After the surgery, in the other hospital, I was in no condition to put on clothes. I had been given a list, so bought two big summer robe/housecoat things and slippers, which were instantly rejected by the physical therapists at rehab. And forget going to the bathroom wearing the housecoats = wrapped around my neck perhaps?
I had arrived for the surgery wearing some above the ankle knit pants with an elastic waist. Since the brace is the thickness of a long cat wrapped around the waist, I can only wear elastic-waist pants with it. (It sort of scrunches up the cotton lounge/bag dress things I brought, so way too much leg shows.) The knit pants have to do for all purposes this week. Since they were new, they still seem fairly fresh. I hope.
I wish I had hidden certain prescription creams in my medicine pouch. There have been unpleasant discussions all week about who decides which of my regular meds I get, and who gives them to me, and when, and how often. My primary physician is not here to get involved in these talks. And a couple of really bad episodes with a certain cream that I did NOT enjoy explaining to a college age boy from the hospital pharmacy. Most of the stress has been blamed on some Medicare rule. Okay, now you know how old I am.
I also need some things to cheer me up. I wish I had more pictures of happy times in my wallet. Even pictures of things I made, to remind me that I can still draw or make a model of a design while I'm wearing the brace, once I escape from this bed and the painful, too-tall, perma-lock wheelchair and get to a place with an actual table. Somehow, when I get my instructions in the wheelchair, and when the meals cart is near, the nurse has to leave before I think to ask her to hand me some paper and to move my pen closer to me.
Just let me say that the nurses are all kind and some are truly friendly. It's the schedule, the crowded room, the iffy medicine-schedule computer, and the furniture moving that make things tough on nurses and patients.
Luckily, the ambulance guys who brought me to rehab also brought the fabulous orchid plant in its very heavy little planter. And luckily it's some variety of orchid that stays alive whether I get there with any water or not.
Friday, November 16, 2012
Wednesday, November 14, 2012
SPINE FUSION Acute Rehab. Why Occupational Therapy?
We've pretty much nailed down the possibilities of the sponge bath. A word has been added to the whiteboard: independent. Who are they kidding--I'm not supposed to get out of bed or out of the wheelchair when I'm alone, so I haven't been to the bathroom alone. By the way, I was the one who suggested letting me use the bathroom. There isn't much ventilation in there. I don't want to faint again; I need the door open. I have met at least one stranger with the door open, but modesty is the first to go in a hospital.
And in the bathroom, here's that latest safety-design, curbless shower that I haven't used. Am I not cleared by the doctor to shower? Of course, I didn't get any list telling me to bring shower shoes. . .
But ignore the future or not, I will be going home. Even if we don't live alone, there are a couple hundred ways to mess up our remodeled spines at home. The family will be at work or at school much of the time. All the things we put where we wanted them at home are now things we won't be able to reach with the Barbie Bend. Or with this delicate "grabber" that will pick up a fried egg, but won't pick up the frying pan off the bottom shelf.
The occupational therapist (OT) is working with me on doing things by myself. She takes me to the event room/lunch room/toy room. There is a bathtub. It doesn't have shower doors, which I'll be dealing with at home. Luckily talking with my hands is my specialty. I show her where the imaginary shower doors are, and what I can grab onto at home, like the flat-top toilet tank, so I'll never unconsciously grab for those unstable doors when getting out of the tub. I even get into the tub to show her I can step that high.
I make a mental note to buy a strong, long-handled bath brush to scrub my calves and feet. This toy long-handled sponge I had to buy at the other hospital will last about two weeks.
We do some walking and stepping exercises and again I'm shocked by how fast I get tired. And of course we practice getting up off the low, low sofa. She hands me some cute lime green two-pound, Head-Start dumbbells and assures me Target has them. I doubt that Target delivers them. I enjoy them and I'm glad I can lift something besides my fork. . .
The room here is crowded, and since the wheelchair sitting is part of rehab, something is always moved to make room for it. The meals cart/bedside cart is usually what gets moved away from me. Or my walker. The real bedside table is somewhere else, to make room for all the moveable stuff, so the purse and phone and call button and my book are often in the bed and falling out of the bed. Often I forget to remind the nurses and aides before they leave that I have to be able to reach my water and hopefully my glasses and my book and a tissue. Helpless.
