Autumn Days

When I had started therapy, my goal had been to complement it with lifting weights. I reasoned that two days a week in physical and occupational therapy plus two or three days going to the gym would yield maximum results. However, until my Go-to card arrived, I would have to pay out of pocket for all of my rides with Metro Mobility. This became expensive, so I decided to dial back my rides to only essential trips such as grocery shopping and trips to the Hennepin County services building.

Before long I became lethargic. I still took Mary out several times a day, went to therapy, and went places with my Independent Living worker. But now I was spending more time in bed, less time outside, and feeling less motivated in the therapy gym. Rather than having him drive me to the gym, I was having my Independent Living worker drive me to run errands, to go grocery shopping, or to the coffee shop where I could work on my blog. This was a generous amount of activity for someone still dealing with severe effects of a stroke, but it wasn’t active for me.

When I began riding with Metro Mobility back in 2016, my left leg, left arm, and abdominal muscles had been so weak that I had often found sitting on the bus for too long to be very difficult. My left arm couldn’t stay on the arm rest. My inner thigh wasn’t strong enough to keep my leg from flopping to the side. I had to use my hand to pull my foot back behind the yellow safety line. If I dropped my phone, I couldn’t bend down to pick it up. So while riding a Metro Mobility bus was more convenient than riding a city bus, it was by no means easy.

I began going to work and to therapy around the same time I began riding the city bus. The first thing I was able to do was start using the arm rest. That had happened during the winter of 2016/17, as my arm began to loosen up. During the Spring of 2017, I had started forcing my left hand to hold my cane as I climbed up and down the bus steps. Now I could open my hand voluntarily whenever I needed to grasp something. The only thing I couldn’t do was move my leg backward.

Then one day in early October, I had the opportunity to ride Metro Mobility again. I sat down in the front of the bus. My left foot was sitting too far forward than it was supposed to be. I decided to try moving my left foot backwards without pulling on it with my hand. It moved ever so slightly. I was overjoyed. If I could move it the slightest bit now, that meant that I could strengthen my hamstring by doing leg curls at the gym. I sat up tall and practiced pushing my foot forward then pulling it back. It felt like one more tiny miracle on a road of many.

One of the last things I was advised against while I was inpatient in 2015 was that I might want to adopt a puppy. They reasoned that even rudimentary training and care might be too frustrating for me. I had needed a lot of help with Mary back then. Now I was able to have her come to me when I called her, so I could put her leash on. She would go in the bedroom if I commanded her to. I could keep her from jumping up on people. When we were outside, I could grip and control her leash. Even bending down and cleaning up after her was now something I could do on my own. Not only did being able to care for Mary give me a deep sense of satisfaction, it also forced me to keep pushing my body when I didn’t feel like it. So living with Mary was good for my rehabilitation.

The one challenge I wasn’t ready to meet was walking Mary outside of the building. I had never tried walking on the sidewalk on 3rd Avenue alone. Trying to do so with a dog was completely out of the question. I might trip and fall. I could lose my grip on the leash. The leash could even snap. Any number of things could happen once we left the confinement of the backyard. So I let our new friend Rob walk her to the park. That way she could get daily exercise despite my physical limitations.

I really wanted to be able to walk with them, but I didn’t even know how far it was. I felt weak, but I knew that Mary needed to play as often as possible. Walking wasn’t enough activity, but it was better than nothing. Each day Rob and Mary disappeared out the front door, I wished I had the courage to go with them.

One day I came home from therapy feeling more energized than normal. When Rob came down to take Mary, I asked him how far the park was. He said it was only a couple of blocks away. There was also a bench I could stop and rest on along the way. So I decided to give it a try.

The first thing I noticed once we left the building grounds was that the sidewalks sloped downward toward the street. My right side was on the side facing the street, so the pavement was slightly higher beneath my left foot. Because the tone in my left leg kept it straighter, I had to work to lift it higher. This challenged me to constantly lift my foot high enough to not scrape the pavement. While this wasn’t physically strenuous, it took a great deal of concentration. So as soon as we made it to the end of the block, I crossed the street so my left leg would be on the outside of the sidewalk.

