Dec 13, 2006
First on the schedule was the group fitness session. Gary asked me if I was going to make sarcastic comments throughout it again this time. I said, “Probably.” It was run the same way as it was last time, so I have the same complaints – too fast through the exercises. But I kept my comments to myself because Gary didn’t rush through the exercises. He has noticeably better range of motion, and of course he can use heavier weights than when we left here in August – and I didn’t have to help him at all by hanging onto him so he could keep his balance, like I did last time. I did the exercises too.
Just before that session started, Gary’s team nurse from when he was an inpatient here came into the gym, gave us hugs, and talked to us a short time. One of his other nurses had seen him here at Shepherd yesterday and is evidently spreading the word he is back. We have seen quite a few familiar faces, and they all say how good Gary looks and are impressed that he is back on the job. His “old” PT commented yesterday how much better his balance is.
Next he had a session with the PT. I think they got my not-so-subtle message that there were times in his schedule that could be put to better use – she told him that next Monday he was going to have a double session with her and a double session with the OT, and that at any other time we thought that what was on the schedule wasn’t useful, we could practice things like what he would be learning with her in this very session – which was the beginning of floor transfers.
So, he got on their mat (which is about at wheelchair height), and they had a second higher mat right next to it – it would be like transferring from the floor to a low bed (not as high as his wheelchair). She had him start by sitting so his legs were parallel to the side of that higher mat. Then he pulled his legs up so his knees were bent and facing the mat. Next she spotted him by holding at his hips, and he got himself up to kneeling position. This he did by having one hand on the lower mat and pushing with that one while having the other hand on the upper mat and pulling with that one – it would probably be more instinctive to have both hands on the upper mat and pull, but what she had him do is more like the technique used in the floor to wheelchair transfer.
The first goal in this pushing and pulling was to get his chest onto the upper mat. She put a pillow on the upper mat where his face would end up because a lot of people end up smashing their face into the upper mat. After he got his chest on it, the next step was to put his hands back behind him near the edge of the mat and push himself further onto the mat. Once he was reasonably well onto it, he could roll to the side and sit. To get himself off the upper mat, he scooted to the edge, mader sure his legs were extended a little (so his knees wouldn’t end up too bent when he ended up in his final position), turned to the side, and (gently!) pushed himself off so he would again end up sideways to the mat with his knees bent.
She had him practice this a few times, and then it was time for the next step – transfers between the floor and the low mat (which is wheelchair height, and this made for a significantly higher transfer than the mat to mat transfer). She did it with him a time and then it was my turn to spot him on it. So, for the first part, where he is trying to get onto his knees (or rather trying to balance on his knees with his chest on the mat), I held him at his hips. I was supposed to give him actual help as little as possible, but I did find I had to put significant effort into pulling him up – I am sure the therapist didn’t give him that much help on the lower transfer from mat to mat. Then, on the second part, where he is trying to pull himself onto the mat, I held him under the knees and gave him lift if it was necessary. It *was* necessary – I gave him a couple little pushes as he, in stages, tried to pull himself onto the mat, because he didn’t seem to be going anywhere – but I didn’t have to put as much effort into it as in the first part.
Anyway, now we know that if he ends up on the floor he’ll be able to get up on his hospital bed – definitely with my help and probably with a lot of huffing and puffing if he tried to do it on his own. So, one possibility if he fell off his chair at home – or intentionally got off it onto the floor, is he could get back on his bed and then transfer from his bed to his chair. Of course, if I wasn’t around, he’d first have to commando crawl to his bed, and he’d also have to drag his chair with him.
Then he did the next step in the progression of learning to go from floor to wheelchair – the wheelchair doesn’t have the room for pulling himself onto it, of course, so a different technique is used. In fact, you may recall I listed three techniques to go from floor to chair (and back). But I think they are only going to go over with the one they think it most likely he would use.