It's hopeless trying to write in bed.
All along, I notice most hospital folk I meet have not gone through this surgery and they can't really picture what it is like not to be unable to reach the call button that fell thru the cute plastic side rails and is tangled up down there. I call "somebody!" Repeatedly. Helpless.
I think about that movie, where the doctor recovered from his cancer makes all the newbie doctors take all the nasty tests patients have to take.
It's a blessing that my daughter will come down here to get me started at home. A big blessing. (I am unable to think beyond that day, and how I will manage when she goes home.)
And in the bathroom, here's that latest safety-design, curbless shower that I haven't used. Am I not cleared by the doctor to shower? Of course, I didn't get any list telling me to bring shower shoes. . .
But ignore the future or not, I will be going home. Even if we don't live alone, there are a couple hundred ways to mess up our remodeled spines at home. The family will be at work or at school much of the time. All the things we put where we wanted them at home are now things we won't be able to reach with the Barbie Bend. Or with this delicate "grabber" that will pick up a fried egg, but won't pick up the frying pan off the bottom shelf.
The occupational therapist (OT) is working with me on doing things by myself. She takes me to the event room/lunch room/toy room. There is a bathtub. It doesn't have shower doors, which I'll be dealing with at home. Luckily talking with my hands is my specialty. I show her where the imaginary shower doors are, and what I can grab onto at home, like the flat-top toilet tank, so I'll never unconsciously grab for those unstable doors when getting out of the tub. I even get into the tub to show her I can step that high.
I make a mental note to buy a strong, long-handled bath brush to scrub my calves and feet. This toy long-handled sponge I had to buy at the other hospital will last about two weeks.
We do some walking and stepping exercises and again I'm shocked by how fast I get tired. And of course we practice getting up off the low, low sofa. She hands me some cute lime green two-pound, Head-Start dumbbells and assures me Target has them. I doubt that Target delivers them. I enjoy them and I'm glad I can lift something besides my fork. . .
The room here is crowded, and since the wheelchair sitting is part of rehab, something is always moved to make room for it. The meals cart/bedside cart is usually what gets moved away from me. Or my walker. The real bedside table is somewhere else, to make room for all the moveable stuff, so the purse and phone and call button and my book are often in the bed and falling out of the bed. Often I forget to remind the nurses and aides before they leave that I have to be able to reach my water and hopefully my glasses and my book and a tissue. Helpless.
It's hopeless trying to write in bed.
All along, I notice most hospital folk I meet have not gone through this surgery and they can't really picture what it is like not to be unable to reach the call button that fell thru the cute plastic side rails and is tangled up down there. I call "somebody!" Repeatedly. Helpless.
I think about that movie, where the doctor recovered from his cancer makes all the newbie doctors take all the nasty tests patients have to take.
It's a blessing that my daughter will come down here to get me started at home. A big blessing. (I am unable to think beyond that day, and how I will manage when she goes home.)
Monday, November 12, 2012
SPINE FUSION - Acute Rehab - exercises for here and at home
Today when I'm in bed trying to rest without knocking the old-time shiny grey pushbutton phone, my purse, or my call buttons onto the floor, the physical therapist appears. She has exercises I can do lying in bed.
In July, my injured spine had been pressing on the nerves to my legs, once causing so much pain that I went to the hospital by ambulance. Lying there, despite whatever pain pills they were giving me, I still had pain when I bent my right knee, moving my foot closer to my buns.
Right now they don't conside me helpless, even though I can't unsnarl the phone cord from the call buttons cord or from anything else.
So -- leg exercises. I definitely appreciate the one that builds strength in my thighs and allows moving the foot closer to my buns and then stretching the leg out again without much discomfort.
The worst thing about the exercises is realizing how easily I could have done them in June - how easily I could often have done them until just before the surgery. It's a long way back.
I learn to move the legs side-to-side flat on the mattress. Hopefully this sideways motion is good for balance, in case those rumors are true about learning to walk with a cane.
