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Archive for April, 2009

Bob & I brought pizza in to the lab an hour early as a thank you. Mmmm…Mellow Mushroom pizza!

I brought up my concerns from yesterday, but the lead therapist didn’t catch the clue so I said straight out – ‘what you said is offensive’ and then she got it. While she put it off to ‘a poor choice of words’ I think she understood the issue.

Hour 1 – back on the treadmill. Surprisingly, the top harness was a little too loose and had to be tightened up before the jog. 20 minutes at 3.2 mph. 2 min at 4.4 mph. Rest. 1 min at 4.6!! Rest. 1 min at 4.6!! Rest. Finish strong with 1.5 min at 4.6!! I really pushed at the end. I aim to finish as strong as I started and boy howdy did I! I feel great about it. There were other therapists that balanced out the lead and really gave me encouragement. The last push was celebrated by having me ‘run through’ a finish line (they wrote Finish Line on toilet paper and broke it across my chest). I felt strong and awesome.

Hour 2 – outside, walking forward in bumpy grass. Walking backward same area. Walking side to side same area. Fast walking around an obstacle course with a ball thrown to me for me to throw back (distraction). Leg strengthening by having one foot on a curb and slowly lowering opposite foot to ground – 2x each leg. Bench (6″) work with me stepping up and down, then stepping up and over, then stepping backward. Tough stuff!

Hour 3 – inside, balance ball work – throwing a ball to someone and someone else giving the ball I was sitting on perturbation (nudging it randomly). Crunches on the balance ball. Wii fit exercises – yoga balancing – Half Moon pose, Warrior pose, Standing on one leg and bringing the opposite leg in pose. Theraband exercises – Plantarflexion, Dorsiflexion, Eversion, Inversion.

What a great finish for this program. I feel really good about it and would recommend it to any stroker as it is customized and the benefits are incredible.

As I am leaving the program, there is a double stroker coming in – he had a hemorrhagic stroke to his brain stem and 4 months later an ischemic stroke to the right sphere. I predict he will be able to walk without his walker by the end. (he is a year out from his last stroke)

I noticed that as new strokers (I count anyone under 2 years), there is a huge need to tell your story. I remember that well. I no longer have that urge, thankfully although it is still my favorite topic to discuss, probably because I am so well-versed!

I am so excited to get back home and into a comfortable bed and familiar surroundings.

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How odd – 1/2 of me is really, really, really excited that this is almost done and 1/2 wishes this could continue because I see and feel the benefits.

Today, I was assigned someone who I had on Day 2 – when I was really frustrated and almost walked out. I don’t know what it is about her – I like her but I constantly fight with her in my head. I couldn’t put my finger on it until today.

#1 – she told me that she is having me do some stuff because “strokers don’t want to do it” which made my red flag peak. She thinks that we just ‘don’t want to do stuff’. I was honestly struck speechless. I think she treats me as though I simply just haven’t wanted to do stuff rather than reality which is that no one has been able to help me a) identify the issue and b) create a program that addresses it appropriately.

#2 – she really likes to analyze and point out all the deficits. One at a time is doable, having each and every deficit told without some type of success is not only exhausting mentally and a blow to the ego, it is counterproductive and defeating.

Okay, enough with that – clearly I survived today (although nothing of much interest happened so I will keep it brief).

Hour 1 – strap on and strap in. 3.2 mph for 20 minutes. A 2 minute burst of 4.4 mph for a jog. Reprieve. Another 2 min at 4.4. After that one, I felt lightheaded so they loosened the chest harness so that I could breathe easier. Whew! A 3rd session of 2 min at 4.4. 10 minutes at 3.2 walking speed. As a finale, 5 minutes at 3.8 so that it is a really fast walk. The primary person stepped behind me to keep me on the treadmill but she often held my hips so that walking was difficult (try to walk without moving your hips!). And – Done.

Hour 2 – hallway walking because my ‘push-off’ is weak – the point where the toes push off to propel the foot forward in the walk. Then, outside for some bench work – as quickly as possible, touching my toes to the bench (6″) one at a time. My leg is pretty good, but my ankle is stiff and terrible. Then the rope ladder is laid out and I need to high step into each ‘box’, then quicker, then backwards, then sideways, then quicker. At the stairs, she said “you’re getting a little better” & I said “you sure are stingy with your compliments!” So, she got silly and told me how I have improved tons and tons and tons. I like her, don’t get me wrong. I just don’t think PT is really for her if she can’t work up some empathy and/or understanding for the patients.