So, anyway, the next step was to practice “bump-ups.” He got back up on the lower mat, and this time sat with his back to the upper mat, about an inch away from it. They strapped a J-pad to him – a cushioned seat that is held on by straps around his legs and waist. He put his legs in frog position, and then “on three” he was to throw his head down and forward and at the same time do a depression to get his butt up high and going backwards to land on the upper mat. Then he was to more depressions while “wiggling” backwards first to one side then the other so that he got further back on the mat (since he initially lands pretty close to the edge). She had him do this a number of times. She was helping with his lift, but I don’t know how much. Not enough to stop her from raising the electronically controlled mat – on his last bump–up there was a 7 ½ inch gap between lower and upper mat!
She told him that he now essentially had a way to get off the floor directly onto his chair provided he had a portable “step” he could use. That is, say for home use, he could build, or have built, a little platform that he could put in front of his wheelchair and bump up to, and from that bump up to the wheelchair. Actually, since his wheelchair cushion adds three inches of height, he’d probably have to remove it, bump up to the wheelchair, then go to the bed and transfer to it, then put his cushion back on his chair, then transfer back to the chair.
So, anyway, this gives him some options for when he is at home alone (or home with me), at least. She told us we could practice these skills anytime he has time in his schedule (or we decide to take the time from some other activity we deem of lesser importance).
His “old” inpatient PT walked by about this time, and his “new” day program PT filled her in on Gary’s progress today. The “old” one greeted this news with enthusiasm, and I remarked that this is what we missed, having our own personal cheerleaders. The new PT laughed and said it did help with motivation. Gary remarked that I was good about saying “good job,” however, so I’ll take that to mean he hasn’t felt a lack of encouraging remarks :-)
The PT gave him one more exercise to do in his “spare time” – when he depresses, to hold that position momentarily. She feels he goes to fast in the middle of his transfers and that this practice will enable him to become more controlled about it.
Next they had rescheduled him to go over his meds with his nurse – I guess the message hadn’t gotten through yesterday but the meeting had been taken off his schedule for other reasons. I had seen his nurse earlier so had told her Gary had no meds, so she then said she didn’t have to meet with him. So now we had a “free hour.” Gary stretched for around twenty minutes of that time, and then he went off to his IC early. The reason for this was because he was to get into the pool in the afternoon, and rather than take the time to get him into his suit then and cut into the pool time, we were going to get his suit on him during the lunch hour. So, after his IC, we went to a corner mat on the third floor gym, and I rolled over some screens for privacy. In the interest of saving time, I helped him get his trousers off, and then I put his swimsuit and his trousers on him. Then we had lunch.
First after lunch was an OT session. She started with “dressing in the chair.” She had a stretchy pair of pants for him to put on over his own pants. So, first he moved himself toward the front of his wheelchair, then grabbed his leg under the knee while falling backward to get his leg up. Then he crossed that ankle over the opposite knee and threaded his trousers onto the lower part of his leg. Very important – when you have crossed your legs, the leg that is on the left is your right leg and still needs to go into the right pant leg ;-). At this stage, before proceeding farther, one puts one’s shoe on that leg – easier than waiting until the end, since at that stage you would have to get each leg up again. After putting the shoe on, one scoots forward as far as possible in the chair so as to have as much thigh as possible off the chair. Then one pulls up the pants so that they’re like short “capri” pants, making sure to tuck the middle (crotch) under oneself as far as possible.
Next one does a high depression and moves back, hopefully not dragging the pants off. Pull up the waistline of the pants as much as possible.
Then there are a few different things to try in order to do the most difficult part of getting the pants up over your butt.
The first thing she had him try was to roll his chair next to and parallel to the mat, which was playing the role of his bed. Then he was to lean to the side, digging his elbow into the mat to get his hip up – she said some people even cross one leg over the other to help with this. Then he was to grab the pants as far to the middle of his back as possible with the hand facing outward, and pull up until tight. Then he was to either spin his wheelchair around so the other side was next to the mat, or to keep the chair as it was and lean on his far tire or over to the floor and proceed similarly with pulling up his pants on the other side. One continues to go from side to side as long as necessary to get the pants up. To finish, the idea was to grab his pants behind him and pull up as he slides forward, and hopefully the pants will finish going up.
