Friday, May 1, 2009

Integration: Beyond Involvement

When I was at Care Partners rehab hospital in Asheville, NC, they preached "involvement" with your affected hand. Not an easy thing if you can't pick up anything or use your arm. First, I had to build up the strength and the coordination in my hand to be able to hold anything. I did this by squeezing putty and stretching rubber bands, the ones that come with the mail. I kept some of each in the car, so as my wife drove me to doctors appointments I could work my hand. I did a lot of wrist-stregthening exercises, too. I kept a hammer with me when I was sitting on the porch or riding in the car.

I also had to build up my shoulder to where I had some range of motion and some strength. I did that by holding a light weight by my side and drawing circles with it, both clockwise and counterclockwise. I also got a wooden dowel at the hardware store and used my unaffected hand to raise my affected hand over my head.

Eventually, I could raise it on my own and I could keep my hand on the computer keyboard. I wanted to be able to drive a car again. I had had a field of vision test at my eye doctors before the stroke, so I had one after. I lost very little, so I headed out with my wife as the driving instuctor. I passed, That was a big day. I started driving with my left arm. I found things like driving, lawn mowing, and vacuuming where you are holding something steady and steering to be beneficial. In the begining, my arm would sway for no reason, so I was careful every time I met a car if I was driving. Eventually that went away. You can't do too much damage with a vacuum cleaner. Yes, I vacuum left handed. I always will. Mowing was good in the early days after I learned to walk well enough to take it on. It involves pushing and I live in the mountains where there are always hills. I found it good for building up stamina. I had to push myself continually to rebuild my stamina. In the begining simple tasks and anything that used my brain drained me. Eventually, I could ride my bike for a couple hours without stopping. Next, I want to learn how to run again.

Once I got some function back, I could start to think about involvement. So, I got down the vitamins with my left hand and arm. I had trouble doing it, so I'd get them all down and then put them back. Get them down and put them back.

Every time I have trouble doing something I do it over and over again until I was satisfied I am doing it right once. So, if my hand shook when I was going to pick up something and I didn't like it, I repeated the motion until I was happy and picked it up.

Once I achieved involvement, I tried to figure out ways to use my affected side in everyday tasks - integration. I got tired of how long it took me every day to do all the exercises I was doing at the time. When you integrate it's like free PT or OT time. It doesn't come out of your time like pulling on a rubber band does. If you balance on your affected leg while your gas is pumping, you are doing PT and the time does not come out of your life, it's extra therapy time.

I walked and walked and walked some more. I walked on my toes I walked on my heels. I hopped in place. I hopped from side to side. I hopped laps. I high-stepped laps. I did ankle dips and raises on a step. I practiced going up and down steps. I walked on every kind of surface and terain.

How could someone is a good a shape as I was get his stamina wiped out? SImple answer, stroke. I believed in pushing myself a little every day. Steady pushing yields steady progress and soon I was able to do some things that meant a lot to me. Walking to the jetty and back at Hunginton Beach State Park was my first big accomplishment. When I got there I thought, "Can I make it back?" I had been so sigle-minded about making it to the jetty, I forgot I'd have to walk back. But I made it, and that was just another step and another confirmation that if I set my mind to it, I could do it. I could recover.

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