Sunday, December 11, 2005

an abundance of optimism

It's a very strange place, full of people who were banged up or sliced up and sewn together. Every single client has pain. To be sure, there are a lot of different kinds of pain, but this is not a place you go to unless you have physical pain or dysfunction.

And yet, this is without doubt one of the most optimistic places you will ever visit, because everyone who comes here is here to get better.

So where is this place? The physical therapist's.

If you have never been to been to PT, it may be hard to imagine. At my therapist's, there are several individual rooms for therapies and manipulations that require privacy. Most clients, though, spend their time in the main room, which has several massage tables lining one wall, and a host of exercise equipment taking up the rest of it. There are free weights and exercise bikes and many things I don't even know how to describe. In the center of the room is an "aisle" -- two railings about 2 feet apart, at waist height, on a slightly raised platform. It looks odd, sitting there in the middle of the room, until you see it in use.

There are probably a dozen therapists working at this facility, and at any particular time, 8 to 10 of them will be working, and each may have 2 or even 3 clients at a time, depending on the client's stage of rehab. Some people don't need much supervision and so can be scheduled at the same time as others; the therapists are very good at managing their time to keep you busy.

So the room can be crowded, but at course people come and go during the course of the day. First thing in the morning things tend to be very hectic, but after that first rush is a nice time to go, since everyone who has to be at work is already there. The tide of people ebbs and flows throughout the day, but the positive vibe is constant.

The clients themselves are an odd bunch, with our only things in common the facts that we are broken and want to fix ourselves. I've seen high school and college students, and just-retired peppy seniors, and one gent who'd I guess has to be at least 90. Generally, we do what we're told, and we try our best, although we may groan a little and tease our therapists that they are slave drivers or worse.

They do make us work, and the work is hard; banter helps. I've watched one woman recovering from encephalitis (I think, some kind of brain infection), and the exercises she has to do to retrain her sense of balance and depth perception are so frustrating to her, but she perseveres.

I used to think PT was a waste of time, but through direct experience I've learned better. Our bodies generally recover well from insult, injury, or illness, but some of these can lead us to bad habits, and when the bad habits perpetuate, we inflict new pains on ourselves. PT is one way to avoid ever getting into those bad habits, and it's the best way to get out of them.

Back in October, the surgeon nagged me to be sure I would get PT. Immediately after my surgery, I could barely turn my head in either direction, and tilting my head back to look up was completely impossible. I've been working diligently on regaining my freedom of movement, and it's almost back to 100%, in all degrees of motion. The nerves controlling my shoulder, arm, wrist, and hand were all affected by the surgery as well, leading to significant weakness and loss of coordination. Now with the rehab exercises, my right side is as strong as my left.

Now, what if I hadn't had PT? Well, my right arm and hand would be pretty much useless -- weakened and getting weaker by the day from disuse. I'd have crashing tension headaches and aching shoulder muscles from having to carry my head "just so" -- I vividly recall those from the early weeks of my recovery, and I worked hard to stretch the neck muscles precisely so I could affect a decent stretch of the shoulders and upper back. Driving would be impossible, since I wouldn't be able to turn my neck. In other words, it would be a disaster.

Did I really need to visit a physical therapist to ensure all these bad things didn't happen? Maybe not, but my therapist knows a lot more about this stuff than I do. I'm not the type to attempt my own auto repairs, and the body is an infinitely more complex machine than a car. Some professional guidance is a really good idea.

Just for comparison's sake, take a look at what happened after my hysterectomy just over 2 years ago. I didn't have any PT afterwards, none was recommended at the time. Recovery was pretty easy, relatively speaking, but I developed some major league bad habits, including letting my ab muscles be lax nearly all the time. Hey, when you've had major dissection in your pelvic area, everything in your gut feels weird and keeping those muscles tight does not feel good.

So: lax abs led to my lower back muscles spasming, triggering recurring problems with my piriformis, the skinny muscle that stretches across the butt. Now, I have fibromyalgia and in my particular case, the fibro causes certain muscles or muscle groups to just get rock hard (at least, that's how it was explained to me -- most people don't have this kind of problem. At least I hope they don't.) So the rock-hard piriformis impinges on the sciatic nerve and gives me the classic symptoms of sciatica, numbness and tingling all the way down the leg. What fun! But to make matters even better, the piriformis' deformation is torquing all the other muscles around the hip/pelvis, and my hip rotates out of alignment. Then all those muscles start freaking out and I end up feeling as if I've crushed my tailbone.

Yes, my own muscles being out of alignment essentially dislocated my tailbone. (More PT helped this condition a lot, but I'm still struggling with it because of the fibro and frankly, not being consistent with my exercises.)

I think all that could have been avoided if I'd had PT, but who knew what domino effect that surgery was going to set in motion? I had no idea.

I really like going to PT, but I'll happy when I "graduate", which may happen this week. I will miss the camaraderie among the clients (not patients, you'll note) -- we're all screwed up somehow or other, but we all want to get better, and we all believe we will get better. And the therapists will help us to do it. It's not a so much question of hope as it is one of faith: maybe I won't be pain-free, but I'll be able to live my life better.

I think you'd be hard pressed to find a church where there was such a uniform adherence to the central doctrine, and such a profound belief in the central mission of the establishment.

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