Also there's one I never heard or read of before: pressing the back of the leg into the mattress so the back of the knee really pushes into the bed. This is supposed to help the--oh whichever muscle. Paying serious attention, I don't really feel what muscles are working, but they are.
The most impressive exercise so far was operating the wheelchair. I could feel it using those forearm muscles like brachioradialis (most interesting word I remember from anatomy.) There is no wheelchair at home. Might as well order some more long-sleeve tops. I'm many months from my next pushup.
In July, my injured spine had been pressing on the nerves to my legs, once causing so much pain that I went to the hospital by ambulance. Lying there, despite whatever pain pills they were giving me, I still had pain when I bent my right knee, moving my foot closer to my buns.
Right now they don't conside me helpless, even though I can't unsnarl the phone cord from the call buttons cord or from anything else.
So -- leg exercises. I definitely appreciate the one that builds strength in my thighs and allows moving the foot closer to my buns and then stretching the leg out again without much discomfort.
The worst thing about the exercises is realizing how easily I could have done them in June - how easily I could often have done them until just before the surgery. It's a long way back.
I learn to move the legs side-to-side flat on the mattress. Hopefully this sideways motion is good for balance, in case those rumors are true about learning to walk with a cane.
Also there's one I never heard or read of before: pressing the back of the leg into the mattress so the back of the knee really pushes into the bed. This is supposed to help the--oh whichever muscle. Paying serious attention, I don't really feel what muscles are working, but they are.
The most impressive exercise so far was operating the wheelchair. I could feel it using those forearm muscles like brachioradialis (most interesting word I remember from anatomy.) There is no wheelchair at home. Might as well order some more long-sleeve tops. I'm many months from my next pushup.
Saturday, November 10, 2012
SPINE FUSION - Occupational (and vehicular) Therapy
I've always thought occupational therapy would be teaching me to run a drill press, or just get the round pegs into any of the holes with injured fingers. Instead, the occupational therapists (OTs) are taking me seriously about living alone.
The shower in my room's bathroom has been studiously ignored by everyone. Now I'm in the wheelchair with a pink basin in my lap. I had learned about NO-rinse soap at the first hospital, due to the wonderful "shampoo cap." Now the basin contains some warm washcloths with no-rinse soap on them. I wash the top half, and get the sputum basin to brush my teeth. I'll wash the bottom half in the bathroom.
Attempts to do my flossing and brushing standing up have lasted less than five minutes. The therapist saved me from melting down onto the walker; she said five minutes is enough standing at first. I did the Barbie bend for the teeth brushing, of course.
And a nurse gave me this spray bottle to use as a sort of portable bidet. Of course, if I drop it, I'm out of luck since I don't bring The Grabber to the bathroom.
After lunch, a bit of clandestine vehicle-therapy. Someone has left my wheelchair unlocked! (I'm supposed to be able to use it as long as I don't get up when alone, but one lock is too tough for me. )I swivel the food/beside table out of my way. The area on the sides of the bed are too narrow for all the equipment in this room, but I am Highly Motivated. By backing up and practicing a bit, I get all the way around the bed, get some of my possessions off the wonderful wide window ledge.
Luckily my walker is on this side. Using it for balance, I'm out of the wheelchair and into the "guest chair." It seems to be upholstered concrete. But the excitement of freedom is wonderful--this is how my baby brother must have felt escaping from his crib at night and fixing crackers and milk in the dark. From now on I'm on the hunt for another wheel chair, though I know I won't need one at one. Probably.
Of course, I have to back the wheelchair out and around the bed to get back to the starting point with minimum damage to the wall. I'm too chicken to go into the hall for fear they will double surveillance in future.
Later the OT gives me a peek into the room where there are a few therapy items. There are some home-made stairs and a home-made "curb" for practicing. We practice getting into and out of the only furniture in the building where my feet reach the floor, a mushy sofa. I know I won't be allowed on the backless piano bench. I hate how hard it is just to get out of this sofa.
I've been here a few days before someone remembers the foot rests on the wheelchair can be raised so my feet don't turn blue, and to avoid some of the pain from the too-tall chair. So much for avoiding blood clots.
