My motorcycle accident happened in June of ‘17. My PT/OT experience started in earnest about five months later. My first goal was to tolerate sitting in a wheelchair for 15 minutes. It was excruciating. Now, three years later, my goals have somewhat changed; for example, one is to ride up a ski lift and sit-ski down a green trail. Quite the difference, don’t you think?
This shift in goals was only possible with over three years of many kinds of physical, occupational, and other therapies, including inpatient and outpatient. I actually never knew the difference between PT and OT until I started both. (PT is therapy for anything below the waist, while OT is for anything above. I needed a TBT – “total body therapist,” but alas, they do not exist… perhaps they should! or is that what a physiatrist does? …ahhh, another blog idea!).
Anyhoo, at first, when I was inpatient and just learning to do everything over again, I did as my therapists told me. Goals were set for me because, well, doing everything except laying in bed was a goal. My rehab hospital required three hours of therapy a day. This included individual sessions, group sessions, play sessions (my personal favorite!), yoga, and even ping-pong for balance. I also had voice therapy, speech therapy, cognitive therapy, and ugg, pelvic therapy – not fun, but absolutely necessary if I wanted to pee on my own.
Inpatient included three stints in rehab hospital settings and two afterward. When I was forced from my pre-amp rehab hospital to a short-term care facility, I also had inpatient therapy there. I learned that every therapist has a different slant and a different way of interpreting where you are in recovery and what you need to do to progress – but this was, for me, a good thing. I enjoyed each new therapist’s unique perspective, as well as different ways to accomplish my goals. I was able to put lots of techniques in my “toolbox.” It took me until I got home and started doing daily living skills to understand that EVERYTHING I did during inpatient therapy was for a reason. Sometimes I would look at my therapist and ask, “why am I doing this?” And the reply would always be something I would need to do at home that I hadn’t thought of in a physically mechanical way. Inpatient was intense; I couldn’t just blow it off if I wanted to. It was scheduled, and I had no choice but to do the work. It took me no time at all to realize that working hard at PT/OT and the subsequent exercises I had to do in my room were the fastest way out of inpatient care and into my own home. I worked hard.
Once I got home, PT/OT came to me for three months. My toolbox grew, as now I could instantly apply the therapy to my needs. For the first time, I was asked what it was I wanted to be able to do, and they came up with a plan to help me achieve those goals. I progressed quickly, as I was motivated to be as independent as possible.
After my amputation, I went back to inpatient immediately, then again for “boot” camp – that is, learning to use my first prosthesis. These stints were laser-focused, for obvious reasons. Once I got RHO (my prosthesis), my goal was to walk out of that rehab with no more than a cane. Adjustments to that goal had to be tweaked, and tweaked, and tweaked again. That’s when I realized that sometimes a goal I had as a patient was not realistic from my therapist’s point-of-view. I left using a walker and had just started figuring out crutches. Translation, more outpatient PT, as well as to stop entertaining delusions of grandeur!
I was lucky enough to find an excellent PT near my home, but not before firing another one. This PT asked me for my goals, then, when I started going, had totally unrealistic expectations which were different from my goals, as well as physically impossible. Although this PT had worked with many amputees, he was not formally certified in amputee PT. It showed. When the company called to ask why I left, my response was “irreconcilable differences.”
The PT I then found has been one of my best and has been working with me for over two years. She not only helped me with shedding a brace from my sound knee but also helped me learn to use a suction prosthesis with no upper-thigh corset from a pin-lock that did. She taught me how to walk with cuff crutches instead of a walker. The first time I tried crutches, I folded like a deck of cards. Now I can walk three miles with them. Learning to walk again went quickly because we came up with goals together. She constantly asked what was challenging me, then came up with the PT I needed to meet that challenge. She even MacGyvered a way to imitate an airport moving skyway using a treadmill. It was ingenious!
IF you need therapy for an extended amount of time, my advice is the same as finding a prosthetist. Trust is a huge factor, and goal-setting is paramount to achieving your best life. I literally trust my PT with mine. Without her, my next goal would not be heading up the hill on a ski lift and skiing down the side of a mountain. If you had asked me if I could have done that after my amputation, I would have called you crazy.
No matter what kind of therapy you have/need, remember the children’s story of Goldilocks and the Three Bears. Each time, she found what was “just right” for her. Same with PT/OT – not so easy that it doesn’t challenge and you don’t reach your goals, not so hard that you give up or hurt yourself, but just right for you – working hard, being pushed when necessary, and achieving your goals in a timeline the two of you have worked out, re-assessing when needed. This is the relationship you need with your therapist. If you feel you can’t work with and nurture that relationship, move on and find another.
And although it goes without saying, I’m gonna say it – you get out of therapy what you put into it. If you don’t do your work, any kind of therapy will not help you improve. That motivation must come from whatever source fires you up – find that, and you’ve given yourself a golden ticket!
And remember: You never know how much strength you have until you are called upon to use it.
P.S. During my winter break, I spent my fourth consecutive day of sit-skiing going up a ski lift and down a green – fell off the lift at the start, found out that you can, indeed, wipe out in a sit-ski, almost broke my arm, and had an absolute blast.