29 June 2009

stormy eyes

m o. m o p. m o p p. Post!

PT this week: Tuesday was rolling and prone stuff on the mat, then rows and chest presses on the Uppertone, closing up with about an hour zap biking.

Wednesday saw a few new tricks, working with a sub trainer and such... First (last, actually), I ended the session with the usual FES bike party. The rest of the time was mat work - my blood pressure was behaving nicely, so we were able to do both long and short sitting exercises without issue. Legs straight long-style, I kicked off with a completely new task. We wrapped my hands together; then, like a prayer ninja, I held my arms forward with elbows bent and pushed downward against resistance. Indeed, it's not the easiest exercise to describe! Imagine you're on your knees, hands clasped, begging for mercy - from there, push your elbows downward against something. That's approximately what I was doing, except that I was seated on the mat with my legs out straight, rather than on my knees. Wow, this exercise works a slew of muscles. The actual push-down part enlists rear deltoids, mid/lower traps, paraspinals, rhomboids and lats (among others): that is, the back of the upper arm (higher than the triceps) and just about every muscle in the mid to upper back. Even better, as a side effect, this exercise works the "good posture" muscles, including abdominals, obliques, lower back and more (the "core"), as well as the upper traps and other neck-related, hold-your-head-up stuff. Hmm, how can we illustrate this? Try sitting at the kitchen table with a ridiculous slouch. Then put your elbows on the table (let's break as many etiquette rules as possible) and push down hard. See how your slouch goes away? Magic! As it were, the kitchen table description demonstrates the task rather well.

While you're still at the table, we can do the next exercise, and you can even help clean up. Do whatever is necessary to get the table at a bit lower than chest level and put an arm out on the surface, palm down (insert washcloth here for cleaning benefits). Now, wax on, wax off! The outward/arm-straightening motion (left hand to the left or right --> right) works some good shoulder and upper back muscles; the opposite move is good for pecs and anterior deltoids, not to mention cross-body range of motion. Instead of cleaning the table, I did this in long sit on the mat with a propped skater's sliding board, pillowcases, and wrist weights, but you can pretend I was doing busboy therapy if you want.

I next did some random short sit stuff for a bit since my blood pressure was remotely close to normal human levels, but by then my shoulders were rather crackly and in and out of socket, so there wasn't anything too intense. As previously noted, I wrapped up with the bike post-matting. End Wednesday session.

Friday was back to fairly normal stuff - typical Wave maneuvers, weights on the first floor, e-stim bike. Woohoo. Sorry, I blew all my words on Wednesdescriptions.

Elsewhere, I'm doing my best to wheel around and attract stares (I appear to have become a bit famous already) for an hour or two every day, with the exception of Thursday's rain and Monday's überwind. I'm traveling much faster and more dangerously than when I started bombing around a bit over a week ago, for sure. Still no accurate speed/daily distance numbers - phone GPS cuts in and out as I go between buildings (and isn't really to be trusted anyway), and though they have some distances around campus premeasured, I don't understand their crazy routes. Too bad the sidewalks aren't functionally defined, or I could just integrate! Pues, my best day was 3h, for I'm guessing 4+ miles. My posture is getting better, too, and I'm taking fewer breaks; improvements all around. I can even roll and play wheel bass simultaneously. Hyah.

Wrapping up, I'm headed to cville over the 4july weekend to meet with my Illinois "help me with managing paid personal assistants" case worker, who will hopefully [surprise] help me with acquisition of assistance up here. I should be starting OT when I come back, so prepare for tales of beans, marbles, PVC trees and mini-basketballs...

aaaaand that's a wrap! Stay tuned next time for more monotony and clean tables. Rocket!

22 June 2009

racing and pacing and plotting the course

Tag, Pepys! Let's see how this sprawls. A marvelous part of blogificating is that, unlike in more formal writing situations, I start whipping up a post with no plan whatsoever. Such is probably why it's never that good. Shucks. Let's rock.