I plan how I really will manage in the shower at home, so I can sound ready to go. It has shower doors, and no grab bars. I had refused a shower stool in the other hospital because I hadn't seen it. Now I will have to buy one.
The shower in my room's bathroom has been studiously ignored by everyone. Now I'm in the wheelchair with a pink basin in my lap. I had learned about NO-rinse soap at the first hospital, due to the wonderful "shampoo cap." Now the basin contains some warm washcloths with no-rinse soap on them. I wash the top half, and get the sputum basin to brush my teeth. I'll wash the bottom half in the bathroom.
Attempts to do my flossing and brushing standing up have lasted less than five minutes. The therapist saved me from melting down onto the walker; she said five minutes is enough standing at first. I did the Barbie bend for the teeth brushing, of course.
And a nurse gave me this spray bottle to use as a sort of portable bidet. Of course, if I drop it, I'm out of luck since I don't bring The Grabber to the bathroom.
After lunch, a bit of clandestine vehicle-therapy. Someone has left my wheelchair unlocked! (I'm supposed to be able to use it as long as I don't get up when alone, but one lock is too tough for me. )I swivel the food/beside table out of my way. The area on the sides of the bed are too narrow for all the equipment in this room, but I am Highly Motivated. By backing up and practicing a bit, I get all the way around the bed, get some of my possessions off the wonderful wide window ledge.
Luckily my walker is on this side. Using it for balance, I'm out of the wheelchair and into the "guest chair." It seems to be upholstered concrete. But the excitement of freedom is wonderful--this is how my baby brother must have felt escaping from his crib at night and fixing crackers and milk in the dark. From now on I'm on the hunt for another wheel chair, though I know I won't need one at one. Probably.
Of course, I have to back the wheelchair out and around the bed to get back to the starting point with minimum damage to the wall. I'm too chicken to go into the hall for fear they will double surveillance in future.
Later the OT gives me a peek into the room where there are a few therapy items. There are some home-made stairs and a home-made "curb" for practicing. We practice getting into and out of the only furniture in the building where my feet reach the floor, a mushy sofa. I know I won't be allowed on the backless piano bench. I hate how hard it is just to get out of this sofa.
I've been here a few days before someone remembers the foot rests on the wheelchair can be raised so my feet don't turn blue, and to avoid some of the pain from the too-tall chair. So much for avoiding blood clots.
I plan how I really will manage in the shower at home, so I can sound ready to go. It has shower doors, and no grab bars. I had refused a shower stool in the other hospital because I hadn't seen it. Now I will have to buy one.
Thursday, November 8, 2012
SPINAL FUSION - REHAB Walk therapy
Yesterday
The admitting doctor comes in and announces that she's disappointed in me. The PTs from the day before have said I didn't work hard enough. I gave her a step-by-step recap of that day, including a detour into the group room to play a few notes standing at the piano, and walking farther than the PTs' goal.
Today: the complaining PTs have disappeared.
The brace, the dumb socks (my Clark's have been pronounced unsatisfactory) and the walker. We're out in the hall. I'm told that I walk with my feet too close together. (This gait is a lifelong habit, but I guess it is really dangerous for my rebuilt spine.) We also work on this. I work on my posture, and standing upright inside the walker-- breaking the habit of leaning slightly and pushing it. I tell them I need repeated posture reminders, since slouching was the norm in high school and I still slouch.
In the hall I see a woman seated in a wheelchair, quietly looking in front of her. Her head is held motionless in a tall wood frame. I realize I have a lot to be thankful for.
There is a wheelchair in my room, so I get to sit up and eat like a normal person. After last week of not eating, the food suddenly looks good.
The chair is locked, however, and I can't unlock the right lock without way too much pulling. (Pulling hard has been a no-no since the spine problem was first diagnosed over a year and a half ago.) So I'm trapped until someone comes, in the too-tall wheelchair that hurts the back of my thighs.
I can't reach my book, purse, phone. I experiment with pushing the wheeled eating table/bedside table to see if I can rotate it enough to reach at least my water. That actually works.
An occupational therapist is due. Maybe we will work on something besides putting on socks.
I haven't had a shower since the morning I reported for surgery.
