep in mind was to start with his hands below him to gently lower himself, rather than keep his hands at his current height and end up plunking down to the lower level. After he did that a few times, I took the place of the therapist in spotting Gary. I was really amazed – all I was doing was providing him guidance (making sure he ended up far enough back on the chair), not lift. I wouldn’t have believed he was lifting his booty up that far and getting on the chair basically all by himself if I hadn’t experienced how little help I was giving him – I thought surely the therapist had to be helping him more than that!

I will have to remember to take a picture of this bump-up device. They no longer manufacture it, but maybe we could find someone to make Gary something like it, although maybe he will decide just to use a portable step, which is what he practiced on next. To do that, first he strapped himself into the J-pad, which is what he would do if he was going to spend some time on floor-level. The step they had was a little low, but we figured out that one about nine inches high, twenty-two inches wide, and fourteen inches deep would work quite well – we would also put a nonskid surface on the bottom of it and several layers of carpeting on the top of it to protect his butt. He practiced bumping up to the stair and then from the stair to the chair (without its cushion) a few times, the last time with me as his spotter, and again I thought him astoundingly successful. To get back down from the chair, he would lower his hands to the step, and then ease down. After the last time of going to and from the chair, he stuck out his tongue, indicating he was beat :-) Fortunately ;-) the session was over. So he transferred over to the mat and put his cushion back on his wheelchair, like he would have to do if he ever “really” bumped up to his chair at home, then transferred back into his chair.

So, if he ever wants to go upstairs in our house, he now has a way to do it, as the technique is similar. He’d strap on the J-pad to protect his booty and then bump up each stair. (Added a few days later when he and I actually practiced bumping up the stairway at Shepherd under a therapists guidance: it is not quite as easy as his bump-up practice to the chair. It is scarier for him because he is throwing his head downward in the direction of a flight of stairs when he is bumping up them! But he would do this with a companion, if at all possible (unless he is alone in an emergency situation), who would spot him (holding him at his waist, etc., as I'll describe on a later day's entry)to make sure he didn't lose his balance.)

Next was an PT session. Since Gary was having some trouble leaning while on the commode chair, she suggested he use his chain loops to wrap around the grab bar that will be to his right and behind him (it is in the shower, actually) when he is at home, and then loop his arm through it and lean. She also said that if the commode chair placement over the toilet seems awkward when we are home, that he could always set the chair over a bucket lined with a trash bag. In fact, she pointed out, this is what he may have to resort to when he is traveling, if the bathroom setup isn’t perfect. It might be easier to do the bowel program in bed, he thinks, rather than lug a commode chair around with him.

Gary’s next task was learning how to do skin checks of his own butt and back. The PT taught him a double mirror technique, lying on his side on the bed and looking into his small flexible-handled mirror to see the reflection from a large mirror. This worked quite well, and she suggested we get a large wardrobe mirror and have it mounted horizontally to the side of his bed.

Next he again practiced coming to sit from a supine position in the bed. As long as he has room enough to roll over practically into a prone and then sit, he is fine, but that coming straight up by grabbing onto his pants or under the back of his legs and then wiggling from side to side trying to get his elbows underneath him is something he can’t do by himself. We can’t see him running into the absolute necessity to do it this way, though.

She taught his some towel roll stretches, because his shoulders and chest are very tight, and also, his posture in the chair isn’t the greatest – he always curves to one side, and the PT thinks it might be because his left chest wall needs stretching out. Both the PT and seating clinic commented on his posture, so I think that is something he needs to make a more conscious effort of being aware of ;-). It would just not be good for him to get permanently deformed in that curved position.

The first stretch she showed him was simply to roll up a towel or two and put the roll lengthwise along his spine as he lies on his back. He then puts his arms out at shoulder level in “crucifix” position, palms up. She said he could do some weight training exercises in that position, like a bench press (or “bear hug,” as she called it), which would, on account of the weights, give him even more stretch. The second exercise was lay on his right side and put the roll of towels under his side. (She said we could use a bolster, but in the catalogue she had, they cost around eighty plus dollars – maybe there’d be just a firm foam roll we could buy cheaper.) For more of a stretch, I could put one hand on his hip and the other under his armpit and stretch him out by pushing on both hands. She said he should do these stretches for fifteen minutes in each position, so while watching TV on the futon would be a good time for this. Fortunately she said it wasn’t necessary for me to be constantly stretching him when he is in the side position, because that would be quite tiring!

Next was an OT session. Since Gary had been having trouble keeping his balance doing his weight shifts while on the commode chair, she had him get on it (fully clothed) and practice the weight shifts. She helped him learn where he needed to put his hands on the chair to maintain his balance to do the depression weight shift. He may not be able to hold it as long as he is supposed to, so she also went over another kind of weight shift which he is now allowed to do but couldn’t before on account of his flap – the weight shift where he bends straight forward over his knees, the goal being to bend far enough forward so that he lifts his butt from whatever chair he is in. She thought that if he did a series of depression shifts for short intervals and then this lean-over shift for awhile, for a total time of about a minute, then he should be fine. In general they don’t encourage the lean-over shift because it doesn’t develop/maintain arm and shoulder strength at the same time as relieving pressure on one’s bottom – a sort of “kill two birds with one stone” method.

