Therapy

As I mentioned in an earlier post, my days in the hospital were filled with therapy sessions and revolved around my therapy schedule.  I remember it clearly, every evening a technician would come in to my room and write the next day’s therapy schedule; typically I would have some sort of combination of Occupational, Speech, and Physical therapy, with each session lasting between 45 minutes to 1 hour.  When I was discharged from the hospital, my physicians recommended that I receive these three forms of therapy on an outpatient basis.

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——– Speech Therapy ———–

Every speech therapy session was conducted in a private designated room, and on a one-on-one basis. Every treatment plan is different.  For example, a patient recovering from brain damage that affects speech through damage to the tongue would have a different treatment plan than someone with difficulty speaking due to damage of the vocal chords.  My case provided a unique challenge in that my speech deficit was due to a poorly understood phenomenon called “Cerebellar Speech.”  Different physicians have explained this phenomenon in various ways: one clinician told me that my tumor had detrimental effects to all of my motor skills.  Fine motor skills are typically the last to recover.[1]  Nevertheless, my sessions usually entailed my completing various oral motor exercises, and repeating different phrases.  Writing and logic also fell into the realm of speech therapy. Thus, I would often be asked to perform writing exercises along with logic puzzles.[2]  At every session my mom would ask the speech therapist for exercises that I could practice on my own. My mom would make sure I practice these exercises in my hospital room, so my days were not only filled with official therapy sessions, but also with these in-room training sessions.

Practicing speech therapy in my room
Practicing speech therapy in my room

———- Occupational Therapy ————-

Occupational therapy focused mainly on my ability to complete practical tasks called “activities of daily living” (ADLs).  These tasks, such as showering, shaving, and dressing, are tasks that we normally take for granted, but can become a challenge under certain conditions.[3]  For me, this also included learning to stand from a seated position.  Visual deficits and compensating for them also fell into the scope of an Occupational Therapist’s duties.   Hence I would normally start my days with the Occupational Therapist, who would help me shower, shave, brush my teeth, and tie my shoes.  If we had time we would then work on tasks such as eating and standing up.  Periodically she would check the movement of my eyes to make sure they were improving.  Many times during our sessions I would become frustrated as I had developed a tremor in my right hand that prevented me from completing many of the tasks that she asked of me.  The tremor was sporadic and seemed to be brought on by fatigue.  Dr. Pearson, who saw me almost every day of my hospitalization remarked to me that he believed the tremor to be a positive sign, and that it meant my “nerves are getting better.” The tremor has since gone away.

———- Physical Therapy ———–

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Of all the therapy modalities that I took part in, it was the Physical Therapy that both my mom and I saw as the most important.  Following the surgery, my physical deficits were the most pronounced.  I could not walk and needed a wheelchair to get around.  Before the surgery I was active, playing tennis and going to the gym every day.  I’m not sure if it’s an Asian mentality or a way of thinking engrained in me (or both) but I am of the school of thought that anything can be overcome with hard work—anything can be unlearned and relearned. Since my physical deficits were so pronounced, my thought was that while the tumor stripped me of my ability to walk and my motor abilities, with hard work I could relearn these abilities.  I spent much of my physical therapy sessions either walking (in an attempt to regain my ability to walk) or on a mat (working on my core strength to help stabilize me).  When it came time for discharge I mentioned how the discharging physician only would allow me to leave the hospital under the care of my mom, fearing a fall.  One of my therapists thought that my being discharged was a bad idea and that one more week of therapy would greatly benefit me.  At that point in my recovery I desperately wanted to go home, as I was eager to return to my wife and sons.  When my wife asked me about my thoughts on discharge and the possibility of staying for one more week, my response was, “of course I’d rather be home, but my thinking is that if you ask any specialist what the most important part of one’s health is, the answer will invariably stem from their specialty.  A cardiologist will tell you the heart is the most important part of the human body, a neurologist will say the brain, a gastroenterologist will say the digestive tract, and yes, a physical therapist would say the body.  That’s why I’m a little skeptical when a therapist focused on my physical well-being would recommend an extra week’s stay because of a perceived benefit.”  Thinking back to that time, it’s hard not to think I was a bit biased in my thinking, but I stand by that thought.  Furthermore, I don’t think I’d want to be treated by a physical therapist who didn’t wholeheartedly believe in their craft.  While all the therapists gave their input on each case, ultimately, the physician would make the final decision on whether to discharge me.  As I said in an earlier post, it was decided that I would accompany my mom to Long Beach Island where she could watch over me and help me rehabilitate—the physician thought this to be a fine idea and decided to discharge me.

—— My Thoughts on Inpatient Therapy ———

I am extremely grateful to each and every therapist I had the privilege of working with while in-patient.  I know that even though their job and paycheck came from helping patients, I would not have made half the progress I have without their help and expertise.  I look back on the experience as a step closer to my ultimate goal: a full recovery.

 

 

[1] As an example, fine motor skills would include a physical task like writing, whereas gross motor skills would entail the act of grabbing the pencil or pen.

[2] For example, I would be asked: “if Jane wanted to make a peanut butter and jelly sandwich, how would she do that?”  The correct answer would be something like: “She would first have to get the bread, toast it.  Then she should get both the jelly and the peanut butter from the refrigerator.  She should use a butter knife to spread the jelly on one piece of the bread and peanut butter on the other.  She would then combine the pieces to make a sandwich.”  Luckily for me, the part of my brain that controls logic was not affected, thus these exercises were no problem.  I often tell people who are surprised with my cognitive abilities, such as memory, that “the tumor affected everything else (speaking, walking, vision) just not my mind.”  Unfortunately, there are many people who have impaired cognition affected and what seems like a simple exercise, like explaining how to make a peanut butter and jelly sandwich, becomes complex.

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[3] Michael J. Fox, who has suffered from Parkinson’s disease for over 20 years now, once said when asked whether or not he uses a hand held blade to shave, “I’m not suicidal.”  (http://www.aarp.org/entertainment/style-trends/info-04-2013/michael-j-fox-interview-parkinsons-family-career.html)

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