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Wednesday, February 8, 2012

A Crack in that Old Plateau

Bob has been "plateauing" for quite awhile now as far as his right leg is concerned. We have been doing the same daily leg exercises for nearly a year now, without much improvement in the movement of that leg. It's tedious and, often, heartbreaking work and, when you're not seeing any improvement, one sometimes begins to wonder: why bother?

Bob does try so hard. You should see the concentration on his face as he stares at that right leg willing it to move the way he wants it to--without much luck. That's the heartbreaking part of it.

The tedious bit comes from the fact that Bob still can't count so I have to sit with him and count off the repetitions. He can count to ten, but once past ten he gets all mixed up, i.e.: 10, 11, 17, 21, 24, 50! (Though I must admit, that's one way to get these exercises done quickly!) So I'm right there, every day, counting for him. He also forgets which exercise comes next, or will completely forget an exercise, even though we've been doing this same routine for over a year. Everything is so much harder when you throw the aphasia into the mix.

One of the exercises we do are leg lifts. This is done lying on the bed and is basically lifting the leg straight up. Bob could never lift his right leg up without first bending his left knee and pressing down on the bed with his left foot, thus pushing his right leg into the air.

So you can imagine our delight and surprise when this week Bob was able to actually lift that right leg into the air, without the help of his left leg! And not only that, he was able to do this smoothly without the usual jerking and jumping of his muscles. (OK, not every single time was it smooth, but several times it was smooth sailing all the way up and down.) It was so fun to watch, as each time Bob did a leg lift, he cried out, "Hey hey hey!!"

So it appears he's gaining more control over that confounded leg! And after all this time, finally, cracked that old plateau.

As they say, folks: Never give up.


Rebecca said...

Can Bob hold his leg up to get it out of the way when you change his bed linens? Can he hold his leg up while you slip the Depends over his hemiplegic foot? Can he move his leg out of the way when he stands up to get out of the wheelchair or do you have to reach down and move his leg for him? All these things help you save energy which is not a small thing.

Diane said...

Rebecca, he can't lift his leg from a sitting position (yet) and so I am always moving his leg for him or he pulls it up with his left hand (if his hand isn't occupied). Changing bedsheets, he can roll to his left side but not his right, though he can lean forward and lift his butt, so that helps. Right now he can only hold his leg up while lying flat and only hold it up for a second. I am hoping that this little breakthrough will wash over to our daily routines, but he's not quite there yet. One step (or leg lift) at a time!

Anonymous said...

Today I saw a woman in Karens PT session use a gate belt to move her leg from the wheel chair to her bicycle exercise as she transferred. Perhaps using his arms along with a belt or towel or sheet can do the same to assist him in leg movement. I was impressed with the woman using the belt to meet her needs in a transfer. I still have to add, keep doing what you are doing!!!
Hugs, Dan

Rebecca said...

When Bob rolls onto his left side in bed does he drag his right leg or lift it for 1 second? I assumed you put the Depends on while he is in bed rather than sitting up. Holding his right leg up for one second may not be enough time for you to slip the Depends over his right foot, but 2 seconds may be enough time. When he uses his hand to move his leg even one inch when he is in bed he loses opportunities to transfer the gains you both have worked so hard for during the leg lift exercises.

Linda said...

Sounds like a very exciting bit of progress.

Wanted to tell you I could not do numbers for a very very long time and my physio people switched from counting moves to doing it with a timer. Apparently that work/ effort level rate stays the same, and it is harder to argue with a beeping timer than a therapist counting.

So for example, I would have to do 10 minutes for my good leg and 5 minutes for the bad leg, it would beep I could stop. At some point we wound up working on how to read the numbers on the timer so I could make it go all by myself.
(I kind of learned to hate the timer but it worked for me)

Barb Polan said...

Congratulations! I have found that if I haven't been able to ever do an exercise, I skip it during my routine. That you and Bob persisted despite so many failures is very impressive. Great to have a reward, isn't it?

Jenn said...

¡¡¡Mucho bien muchacha y muchacho!!!
....Never. ... Give.... Up. . .....
Oh dearest Universe, we see how you're working. We get discouraged, we let go, and BAM! A breakthrough. Sneaky, sneaky Universe!