Last round covered up to martes for therapy, so let's pick up at miércoles. And, miércoles! I only vaguely recall. There was e-stim biking for sure, as well as a giant heap of mat work. We did triceps extensions in the short-sit position - that is, sit up with hands on mat on each side; then, bend an elbow to lean to that side and push back up through that arm to straighten the elbow and return to upright position. This is amusing with barely functional triceps and barely measurable blood pressure... Further, my right shoulder exhibits subluxation (shifts out of socket) in certain motions, so we have to get it just right. I also did some prone-on-elbows stuff, i.e. face-down on the mat ("prone", opposite of face-up "supine") supporting my upper body off the mat by putting weight on my elbows. These activities are usually scapular protractions, which are basically doing shoulder-powered push-ups, and side-to-side weight shifts. Sem açúcar, prone on elbows is one of the most uncomfortable positions out there. Eh, whine whine. I think that's all for the hump?

Viernes was pretty standard, with weights, some long-sit entertainment, and a zap bike wrap-up. I'm no longer any good at Wii tennis; however, my score still magically increases when I am viciously trounced?? Wii Math is just as realistic as the rest of the console. Good riddance, Sarah/Elisa!

In the gorgeon of viernes tarde post-session, I took the opportunity to grab some headphones and push around the DMC campus for a while in the manual chair. I toured mostly familiar locations, including a few laps around the brush mall and a trip over to where the ER is and the pharmacy used to be, heading back home by way of the northern border/street-side/"[something something] Spain Elementary" sidewalk. I don't have an odometer, nor do I know how fast I go to do a rate times time equals distance calculation, but I'll randomly guess it was about two miles (3.2km).

Observations? People don't look before they pull into a driveway/loop from the street. There is no way the sidewalk curb cuts are even close to ADA compliance (you know, JKL/KG!). Pedestrians here scare me when I'm not a zinging electrified 1/4 ton of evil, though five-fingering my phone seems trivial when you consider how many large I'm sitting on at any given moment. I must modify my mobile music mashup, even if it means ruining my nerd-humorous total of 1337 songs.

Sábado, Henry Ford Museum! I'm not exactly a museum addict, but the padre and I had a few hours of fun. Mr. F was an industrial polymath, as it were, building trains and electrical monstrosities and whatnot. Not surprisingly, though, I was there for the cars and not disappointed. Go there if you're in the area or read if you're not.

Domingo, lunes were wonderfully uneventful. I went out and about both days, for a total of five miles or so (8ish km). It is outstandingly boring wheeling back and forth over the same few chunks of DMC sidewalk, but meandering too adventurously would be outstandingly unintelligent. Yay for the same people staring at me all the time, every time I pass. At least I've moved, chubbies. Get over it.

I guess we're summarized. I apologize for not having any jl pictures yet! Until then...

Sascha has not only figured out that I am no longer in my room in cville, but also solved where I have gone. Sorry, my little kitty, sneaking into a package to Detroit is not a wise way to travel.

Paz afuera! Wink.

16 June 2009


Hey hey, home fries!

Most important for this update is that Dr. Carlos Lima and friends were in town over the weekend to give a presentation on his OMA surgery, research, etc., over at the WTLTSCIR facility in town.

I'll share a better explanation soon, I hope, but for now, a quick refresher: "OMA" stands for "olfactory mucosal autograft", which refers to an adult (non-embryonic, not NC-17) stem cell transplant procedure that involves moving stem cells from waaay up in the nose ("olfactory mucosal") to the site of spinal cord lesion ("autograft", where "auto-" indicates that the graft uses a person's own cells). I had this surgery last year, 11 April 2008, and it's why I'm here recovering and writing. That's good for now, and I'll pretend you're in suspense until I reiterate the process more thoroughly or you reread some old posts.

Anywho, Dr. Lima's presentation was hi-qual if not a bit old hat, and it was good to see/hear/brag to him about progress. I like to keep under my hat the stuff that is most important to me, but take my word that I can do quite a bit more than a C4-C5 quad should (manual chair, anyone?), and Dr. Lima deserves some credit in that regard.

