My body was slowly getting better from physical therapy and general use My left limbs had been stiff from tone ever since my stroke. My left leg was stiff and straight; even my foot tended to point. Over the years, I had regained some amount of flexibility just from walking. Having to bear my weight had caused my joints to bend. I had been lifting leg weights for three years – first in physical therapy, then in a regular gym. I also received Botox injections in my calf to relax the muscle. So I was doing all I could to regain mobility in my leg.
My arm required more deliberate attention. Unlike the leg, it was not receiving constant use. I was working it out in the gym; I was receiving Botox in my bicep and forearm; I was even enlisting it to carry things And while I was regaining muscle function, I could not straighten my arm. The bicep was perpetually firing and keeping it bent. My triceps simply couldn’t overpower it, even with Botox injections partially relaxing the muscle. I slept each night in an arm splint. While that helped a great deal, it was still not enough to get my arm fully straight.
I could work my arm most productively in the shower. I would stand beneath the shower head and use my left hand to grasp the grab bar. This would open my hand and it would keep my arm in a straightened position. Then I would wash my underarms and head, Next I would sit down with my arm still stretched and holding the bar. Once I was seated, I would thoroughly soap myself off. When I finished washing myself, I would stand up and sit back down repeatedly. All of the activity would help build arm strength. The slipperiness of the bar improved my grip.
The one thing that frustrated me in the shower was not being able to reach my left foot. It would stay firmly planted while I was standing or seated. But as soon as I bent over to wash it, it would jut out and I could no longer reach it. I would use my hand to pull it back underneath me. If I tried to bend down, I would risk tumbling over. So I simply could not scrub my foot. To remedy this, I began using a back scrubber to scrub the top of my foot. But when it was time to wash the sole, I would have to position the brush next to my foot on the floor, then lift my leg up and lower it down on top of the brush.
I used the back scrubber to wash my feet for months. Then one day I dropped my washcloth as I was about to leave the shower. Without giving it much thought, I bent over to pick up the towel. I noticed, after I had picked it up, that it had been in front of my left foot. So I bent forward and grabbed my foot. It wasn’t the least bit difficult. All the therapy and exercise had given me the flexibility to reach my foot in the shower!
I had just begun lifting weights again. I used two different gyms – Planet Fitness and L. A. Fitness. At Planet Fitness I would perform workouts that included triceps and squats. When I went to L. A. Fitness I would do a workout that included leg presses, chest butterflies, and leg curls. Now that I had my ILS worker available to help me, I had him work with me once a week at each gym. I didn’t require his help with every exercise, but I always asked him for help with a few.
When we went to Planet Fitness, I would start with lat pulldowns. I would sit down on the bench, then have him pull the bar down so I could reach it. Then I would grasp the bar with both hands and pull it towards me. While this exercise was designed to develop the back, I concentrated just as much on the upward motion. The weight’s pull on my arms and shoulders would assist them in getting a full stretch. I could feel my upper body getting incrementally looser.
The other thing I would have the ILS worker help me with at this location was squats. Since I walked more slowly than I wanted, I would send him ahead to reserve an open machine. Then he would be responsible for putting the free weights on the bar and aligning the weight bench. With someone standing there beside me, I could squat lower and with increased speed, secure in the fact that I wouldn’t fall during the exercise or on the way home.
At L. A. Fitness, he would help me with pectoral butterflies. I would sit down on the bench and grasp the bar on my right side. He would hold my left wrist and guide my hand to the bar. Once my hand was in place, I could perform this exercise on my own. I just couldn’t lift my arm high enough to get it into position on my own.
The other thing I would have him help me with was removing my brace. When I performed leg curls or leg presses, my foot brace would constrict my movement. My worker would remove my shoe, place my sole insert in it, and remove my brace. Then he would help me put my shoe back on so I could perform the exercise. Sine I needed the brace to walk safely, he had to help me put it back on each time I went from one machine to the other. I could not have done this on my own, so I was so thankful to him for helping me to maintain the speed and intensity of my workouts.