Hour 3 – inside. Balance work with my feet touching each other and having a basketball thrown at me for me to catch and throw back. Then the same with a medicine ball with feet in a semi-tandem stance (one foot in front of the other so that they are just barely not touching and the front hee’ul is just a little offset from the back toe). Same thing in a tandem stance (hee’ul toe). Same thing in a lunge. Then tandem walking while swinging the medicine ball from side to side to challenge the balance.

Done.

I’m sorry that this is a grumpy post. I’m even posting this 2 hours later & I’m bugged by today’s session.

~sigh~ Tomorrow’s the last day, so there’s that, right?

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The home stretch!

Hour 1 – the usual, strap in the harness, tether to the treadmill. 20 min of 3.2 mph. 10 min at 12% incline (whew!). 10 min at 10% decline (a little scary, in my opinion). 3 sets of 2 minute jogging intervals without assistance. 1 set of fast walking without assistance and focus on hee’ul strike. At one point during the jog, I have 1 person saying ‘hee’ul, hee’ul, hee’ul’ to remind me to focus on the heel strike. Then there is another person saying ‘remember to swing your arm’ – it got too crazy and I finally said ‘pick one because I can’t do both’ & they said heel strike. I can focus until one is second nature but I can’t focus on both easily.

Hour 2 – inside, step aerobics practice. Fun but weird since everyone is just watching one person step up, down, & all around and it is tiring!

Hour 3 – balance practice on the balance ball. Good balance practice. Then on to the Wii fit. I think we might get one of these. I tried to soccer ball one that makes you lean from side to side to either hit the ball with your head *OR* avoid cleats and panda heads(!!). I also did the slalom one where you have to lean to make it through the flags – toughie! Then we finished up with the yoga Wii exercises doing Warrier Pose and Half Moon. I scored pretty well with these & was proud given the effort I put in.

I was talking to Bob before the session and realizing how these sessions are bringing back some hard memories. I had bad PT experiences for the first year or so. I had therapists ask me to do things that were not correct such as doing a squat keeping the back completely perpendicular to the ground. This hyperextends the knee and is incorrect (the correct position is to stick your butt out as though you are sitting in a chair and squat down keeping your knees above the foot and not to extend beyond the toes). And, really, PT sessions are tough on the ego anyway – pounding in what I can’t do. I realize that I am improving and PT is the reason for it, it is just difficult to realize what I can’t do now that I used to be able to do BS (before stroke). It seems as though every time I accept that I will have to work on one thing, another is pointed out.

I realize how pitiful that sounds. I’m okay with that. It’s simply tough to have these things in your face A LOT.

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I was sore all weekend – hamstrings, quadriceps, abductors, adductors, calf – you name it, it was sore! Trying to stand and sit was probably amusing to watch – it was gingerly up and down with a lot of upper body grasping to help.

My muscles were finally all happy, relaxed, and groovy & they forgot about the return to torture today!

Hour 1 – the usual. Harness on, tethered to treadmill, walking at 2.5 mph to start and 3.2 for a good pace. The usual now includes 2 minute intervals of jogging. The upper harness is really tight so 2 min is about all I can do for the amount of oxygen I am able to exchange. I went through the first jogging interval without assistance, the second one included a PT trying to correct my foot for eversion, supination, and heel strike (fixing so my foot doesn’t point out and land on the outside – getting it to have first contact with heel which is normal). That is tough, tough work. To have someone attach themselves to your foot while you are trying to jog adds workload, distraction, and increases the right foot’s tendency to compensate for what the left foot is going through. Out of 4 intervals of 2 min jogging, left foot assistance 3 times. Whew! I was sweaty!

Hour 2 – outside. Throwing balls between 3 people with me in the middle and 2 people throwing to me alternatingly (I know, that isn’t a word, but I don’t want to reconstruct the sentence, sue me). Throwing a frisbee so that I have to reach and try to ‘rush’ to the ball. I put rush in quotes because I can’t really rush too much, when I am trying to rush or when I am anxious, I get a lot of tone in my whole left side (arm included). They tried to make me rush anyway but I think that is a long-term project, not a short-term possibility.