The other presentations were excellent as well. There was a showcase of Japanese "robosuit" technology, implementing electrically assistive prosthetics - exoskeletons, really - to enable patients with rather high spinal injuries to sit, stand, and even walk without other assistance. Wow. Finally, Dr. Steve Hinderer of DMC/Wayne State gave a very thorough analysis of available therapeutic activities; I'm hoping to get a copy of his slides, but until then I can't begin to do justice with a summary.

In the usual realm of therapy, just a few particularly special activities happened in the past weekish. I used a new weight machine, the Uppertone, over on the inpatient neuro floor (6) of RIM. Without buttering it up too much, it's just a different, more self-contained and quad-friendly weapon for doing the exercises I usually do with the weights at first floor Brasza's gym. I did rows and chest presses - standard weighty fare. Also, for the first time in a long time, I did rolling stuff on the mat. My shoulders were not pleased! Oh well. Otherwise, no Giger since my first session, but plenty of e-stim biking and some time outside in the delicious Friday weather, being warm and relearning how to travel in a straight line with the power assist wheels.

Today-at-time-of-writing, Tuesday, consisted of some random short-sit exercises, followed by Uppertone rows/chest presses, and a wrap-up of FES bike and Wii tennis. Blood pressure and shoulder muscles were misbehaving, so it wasn't the most productive session on record. Further, I was pretty much awful at digitennis - rusty! On the optimistic side, I didn't go passive on the bike, so my leg muscles are getting back into the swing of things.

Wait, what's "going passive" all about? Ideally, the e-stim bike runs in "active therapy" mode, meaning the cycling procedure is accomplished by my own muscle power through the evoked contractions caused by the bike's timed electrical impulses. That is, I am actively pedaling. In contrast, "passive therapy" means there is no electrical stimulation of my muscles, and the cycling process is merely the bike-powered rotation of the pedals with my feet attached. In other words, I'm not doing anything, passively going through the motions of pedaling the bike. Active therapy is obviously much better - it is real exercise, since my muscles are doing the work. However, the bike goes into passive when it detects that the necessary muscles are sufficiently fatigued. Passive is better than nothing, as it's still reminding the body of a useful motion system, but the goal is to stay in active therapy through the entire cycling session.

Eh, I guess I should stop and actually post. Those who know, bask in the glory of what hasn't been said... Rock out!

06 June 2009

chez j

Whatup rock stars!

Home sweet home, I'm back for more phys therapy in Detroit. We drove all day lundi, arriving circa 00:15 mardi. Delicious. No skirting around the issue - almost 12h in the car is awful in myriad ways. Upon arrival, though, joy! I had been assigned to a crummy, essentially inaccessible suite to start until a better one became available. However, when we picked up the keys, they were for the same [slightly less crummy, slightly less inaccessible] suite I was in last year... So, without delay, I get a roll-in shower! I'm a psychotically clean person; unfathomably important and meaningful is a daily real shower to me. Yay. I'd describe the two-room suite's layout and all, but last year's explanation is much more entertaining and inaccurate. It instantly felt like home.

My first PT session started about 12h later, consisting of two hours of eval and some time on the Giger. Weee. We didn't do the complete ASIA exam, but strength testing showed that I'm about the same as I was when I stopped in December of last year - not bad, as I went almost six months without any official PT.

Mercredi was the next round. Two hours of mat work, one hour of lower extremity FES bike. Endurance isn't quite where it was, but again, not a big shocker there (oh yes, pun thoroughly intended).

Nonsequentially, vendredi afternoon was round three of PT for the week ("doing the math", that means sessions TWF afternoons for now). We started out with chest presses and rows downstairs on the weight machines; then came some push-ups and such on the Wave vibration plate, followed by significantly better performance on the leg zap bike. Soon I'll be back to ideal levels with that exercise weapon.

Rewinding a day, we hit the highlight: manual chair acquisition! After entirely too many months of insurance battles, compromises, and plain old waiting, I finally have the thing. It's me-sized. It's comfy. With the power assist, it might even be too easy to push. Wheelies all around. Smiles, too.

I'm worn out and there are approximately 6.022x10^23 things to accomplish ASAP, so that's it for now. Welcome back to a blog with a purpose!