Monday, December 1, 2008


It is now just over two weeks since I've returned home and I figure it's time for an update. Unfortunately I don't have any great improvements to speak of; on the contrary the last week has been more difficult for me. I had seen improvements in my level of spasticity but those seem to have diminished recently. I have found my legs feeling more tired and I'm experiencing more difficulty moving around. I'm not sure what this means if anything but it's not the direction I wanted to be moving. I guess I still have to adhere to the one day at a time mantra. The good news is that I have found therapists to work with so I have continued my rehabilitation routine.
I've previously written about the different mindset behind the physical therapy that I experienced in China compared with the therapy that I’ve received at home. In the hospital the treatment goal was to improve my walking and balance abilities with the belief that they could return to normal. I thought it would be very difficult to find this type of attitude and treatment at home but I found it. My therapist is known as an athletic therapist and rehabilitation specialist. Athletic therapy analyzes the essential elements of each movement and identifies problems that need correction. Improper movements and imbalance lead to muscle compensations in other areas of the body which eventually result in poorer performance and increased difficulty with many movements such as walking and climbing stairs. I was especially encouraged by my new therapist when she told me about another client of hers who’d been to China for stem cell transplants. This client was a quadriplegic who had regained the use of his upper body which is a huge motivator and reinforces the idea that improvements are possible and realistic.
When Andy, my therapist in China, would correct my body from cheating while walking or going up stairs the action would virtually become impossible. My body has forgotten how to properly perform certain movements after years of naturally compensating for certain difficulties like rotating my hips and pelvis or straightening my leg for stability. Andy could always see where my difficulties originated from but he couldn't explain it to me. My new therapist can also identify these difficulties however she can explain to me in simple terms what my body is doing wrong, why it's doing it wrong and what needs to be done to correct it. During my first assessment the therapist viewed me walking, sitting, standing, lifting a leg and all kinds of basic movements and postures. The reasoning behind why I do or can't do certain movements is very logical and the corrections needed sound rather simple. I was aware that I had to strengthen certain muscle groups like my hamstrings and glutes but completely unaware of the other muscles that require strengthening. The main muscles required to perform certain tasks referred to as your mobilizer muscles are obvious but your stabilizing muscles are just as important. Apparently many of my stabilizer muscles have gone to sleep leading to the awkward way that I compensate for them in many movements.
Waking up and retraining these muscles does not require going to the gym, it is much simpler than that. For example some of the exercises I must do are squeezing my left or right butt cheek and holding for three seconds, a tummy squeeze for 30 seconds as if I’m holding back urine or squeezing a ball between my knees. I would find it easier if I could go to the gym to work out rather than completing these exercises. Even though these exercises might sound very undemanding, I have problems with them. For example I find it difficult to isolate and flex my right bum cheek and tasks as straightforward as standing straight while shifting my body weight from one foot to the other and lifting the opposite foot are very challenging. In order to do this last exercise properly I have to lift one leg by bending my knee keeping my weight on my heels with my core tight and hips level without any rotating or tilting of my hip bones. A very large part of these exercises is learning self awareness and any deviation from proper form is so subtle that it’s very hard to recognize.
I’ve now had two sessions with this therapist whom I’m supposed to see once a week and work on the exercises myself the rest of the week. Self motivation is not easy with this training, like I said I have a hard time with some of it and it’s difficult to see the results! It is much easier for me to go to the gym or to my basement and workout. I must keep at it though and stay committed because I do believe the benefits will come!
I have now started up with acupuncture as well. I had my third treatment today and will be on a schedule of twice a week for the first four weeks and then moving to once a week. My acupuncturist is from China and was trained there but he does speak English pretty well. As I suspected this treatment was much tamer than what I had in China. The needles are much smaller and the procedure is much gentler than my previous experience. Dr. Tse also uses electrical stimulation by attaching electrodes to the needles which is not new but wasn’t done by my acupuncturist in China. The process is much more relaxing here where the needles remain in me for 40 to 60 minutes and I find myself very relaxed and even dozing off occasionally. Dr. Tse can also explain to me what he’s trying to achieve by placing needles in different areas of my body. Some of the goals are to increase my energy and stimulate the nerve endings in my feet and establish a connection between my brain and different areas of my legs and feet. It makes sense for now but I don’t know how I’ll judge if I’m receiving any benefits from this.
For now I’m following recommendations of the hospital which are to continue with physical therapy and acupuncture and do not smoke or drink alcohol. These recommendations require a lot of commitment on my part and significant changes to my lifestyle and daily routine. Well I’ve been through a lot to go to China for this treatment so I figure working hard for improvements for the next five months is something I have to do in order to achieve the best possible outcome for myself. I know it won’t be easy but I have to stay positive and keep the hope alive.

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