Tuesday, May 27, 2014

The First Day of Real Physical Therapy

After a couple of days that were basically uneventful, the first day of real physical therapy is at hand. I admit, I am getting very comfy in my recliner with maybe a dog lying beside me in it. I'm quite comfortable and content sitting on my butt and watching TV and using my laptop. I'm home. Why should I have to be reminded more about my condition than I already am? I have to see the walker and the oxygen tubes and tanks and pump and the home health nurse here almost every day and daily or more checks of the dressings and the surgery sites and BP and weight and breathing treatments and the millions (it seems) of pills I have to take daily... even a few of the breathing therapies on those silly little things we brought home from the hospital, but not many.  I want to forget it all and just get back to normal. In my mind, the best way to do that is to watch TV and sit in my chair and do little to nothing. In the back of my mind I am actually noticing that the weight is still rolling off and that is because I am not wanting to eat. I'm just not hungry. Food has no appeal to me at all. At this rate I will be losing 7 to 10 pounds a week and I know that is not good, but I also know I was quite overweight... So I have it to lose. Or had. I'm also noticing my look in the bathroom mirror each morning. There is a large loss of weight that is already quite noticeable, but I'm also starting to notice the loss of a LOT of muscle... My build. Even my butt and legs, which I had been told were a couple of my better features. The "skinny and feeble" look is starting to settle in. I'm not liking that at all.

After the now typical morning routine, I sit in my throne recliner in the living room in front of the TV and await the coming of the physical therapist, and the home health nurse. I wonder who will come first. Doesn't matter who gets there first, it's just something I wonder about to amuse myself. If the therapist gets there first my BP will likely be messed up and maybe my oxygen saturation. Who knows? It doesn't take long to find out. Doorbell rings... Lea Ann answers and its the nurse. She is a nice young woman. Very personable. Very professional. I have no complaints about her. Lea Ann seems to like her too. They get along well and talk quite a bit in a chit-chat fashion while I go through the usual battery of checks. BP is the best it has been. Just a tiny bit above normal. Oxygen saturation is good. So good in fact that she decides to dial down the oxygen a bit. Fine with me, just as long as I tolerate it OK. Should not be a problem. She is still hearing some crackling when I take deep breaths, but she says they are seeming to get less and less. So see? I AM getting better. Why do all this extra stuff? Then I remember the vision of myself in the mirror. There is a war starting in my brain. The one side that says I am getting better doing just what I am doing now, versus the part that doesn't like what it sees in the mirror. The part that wants to get back what I have lost. The part that is the merest spark of what I used to be... of how I used to feel. Maybe, just maybe, the Brian that was here before this diagnosis and surgery is still inside and is just now waking up and starting to try to fight his way out. I notice that, but just file it away to maybe look at again later on. The "stay the current course" part of my brain is still far too strong to succumb to a single fleeting thought. The nurse finishes her stuff, I sign the paper, well actually I sign her iPad with a stylus thinking that this is rather cool. I am a geek when it comes to electronics and toys like that.  Before she leaves she says she is going to start coming every other day if we feel comfortable with that. Lea Ann asks me what I think, I say that's fine. She still wants the daily BP and weight checks logged and also maybe the oxygen saturation. Lea Ann agrees to that, as do I, then she bids us a farewell until the day after tomorrow.

