Tuesday, September 16

Several of you have asked me questions about yesterday's post--specifically, why has his discharge been delayed if he's advancing so well with walking. Yes, it's true that Tommy's progress with walking has been encouraging; but remember, he has had a lot of sessions, even dating back to his time at Milford Rehab during the month of July, when he was walking along the parallel bars. So, he's been working up to being able to walk for a long time. But there are other skills where he needs a lot more practice. For example, he needs to learn to pivot--that's when he stands up in front of, say, a bed, and he needs
to sit down in a wheelchair that's sitting alongside the bed. Before he can sit down again, he needs to "pivot"; i.e., he needs to move his feet in a simple turning pattern--with assistance from one person--so that his back is no longer facing the bed, but is instead facing the wheelchair. As with other seemingly simple tasks that Tommy has had to relearn, such as swallowing or standing up, it's more complicated than one would think. Think of riding a bike or driving a car; it seems seamless to us now, but when we were first learning, the number of individual things to remember and integrate was daunting. Also, Tommy needs to learn how to reach back behind him to find the armrest of the chair or the side of the bed before he commits himself to sitting down. And, of course, he needs to become more dependable at being able to stand up at all--that is, sometimes he stands up without weight-bearing help from the person assisting, but sometimes he doesn't--and on those occasions when he doesn't stand by himself, it can take a toll on the back of the person assisting him. (I was chatting with one of Tommy's nurses, who told me that the backs of most nursing aides are "shot" by age 40 because of so many years of lifting.) These are all basic necessities before Tommy can come home, where, for much of the time, only one person (that would be me) will be available to assist him.