Sunday, 29 April 2012

29 April - first bike ride!

I've been riding my stationary bike for several weeks now, but today, I rode a bike outside for the first time. Here's a clip of the first moment - a practice run near the bike  hire shop, and then me off with Max & Amy through East Coast Park. A wonderful afternoon - and one more family activity regained. It feels fantastic, for all of us I think! 

Tuesday, 24 April 2012

24 April - two months on

It's two months since I came home from Carlsbad  - already!! So, as some of you have told me, I'm overdue an update!

I started back at work a couple of weeks ago. I'm easing back in slowly, working just two half days in the first two weeks, and aiming to increase to three full days by week 5. When I get to full days, I will start late morning to allow time for my therapy or training. As I've said many times before, the support from Diageo has been phenomenal. I had a really warm welcome back and now there are many people wanting to help ensure that my transition is successful, and that I return to full capacity over time. My boss has told me to structure work around my rehab, not the other way around, which is a fantastic way to help me keep on with my physical recovery, whilst at the same time re-building things on the work front. I'm very fortunate! Its early days, but so far so good - I've been able to get done what I planned to do, in the way I wanted to do it.  I've been tired at the end of each day, but that's to be expected whilst I re-adjust. This is a really big step for me, but the timing feels right and I know I can make a success of this.

I'm driving again!! One of the local hospitals runs a driving rehabilitation assessment. There is no legal requirement to do the test (as far as I know), but it was clearly the right thing for me to do, for everyone's sake. The assessment was pretty straightforward. First, I met with an OT (if you're reading this, hi Florence), to talk through my rehab and my physical and mental condition; and to perform some tests on basic functionality. A week later I had an on road test with a driving instructor. That went really well - except that I completely stuffed up an attempt at reverse parking!! The instructor didn't seem to mind, and I passed and got a certificate that I'm fit to drive. I'm loving the liberation and I've thought to myself that behind the wheel of a car I feel just like everyone else. I do tend to think a lot about the placement of my right foot on the pedals, but last week I drove through a massive storm (big, even for Singapore, which is saying something) - and all of a sudden I found that if my mind is distracted my legs and feet still work perfectly well!! Interesting! More of that later. I thought that I might have some issues with the tightness in my hands, but they are fine - and in fact I think my left hand benefits from having to clench and unclench as I move it from the steering wheel to the gear stick. So, another big box ticked!

In my last post I said that after returning to Singapore I needed to think about which therapists to work with and how to structure my training. I wanted as far as possible to replicate what I had in Carlsbad - a trainer (not necessarily a physio) who might be a kinesiologist or strength and conditioning coach, who could help me with gait training, strength and stability and who understands something about the neurological challenges. It was important for me to find someone with the right attitude - who can share my belief in my ability to beat the odds and make a full recovery, and who can keep me motivated and making good progress. And I needed access to a good facility with the right equipment. I expected to have to piece together a team of several people in different places. Actually, I think I've found it in one person in one place. I've been working with Dr Tan Swee Kheng, whose business is called Fifth Ray Integrated Activities. Swee Kheng ticks pretty much all the boxes. She's not worked with an SCI client before, but I didn't expect to find that outside of the main hospitals. She has a really cool facility in a warehouse down by the river. She does a lot of work with kids, but also gait, running and conditioning work with adults. Five weeks in, I seem to be making really good progress, especially within the last week when a lot of the gait training and strength work really seems to be bedding in, to the point that my movement has become more automatic and fluid and less effortful. Swee Kheng took a few videos of today's session, which I will post soon. 

Its a strange thing - I can now count at least 5 times during this rehab when exactly the right person has popped up at exactly the right time to help me on my journey. A couple of people have said that its about putting it out there and allowing the universe to arrange it. I'm beginning to believe it!!!

One of those people was Andrew Liaw. Andrew popped up as a cranio sacral therapist last October. He's also a physio and over time we started work at the gym and the track. Andrew had a quite uncanny knack of reading exactly what was happening in my body and his exercise program was a really good pre-cursor to the stuff I did at Project Walk. He's had total faith in my ability to recover, and has been hugely motivational. I'm now moving off on a different path (for a while, at least) but want to say a really big thank you to Andrew. He keeps a fairly low profile, but if anyone in Singapore wants his number, give me a shout. 

I'm still working very hard on the rehab - twice a week with Swee Kheng, twice a week at the gym near the office, once a week on a long walk, Saturday mornings in the pool, and every day a "get me moving routine" first thing in the morning and stretches at night. I've hooked my bike on to a stationary bike stand, and do a half hour ride on that once or twice a week. I also have one OT session a week, and try to fit in a weekly massage. A lot! 

In the first few weeks back from Carlsbad I struggled with increased tone, especially extensor tone in my right side, which causes my leg to straighten and forces my foot into plantar flexion. That seemed to worsen for a few weeks. Having spoken to a consultant and physio at the hospital, and to Swee Kheng, I decided that I needed to adjust my exercise regime, reducing the intensity in some areas for a while to allow me focus on form and quality of movement. That has meant that for the last few weeks I have pulled back from jogging, reduced the amount of jumping and shifted away from a focus on speed. Other than that, the home program that David, Genny and Steve built for me is still the core of my gym routine. The results seem good. Over the last few days there has been a noticeable improvement in my gait. I've felt much more fluid and smooth pretty much every time I have moved. Today I noticed that I am putting less mental and physical effort into walking. And that is making the whole thing more efficient - and faster! Other people are noticing too - especially Ali!

One strategy to address the tone is to try to divert my mind from it. That's really hard to do, because the tone can dominate my movement and I've developed a habit of thinking hard about every step. But over the last week or so I have had a bit of a breakthrough and found a technique that seems to help. I'm learning that if I can distract my mind to something else (eg to think about putting force through my left leg), my right leg is able to move automatically (almost) and more smoothly.  

The last few weeks have been tough going sometimes. I've felt low some days and sometimes felt that my progress had slowed, or even slipped backwards. That's the first time I've experienced that, other than for the odd day or so - and I know how fortunate I am to be able to say that. But I never expected my progress to be straight line the whole time, and in some ways its good to have been through this - I've learned how to come out of it. And I expect I'll need to use that knowledge again some time.

Ali is battling hard with her own recovery. A few weeks ago she went on an intensive therapy course in Australia. The course is known for being pretty tough, and Ali was anxious about going, but she did so, very bravely. She had a good experience, made some breakthroughs and came home in a much better place than before she left, and with some tools and techniques that will help her as she fights on. Its still really hard going for her, but she keeps on fighting.

The kids are doing fine. Max has got me playing football on the drive (my right leg moves much slower than my left, but the fear of falling over when I kick the ball has gone away!) and Amy has me playing tennis. Amy is storming ahead with her reading (not far off chapter books!) and Max is in a school play this week!

That's it for now. I'll post some videos soon.