My therapy assessments began after lunch. The occupational therapist took measurements of how far I could bend my arm and straighten it, how high I could raise my shoulder, and many other things. When she asked me about my goals, I declared that I waned to recover as much function as I could. I had learned to dress and bathe myself, and I was even doing some light weightlifting with my left arm. Since Hennepin County would provide a PCA to help me with any basic household needs like cooking, cleaning, bathing, and dressing, I wanted to be extremely aggressive with developing muscle use.
Next was my physical therapy assessment. I was excited to work with physical therapy because this meant walking, and I had been working my legs so often in the gym that whatever expertise a professional could offer certainly would speed up the process of me no longer needing a cane. The therapist had me perform some balance tests then asked me to walk down the hall and back for her. During this time, I explained that I was committed to going to the gym and working as hard as I could. If I could dedicate myself to building brute strength, I would benefit most from her helping to correct my fine motor movements.
After I finished my therapy evaluations for the day, I went out to the dayroom. While I was sitting there, a doctor came over to perform another intake evaluation. In talking to me about my medication regimen, he told me that I would have to turn over all medications to be administered by staff nurses. I told him that, while I did not have a problem with this policy in general, I tried to go to the gym or other places in the community as often as possible. So as not to run the risk of another stroke, I would like to keep an emergency supply of the blood pressure meds that were to be taken three times per day. He told me that that shouldn’t be a problem. He just had to clear it with the head physician.
When the doctor finished examining me, he went to the nurse’s station to ask the head physician. The head physician told me, “We don’t really do that here.”
“I’m not asking for all of my medications; just a portable supply, in case I’m delayed coming home.”
“The problem is that you are supposed to have all of your medications administered by medical staff.”
“I don’t mean to be difficult. It’s just that I narrowly survived one stroke, and I really don’t want to risk another. I’m very diligent about my prescriptions.”
“The problem we’re going to run into is insurance is going to ask, ‘Well if he can do all of this himself, does he really need to be here?’”
“Okay then. I’ll just try to schedule my outings so I’m always back here in time.” I wanted greater independence, but I didn’t want to jeopardize this opportunity to get transitional care – especially if it meant finally getting my rehab done the right way.
Although I felt I was now in the correct situation to take the next step forward, it had one glaring drawback: I wasn’t getting adequate sleep. This was because they had placed me in a room with a very sick patient. He appeared to have suffered a very recent amputation of the lower leg. He trembled very violently, and the tremors were almost constant. I have never been a deep sleeper, so the sound of him shaking could easily keep me awake. About half of the time, his leg would bounce audibly against the wooden bed frame. When this happened, I would g often get up and leave the room because I couldn’t even drown out the sound by playing YouTube videos.
I didn’t hold any resentment toward my roommate, because he was not behaving this way out of malice. He was just a very sick man. He had to be bathed and have his bedding changed almost hourly. So when I finally could fall asleep, I would be awakened by lights and voices. I began trying to figure out when my roommate would be out of the room so I could just take brief naps. I was miserable.
One night things got so bad that I decided that it would be best to try and sleep on the couch in the dayroom. I dressed and grabbed my parka to use as a blanket. When I got to the couch, I had to figure out how to get my body and enough of my legs on it so I wouldn’t lose balance and fall. There wasn’t room for a pillow, so I knew I was in for a stiff neck in the morning. Worst of all, I didn’t take my CPAP machine. The sleep I got that night would not be restorative, but I was desperate.
The next morning, I told the nurse that I really needed a new room assignment. She told me that she was aware of the problem and that she had already asked management to switch me. I was a bit surprised she had taken that much initiative.
“Did they say anything back?”
“It takes a few days after I put in the request.”
“Can you guess about when you might hear something back?”
“It’s hard to say, but probably by Wednesday.”
I was too tired to go to the gym that day, but I was encouraged that things would get better.
I was thrilled to be entering speech therapy again. It was the one component I was seldom prescribed. And because it was the one I couldn’t augment with time in the gym, I had become despondent about how well my voice would recover.
Speech therapy began every morning after breakfast. First the therapist would have me go through a series of tongue exercises. These were strenuous for me. Next she would have me exercise my lips and cheeks. These were like child’s play after the tongue exercises. Finally she would have me read a passage aloud, varying pace, emphasis, pitch, and volume. My eyes were still having a hard time working together, so scanning was difficult. This made it hard to predict where the pauses in the text would be.
