Tuesday, October 7, 2008

Therapy Ins and Outs

Yesterday, the occupational therapist taught Michael how to tape my shoulder so we can renew the tape at home when it peels loose. She then had him do the actual taping as she coached him. She was pleased with his facility in picking it up, but taken aback by the full Walker approach, which involved marking with his pen on my skin where each piece of tape begins and ends and numbering the order in which the pieces are applied. (When we got home, he took pictures, too, so he had good documentation of the correct approach. And went over the marks with a permanent marker, so they hang around longer. He also added strips of tape at the ends to keep them from curling. He will be able to recreate this with consistency, never you fear.)

As we understand the effect of the taping, it lifts my shoulder blade a bit and thus calls into action the muscles beneath/around it, which otherwise weren’t doing their job. What we didn’t ask, and should have, was how long this will be necessary and what the natural progression is of this treatment approach. The effect of the taping is so terrific—it gives back almost full use of my arm—that was more the focus at the time. With the taping, almost everything I want to do with the arm is possible. Writing on a blackboard is still difficult unless the right elbow is being supported with my left hand. There are still movements at which the arm just fails, but they are so dramatically reduced that, as long as I’m careful, it’s almost as good as new. The shoulder still gets tired and my hand needs to be supported after a while (pockets and table tops are good), but there is real, discernable progress here. It feels good.

We have been trying to understand the difference between physical and occupational therapy; it turns out we’re not alone, as when I consulted Dr. Google, it was a common search that many others have also done. And, there were many sites with information. In my case, the physical therapy is working on gross motor skills and balance and focusing on my leg. The occupational therapist is an arm/hand specialist (specially certified) and is working on my arm and hand. As far as I can tell from my superficial search, occupational therapists focus on life skills (not necessarily occupational skills), so hair and tooth brushing, doing buttons (if that were an issue in my case) and writing on the blackboard are all in that domain. One web page suggested that PTs are state-licensed and OTs are nationally certified, but I didn’t see that elsewhere and didn’t pursue it. For me, the two are coordinating (and with the strength training coach as well), so they are avoiding overlap or contradictory approaches. Over time, the PT may work on my head and neck as well, but right now, the scalp is sensitive enough for that to be out of the question.

Posting the rest of the week may be spotty, as I’m off to California at 6 a.m. tomorrow. I was able to do all three hours of my law class yesterday (hurrah!!!) though the wonder-friend and teacher who covered and is now co-teaching with me and focused pretty hard on getting me to sit down whenever possible. Please note that I followed her advice without question. Overall, I would give myself a B for yesterday: the day was devoted to resting and class, but still probably included a little more of “other” than the situation calls for. At one point, in communicating with my terrific assistant at the law school, I was so fuzzy I was sending her confusing information. I took a nap and cured that, but should have recognized earlier the need for some rest. That is a skill that needs honing. It’s on the list.

Happy Tuesday to all. Take a moment in this day, somewhere, no matter how busy or rushed your day, to give yourself a moment to enjoy or appreciate beauty and friendship.

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