Beginning as an Outpatient

Returning to the rehab hospital was strange to begin with; so familiar yet so different. I was in surroundings that I knew so well, but my part had changed. I was no longer part of the surroundings, I come and I go again. On that first day, I met my new physio. With this new stage in my rehab, with a new physio, that first morning was spent undergoing a new assessment. And the assessment was very humbling.

I had to retell my story from the beginning, including what the nerve damage was like pre-op and the kind of progress I had made within the three weeks post surgery. We tried basic exercises. Lying on the bed, knees bent up, then keeping one knee still, allowing the other knee to fall to the side and bringing that knee back up again. If I thought about it, I could bring up my left knee, very slowly though. But no amount of thinking would move my right knee from its fallen position. We did more of these simple exercises and each time my right leg failed and my left leg did only a little bit better. By the time the physio got me up from the bed I thought I had gone back to step one. And by the end I knew I was right. The physio asked me to sit on a chair. I knew that I had the muscle control to sit back part of the way, but then I have to let myself drop, trusting that the chair was still there. The physio then asked me to stand up again. She took my walking stick and asked me not to use my hands to push myself up. So all I could do was stay there. I couldn’t get up. She asked me once more to get up, but all I could say was, ‘I can’t’. She asked me to hold onto a chair that she had placed in front of me, I managed to move an inch up from the seat, but then fell back down again.

She could see through the progress I had made. I thought I was further down the track than what my new physio proved to me that Tuesday. For some, this could be discouraging, but for me that outpatient assessment acted differently. The assessment brought a sense of reality. My physio had set the baseline. This new stage of rehab was now about moving forward knowing exactly what I couldn’t do.

So the pattern began. Rehab twice a week. The second day as an outpatient was the following Thursday afternoon. I signed my form, waited for my physio, and walking with her to the physio room, she told me her plan. She didn’t want to move straight into a program until she had further assessed each major muscle group in my legs. So for the next half hour, the physio put me through a series of slow actions, moving through each muscle group. I had to think hard about every movement. Not many actions were smooth, mostly they were spasmodic and shaky. The physio didn’t let my concentration lapse. Relentlessly, she fed my mind instructions. I didn’t move off the bed, the physio just worked her way systematically grading each muscle in my legs. For the first time since the surgery, I was moved to lying on my front. Unexpectedly, I started to panic and I had to keep telling myself to breathe and relax. What we learnt that day, which we didn’t know before, my muscles had lost the ability to extend my legs behind me. The half hour of continuous and repetitive movement, thinking about how to do each move, left me mentally and physically exhausted. But my physio was very clear afterwards. I just don’t have the muscle control or muscle strength to do standing exercises. I would be doing physio from a lying or sitting position until my muscles were stronger. So from that first week as an outpatient, I started again.