Tyler’s Typing Today

Hey everyone, Tyler here. I figured it was about time I started shouldering more of the load of these updates. Dacia has been super busy making sure the kids are getting to school, that the house is clean, and planning all of the adaptive tech we need to install in order to make my life easier when I get home next month. So I thought I’d use this relatively quotidian Thursday to give you all a sense of what’s happening in rehab.

But before all that I really want to thank all of you for the just staggering support and love I’ve experienced over the last month. Y’all have sustained me through some very tough times (I’ll write more about that when I’m emotionally ready) and know that I’m thinking about all of you and can’t wait to see everyone again.

My day starts at around 7:00am when the night Patient Care Technician (PCT) brings my breakfast. Generally speaking, they don’t like to do this. It’s the end of their shift and they just want to hand off to the daytime team. So it basically took an act of congress and several pleas to the nurse leaders to get them to bring my breakfast early.

Why do I want to eat so early? Because after 8:00 everything starts to kick into high gear. Trying to eat while I’m getting catheterized, dressed, and transferred to the chair for my 9:00 physical therapy session gets too complicated—I would routinely end up late. And if you know me, you know that I do not like to be late, especially to class.

PT today was about chair transfers, using the bed ladder to sit up, and most importantly to this stage of recovery, seated balance.

Chair transfers are getting much easier. Sean (one of my main therapists) helped me with a rocking technique that helped improve the distance I could cover with each push-off. I’ve also started managing the location of my feet during the transfer—something that before today was done by the therapist assisting me in the transfer.

The bed ladder—essentially a rope ladder anchored to the foot of the bed—allows me to pull myself up on one side, then to my elbow, then to my palm and eventually to a seated position. This is the first time I’ve been able to sit up by myself since the accident, and is a huge milestone on the road to independence.

Finally, we spent a bunch of time on seated balance. This starts with simply sitting up and balancing with my hands on the mat slightly forward of my hips. Then I walk my hands back until they’re far enough behind me that I can lock out my elbows and prop myself up. The first time I did this, a week ago, it took several penguin-like steps with my hands to get to the rear position. Today I was able to sweep my hands back in a single motion all the way back. And then all the way forward in a single move as well. This is a simple but crucial movement. Mobility for me now is about momentum, leverage, and balance, and the front-back-front motion is the foundation for all of that.

Reese then reminded me that PTs are all sadists at heart by getting me into the forward seated position and then abruptly pulling my shoulders back so that I have to throw my hands back to catch myself. Which I managed to do so I guess she’ll have to come up with some other torture tomorrow.

We then worked through some more exercises focused on balancing while freeing up one hand to perform tasks:

• leaning to one side and finding a balance point such that I can lift my hand off the mat,
• Leaning to one side and reaching out to touch three cones placed on a table in front of me,
• Leaning to one side and reaching out to stack those same cones, and
• Leaning to one side, grabbing a weighted ball and moving it from one side of the table to another.

After all this I was completely wiped out so we spent the remaining five minutes stretching my hamstrings. Long hamstrings are important to many of the functional positions I will need to dress myself and go about my daily business.

After PT I have a half-hour break until Occupational Therapy, so I spent it today as I often do, by sitting in the sun and watching the bay from the rehab floor’s patio.

OT today, and for the past few days, has been about building trunk strength so I can get out of my big bulky wheelchair and into what they call a “high-mobility” chair. They should have a new chair for me on Friday, if I can keep improving my core strength and recruitment.

After OT I head back to the room for lunch. I’ve eaten every halfway decent lunch option here at least twice (today: chicken caesar salad) and I’m extremely bored of all of them. So I’m very happy to report that, as I type this, Dacia is on her way with Zachary’s pizza for tonight’s dinner.

In the afternoon, I have an hour to rest and reset before heading back to PT. My afternoon sessions on Tuesdays and Thursdays are all about blood pressure management. I spent the entire hour on the tilt table again, but my blood pressure still won’t let me get anywhere near vertical. I’ll try again on Tuesday.

No Spinal Cord Injury class today, so I ended up heading back to the room and hanging out in my chair for a couple of hours before getting back into bed. From this point forward I’ve got dinner (yum), followed by the “bowel program” (wherein I induce the pooping so that I don’t end up being incontinent in class tomorrow), a shower, and then back to bed to rest up for tomorrow.