The physical therapist told me that since I was on the go and working out regularly, I would not qualify for physical therapy treatment. Insurance would only pay for someone learning to walk again while inpatient. She encouraged me to keep doing leg weights and walking around as much as possible every day. Once I was out of transitional care, I could see a doctor and ask for a referral for outpatient physical therapy.
Now that I knew that they wanted to have me do therapy every weekday, I told them that I would do therapy in the morning, so my afternoons would be free to leave the building. They would try to prioritize me in the mornings. However, a lot of the patients with more acute issues would take priority. The new patients arriving each week would need to be evaluated, and that would take precedence. With the unpredictability of the morning schedule, therapy often couldn’t see me until the afternoon. This would mean that I would have to choose between therapy and a ride to the gym that had to be scheduled at least one day prior. Because I often felt lazy, I was usually happy to skip the gym.
The one occasion I never let myself miss a gym appointment was on the weekend. Since I could count on not having therapy, I would have one day with no scheduling conflicts. Even if I didn’t feel great, I could drag myself downstairs to wait for the Metro Mobility bus. Once I was on the bus, I had no choice but to go to the gym. Consequently it was easier to begin mentally preparing myself to workout. After I’d arrive at the gym, I would go to the locker room and hang up my coat. I would be so close to the weight room and would have moved around so much that it was automatic to walk out and warm up on the leg extension machine.
Even on days when I didn’t cancel my rides to the gym, I was still in a funk. My workout had gone stale, repetitive. I needed to add a new exercise to my rotation. A leg movement would have the most immediate payoff, because it would be a large muscle group and because it was a body part I constantly used. On the first day I tried the leg press, I thought the hardest part would be trying to get into the workout station. However all I had to do was step inside with my right foot and drag my left up and inside. Then I could slide down onto my butt. I would lean back, then the hardest part was getting my foot up against the sled. Now it was a matter of pushing.
Like most people I know, I used to love leg presses. Unlike exercises such as squats or bench presses, there is no need to balance the weight. This lowers the degree of difficulty, so people have a tendency to load up the sled with as much weight as possible. I didn’t even use any weight. The weight of the sled itself was unimaginably tough. I did three sets of ten or fewer reps, then I collapsed from exhaustion.
I could hear myself taking deep breaths. They were full and barely voluntary. It seemed like I was listening to the sounds of someone else’s throat reverberating from the walls of the room. It felt so satisfying.
Living in transitional care allowed me the opportunity to start organizing all of the areas of my life. By having meals, medications, therapy, and lodging in the same space and all on a schedule, my mind was free to work on others tasks. One was finding out to whom I needed to give paperwork regarding my dog. I was told to go see the Trend Nursing Assistant (TNA). The TNA runs a makeshift store out of her office, providing snacks at no profit to residents. She also helps with mail delivery, clothing repair, and other miscellaneous patient needs.
“I was told that you’re the person who signs off on emotional support animal visits.”
“I do. What do you have?”
“I have a dog. The doctor at Abbott Northwestern gave me a letter. Is that all I need?”
“We need her complete immunization records. Can you get those?”
“Sure. She’s only ever gone to Banfield Animal Hospital because I wanted instant nationwide access to her medical records.”
“Bring her by here when she comes in. I love dogs.”
The TNA told me that she was also the person who would make store runs if I needed anything. I told her that I could pick up any toiletries when I went to CVS in a few days.
That afternoon, I called Metro Mobility and scheduled a Sunday ride. I would have them drop me off at CVS and pick me up across the street at Starbucks, three hours later. The plan was simple enough, but I had anxiety about not being able to walk across the four lanes of Nicollet Avenue in one cycle of the green light. I hadn’t attempted a four-lane crossing in over a year. On the way home from work, I would always get caught halfway across Hennepin Avenue. The fear of getting caught by the red light in the middle of Nicollet caused me to want to change my ride schedule several times, but I remained adamant that I would try.
When Sunday came, I was waiting downstairs for the bus. It ambled over to the CVS parking lot and dropped me off. I finished my shopping much more quickly than I had expected, and in less than ten minutes, I was out the door. Nicollet Avenue stretched out before me like a daunting obstacle.
The light was already green, so rather than risk getting caught, I waited for another green light. After the light turned red, I walked up to the edge of the sidewalk. The light turned green, and I began walking carefully but with purpose. So I wouldn’t get too distracted by the other pedestrians, I focused on the light on the far side of the street. By the time the crosswalk timer indicated that there were fifteen seconds until the light changed, I was already past halfway. When I made it safely to the other sidewalk, I still had five minutes to spare. I took one more bold stride on my road to recovery.