The admitting doctor comes in and announces that she's disappointed in me. The PTs from the day before have said I didn't work hard enough. I gave her a step-by-step recap of that day, including a detour into the group room to play a few notes standing at the piano, and walking farther than the PTs' goal.
Today: the complaining PTs have disappeared.
The brace, the dumb socks (my Clark's have been pronounced unsatisfactory) and the walker. We're out in the hall. I'm told that I walk with my feet too close together. (This gait is a lifelong habit, but I guess it is really dangerous for my rebuilt spine.) We also work on this. I work on my posture, and standing upright inside the walker-- breaking the habit of leaning slightly and pushing it. I tell them I need repeated posture reminders, since slouching was the norm in high school and I still slouch.
In the hall I see a woman seated in a wheelchair, quietly looking in front of her. Her head is held motionless in a tall wood frame. I realize I have a lot to be thankful for.
There is a wheelchair in my room, so I get to sit up and eat like a normal person. After last week of not eating, the food suddenly looks good.
The chair is locked, however, and I can't unlock the right lock without way too much pulling. (Pulling hard has been a no-no since the spine problem was first diagnosed over a year and a half ago.) So I'm trapped until someone comes, in the too-tall wheelchair that hurts the back of my thighs.
I can't reach my book, purse, phone. I experiment with pushing the wheeled eating table/bedside table to see if I can rotate it enough to reach at least my water. That actually works.
An occupational therapist is due. Maybe we will work on something besides putting on socks.
I haven't had a shower since the morning I reported for surgery.
Wednesday, November 7, 2012
SPINE FUSION Defining rehab terms
Since there is so much rehab lingo and more abbreviations than an ad for government technical writer, I really need to clear some things up:
Lumbar spine - near your waist (I'm sure there is a more exact description) but I'm giving you what some medical types use in conversations. And of course I can't see back there.
BLT - you will not find this item on hospital menus. It's about what we fusion types are not allowed to do, especially lumbar patients:
B is for bending (a definite no-no) and B is for Barbie. In an emergency, lumbar problems patients can do what I am going to call the Barbie and Ken bend--from the hip and only from the hip, not the waist. Since I'm no longer 29 or even ... never mind) squatting instead of bending to pick up things is rarely an option. It took what seemed like a half hour to pick up a large grape off the kitchen floor so I wouldn't slip on it and break my neck.)
What causes bending? For instance, our overpriced cell phone/robot slips out of our fingers or pocket and heads for that stream of mystery liquid beside the curb--we BEND with lightening speed, by reflex, to save it and our entire communications life. This reflex has been in our DNA since the first caveman had a red-hot spear point fall out of the fire and hit his foot. We can't help bending. But now we must not bend.
L is for lifting. Picking up anything heavier than your thermos bottle, well actually anything more than 5 pounds for post-op patients, is not allowed. My laptop weighs 5 1/2 pounds. (Never mind how I found out.) I want to go back to work. Between no bending and no lifting, even a file clerk job is out of the question. As for corporate work, the million-string black brace is very hard to hide under a white shirt. Have you ever seen someone try to lift a walker onto the bus?
T Twisting is perhaps the worst mistake. No, they're all the worst. But what are you going to do when you're in Priscilla's Gourmet Coffee shop (having arrived there without climbing onto a bus) and you know positively that the voice from the table behind you is definitely George Clooney. (Ok. We both know George doesn't go there for fear of being trampled. This is just an example. Work with me.)
We hear George and our brain flips our upper torso around for a quick peek. The only way I can think of to avoid this is to sit with my back firmly against the wall so no famous people can get behind me. Must remember Barbie doesn't twist, either. And you can forget fund-raiser dances because somebody will grab you to demonstrate a so-called dance step, and you're back in rehab.
If this little bloginar was of no help, I hope it at least made you smile.
Lumbar spine - near your waist (I'm sure there is a more exact description) but I'm giving you what some medical types use in conversations. And of course I can't see back there.
