October 1, 2012

Physical Rehabilitation

As frustrating and slow as the physical rehab process has been, it has actually been quite fascinating.  I wish I could say that the process is over, but it's not.  It's still very much a daily challenge .
 
As mentioned before, the day after surgery Jared couldn't as much as squeeze my hand.  People would come in from the rehab unit of the hospital to work with him a couple times a day for a few minutes.  But to be honest, they did most of the work.  But we could see slight improvement every day.  By the second day, he could squeeze my hand, but he couldn't release it.  But we were so happy!  At least it was something!  The workers did a lot of stretching.  They told us that stretching was very important so he wouldn't lose his range of motion.  I wasn't very good at stretching him.  He usually got mad that I was doing it wrong or that I wasn't strong enough to where he could feel it.  So I started to leave that job to his siblings!  (Even now it's a problem!)
 
The major progress didn't begin until he got to the rehab center a week after surgery.  At the facility, he was now in full-time rehab.  I was always excited to see the progress for the day!  It was little minor things that were such break-throughs and kept him going.  He clearly remembers sitting in his hospital bed and trying to move each individual finger.  He would stare at his fingers and concentrate.  Finally he was able to move his thumb, then his index finger, then eventually the other fingers came.  He was so excited!  That was about 9 days after surgery.  Another breakthrough was about 11 days after surgery.  He usually had to use his left arm to place his right arm on his lap.  Again, he focused really hard and after a couple minutes, he was able to lift his right arm onto his lap without the help from the left arm.  These small things gave him hope and kept him going.  He did little exercises during the day.  One he remembers is sitting at a table and they placed a tiny skateboard on the table.  His job was to place his hand on the skateboard and move it outwards (working his range of motion to the side).  He said it felt like it weighed 300 lbs. and he couldn't do it.  He would get so frustrated!
 
One thing that I watched that was fascinating is how they would tell him to do an exercise like a calf-raise.  One worker would help him stand while the other would continually tap his calf muscle to try to "wake up" the nerve or muscle.  And many times it worked!  They would also use an electric massager to try to stimulate a nerve or muscle.
 
He was excited to show us the new things he had learned.  Eventually he was able to get himself out of bed and into his wheelchair by himself.  I think the ultimate goal at the rehab center was to get him walking before they would send him home. 
 
I would dare say those first couple weeks were the most humbling, humiliating weeks of his life.  He needed help with pretty much everything - from going to the bathroom to getting dressed.
 
When he got home he started making rapid progress.  He came home with a cane (and actually a wheelchair, but never used it).  Within a day or two he was walking up and down the stairs, very carefully.  He started using an exercise bike and lifting weights and was also starting to get his strength back.  He was making such rapid progress that I was just sure he'd be back to his old lifestyle within a few months!
 
The radiation treatments, infection, and blood clot set the rehab process back dramatically.  It was really frustrating for him to digress.  And he would try to work on it, but it seemed like something always held him back!  I remember getting mad at him pretty much every night around March-April because he would work all day, then once the kids would go to bed he would start to rehab but he wouldn't stop!  It would be midnight and he'd still have a weight ball in his hand swinging it around!  I was just worried he was going to kill himself over from exhaustion and lack of sleep!  He would just say that it was addicting and he was feeling himself get stronger. 


This just might be my very favorite
picture ever. Drew liked to do the
rehab exercises with his dad.

Once he made the commitment to go full force and get completely off the steroids, he once again felt so horrible that his rehab digressed again.  But he knew that unless he had the steroids out of his system, he'd never fully recover.  So by July, he was still pretty wobbly and had little strength.
 
FINALLY, NOW, a year later, he is back at the gym, he is starting to see improvement in his coordination, his balance is quite a bit better, but we still have much to do.  And it's weird to find out the things that are actually a re-learning issue and not an inability issue.  For example, about a week ago we for some reason decided to focus on the way he turns around.  I knew he did it wrong, but I thought he was just unable to do it right.  But it turns out he had just forgotten how to turn.  So I showed him how I put my weight on the ball of my foot and pivoted.  And within a few minutes of practicing and watching, he looked a million times better!
 
His first attempt to run made us both laugh.  It was pretty sad!  But he is starting to run faster.  I raced him about a month ago.  I ran down and back, and he just had to run back, and I still beat him.  Tonight we raced up a hill with no head-start and we tied.  From the waist down his running looks normal.  From the waist up, he swings his left arm and his right arm doesn't move much.  So there is work to do, but continual improvement. 
 
The only thing he still doesn't have is side-to-side movement in his ankle.  We have worked to try to get it back, but not much progress.  So this may be a permanent loss, but we will continue to work on it.