Once my left leg had more room to operate, walking was nowhere near as laborious. When we were almost to the park, Rob pointed to the bench where I could rest. I could see the park less than a block away. There was a bench that would be easy to walk to. So I told Rob that I could keep walking, then rest when we got to the park. I was getting tired when we got to the last intersection. I had to cross both streets, but I made it safely to the park. I pushed myself a few more feet and sat down on the bench. The view of downtown was framed wonderfully by the trees.

I sat on the bench while Rob walked Mary around the park. Just walking there had been enough exercise for me, but we wanted her to get more As I sat there, I began thinking about my next milestone. By the Spring, I wanted to be able to walk Mary all the way to Chateau, the place where I’d lived during transitional care. The park was only about three blocks down the street from Chateau. If I began walking to the park every other day, I could easily stretch my endurance to reach this goal even sooner.

After several minutes Rob and Mary walked up. Her mouth was wide open as though she was smiling. She had expended a lot more energy, so I got up to walk back home. This side of the street was lined by a lot of fenced yards. Since I was tired, I walked using these to steady myself as opposed to balancing with my cane. I wasn’t nearly as fast as I had been on the way to the park. But while I was exhausted, I never came close to falling. My legs were becoming reliable again. I dragged myself back to my apartment and passed out.

A week later, my therapists stepped up the intensity of my program. In physical therapy, I walked on the treadmill. Whenever I walk a treadmill in physical therapy, they strap me into a harness designed to hold me upright if I stumble. The therapist started the treadmill, and I began putting one foot in front of the other. In the past, my therapists had had to use their hands to help me advance my left foot. Now I had enough strength in my hip and glutes to pick my foot up on my own. I walked for five minutes before I had to stop.

Next the therapist had me lie on my back with my feet planted. Then he instructed me to lift my butt off the mat. With my weight off the mat, I had to lift one foot off the mat, then switch feet. This was so hard that I couldn’t keep my butt from falling. I had to reposition myself several times. After ten reps, he told me to stop and rest. Once I had rested, he asked me to do another set of ten. This time it was much easier. I was able to lift my feet without losing balance. I felt so strong that I completed fifteen reps.

The next thing he did was get an exercise ball that was about a meter in diameter. He told me to sit atop it and turn in the opposite direction of the mat. So if I fell backward, I wouldn’t hit my head on the floor. Just with the lying exercise. Now he had me alternate between lifting each foot again . It often felt as if I might fall, but he would use his hand to steady my knee if I started to roll off the ball. This exercise was kind of frightening, but soon I was enlisting muscles that I seldom used.

In occupational therapy, I began cooking. The therapist had me gather my ingredients and place my pot or skillet on the stovetop The first session I made toast and eggs. The most difficult part of this process was cracking the eggshells without dropping them in the bowl. The following session I made spaghetti. With this meal, I had to alternate between boiling noodles and stirring pasta sauce. Everything I would cook was a lot more manageable than I had initially suspected. It just took planning and awareness.

One thing I had only been doing at home was walking without my cane. Now that I needed to use my right hand in the test kitchen, the cane would get in the way. I set it down on a table and took a few careful steps back to the countertop. I began opening jars, mixing ingredients a walking between the refrigerator, the sink, and the stove. Before long I became so involved with what I was doing that I stopped worrying about falling altogether.

Cooking was an important part of my rehabilitation, because the Minneapolis Public Housing Authority would not turn on my stove without me receiving documentation that I could operate it safely. This meant that the people working in the assisted living program were responsible for doing all of my cooking. Because they were often busy with handing out medications and other things, cooking took a lower priority. I had rides as early as 9:00, so it could often be impractical to wait for assistance. My occupational therapist had given me shoe buttons so I would not have to wait on assisted living to help starting my days.

 

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