He was able to do this with her, and he said it was challenging but easier than he thought it’d be. BUT, I don’t know if it the bits of help she gave him, or her talking it through with him as he was doing it, or the fact that the pants were stretchy, that accounted for his success there, because he couldn’t repeat this with success after he dressed after being in the pool. More on that later.
Anyway, another technique she showed him for “the hard part” was to move way forward and to the side of the chair so his butt was already half off the chair. Then he was to use the mat or the back of his chair or his tire to help him bend over and get his hip off the chair. This was even easier for him than the first technique, but he couldn’t replicate the success while dressing after the pool.
The final technique was to “depression lift” into the pants: put two fingers of each hand into the sides of the pants with palms up, then use the wheel of the chair to do a depression lift with the rest of the hand, and go forward into the pants. He didn’t try this one – this was what they showed him when he was an inpatient and he had gotten nowhere with it.
Getting the pants off was easier – either reverse the above last technique, i.e., do a depression and push them off, or go side to side and pull them off. Then repeat as necessary until they are far enough down. To get them off the lower leg, again reverse the procedure of getting them on that part: scoot forward, get a leg up, cross it over the other one, take your shoe off, then your pants.
So, another assignment she gave him was to practice dressing in the wheelchair whenever he is putting on or taking his clothes off while here (unless he is rushed for time).
Next she went over how to prone himself in the double bed. He sat in the bed and positioned a quad pillow (which is shaped as a long, thin rectangle) under the ankle closest to the middle of the bed, then under and below the corresponding knee, then under and above that same knee. Then he crossed his opposite ankle over the pillowed ankle. Then he put his pillows that would go under his chest in approximately the position they should end up being in. Lastly, he turned over, reaching over with one arm and pushing with the other so that he was sort of in pushup position, making sure to aim his head to the top of the bed, so his body follows and ends up straight in the prone position. He did this very well. I might have to adjust the pillows at his knees a bit, just to make sure he isn’t putting any pressure on that area. He tried proning himself in the hospital bed tonight at bedtime. The problem with the narrow hospital bed was he ended up farther on one side of it than he liked, so I had to move him over. The padding seemed acceptable, but we decided to have me adjust it “to be safe.” At some other time we’ll let him pad himself completely on his own and have him stay in it for an hour just to make sure that the slightly more pressure some areas looked like they might get when he does it himself won’t be the cause of any problems, and then he can try to go for his entire regular nighttime proning like that.
Back to day program. He finished up his OT session by doing his “terrible threes” in the prone position, and then he transferred back to his chair and we headed to the pool!
We both headed into the men’s bathroom. There were two areas with mats that were curtained off. I changed into shorts and T-shirt and Gary, while in his chair, stripped down to his swim trunks (he finds getting his pants off far easier than getting them on!). Then we went out to the pool area. A rec therapist and a lifeguard helped him transfer into the “pool chair.” It wasn’t a difficult transfer, so I think Gary and I could handle it (and probably a lifeguard is required to be there too). The lifeguard is required to operate the pool chair. After we got Gary strapped into it and a floatation belt was put around his chest, it swung around over the water and lowered him into the water. The therapist and I went down the pool steps and met him in the water. He was unbuckled from the chair, and then he was floating! The first thing the therapist went through with him was how to keep his balance in the water – again, a head and shoulder thing, aiming them in the direction opposite the one you are overbalancing in. His arm movements were a little frantic, and the therapist told him it would be easier if he were more gentle with them. I was reminded of the wheelie person telling him he needed to be more zen. After a few minutes of talking and just getting used to the water, the therapist asked him how he felt. “Excited!” he exclaimed. And then he started to cry. Naturally, that made me cry too. After we’d calmed down ;-), she had him swim a lap of elementary backstroke. She just stayed at his head as he went down the pool, not touching him. I was surprised – I’d thought that he might need more help in the water, but with that belt on
he was free to move on his own. We did a lap – she had him circle at the deep end by leaving one arm still and just using the other so he’d pivot around. If he and I were in a crowded pool I’d help, because his circle was rather a wide one. We got back to the shallow end, and she asked him how that was. He said, “Great!” We did two more laps like that, after each one her asking him how he was doing. His reply was always, “Great!” with a big smile on his face. Next she taught him some exercises that she thought might be particularly useful with his arthritic shoulders. Standing behind him, I was to balance one of my knees under his butt and to hold him lightly at the shoulders to help him keep his balance while he did the exercises. The exercises were simple ones: bringing his arms from shoulder height at the side to down to his thighs, and bringing his arms from shoulder height in front of him down to his knees. She said we could stay in longer on our own (we had been in the water for about a half-hour and it was about 3 pm), but we were both popsicles by this time. So she showed me how to get him back into the pool lift chair, and that took him out of the pool. They have shower chairs there, so he and I transferred him into one of those with the lifeguard standing nearby. The shower chair isn’t easy to wheel oneself, so I wheeled him into the shower. We were afraid they were going to keep the water at a nice safe lukewarm temperature, but the showers were nice and hot! After we took showers and dried off, Gary attempted to dress in the shower chair. It was now 4pm. The dressing in the chair didn’t go as well as it seemed to at therapy, and after trying to do it for a half hour, Gary called it quits – he couldn’t quite get it up over the last part of his bootie. So I helped him with that.
