End of Phase 3

Mary Ann had a graduation of sorts on Wednesday, and here is her good-bye photo!

Mary Ann and Christa saying good-bye.

Due to a scheduling mixup, Monday didn't turn out to be Mary Ann's final day of physical therapy, but Wednesday was.  In that session, Mary Ann took several walks without her cane, as Christa followed and watched carefully.  Then she gave her professional assessment of how Mary Ann did and recommended a few exercises for her to do at home.  She also gave her a length of rubber-like material to assist in one of them.  Then it was time for words of thanks and goodbye, and, of course, the photo which you see above! 

Thank you, Christa!  We both feel that you are highly skilled and did an excellent job in helping Mary Ann.  We were fortunate to have you as Mary Ann's primary physical therapist.

This brings to a close what I think of as Phase 3:  out-patient physical therapy.  It began on July 6 and ended on August 17.

Phase 1 was Mary Ann's hip replacement surgery and time in Winter Park Hospital, June 20-24. 

Phase 2 was in-patient care and rehab at Life Care of Altamonte Springs, June 24-July 6. 

Now we enter Phase 4, which will be a time of building up stamina and endurance, a time of applying the principles learned and mastered at Life Care to new situations: longer walks, inclines, stairways, all the challenges we encounter in every day life.  I think it's fair to say that we enter this new phase with feelings of accomplishment, optimism, and faith in continued progress.

We are also filled with appreciation and gratitude for all the people who have helped us in any way, and we thank you all.  This includes not only every single person in the hospital and at Life Care who in any way cared for Mary Ann, but also for all of our family members and friends who supported us with good wishes, kind words, kind works, prayers, and just plain love.

There may be more blog entries as we go forward.

  

A good week...

...in which Mary Ann walked and walked.  Here she is on Friday near the end of her physical therapy session:

 She walked up and down those steps several times with no difficulty.

The focus of this past week was walking with the cane and then weaning herself from it to walk without assistance.  The walker has fallen into disuse. 

Mary Ann made several trips outside again with Christa, worked on walking indoors while looking up and down and from side to side, and did some two-step routines led by Christa that required quick foot movements.  She did the exercise with the steps that you see above, going and down multiple steps.  She practiced at home with and without the cane.

Interspersed with all of this were various exercises, like getting up from a chair by leaning forward and using leg muscles--without using the arms of the chair.  It was challenging because always using the arms to get up is one of the hip precautions that Mary Ann needed to observe for the first five weeks after her surgery, and also because it requires good balance and strong leg muscles .

She has come a long way through this physical therapy and I am proud of her.  We have another session this morning that may be her final one.



Walking on the Grass & Improving on 20-30

Mary Ann's physical therapy on Friday
Christa started by watching Mary Ann walk with a cane.  During two long walks that Mary Ann took without tiring, she observed that--except for one or two times--Mary Ann's hip was in the correct position.  Then she took Mary Ann outside so she could feel what it's like to walk on the grass, the concrete, and the wood chips that are immediately outside the back door.  I think Mary Ann surprised herself by how well she did. 


Then back inside, Christa instructed her in how to coordinate the movement of her right arm--the one without the cane--with her steps.  She pointed out that Mary Ann had been using a walker not only since her surgery almost seven weeks ago, but for many months before that.  And since she had both hands on the walker, she did not swing her arms.


This sounds simple but does need to be re-learned.  Since her left arm (with the cane) comes forward when she steps with her right leg (the hip replacement leg), her right arm swings forward when she advances her left leg.  Mary Ann did well at this but not perfect.  She needs more practice, but she has come far this past week. Last Friday she took her first steps with a cane, and three sessions later, she walked well with her cane on grass.  


As with all sessions, Christa guided Mary Ann through additional exercises designed to strenghten critical muscles.  I liken one of the newer ones to what a figure skater does when going down on one leg for a sit-spin.


While sitting in an arm chair with her left leg extended forward, she lifts herself up with her hands and puts all her weight on her right (hip replacement) leg.  The goal is to rise from the chair until the "bad" leg is vertical, hold for several seconds, then sit back down.  Mary Ann did well.  


The progress she has been making seems remarkable to me.  Her resolve is amazing, and it will pay off.


Meanwhile, back at my regular Ophthalmologist
In the week since  I saw Dr. Cooperman, my eyesight improved a bit.  At Dr. Cartwright's, my right eye checked out at 20-25, the best it's been since the surgery on June 29.  My left eye is 20-20. 


I had a long conversation with the doctor and saw for myself the level of concern he had.  I learned that he spoke with Dr. Cooperman after each of my visits with him, also that he could not get over the fact that nothing grew out of the culture they took, therefore, the type of  infection could not be identified. 


Because my cataract surgery in that eye was seven weeks before the infection showed up, he suspected a slow developing cause.  But since he had seen a clear vitreous in my eye two days before his partner saw a virteous full of infection several hours before the surgery, it had to be a quickly developing infection.  He was also very impressed that my family doctor took so much interest in my eye, even calling and speaking to Dr. Cartwright about what she saw. 


So we will never know what caused it, but the infection in my right eye is gone, and my vision is back.  What do I make out of all this?  I will continue pondering as I thank God, the doctors, and the surgical team! 

Cane Walking again

Here's Mary Ann yesterday, when she walked much more smoothly with the cane.  This brought about the big smile you see below, on her face as well as her physical therpaist Christa's face!!  Christa gave Mary Ann permission to practice with a cane at home now, if she wants to.  I'm off to buy a cane today!!

Mary Ann and Christa

Enter: The Cane

Last Friday at physical therapy, Christa picked up a cane, adjusted it to the right height, and gave it to Mary Ann to try.  There's a correct way to use a cane, which Christa showed her.  You hold the cane in the hand opposite the hip bring rehabbed.  In Mary Ann's case, her right hip was replaced, so she held the cane in her left hand.  You advance the cane when you advance the foot of the leg being rehabbed.  So for Mary Ann, right leg and left arm (with cane in hand) come forward at the same time. 

It seems odd at first, but not after some thought.  The cane shares the load with the affected foot.  In normal walking, there's an instant when we put full body weight on the foot being advanced.  By advancing the cane and leaning on it, the affected foot is only being asked to support half of the body weight. 

There is a rhythm required, and one learns it by counting seconds for each step and walking slowly.  Oh yes, and by practicing!  Mary Ann took a brief walk out of the gym and into the hallway, going a little distance in the hallway, and then returning to the gym.  This was shortly before the session ended, and Christa asked Mary Ann to be thinking about the internal counting and the step rhythm over the weekend.

Yesterday after 30 minutes of a pretty rigorous set of exercises, some with weights on her ankles, Mary Ann was once again given the cane.  This time the practice walks went longer, and the patient improved.  At several points along the walk, Christa lagged behind Mary Ann by maybe six feet or so in order to observe her hip aligment.  This made me very nervous, because Mary Ann was actually walking without any support except that cane. 

After observing many P.T. sessions, I have come to realize that re-learning how to walk properly is much more involved that I first thought.  Balance, muscle development, hip alignment, correct posture, coordination, and more need to be relearned and practiced.  Fortunately, Mary Ann is a motivated patient and Christa is a very good physical therapist.  They make a good team.