She then had him wrap chain loops (the ends of a piece of cloth are sewn together to make a circle and then these “loops” are “chained together” to a length good for the individual to use for stretching, etc.) around a support in a position behind and to the side of him – the position they would be in if he wrapped them around the grab bar in the shower while he was on the commode seat over the toilet – and she had him use them to lean over while simulating doing the bowel program. Gary thought that technique will work out well.

He will need to put a support under his feet while on the commode chair so that they don’t dangle, for one thing. More importantly, that would keep his knees slightly above thigh level, and that would put a little pressure on his abdominal cavity, she said, aiding with the bowel movement. We figured out he needs a step about four inches high.

She then went over some arm exercises with dumbbells and back exercises with an exercise band (theraband) that she would like him to incorporate into his routine, three sets of twenty of each exercise. She said if he did them every day, that would be great, but he should do them at least three times a week (I’m betting he goes for the latter ;-) – I could see him resisting the idea of adding in more exercises to the routine he has been doing; but he really hasn’t been doing the triceps work they would like, for one thing; hopefully he will talk to a trainer at the university and figure which exercises he has been doing target the muscles this PT wants him to, and hopefully he will then add in any additional exercises he really should). The first two are done while seated in the chair. The first exercise is a front extension to ninety degrees – in other words, lift arm straight out in front of you to shoulder height – and do so nice and slow. Next, biceps curls, two sets with palms up, last set “hammer curls” where the thumb is up – those are only done to ninety degrees, though. The next exercises are done on the mat. Lay with the towel roll under the spine for them. The first is the triceps extension, elbow pointing up to the ceiling and the other arm supporting the working arm. The arm is lifted straight up. Next were serratus punches – both arms are extended simultaneously straight up, and one “punches” them toward the ceiling simultaneously. Next was the bend press, circling the arms around as in a bear hug and squeezing the pecs. Finally for the arms was external rotation. You lie on your side, keep your top elbow tucked to your side, and lift the weight from bed (or mat or whatever your lying on) in a semicircular motion as high as possible (still with elbow pressed to the side).

Then came two back exercises, done in the chair with the theraband. The first you loop the band around a post and pull straight back and squeeze your traps for five seconds. The second you hold both ends of the band in your hands, keep your elbows up and out to the sides, and squeeze straight back.

Next with the PT came car transfers to an SUV. She taught him a slightly different way to do it, so we will have to go over that with Michel Smith (don’t worry, Michel, it’ll be easy ;-)). Gary is to angle the chair more straight in at the car seat, giving less slope to the transfer board, and he also is to put his feet into the car first so their weight doesn’t dangle. He pulls his legs forward as far as possible, scoots to the left corner of the transfer board, and then transfers up. The key to getting out of the SUV is to go slow down the board. The helper (me or Michel, for instance) only needs to stay behind him and keep a knee aimed under his butt in case he needs the support or help with his balance.

Next with the PT he practiced transfers to and from a low sofa seat. He needed a little help, but was so much better than when he did these last summer.

The next hour was with the nurse, during which she was supposed to be going over skin checks with him. She was of no help, in fact, didn’t seem to have a clue. Most people here are helpful, many extraordinarily so, but occasionally there is the person that is not very good. One thing that Gary didn’t like was when we brought up the problem of how he would do skin checks of his back if he was traveling alone, and she told him he wouldn’t be traveling alone. He told her that NOW he couldn’t travel alone, but that he would in the future. He commented to me afterward that he didn’t appreciate her saying to him that he wouldn’t be traveling alone.

That was the last of the day, so we went home and carried on our usual routine. I had checked my email, and on the RSFic list someone was “complaining,” at least partly in jest, that she was blocked in writing a “fic” (fiction story based on the characters of a TV show, etc., in this case “Remington Steele”) because she wanted L.A. to be cold, wet, and rainy. I wrote her back and said she should get over it, because L.A. was unlikely to experience a dramatic climactic change soon. She wrote back something on the order of, “Bugger! How am I supposed to recreate a Yorkshire moor if the weather won’t wuther?” Her “weather won’t wuther” made me laugh, and while I was on my walk (and more later, while I was meditating) a poem for her came to mind. In case it you can get some enjoyment from it, here it is (I suppose I should say that this person is Australian, and her name is Robyn. I hope she won’t mind me identifying her that much):

Why, weather, won't you wuther?
Robyn rants and raves.
Frost and sleet and frozen feet,
Is what the Aussie craves.
But no, L.A., you do not provide
That which Robyn seeks.
You give her sun, you give her tide –
If she is lucky, rain for weeks.
This, she cries, just will not do –
What story can be made from these?
And so, dear weather, we beg of you:
For Fic's sake, her appease.

December 17, 2006

I slept great on the hospital bed, much to my surprise. And Gary did just fine in the double bed. So, maybe we will switch beds when we get back home. Only, we’ll have to get someone to take my mattress and box springs off the bed frame – that would be a very high transfer for Gary to have to do twice a day!

