My First Physical Therapy Experience: The Stand
Atrophy refers to the partial or complete wasting away of a part of the body commonly due to prolonged inactivity. My muscles had withered from not being used for months.
I weighed into the hospital at 172 lbs in early May. Now, five weeks later, I was 139 lbs. I had lost 33 lbs.
I was weak… Very weak! When I was placed in a chair I would slide down it. I had no strength to even SIT without assistance.
I couldn’t eat or walk, and my left hand was rendered useless. It scared me that I would not regain these abilities. I was beginning to grasp the significance of these injuries and that I was not going to simply heal up. I was going to have to fight for my recovery.
There were hundreds of unanswered questions. I was too confused to be scared, and it was my confusion itself that was so scary.
Before I could ask “how” I was going to recover, I had to first find the “why.” I didn’t ask why I fell or why it happened, but I was searching for the reasons why I should press on. I was searching for meaning.
My mom could clearly see that I was depressed in my confusion, fear, and loneliness and so she told a friend that he could put the word out to have other friends who would like to visit to contact her. He relayed the message over social media, along with my mother’s phone number, and soon my mom was scheduling visitors.
During a friend’s first visitation, a physical therapist arrived to work with my lower extremities (waist, legs, and feet). My left foot was pointing away from my body (plantar flexion) and slightly inward (supinated). I called this foot my “ballerina foot,” but the condition is called Spastic Hypertonia, Spasticity, or “drop foot.” It is a common condition with strokes and other forms of brain injury.
This condition did not originate in my leg, but in my brain. A spinal reflex was continuously sending signals to flex the extensor muscles in my left foot. Normally, the brain shuts off this reflex, but my damaged brain was unable to tell my muscles to relax, so my toe was flexed to point down.
If this condition persists, botulinum toxin (Botox®), a bacteria that is considered to be the most potent known neurotoxin, is sometimes very carefully injected into specific muscles to turn off the muscle’s ability to flex. This is done by shutting down the release of neurotransmitters, which is the chemical means by which neurons communicate.
With botox, it is essentially impossible for neurological signals strengthen a muscles ability to flex and to relax. Botox wears off eventually, but we are unable to rehab a muscle that is unable to flex, so while botox can lessen the pain of from being in a spastic or hypertonic state, it seems to stall neurological recovery. Oftentimes, through physical therapy and time, this condition lessens or resolves completely without the use of botulinum toxin or with only very temporary use.
After introducing herself, the therapist began to explain that she was going to do a neurological test in which she would use a wand to touch me in different places while my eyes were closed, and I was to tell her what part of my body she was touching.
To accelerate my recovery, I asked for “homework.” On my list of tasks, I was to raise both arms and legs one at a time. I was also to roll my ankles and to wiggle my toes. This proved to be difficult homework for me. The medical records state that I was “lethargic, delirious, and agitated.”
“What are your hobbies?” She asked and my voice quietly explained that I used to sing and play guitar. “Perfect… Would you sing me a song?”
Without any sign of self consciousness, a rough melody that resembled a song that I had written and played hundreds of times gargled from my throat.
My shoulders began to broaden as I sang. My birdlike chest began to press outward as my spine straightened with each lyric.
My mother rushed to my side with a look of surprise, excitement, and alarm. A confused smile took shape under my googly eyes as the lyrics continued to rise and fall from my lips.
Between the chorus and the second verse, I looked over my shoulder, smiled at my friend, and said “I’m standing up.”
With help from a walker and my mom’s worried excitement holding behind me, I rose to my feet!
Expressions of wonder and amazement were worn on all of our faces as my legs trembled under my weight.
This was the first time that I had stood since balancing on the scaffolding of the water tower that I fell from on the night of May 7th (Morning of May 8th).
Reading about this moment again reminds me of some of the folks who I work with today. It is so exciting to see clients regain their abilities… even small victories.
Milestones, big or small, are to be celebrated. All of them end up being significant. And it is when we measure how far we’ve come that we know how much farther we can go.