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Friday, March 30, 2012

Therapy: A Revolving Door

This week we had the "last" session of Physical Therapy, which made for a total of five sessions which means 15 left to use later this year. We are now armed with some new exercises, some of which are quite labor intensive (and I'm talking about for me!)

And I'm telling you, I am using muscles I didn't know I had. So Bob and I are both getting a workout.

In addition to our "hall dancing", I am manipulating his right leg, bending that troublesome knee in all sorts of ways and his leg is heavy. This is totally the opposite of what the Outpatient Rehab therapist had instructed us to do, which was to let Bob struggle on his own to bend that knee. The new therapist tells me that to let Bob struggle was fruitless, that instead, I should get in there and bend that sucker myself in order to "wake up" those muscles. So I am now kneeling on the bed while pushing his knee, this way and that, and instructing him to push back at me.

I must say this new technique is working. Bob is able to push harder and harder each day. He has also just begun to be able to slide his heel down the bed after I stand his knee up. In addition, he has just now begun to be able to squeeze his thighs together--though not all the way together, yet. And to keep his right knee up in the bent position--previously that leg would just flop to the right. So muscles, indeed, are waking up!

In addition to the knee/leg exercises, I am to get Bob sitting at the edge of the bed daily. I do wish someone had told me this simple exercise before, as we could have made much progress by now if they had. Alas, no therapist mentioned this. Seems that Bob's back and abdomen are very weak from always being supported by the back of wheelchair or the back of the bed. So now, we sit side-by-side on the edge of the bed, with my arm around his shoulders and we sway back and forth, shifting weight and moving those muscles. After that, I pull a chair up in front of him, take his hands in mine and pull him gently toward me and back, a sort of bending exercise. And in this short amount of time, Bob has gone from toppling over immediately to being able to keep himself erect at the edge of the bed for ten minutes. Though he is still a bit wobbly.

So PT discharged Bob, with the understanding that as soon as Bob masters these new exercises, we will be calling her back for more. Right on her heels, Speech Therapy showed up for the first evaluation visit.

The ST evaluation went smoothly enough, I guess. The new therapist watched Bob eat pudding, often placing her fingers on his throat to feel the movement. She asked me how the thickened liquids were going, but really, truthfully, I've only done it a few times because Bob would begin coughing and later, making gurgling noises which pretty much scared the heck out of me. So she is planning to work with the thickened liquids and she will also do e-stim for swallowing. The latter at my request, because, hey--can't hurt and maybe will still help at this late date. As for speech, she ran Bob through the typical questions, had him count to ten, had him point at things, try to name a few objects, and then this:

ST:  Bob, I am going to say a sentence and I want you to repeat it. OK?

Bob:  OK.

ST:  Good morning.

Bob:  Oh! Nice to meet you!

ST:  Bob, I am going to say a sentence and I want you to REPEAT it. OK?

Bob:  OK.

ST:  How are you?

Bob:  I'm fine, thank you!

So, speech therapy is off to a roaring start! We have our first session on Monday.


Rebecca said...

All of this sounds soooo good. It sounds like your current PT has found the just-right challenge.

Anonymous said...

I am so excited for you two...These are great moves forward. Nothing like hard work to make day pass fast...
Best Wishes,

Anonymous said...

Your PT for Bob and my PT for Karen are on the same track when it comes to back/abdoman/trunk strenght. We are doing the same thing with her sitting up without back support, bending forward and back up, twisting, and working her neck and head. In the past she fell over backwards or to her left she can sit without assistance for about 5-7 min.

It sounds as if Bob will work well with his speech therapist. Keep up that great work. As I've said before, you both amaze me. Hugs, Dan.

Anonymous said...

D. Keep up the good work, like Dan said you and Bob amaze me. There is a beautiful love story here that needs to be written someday !! Love, Patricia

Jenn said...

Wooo hooo! yay! Magwonderlous! My heart just soars for you two <3<3<3