He practiced with the commode chair again, only he had trouble keeping his balance while doing a weight shift on it because there is no back of the chair to hold him. So he wanted me to help hold him up while he was depressed upward! That was tough – we’ll have to ask the therapists what he should do, as I’m certain we’re not supposed to do that for the rest of his life;-). The next time he needed to do the weight shift, he said to try just holding him in place for his balance and not actually lifting him up. That was easier on me! I guess like other things he will just learn to keep his balance better. He said that he thought doing the bowel program on the chair was faster than in the bed. It took him fifty minutes from start to finish. He took a shower after that, but skipped dressing in the chair – he hadn’t dressed in the double bed, so he wanted to make sure he could do that. At any rate, it took him four hours to do the four things of eating, bowel program, shower, dressing – it would have taken even longer if he’d dressed in the chair. But he says that he thinks he is going to like using the commode seat once he gets the transfers down to where I don’t have to help him with that (and as well figures out how to do his weight shifts on it without my help).

We spent a “lazy day” around the apartment, except for going grocery shopping in the afternoon. I spent time working on my story and also went online to buy Gary some Christmas gifts.

Dec 16, 2006

Gary said he thought about why the swimming was such an emotional experience: suddenly, all the deadweight from nipple level down, which is so difficult to move around on land, was floating, weightless, moved easily.

This morning he tried doing his bowel program on the commode chair for the first time. It took him about twenty-five minutes, his minimum time for doing it the other way. He found it easier to do it “the old way,” lying down, what with all the leaning he has to do in the sitting position, but we expect he’ll get used to doing it this way and will eventually prefer it. He got a little redness in his booty area from using the chair so ended up going back onto the bed and proning to give the area a little relief. Turned out that he had forgotten he was supposed to do weight shifts every fifteen minutes while on the commode seat, and he didn’t do one. Not sure if that would have made a difference.

He next greased his own flap, me watching to make sure he got vaseline on the entire area. It will take a little practice, but he does it pretty good, using the feel of the seam and “memory” on the places where the seam isn’t obvious to the touch.

Next came the new task of dressing in the chair. Partway during his getting his pants on, I heard this big “whoa!” come from the living room where he was. I raced around the corner from the bedroom, and helped him sit back up in his chair. He had lost his balance while leaning over the side of the chair and had been afraid he might slip out of it. So, I stayed with him while he continued to try to get his pants on. He gave up after about twenty, twenty-five minutes, and I tugged them on the last little bit over his booty – he’d already spent forty-five minutes dressing. He wonders if dressing in the chair will ever be easier than dressing in the bed. He could sure use a third arm! Two for depressing, the third one for pulling the pants up while he is in that depressed position.

So, we had gotten up about eight, though Gary had done his IC at seven (we had supposedly slept in, though I had still, for some obnoxious reason, again woken up at five and hadn’t gone back to sleep for quite a while; the elephant, at least, hasn’t been here the last day – we’re hoping he/she is off visiting relatives for the holiday and won’t be back until after we leave ;-)). Gary’s morning then was: eat breakfast in the nude while in the chair, go to the bathroom using the commode chair, get dressed in the chair. It was just about noon when he finished with these three tasks. This is reminding us of our first day in the Transitional Living Apartment.

Debra Talley, my friend from RS Fanfic, is coming about 12:30, and we will go out to eat to Mellow Mushroom Pizza (I’ll bring my rice), and then we are going to go to a movie at the same place Gary and I went to last time when we were here. We are going to see “Stranger than Fiction.”

***
Debra saved me a lot of effort and time by stopping at an Indian grocery store on her way to our apartment and picking up 60 lbs. of Basmati rice for me. That should hold me awhile ;-). We went to the pizza place and Gary and Debra ordered small pizzas. They said the pizzas were very good. We ate and talked for a while, which is always enjoyable with Debra, then headed for the movie. We all liked the movie – I found it very creative and different and funny, sometimes in a dark or tender way. Debra characterized it as “quirky.”

After the movie we headed back to the apartment and said goodbye to Debra. (She said it had been very enlightening to watch Gary do his transfers and watch me break down the wheelchair, to actually see what I had been talking about on the blog). I took a very short walk while Gary did his IC, and then he wanted to “practice” in the double bed in preparation for this evening. So he transferred into the double bed and padded himself off for proning. I checked him, and he did it pretty good, just not leaving quite enough of a gap between the quad pillows that go below and above his knees. The he said he wanted to pretend it was 3 am and time for his IC when he would have to get out of the prone position and into the side position. I went into the other room, and I hear him say, “Oh, damn, it’s 3am and I have to do my IC.” Funny guy. He said he thought the repositioning he had to do was easier to do on the double bed than on the hospital bed, so it is a “go” for him to sleep in the double bed tonight. The only drawback for this from my point of view is that I had unmake and remake both beds, because I had my bedwarmer on the double bed and now it would have to be put on the hospital bed. This makes five times I have had to make a bed since last Sunday. I am getting pretty sick of that task ;-)