So mom, you mentioned how frustrated you used to get after going to the pool and seeing how long it took you to get dressed after, and how you were inspired by how Gary copes with things taking him longer. Now you have his pool experience to compare with. It took him an hour and a half to shower and dress after his swim, and he didn’t finish the dressing on his own.
But, we are confident in time he’ll get this chair dressing down. It’ll just take practice, just as his learning to dress himself in bed did.
We next went back to the apartment. After letting Gary into it, I did some grocery shopping, and then our evening routine was pretty much as before. Gary commented that he didn't know why the swimming had been such an emotional experience for him. He said he’s always liked the water, but he didn’t know he liked it THAT much! :-)
We had planned to sleep in about a half hour because Gary was doing life skills training at the apartment Thursday morning, and he was to be in bed when the OT and PT came. Too bad the elephant upstairs decided to start stomping around at 5am. Just as he/she did yesterday. Given that he/she is stomping late at night too, this is truly an elephant that doesn’t sleep.
First on the schedule was the group fitness session. Gary asked me if I was going to make sarcastic comments throughout it again this time. I said, “Probably.” It was run the same way as it was last time, so I have the same complaints – too fast through the exercises. But I kept my comments to myself because Gary didn’t rush through the exercises. He has noticeably better range of motion, and of course he can use heavier weights than when we left here in August – and I didn’t have to help him at all by hanging onto him so he could keep his balance, like I did last time. I did the exercises too.
Just before that session started, Gary’s team nurse from when he was an inpatient here came into the gym, gave us hugs, and talked to us a short time. One of his other nurses had seen him here at Shepherd yesterday and is evidently spreading the word he is back. We have seen quite a few familiar faces, and they all say how good Gary looks and are impressed that he is back on the job. His “old” PT commented yesterday how much better his balance is.
Next he had a session with the PT. I think they got my not-so-subtle message that there were times in his schedule that could be put to better use – she told him that next Monday he was going to have a double session with her and a double session with the OT, and that at any other time we thought that what was on the schedule wasn’t useful, we could practice things like what he would be learning with her in this very session – which was the beginning of floor transfers.
So, he got on their mat (which is about at wheelchair height), and they had a second higher mat right next to it – it would be like transferring from the floor to a low bed (not as high as his wheelchair). She had him start by sitting so his legs were parallel to the side of that higher mat. Then he pulled his legs up so his knees were bent and facing the mat. Next she spotted him by holding at his hips, and he got himself up to kneeling position. This he did by having one hand on the lower mat and pushing with that one while having the other hand on the upper mat and pulling with that one – it would probably be more instinctive to have both hands on the upper mat and pull, but what she had him do is more like the technique used in the floor to wheelchair transfer.
The first goal in this pushing and pulling was to get his chest onto the upper mat. She put a pillow on the upper mat where his face would end up because a lot of people end up smashing their face into the upper mat. After he got his chest on it, the next step was to put his hands back behind him near the edge of the mat and push himself further onto the mat. Once he was reasonably well onto it, he could roll to the side and sit. To get himself off the upper mat, he scooted to the edge, mader sure his legs were extended a little (so his knees wouldn’t end up too bent when he ended up in his final position), turned to the side, and (gently!) pushed himself off so he would again end up sideways to the mat with his knees bent.
