Thursday, February 6, 2014

Rehab Redux

“Remember, don’t put any weight on the surgical site.”
With that reminder, I got the green light to return to my local hospital’s rehabilitation unit, the last stop before I could go home. As it was explained to me, I needed a couple weeks of physical and occupational therapy before I would be ready to safely take care of myself outside the hospital setting. During those weeks, my friends and family would make changes around the house to prepare for my return. I was well aware that my ninety-year-old Craftsman-style home was fine for a healthy and energetic gal with all her limbs, but it was no place for a weak and spliced-together woman with one leg.  I was worried about the number of changes that had to be made in such a short amount of time.
I decided to trust that it would all work out and focus on how excited I was at the prospect of being in my own home again. It was the stuff of my fantasies. For months, I had imagined in great detail how I’d prepare dinner for my kids again, write in front of the fireplace again, and sip tea with Arleen on the porch again. It blew my mind that the only thing standing between me and my dream was a couple of weeks of rehabilitation.  I planned to make the most of it, and return home ready to rock this new life of mine.
I said goodbye to all the incredible people at University of Maryland Medical Center’s Shock Trauma Unit. I got hugs from some of the nurses, aides, Reiki practitioners, and even my favorite surgical resident, who made a special trip to my room just to say goodbye. I got strapped onto a stretcher. Clutching a large plastic bag full of my personal belongings, I was rolled down a maze of hallways and tunnels until we eventually reached a set of automatic double doors. The medical transport technician tapped his palm against the push plate and the doors unfurled.
I was out!
The shock of the cold February air made me gasp. How blissfully different it was from the recycled, stale, and faintly metallic air of shock trauma. This was real air. Cold air in my lungs! Honest-to-God natural air created naturally by the natural laws of nature!
Since this is downtown Baltimore I’m getting all giddy about, I’ll move on, but really, I can’t even describe what a thrill it was to be somewhere other than the beeping, chiming, and sunless closet that had been my reality for so long.
I was once again a citizen of the world.
For the hour and a half it took to drive to my hometown, I stared in awe out the back windows of the ambulance. I noticed how the broken lines on the highway sparkled with sunlight, how the dome of the sky stretched out like a sheet of blue-tinted glass, and how the skeletal fingers of winter trees reached toward the heavens. As you might surmise from that bit of descriptive prose, hardcore narcotics enhanced the entertainment value of the road trip. And yet, every pothole and bump made my eyes water. There’s a limit to what meds can do for a patient who’s been ravaged by killer bacteria, had her leg chopped off, and then received a graft using flesh peeled from her healthy thigh, I suppose, but now that I was out of my familiar surroundings, I began to see how bad the pain really was. Everything below my hips throbbed, ached, stabbed, burned, or buzzed. Bolts of fire would slice through me at odd intervals. And I got to thinking . . . I’m supposed to ramp up the physical and occupational therapy now? With all this pain? Are they kidding?
But then I remembered. I wanted my life back. I would not spend the rest of my days in a wheelchair. So as much as I wanted to pull an Amy Winehouse and say “no, no, no” to rehab, I knew in my heart I would do whatever it took.
I was exhausted after the trip but happy to be back in my town’s lovely new hospital. I was assigned the same room I’d had before, directly across the hall from the nursing desk. The staff seemed genuinely pleased to see me again, and some of the nurses hugged me and told me I looked wonderful.
Remember the sweet night nurse from my first go-around, the one who didn’t know how to bandage my open wound? She was back, all smiles, squeezing my hand and saying, “You are one tough cookie.” In the coming days, I would hold onto her words like a life raft. I would remind myself she was right – I was tough, determined, strong, and I was up to this challenge.
Therapy began immediately. I had three sessions a day, usually two turns in the gym and one with my occupational therapist. I had the familiar problem with my bandages – they kept falling off – until nurses rigged a system that wrapped around my surgical site, supported the remaining thigh, and closed around my waist with Velcro tabs. The accessory was attractive and partially effective!
