A day in the LIfe - Rehab by the Numbers - Part ten

Continues...

With more discernible improvements the opportunity arose for ‘day leave’ and, eventually, ‘weekend leave’.  This was an exciting if somewhat daunting prospect.  We had to pass a ‘car management’ exercise to gain approval for leave.  I was reminded to an extent of boarding school strictures around personal leave.  All in all, it was worth a sense of disempowerment around leave protocols to get Carolie out of the place.   

I was reminded of limited release afforded prisoners as they approach the end of a jail sentence.  We took advantage of this immediately it was offered.  After demonstrating to a ward physiotherapist the correct technique for managing a wheelchair transfer via car we were able to have our first outing at a lunch with some old friends visiting from Sydney.  The sense of freedom for Carolie was palpable.  She coped remarkably well with her new chariot, and greatly enjoyed a lunch with friends.  The little things of life become hugely significant when your are denied them.

Carolie:  

Gradually I was becoming more and more confident and adept at using my upper limbs.  Soon I discovered that some of my fellow patients were visiting the hospital’s cafeteria, called “The ‘Hoz’” I mentioned this to Mark and we discussed the possibility of going so that I could have a more varied diet.  One day Mark came with a wonderful surprise, we were going out for lunch to “’The Hoz’”. What pure joy to have fish and chips to eat, at last!  It was so delicious. I enjoyed being surrounded by normal people in the cafeteria setting.   

During this time Mark was given lessons by the occupational therapists in dismantling the wheel chair so that it could be put into the car. I went with them out to the side walk outside the hospital, not far from the ward.  I had to stand and then slide into the car seat by putting my right leg out first. I managed this successfully, the first time I tried.  

Once we had achieved success, I was ready for going out. At one time some dear friends came to Canberra and discussed going out to lunch. I chose the Hyatt Hotel as a favourite spot.  I knew that it had wheel chair access, through the back entrance. So a date was agreed and Mark picked me up. We managed the wheel chair without any difficulty and I was thrilled to be out, especially in the elegant art deco environment of Canberra’s Hyatt Hotel. It was a delightful meal and such a treat for me to be out of the hospital, socializing with Mark and dear friends.

To be continued...

A Day in the LIfe - Rehab by the Numbers - Part nine

Continues...

Core business of the ward was physiotherapy.  The other specialists worked around this given.  Most days were taken up with the physiotherapy regime, mornings and afternoons.  Upper limb therapies were integrated into the workings of the gym.  An afternoon a week the various specialists got together for a ‘case conference’, where the progress and treatment regime for each patient was discussed.  This afternoon was ‘time off’ for the patients.  It was the only unstructured period during the business week.  Weekends were also unstructured.   

The resources of the gym were in great demand throughout business hours.  The physiotherapist cadre was supplemented by an assistant and final year students undertaking practical units toward completion of their degrees.  Much of the ‘hands-on’ therapy was managed by students under close supervision.  Again, the teaching function of the hospital was to the fore in gym operations.  We enjoyed the attentions of this enthusiastic cadre of young people, some of whom were studying at our alma mater, the University of Sydney.  

Rotation of student cadres under the gym schedule enables it to function more effectively.  Without these resources it was obvious the gym would struggle to meet the demands of the ward.  Brain trauma patients alone would have tested the capacity of the unit.  Treatment of certain patients was resource intensive, demanding regular attention from qualified therapists.  The students enabled the latter to manage their ‘hands on’ workload flexibly, whilst maintaining overall quality control of gym therapy.  It was impressive.

Over the weeks Carolie began to find renewed strength and flexibility.  The palsy on her left side was a major challenge.  With a lot of treadmill work and other strengthening exercises over many weeks she went from being wheelchair bound to walking with assistance for small stretches, including on a stair apparatus.  Upper limb therapies were an integral component of the overall strategy. 

Occupational therapists targeted her left side palsy with a range of activities, including showing her how to dress with limited left side mobility.  A glove was employed to encourage Carolie to favour her left hand in doing basic tasks.  A little later they encouraged her to try basic kitchen tasks such as making tea.  She is naturally left handed so palsy on this side was especially challenging.  It was important to position oneself on her left side to encourage left-sidedness responses and consciousness.  Her body had to revive communication channels between the brain and the complex processes that make up movement.  All manner of stimuli were employed to reawaken the ‘signals systems’ and the interconnected channels that enliven the limbs.