The last week of October was also my last week of physical and occupational therapy. I felt like I hadn’t progressed nearly fast enough, so I asked my therapists to ratchet the intensity up for the last two sessions.
The first activity in physical therapy was kneeling on one knee again. This time my body was able to better anticipate how it needed to adjust. When I was on my right knee, balancing was so easy that I didn’t have to hold myself up with my hand at all. When I switched knees, I had to put my hand down frequently to steady myself, but I was able to lift it for short intervals without collapsing. While I had dreamt of being able to balance without using my hand, letting go wasn’t nearly as frightening as it had once been.
I told the therapist that I wanted to walk on my knees. This was a strength and balance exercise that relied on the hips, thighs, an abdominal muscles. Completing one circuit around the stool I used for balance had been a chore the few times I had tried it in the past. It was almost impossible to advance my left knee. And when I was able to jar my left knee forward, I would often lose balance and fall over. I wasn’t really looking forward to the exercise.
But I had recently begun lifting weights again. All of the muscle groups involved in this exercise, while not that much stronger, were becoming used to constant work. Walking on my knees was also far easier than I thought it would be. Not only did I move faster, but I didn’t fall over once. After completing one circuit around the stool, I was so overjoyed that I went around for another one.
After I came over to the edge of the mat, the therapist asked whether I was ready to do some standing exercises. I told her that I wanted to see how much progress I had made on hip raises first. With her permission, I sat on the edge of the mat, lay back, and began lifting my left knee toward the ceiling. This was another exercise that had once felt strenuous. Only a month earlier, I had barely been able to lift my foot off the floor and I had to pause once I reached five reps. Now I was able to power through 15 reps with my thigh reaching above a 45º angle. It felt so gratifying.
We were done with the mat exercises, so now it was time to do some walking ones. We walked over to the bar, where she had me walk alongside it without touching it. Once I got a third of the way down, she told me to start taking bigger strides. When I started doing this, my gait became more even and it wasn’t hard to balance. For the final two-thirds of the way, I didn’t touch the bar.
After I made it to the end, she asked me to walk backward. I wanted to do this without touching the bar as well, but I didn’t feel like it would be safe. Although my leg didn’t bend as well as I would have liked it to, I was now able to lift it well. My left foot squeaked a little along the floor, but I was able to continue moving at an even pace. Once I made it to the end of the bar, she had me walk forward and backward three more times, then our session was over.
For my last two sessions of occupational therapy, we worked on things that would be helpful in my daily life. On Wednesday the therapist aggressively stretched my left shoulder. After it was loosened up, she hooked up e-stim electrode pads to my triceps and my anterior deltoids. Then she got a rod for me to practice pushing forward in order to extend my triceps. The e-stim would cycle on and off in ten second intervals. When it was on, I would push as hard as I could. When it cycled off, I would rest.
I was disappointed, because I could not push very far. When we were done, I asked the therapist to trace around the edges of the electrode pads with a waterproof marker, so I would be able to perform the same exercise at home. I could also have my ILS worker place the pads on my triceps while I was doing triceps exercises in the gym to help me while I lifted weights.
For my final therapy session on Friday, the therapist told me that I would be baking. She gave me the choice of cookies or brownies. I told her that I didn’t care for either, but that wasn’t the point. I had previously cooked on a stove top. Once I demonstrated that I could safely use an oven, they could sign off on my ability to cook in my own kitchen. Then my gas could be turned on by the housing authority.
I gathered all my ingredients and utensils and put them all next to the oven. I preheated the oven, mixed up everything, then put the pan of brownies in the oven. While they were baking, I helped the therapist unload the dishwasher. When the brownies were done, she packaged them up for me to take them home.
At home I cut up the brownies and ate a couple. I gave some out to the assisted living staff and a few neighbors. There seemed to be a consensus that my first batch of brownies were a success. I even gave some to Rob when he came down to help me walk Mary. Therapy had been full of new beginnings. Now it was time to go forward on my own.