Hour 3 – still outside, on the gravel, tandem (hee’ul toe) walking forward, then backward, then backward with my eyes closed, then forward with my eyes closed. Walking up a very steep hill (dirt, clumps of grass, and some landscape netting) and walking back down 6 round trips. Go inside for some big ball balancing – sitting lifting one leg while balancing for 15 seconds, then other leg for 3 times each leg. Laying back on the ball and lifting one leg for 20 seconds, 3 times each leg. Crunches on the ball – 3 sets of 10 reps each.

I’m not nearly as exhausted as last Friday or Thursday, but I definitely feel as though I got a workout.

On a side note – there are other improvements that I have noticed. I feel mentally healthier. Whether it is because I am improving or because I am being challenged in a different way, I don’t know. But I like it. I feel like I have more confidence and I feel as though things are possible now. Before this, I felt as though little things either wore me out or I just didn’t feel as though they were even possible (e.g., making a quick trip into the apartment or store).

This makes me a better person – for myself and to be around. I will definitely think about ways to maintain this when we get back home.

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After the demanding Day 5, I was feeling a little weak on Day 6 but ready to go!

Hour 1 – the usual. Harness securely up my butt, and desperately squeezing my hips and ribs together. On the treadmill. No assistance whatsoever. This thrills me and makes me curious. How has my foot learned so quickly? I’m sure that the procedure of strapping into the harness and getting onto the treadmill has conditioned my foot how to behave so I asked the PI (primary investigator of the research project) how they measured transfer of training (what measures are being used to ensure that the treadmill training will take once the harness is removed and I am ‘in the real world’ so to speak). There is a long mat (12′) that I walked across for the pre-test measure that will test this. Anyway, back to the treadmill. No foot or hip assist. 25 minutes of walking at a good clip (3 miles/hour). I have a firecracker for a primary PT on Day 6 (there is a different one every day) so she pushes me as asks if I am ready to jog. What the heck, right? So, with someone standing behind me, just in case and lifting the harness by taking 30% of my body weight (atomic wedgie once again!!), she cranked up the speed to 4.5 miles/hour. I’m still supinating and everting so they encourage me to lengthen my stride so that a heel strike is more possible. I try and try but get worn out pretty quickly. At 2 min into the jog, I ask for it to be slowed. Speed is reduced to 2.5 miles/hour and I get a breather. I know that I’m not in the physical condition that I used to be but I feel pretty ridiculous for quitting so early. We do this 3 more times at 2 min per jogging session. Then, THEN I realize why I poop out so early – the harness is squeezing my lungs and makes me breathe very shallowly so I’m not getting to breathe deeply when jogging. I feel like less of a fool then.

Hour 2 – stayed inside (stinking hot out). Focused on strength training back to back. On hamstrings (lunges) and calves (s-l-o-w-l-y raising and lowering on tip toes). The calves workout involved me holding onto a shiny silver pole on the stairs while slowly raising into a tiptoe and every so slowly lowering into a stretch. I jokingly said that the pole reminded me of my college days there was a shocked gasp or two and a few giggles which is what I was going for.

Okay, so also did a silly ‘carpet roller blading’ thing that was really hard – strapped slick plastic to my feet, while keeping in full contact with the floor, take long strides without a) falling over or b) losing contact with the floor. Someone has a grip on me from behind and someone in front at all times so that I don’t fall over.

Hour 3 – inside. Balancing – while standing on a big inflated half ball thingy (sorry for my loose terms, I don’t know the technical terms for these things), one person throws a ball on my left side. When I throw it back, I count and another person throws a ball to me on my right side, I throw it back and then the left one throws – on and on. Combining balance with distraction and some cognitive activities. Whew! Well, we can’t leave that as it is, so we make it harder! One foot on one inflated disk and the other foot on a different inflated disk – the same activity repeated. This one is tougher because the unaffected leg can’t help stabilize the affected leg like on the one big inflated half ball thingy. I count up to 22 without dropping a ball. I’m very proud of myself. Then, sitting on a big yoga/pilates exercise ball, perturbation from behind (random tapping to try to make me fall over but making me balance) with another person hitting a balloon to me & I am to hit it back and count. Good core exercise!!