My core activity was to accompany her for a large share of the daily gym program.  I assisted with some of the routines such as sitting and standing exercises, and gentle encouragement to keep her going on certain tasks.  Her concentration wandered and tiredness would descend mid-activity.  Bouts of nausea continued to wrack her body and we frequently had to stop gym work to enable her stomach to settle.  Vomiting was debilitating and frustrating as it disrupted her physical progress.  Sometimes the urge to sleep would get the better of her but a fierce determination to recover her moorings would see her back in harness after short naps and drugs to ease the nausea.  It was harrowing at times but we ploughed on.

To be continued....

A Day in the LIfe - Rehab by the Numbers - Part eight

Continues...Carolie rejoins the blog

Eventually, I achieved my goal and was moved into the Rehabilitation Ward where I met some lovely older women who had also had strokes.  They were  more independent than I was,  and they were able to move about in wheelchairs, using their arms to propel themselves to the gym, the shower and to the dining room without needing a nurse, or one of the ward assistants.  I was determined to learn this new skill as I had never before propelled a wheelchair.  I was also anxious that I might fail;  the steering was confusing for me at first, and on a number of attempts I met with the wall.  Oops! 

I managed to follow others down a corridor to the dining room, where I learned to guide the wheelchair up to the table and to park between the white linen table napkins that had been set out before the evening meal.  At last I was able to have more solid food.  This proved a huge disappointment, as what sounded appetizing on the order sheet, filled out the previous day, was often tasteless and too salty, especially for people who were stroke victims. I was also challenged by having to use knives and forks, by myself.  My left hand ached when I tried to cut the tough chicken or roast, lamb or beef.  

One of the women, whose name was Shirley, was an artist with works, she said, hung in the National Gallery here in Canberra. Her daughter had brought in one of Shirley’s superb works to decorate the dull walls of the ward. Now that I had moved, I hoped that the singing could continue. But one of the sisters in charge was worried that it might disturb the other patients.  The other women were very happy to have the singing and would ask if the “choir” was coming today when they saw me at meal times in the dining room.   

Once I had moved to the new ward, Mark transferred the vibrant posters made by the children. Soon, there was a complaint from the sister in charge, about hanging things on the wall. I was distressed as the posters were my guide for the location of my bed. They were a happy reminder of my former life at school.  One of the girls who came to sing, helped solve the problem by making a hanging out of bright fabric on which cards and messages could be pinned. 

It was a delight to have community singing. Once the singing was accepted, with certain restrictions, it became a regular part of my gym therapy. A group of parents of the girls organised to bring them to the hospital on a regular basis. At one time when my speech had sufficiently improved, Mark brought in my mobile phone and I was able to make calls and to receive them. I had a call from a cousin who is a physio therapist; she was just about to board a plane and phoned me from the airport. Her last final words of advice were to “do what the physios say”. 

If I was in the gym, the singing group came into the gym and sang with me there. Other patients enjoyed the visits and joined in. They would look forward to these visits and would ask me if the “Choir” was coming today. As my balance improved, I was able to bob up and down in time with the beat. One day I noticed one of the other patients doing the same thing too. If I was in the ward then my visitors were encouraged to sing too. Soon my friend had put together a book with lyrics on the front of which was typed:

                                                   “Carolie’s Visitor’s

                                                         Song Book

                      A collection of songs that anybody can sing

                         To help with Carolie’s music rehab.

                      Please help to sing a song. It will do you good as well as Carolie.”  

 It certainly did me good, as well as being enjoyed by the other participants. One teacher later shared how much she had enjoyed singing “Eidelveiss”, from the “Sound of Music”, when visiting me in hospital. It was a regular request to be sung from one of the other patients, who enjoyed our singing. Eventually my singing improved and as we continued I was able to reach higher notes. The singing seemed to improve my speech as well and I became more confident to speak and more articulate.

One very enjoyable aspect of being on the Rehab. Ward, was the occasional visit to the Rehab. Kitchen, where I was supervised by occupational therapists making cups of tea. One of the assistants was a parent of a former pupil from my school. I greatly enjoyed our frequent conversations about the school and its fabulous music program and, also, the very supportive parent community.  

To be continued....