She had him practice this a few times, and then it was time for the next step – transfers between the floor and the low mat (which is wheelchair height, and this made for a significantly higher transfer than the mat to mat transfer). She did it with him a time and then it was my turn to spot him on it. So, for the first part, where he is trying to get onto his knees (or rather trying to balance on his knees with his chest on the mat), I held him at his hips. I was supposed to give him actual help as little as possible, but I did find I had to put significant effort into pulling him up – I am sure the therapist didn’t give him that much help on the lower transfer from mat to mat. Then, on the second part, where he is trying to pull himself onto the mat, I held him under the knees and gave him lift if it was necessary. It *was* necessary – I gave him a couple little pushes as he, in stages, tried to pull himself onto the mat, because he didn’t seem to be going anywhere – but I didn’t have to put as much effort into it as in the first part.
Anyway, now we know that if he ends up on the floor he’ll be able to get up on his hospital bed – definitely with my help and probably with a lot of huffing and puffing if he tried to do it on his own. So, one possibility if he fell off his chair at home – or intentionally got off it onto the floor, is he could get back on his bed and then transfer from his bed to his chair. Of course, if I wasn’t around, he’d first have to commando crawl to his bed, and he’d also have to drag his chair with him.
Then he did the next step in the progression of learning to go from floor to wheelchair – the wheelchair doesn’t have the room for pulling himself onto it, of course, so a different technique is used. In fact, you may recall I listed three techniques to go from floor to chair (and back). But I think they are only going to go over with the one they think it most likely he would use.
So, anyway, the next step was to practice “bump-ups.” He got back up on the lower mat, and this time sat with his back to the upper mat, about an inch away from it. They strapped a J-pad to him – a cushioned seat that is held on by straps around his legs and waist. He put his legs in frog position, and then “on three” he was to throw his head down and forward and at the same time do a depression to get his butt up high and going backwards to land on the upper mat. Then he was to more depressions while “wiggling” backwards first to one side then the other so that he got further back on the mat (since he initially lands pretty close to the edge). She had him do this a number of times. She was helping with his lift, but I don’t know how much. Not enough to stop her from raising the electronically controlled mat – on his last bump–up there was a 7 ½ inch gap between lower and upper mat!
She told him that he now essentially had a way to get off the floor directly onto his chair provided he had a portable “step” he could use. That is, say for home use, he could build, or have built, a little platform that he could put in front of his wheelchair and bump up to, and from that bump up to the wheelchair. Actually, since his wheelchair cushion adds three inches of height, he’d probably have to remove it, bump up to the wheelchair, then go to the bed and transfer to it, then put his cushion back on his chair, then transfer back to the chair.
So, anyway, this gives him some options for when he is at home alone (or home with me), at least. She told us we could practice these skills anytime he has time in his schedule (or we decide to take the time from some other activity we deem of lesser importance).
His “old” inpatient PT walked by about this time, and his “new” day program PT filled her in on Gary’s progress today. The “old” one greeted this news with enthusiasm, and I remarked that this is what we missed, having our own personal cheerleaders. The new PT laughed and said it did help with motivation. Gary remarked that I was good about saying “good job,” however, so I’ll take that to mean he hasn’t felt a lack of encouraging remarks :-)
The PT gave him one more exercise to do in his “spare time” – when he depresses, to hold that position momentarily. She feels he goes to fast in the middle of his transfers and that this practice will enable him to become more controlled about it.
Next they had rescheduled him to go over his meds with his nurse – I guess the message hadn’t gotten through yesterday but the meeting had been taken off his schedule for other reasons. I had seen his nurse earlier so had told her Gary had no meds, so she then said she didn’t have to meet with him. So now we had a “free hour.” Gary stretched for around twenty minutes of that time, and then he went off to his IC early. The reason for this was because he was to get into the pool in the afternoon, and rather than take the time to get him into his suit then and cut into the pool time, we were going to get his suit on him during the lunch hour. So, after his IC, we went to a corner mat on the third floor gym, and I rolled over some screens for privacy. In the interest of saving time, I helped him get his trousers off, and then I put his swimsuit and his trousers on him. Then we had lunch.