About an hour later the physical therapist shows up. He does the same type of lead-in paperwork that the home health nurse does. In fact, he mentions that he is in contact with her quite a bit about me and how I am doing physically. He mentions the log Lea Ann has been keeping, so she shows it to him. He makes mention of the weight loss. There is a little flare of that spark in my brain again. Just for a second. He asks how I have been eating. I say I have been, but Lea Ann corrects me. I have been eating, but tiny bits if anything. Not even doing much with the protein shakes. He mentions that the protein is what is needed to keep the muscle mass up, along with working those muscles... which we will start doing today. He asks how I have been walking. I have to be honest and say that I have not been walking a lot, but when I have been I've not been using my walker. I just go slow and make sure I am near a wall or door or chair to help support me if I get light-headed, but to be honest that has not happened lately. He asks where my portable oxygen is, and Lea Ann brings it our of my office. He hooks up the shorter hoses and turns on the tank and we swap tubes. He also puts his own pulse/ox monitor on my finger. He will be paying close attention to the pulse as well as my oxygen saturation levels as we walk. That is all we are going to do today. We are going to walk out front. Whatever I feel comfortable with. This will be used as my first benchmark or as a baseline. He will be beside me all the way. I have nothing to worry about when it comes to falling or passing out or anything. Passing out? Me? Never.. but I do admit that I've worried about that from time to time recently. He's a big enough guy that he could keep me from cracking my head open on the concrete or where ever I happened to fall if I did. He tells me to stand up, and I do. Apparently too fast. Have you ever gotten up too fast or maybe yawned while standing and had your vision start to dim and get shaky in the legs? That is exactly what happened. He noticed it right away and told me to sit back down. I do and the episode subsides. I look at him and smile a little sheepishly. Maybe I am not quite as strong or as far along as I thought. He says that it's OK, just slide up and sit on the edge of the chair for a minute and then stand slowly. As I do, he helps me up. No vision darkening this time. Hopefully it was a one time thing. We are going to start by walking down the hallway and back, then out back on the patio like we did last time he was here. We do that without much issue, but I do note that I am already breathing a bit harder and coughing occasionally. How could I be this weak after only maybe a month and surgery? I ask him that. He says, "Because your body was insulted and cut on and sewed back together and you are not eating or drinking much and you need to get some strength and stamina and breath back. Not to mention you are sill having lung issues. This is not an immediate correction. This will take time and work. That's why I am here." He lets me sit for a minute and catch my breath and also grab by rescue inhaler, just in case I need it. I get back up and head for and out the front door. I tell Lea Ann I will be back in a few minutes, and she says I better be and smiles.  I smile back and walk out, pulling my little oxygen cart behind me. The sidewalk out to the driveway is flat and easily navigated. It is straight then a left turn and you get to the driveway. By the time I get to the turn, maybe 30 feet, I an starting to breathe hard and cough a bit and my oxygen saturation is dropping.  92... 91... 89. The therapist tells me to stop, try to relax and take puff off the rescue inhaler and take a few deep breaths as he increases my oxygen. As I stand there, the saturation goes back up into the mid-90's again. What the hell? I can't even walk around the house and to the driveway without having issues? How pathetic am I? The therapist seems to know what I am thinking, tries to pump me up a bit and asks if I am ready to start again. The athlete part of me seems to take over and says "Let's go." That part of me actually says it out loud. He smiles, claps me on the shoulder and says that is what he likes to hear, and off we go again. Once we get to the driveway, he checks my saturation level and pulse again. They are OK. Our driveway slopes down to the sidewalk and curb. It's not very steep or anything, but it is a slope. The therapist says that we will go to the curb, the turn around and go back into the house. I nod and start moving. By now my legs are shaking a bit and I am shuffling more than walking. Quite a bit more than I would like to admit. Getting to the curb isn't hard. Gravity is my friend. Well... I thought it was until we turned and had to go back up the driveway. I am amazed at how hard it actually is to get up a slope that small. I am shuffling and huffing and puffing by the time we reach the sidewalk back to the door. So much so I go into a coughing fit and have to stop again. The therapist is very patient and as soon as the coughs subside I start up again, without his having to prompt me. We walk the rest of the way back into the house and I basically collapse into my chair, again coughing and huffing and puffing. My legs are trembling as I sit and I am starting to sweat. The therapist says I did well for my first time. Next time we will go further. Oh joy... but at least I got through it today. I am a little down on myself because of how many times I had to stop and how weak I really seem to have become. Maybe this therapy will end up being a good thing. That is if I am able to live through it, and I tell the therapist that. He laughs and says he has no plans on seeing me die anytime soon, but he will help me get some strength and stamina back. All I have to do is trust him. Honestly, I find myself actually doing just that. No real idea why as I have only met this kids twice, but he seems to know his stuff and also seems to care. My instincts tell me I can trust him, and I trust my instincts therefore I suppose I trust him.

He finishes his paperwork, he and Lea Ann switch me back over to the in home O2 pump and shut off the tanks so they can be used more when I am out. That time will come within the next week or so when I go see all my doctors for my first post-hospital checks. The therapist stands up, shakes my hand, tells me not to be too hard on myself and that it will get better, and that he will see me day after tomorrow. We are going to do PT every other day to start. He reminds me that in order to get stronger I need to eat and drink with an emphasis on higher protein. He looks over at Lea Ann and winks and smiles letting her know he has her back on that issue, and she sees him to the door. The step outside to talk for a moment, then he leaves. She comes back in and asks me if I need anything. I actually ask for a protein shake and to turn on the ceiling fan. I expect both will help cool me off. My legs are starting to calm down and the coughs have subsided... I think to myself, "This is going to be harder than I thought..."

Thanks for reading along and I hope you come back for the next post!


bforrestjr said...

Keep on!!

Brian Brown said...

Absolutely! I plan to for as long as I am able! Thank you for reading along. I appreciate it very much!

Margie said...

keep on improving Brian look forward to reading your next blog :)

Brian Brown said...

Thank you, Margie! Glad you are enjoying the read and hope yo continue to do so! :) I'm getting better every day!