BLT - you will not find this item on hospital menus. It's about what we fusion types are not allowed to do, especially lumbar patients:
B is for bending (a definite no-no) and B is for Barbie. In an emergency, lumbar problems patients can do what I am going to call the Barbie and Ken bend--from the hip and only from the hip, not the waist. Since I'm no longer 29 or even ... never mind) squatting instead of bending to pick up things is rarely an option. It took what seemed like a half hour to pick up a large grape off the kitchen floor so I wouldn't slip on it and break my neck.)
What causes bending? For instance, our overpriced cell phone/robot slips out of our fingers or pocket and heads for that stream of mystery liquid beside the curb--we BEND with lightening speed, by reflex, to save it and our entire communications life. This reflex has been in our DNA since the first caveman had a red-hot spear point fall out of the fire and hit his foot. We can't help bending. But now we must not bend.
L is for lifting. Picking up anything heavier than your thermos bottle, well actually anything more than 5 pounds for post-op patients, is not allowed. My laptop weighs 5 1/2 pounds. (Never mind how I found out.) I want to go back to work. Between no bending and no lifting, even a file clerk job is out of the question. As for corporate work, the million-string black brace is very hard to hide under a white shirt. Have you ever seen someone try to lift a walker onto the bus?
T Twisting is perhaps the worst mistake. No, they're all the worst. But what are you going to do when you're in Priscilla's Gourmet Coffee shop (having arrived there without climbing onto a bus) and you know positively that the voice from the table behind you is definitely George Clooney. (Ok. We both know George doesn't go there for fear of being trampled. This is just an example. Work with me.)
We hear George and our brain flips our upper torso around for a quick peek. The only way I can think of to avoid this is to sit with my back firmly against the wall so no famous people can get behind me. Must remember Barbie doesn't twist, either. And you can forget fund-raiser dances because somebody will grab you to demonstrate a so-called dance step, and you're back in rehab.
If this little bloginar was of no help, I hope it at least made you smile.
Monday, November 5, 2012
SPINE FUSION - Actual rehab begins
Practice new method of getting out of bed: shoulders and pelvis must move in the same plane - no twisting. Ever. Funny non-skid socks. And we go out in the hall to walk.
I still have a mental picture of physical therapy in the movies. Remember to be grateful that I'm not as damaged as in the movies. I also miss the machines that my physical therapist (PT) had me use many months ago, after the first diagnosis. I guess I'm not even strong enough for them yet.
There is a "seat belt" physical therapists use over my brace, just around the waist, so they can grab me if I fall, even though I use the walker.
Walking doesn't seem like rehab to me until I remember the pain in July and more recently, before the X-rays, especially in my right leg. Those leg nerves have to heal. The two PTs go with me. They seem to hover, pat my shoulder, give me a lot of encouragement with each step. What I really need is reminders to stand straight, hold my stomach in, shoulders back. I'm not used to someone talking at me.
Too soon, we're back in my room. I'm tired. Remove brace, fasten it on the walker. Every time I meet a new pt or nurse, I have to explain that basically, I live alone, and if the brace falls on the floor at home, there is no one to pick it up. Back to bed.
I manage to get someone to give me my book and put my water where I can get it. I want my purse in the bed, since it is the only safe place for my cell phone--feels like my survival machine.
I still have a mental picture of physical therapy in the movies. Remember to be grateful that I'm not as damaged as in the movies. I also miss the machines that my physical therapist (PT) had me use many months ago, after the first diagnosis. I guess I'm not even strong enough for them yet.
There is a "seat belt" physical therapists use over my brace, just around the waist, so they can grab me if I fall, even though I use the walker.
Walking doesn't seem like rehab to me until I remember the pain in July and more recently, before the X-rays, especially in my right leg. Those leg nerves have to heal. The two PTs go with me. They seem to hover, pat my shoulder, give me a lot of encouragement with each step. What I really need is reminders to stand straight, hold my stomach in, shoulders back. I'm not used to someone talking at me.
Too soon, we're back in my room. I'm tired. Remove brace, fasten it on the walker. Every time I meet a new pt or nurse, I have to explain that basically, I live alone, and if the brace falls on the floor at home, there is no one to pick it up. Back to bed.
I manage to get someone to give me my book and put my water where I can get it. I want my purse in the bed, since it is the only safe place for my cell phone--feels like my survival machine.
Subscribe to:
Posts (Atom)