First after lunch was an OT session. She started with “dressing in the chair.” She had a stretchy pair of pants for him to put on over his own pants. So, first he moved himself toward the front of his wheelchair, then grabbed his leg under the knee while falling backward to get his leg up. Then he crossed that ankle over the opposite knee and threaded his trousers onto the lower part of his leg. Very important – when you have crossed your legs, the leg that is on the left is your right leg and still needs to go into the right pant leg ;-). At this stage, before proceeding farther, one puts one’s shoe on that leg – easier than waiting until the end, since at that stage you would have to get each leg up again. After putting the shoe on, one scoots forward as far as possible in the chair so as to have as much thigh as possible off the chair. Then one pulls up the pants so that they’re like short “capri” pants, making sure to tuck the middle (crotch) under oneself as far as possible.
Next one does a high depression and moves back, hopefully not dragging the pants off. Pull up the waistline of the pants as much as possible.
Then there are a few different things to try in order to do the most difficult part of getting the pants up over your butt.
The first thing she had him try was to roll his chair next to and parallel to the mat, which was playing the role of his bed. Then he was to lean to the side, digging his elbow into the mat to get his hip up – she said some people even cross one leg over the other to help with this. Then he was to grab the pants as far to the middle of his back as possible with the hand facing outward, and pull up until tight. Then he was to either spin his wheelchair around so the other side was next to the mat, or to keep the chair as it was and lean on his far tire or over to the floor and proceed similarly with pulling up his pants on the other side. One continues to go from side to side as long as necessary to get the pants up. To finish, the idea was to grab his pants behind him and pull up as he slides forward, and hopefully the pants will finish going up.
He was able to do this with her, and he said it was challenging but easier than he thought it’d be. BUT, I don’t know if it the bits of help she gave him, or her talking it through with him as he was doing it, or the fact that the pants were stretchy, that accounted for his success there, because he couldn’t repeat this with success after he dressed after being in the pool. More on that later.
Anyway, another technique she showed him for “the hard part” was to move way forward and to the side of the chair so his butt was already half off the chair. Then he was to use the mat or the back of his chair or his tire to help him bend over and get his hip off the chair. This was even easier for him than the first technique, but he couldn’t replicate the success while dressing after the pool.
The final technique was to “depression lift” into the pants: put two fingers of each hand into the sides of the pants with palms up, then use the wheel of the chair to do a depression lift with the rest of the hand, and go forward into the pants. He didn’t try this one – this was what they showed him when he was an inpatient and he had gotten nowhere with it.
Getting the pants off was easier – either reverse the above last technique, i.e., do a depression and push them off, or go side to side and pull them off. Then repeat as necessary until they are far enough down. To get them off the lower leg, again reverse the procedure of getting them on that part: scoot forward, get a leg up, cross it over the other one, take your shoe off, then your pants.
So, another assignment she gave him was to practice dressing in the wheelchair whenever he is putting on or taking his clothes off while here (unless he is rushed for time).
Next she went over how to prone himself in the double bed. He sat in the bed and positioned a quad pillow (which is shaped as a long, thin rectangle) under the ankle closest to the middle of the bed, then under and below the corresponding knee, then under and above that same knee. Then he crossed his opposite ankle over the pillowed ankle. Then he put his pillows that would go under his chest in approximately the position they should end up being in. Lastly, he turned over, reaching over with one arm and pushing with the other so that he was sort of in pushup position, making sure to aim his head to the top of the bed, so his body follows and ends up straight in the prone position. He did this very well. I might have to adjust the pillows at his knees a bit, just to make sure he isn’t putting any pressure on that area. He tried proning himself in the hospital bed tonight at bedtime. The problem with the narrow hospital bed was he ended up farther on one side of it than he liked, so I had to move him over. The padding seemed acceptable, but we decided to have me adjust it “to be safe.” At some other time we’ll let him pad himself completely on his own and have him stay in it for an hour just to make sure that the slightly more pressure some areas looked like they might get when he does it himself won’t be the cause of any problems, and then he can try to go for his entire regular nighttime proning like that.