My first challenge was two-fold: I needed to transfer from the bed to my wheelchair without assistance and travel under my own power. The process was more involved than it might sound. First, I had to sit on the edge of the bed, make sure the chair was locked, test the slip-proof bottom of my hospital sock, and then pull myself to a stand on my remaining leg. While balanced like that, I transferred my hands from the bed rail to the arm of the wheelchair, then pivoted and sat down. It hurt like hell to move around so much, but the maneuver was far from over. I still needed to cushion my amputation site with pillows (remember that warning about putting any weight on it) and arrange my sliced-up thigh so that it didn’t get jostled.
I admit that by this point I had become quite immodest. The only thing that mattered to me was that NOTHING touched either of those places, and if that meant I had to ride around wearing a T-shirt and a diaper-like arrangement of a bed sheet, then so be it. People would have to deal.
So there I was, a middle-aged, one-legged exhibitionist trying to wheel myself around the third floor. I barely made it fifty feet down the hallway on my first attempt, but with each subsequent trip I added a few more feet. Eventually I got myself all the way to the gym without help, and after a few days I was wheeling around the rehab floor, looking out windows, watching people get off the elevators, and whizzing by offices where people would look up, smile, and sometimes wave. I’m dead serious when I say I couldn’t remember the last time I’d had that much fun, diaper or no diaper.
Occupational therapy consisted of me relearning how to perform basic self-care with my new reality of one leg and reduced strength. Once I could show the therapist I was capable of brushing my teeth, giving myself a sponge bath, combing my hair, and putting on a clean T-shirt – all while in my hospital bed – I was ready for bigger and better things. The day came that I got to venture into the bathroom. It had been close to three months since I’d experienced the civilized joys of indoor plumbing – can you imagine? I was so overwhelmed by the normalcy of it that I cried. I felt human. Later that afternoon I made several phone calls to share my big news. And I knew that one day soon I would be allowed to take a shower, and my return to personhood would be complete.
Next door to the physical therapy gym was a mock-up of an apartment, where I would learn how to perform housekeeping tasks from my wheelchair or balancing on my good leg. I practiced opening and closing the door. I also learned how to set the table, load the dishwasher, and pour uncooked rice into a pot. (Everything I would need to host a fabulous post-hospital dinner party!) But I’ll never forget my very first occupational therapy session, and neither will the poor therapist.
It was about seven A.M., and I’d been sipping on a cold ginger ale but hadn’t eaten breakfast. I began to feel slightly nauseous just as the young male therapist came to fetch me, smiling as he read from the checklist on his clipboard. We arrived at the apartment and he began showing me around, asking me questions about the layout of my kitchen at home. That’s when I suddenly lurched forward and barfed in the sink. I then grabbed the dishtowel from the hook, ran it under cold water, and pressed it to my face. He looked puzzled – I don’t think puking in the kitchen sink was on his checklist.
My physical therapy sessions varied. I did a lot of stretches and leg lifts while lying on my stomach, careful not to put any pressure on my amputation site. These exercises kept my hip joints flexible and increased my muscle strength – things I would one day need to operate a prosthetic leg. I lifted two-pound barbells, worked with resistance bands, and rode a stationary hand cycle. The first time I tried the bike, I was spent within five minutes. It shocked me, considering how I used to put in an hour on the elliptical trainer like was nothing. Now I could barely do five minutes of slow and plodding movements of my arms. I gained strength quickly, though, and within a week I was up to about fifteen minutes on the hand cycle.
     Physical therapy was exhausting and it made the pain worse, but I was willing to do anything if it meant I could go home. I continued along, trying to remain cheerful, trying to smile, trying to keep my eye on the prize.
Then came the day I met the physical therapy stairs. This wooden box-shaped structure featured three steps covered in non-slip treads, a handrail, and a small platform landing. It looked like such an innocent contraption, but that thing would become a ruthless teacher. It would cut through my warm and fuzzy optimism to reveal the terrifying truth.
Those steps would introduce me to the enemy.

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