4:00 and we jet the heck out of there! I met a good friend of mine that I haven’t seen in at least 5 years. On the way there, I almost puke in the car. We had to pull over so that I could gather myself. I only had a salad for lunch in preparation for the dinner I planned to have. Well, I didn’t have enough carbs or calories to handle the 3 hour workout I just had so we stop to get some baked chips. My stomach is settled so we meet up with my friend and we go out for good food and maybe a glass of wine and a couple of beers (liqueur before beer and all). I fell into bed at 10:30 but still can’t just oh-so-easily fall asleep. Asleep around 12:00 or so. I still need plenty of sleep for my brain to retain and make all of the connections we are throwing at it so I slept until 9 am. Looking forward to the weekend and 2 day break. My legs are killing me today – standing and sitting are painful.

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Okay, people, Day 5 has arrived

Deep breath – halfway through after today!

I had a terrible time sleeping last night so I was a little concerned today. Bob woke up at 1:30 am and was futzing around so I thought it was time to get up. Nope, he told me – only 1:30 am, go back to sleep. It took me over 2 hours to go back to sleep. Yuck. I remember thinking ‘not much time has passed so I’ll just peek at the clock – 3:30 am, drat!’ I think I convinced myself to relax and finally go back to sleep shortly after peeking at the clock.

Hour 1 – treadmill with no help at all with foot or hip. Did you read that right? You sure did! NO HELP!! So 20 min forward at varying speed. 20 min on decline combined with ball toss to distract me to see if it is a fluke that I am concentrating so hard or if it is really taking. 20 minutes really slow with really steep incline and obstacles (pool noodles in my path). Then…THEN – flat with speed ramped up so that I started jogging. Seriously – jogging!!! I actually got an ovation I was a bit disappointed that I couldn’t replicate the heel strike that I had gotten so good at but I DID IT!! I got pretty darn sweaty too.

Hour 2 – outside for some work on a low bench (~6″ height). Quickly putting toes on bench and switching feet up, standing on the bench while s-l-o-w-l-y lowering one leg until the heel hit the ground (2x each side), then batting around a birdie with rackets, riding a scooter (working on balance and heel strike).

Hour 3 – inside. Balance ball work – sitting on the ball lifting one leg and holding for 30 seconds. 2x each leg. Rolling down on ball so that hips and upper back is on the ball, lifting one leg and holding for 20 seconds. 2x each leg. Sitting on balance ball and holding 3 lb weight in hands with arms straight in front of me out for 1 min. 4 times. Using exercise bike training foot to dorsiflex while on pedal.

Although Day 4 was mentally exhausting – today was physically draining. But I did it!!

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Holy moly – today exhausted me to the point where I actually had to take a nap & I am not a napper. Although, I slept terribly last night too…

Hour 1 – the treadmill. Reduced weight lifted on harness to 5% (that means I have 95% of my body weight), walked with minimal assistance on foot and hardly any hip work at all for 20 min. Turned around and walked on decline for 20 min. Turned back around and walked on incline at a good clip for 20 minutes. 10 minutes of ‘obstacles’ – one person on right and one on left with pool noodles. Every so often one would get placed in the path of the corresponding foot & I was to step over it without a) losing balance, b) pronating (rolling foot to the outside), or c) everting (walking like a duck [opposite of inverting which is pigeontoed]).

Hour 2 – outside. On the grass: Grapevines to the left for 30 feet (feet shoulder width, cross left leg behind right, step right leg out, cross left leg in front of right) and grapevines to the right for 30 feet. Side squats (step to the left, squat, feet together, another step to the left, squat) to the left for 60 feet, side squats to the right for 60 feet. On the gravel: tandem walking forward (hee’ul toe) 20 feet, tandem walking backward 20 feet. Stair work walking one step at a time heel strikes up 2 flights, walking one step at a time heel strikes down 2 flights.

Hour 3 – inside. Wii fit balancing for 15 minutes. Lunges on a air filled oval ball thingy with left foot on ball, lunges with right foot on ball. Theraband working dorsiflex, evert, invert, and plantarflex. Walking on tiptoes down 2 halls, walking on heels down 1 hall.

We stopped by a drugstore and Bob bought a sphygmomameter (sp – blood pressure machine) because his blood pressure drops at night making his hands tingle. I hope it is nothing – we don’t need 2 health concerns in such a short time frame.

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