Back to day program. He finished up his OT session by doing his “terrible threes” in the prone position, and then he transferred back to his chair and we headed to the pool!
We both headed into the men’s bathroom. There were two areas with mats that were curtained off. I changed into shorts and T-shirt and Gary, while in his chair, stripped down to his swim trunks (he finds getting his pants off far easier than getting them on!). Then we went out to the pool area. A rec therapist and a lifeguard helped him transfer into the “pool chair.” It wasn’t a difficult transfer, so I think Gary and I could handle it (and probably a lifeguard is required to be there too). The lifeguard is required to operate the pool chair. After we got Gary strapped into it and a floatation belt was put around his chest, it swung around over the water and lowered him into the water. The therapist and I went down the pool steps and met him in the water. He was unbuckled from the chair, and then he was floating! The first thing the therapist went through with him was how to keep his balance in the water – again, a head and shoulder thing, aiming them in the direction opposite the one you are overbalancing in. His arm movements were a little frantic, and the therapist told him it would be easier if he were more gentle with them. I was reminded of the wheelie person telling him he needed to be more zen. After a few minutes of talking and just getting used to the water, the therapist asked him how he felt. “Excited!” he exclaimed. And then he started to cry. Naturally, that made me cry too. After we’d calmed down ;-), she had him swim a lap of elementary backstroke. She just stayed at his head as he went down the pool, not touching him. I was surprised – I’d thought that he might need more help in the water, but with that belt on
he was free to move on his own. We did a lap – she had him circle at the deep end by leaving one arm still and just using the other so he’d pivot around. If he and I were in a crowded pool I’d help, because his circle was rather a wide one. We got back to the shallow end, and she asked him how that was. He said, “Great!” We did two more laps like that, after each one her asking him how he was doing. His reply was always, “Great!” with a big smile on his face. Next she taught him some exercises that she thought might be particularly useful with his arthritic shoulders. Standing behind him, I was to balance one of my knees under his butt and to hold him lightly at the shoulders to help him keep his balance while he did the exercises. The exercises were simple ones: bringing his arms from shoulder height at the side to down to his thighs, and bringing his arms from shoulder height in front of him down to his knees. She said we could stay in longer on our own (we had been in the water for about a half-hour and it was about 3 pm), but we were both popsicles by this time. So she showed me how to get him back into the pool lift chair, and that took him out of the pool. They have shower chairs there, so he and I transferred him into one of those with the lifeguard standing nearby. The shower chair isn’t easy to wheel oneself, so I wheeled him into the shower. We were afraid they were going to keep the water at a nice safe lukewarm temperature, but the showers were nice and hot! After we took showers and dried off, Gary attempted to dress in the shower chair. It was now 4pm. The dressing in the chair didn’t go as well as it seemed to at therapy, and after trying to do it for a half hour, Gary called it quits – he couldn’t quite get it up over the last part of his bootie. So I helped him with that.
So mom, you mentioned how frustrated you used to get after going to the pool and seeing how long it took you to get dressed after, and how you were inspired by how Gary copes with things taking him longer. Now you have his pool experience to compare with. It took him an hour and a half to shower and dress after his swim, and he didn’t finish the dressing on his own.
But, we are confident in time he’ll get this chair dressing down. It’ll just take practice, just as his learning to dress himself in bed did.
We next went back to the apartment. After letting Gary into it, I did some grocery shopping, and then our evening routine was pretty much as before. Gary commented that he didn't know why the swimming had been such an emotional experience for him. He said he’s always liked the water, but he didn’t know he liked it THAT much! :-)
We had planned to sleep in about a half hour because Gary was doing life skills training at the apartment Thursday morning, and he was to be in bed when the OT and PT came. Too bad the elephant upstairs decided to start stomping around at 5am. Just as he/she did yesterday. Given that he/she is stomping late at night too, this is truly an elephant that doesn’t sleep.
posted by Peg Daniels at 9:10 AM
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