Me, "V" and a Dose of PT

Having worked in the Human Services field for twenty-five years, I have become all too familiar with the many facets of health care that I am not at all capable of doing on a regular basis.  

 

Earlier in my career, when I first worked as a direct caregiver in a group home for the mentally ill, I got my first glimpse into emergency psychiatric care.  All I can say now is WOW!  In fact, that's all I could say back then, come to think of it.  The people who devote their lives to staffing a psychiatric crisis unit are amazing, and I have always been in awe of the incredible work they do.

 

Later on, after I decided to become a case manager, I got to see other aspects of the health care field.  Nursing always fascinated me, and at one time, I seriously considered this course of study.  With degrees in English Education and Counseling & Human Development, I knew that my occupational choices might be somewhat limited.  I also knew that I would never in a million years be able to pass the science classes required to become a nurse.  (Yes.  I admit it.  My self-esteem was flying quite high back in those day!)

 

Over the years, I've had occasion to visit many of the people I serve in a variety of settings, including medical hospitals, psychiatric facilities, state-run institutional settings (which, happily, have been almost virtually eliminated as a method of caring for the disabled in New York State), rehabilitation centers, nursing homes, assisted living facilities, community residences, supported apartments, and most often, in their own homes. 

 

And I've also been privileged to sit back and observe the many incredible tasks performed by staff members ranging from Janitorial Workers to Dieticians to Nurse's Aides to Unit Supervisors to the Chief of Medicine him or herself.  And I have developed a much deeper respect, understanding and compassion for all aspects of health care, particularly for those individuals that perform their roles with such seamless expertise and dignity.  Think about it.  How many jobs can you name that, to be done at their absolute finest, involve a delicate balance of both expertise and dignity?

 

This past weekend with "V" truly highlighted just a sample of the incredible work that those who are not in the specific profession of caregiving do on a daily basis.

 

I arrived at the Rehabilitation Center on Friday afternoon to perform my usual weekend shift only to find an extremely exhausted "V" sitting in a state-of-the-art reclining chair... complete with wheels (trust me, the wheels will become a big part of this blog in a few paragraphs!).  In fact, throughout the rest of the evening, including dinner time, "V" could barely keep her eyes open. 

 

Overall, "V" looked far better than she had when I  last saw her the previous Sunday morning.  Her hair was brushed nicely.  She was fully dressed in her usual plain colored T-shirt and jeans.  And most noticeably, she had on bright, perhaps even blinding, neon socks.  Socks suited to "V"s preferences perfectly!
 

"I'm sorry I'm so tired," "V" explained to me apologetically after I arrived.  "Today was shower day," she continued, straining to even say the words.

I looked at the bulletin board of the day's activities, and there it was in big, bold, black magic marker:  SHOWER!  And not the kind of shower where the patient sits in a bath chair and the nursing staff gently do the washing.  No...  After only a week in the Rehab Unit, "V" was being taught to wash on her own (which is a skill, I suspect, that she already mastered during the previous ten decades!).  Specifically, "V" was learning how to reach parts of her body that could be very difficult due to her body's recent trauma. 

"You don't need to apologize," I replied comfortingly.  "I like you just the same whether you are awake or asleep!" 

"It's good to see you," "V" smiled wearily, but her eyes began to close again almost before the words were out of her mouth.

"You too," I answered, not sure if she heard me or not.

The day-time caregiver had left for the evening, but one of the nursing staff came in and explained to me exactly what type of activities "V" had done during the day.  As it turns out, not only is Friday shower day, but it also involves a regular Physical Therapy session, which "V" had been participating in daily throughout the entire week. 

"That's why she's so tired," the staff member stated.  "She's been working really hard in Physical Therapy, and is making terrific progress."

Hmmmmm... I decided that I would like to observe a Physical Therapy session for myself, just to see exactly what the Rehabilitation people were making "V" do that would wear her out so completely.

They say (who exactly are "they"?) be careful what you wish for, and that generally turns out to be true.  Sure enough, the next morning, I had the opportunity to observe/participate in a Physical Therapy session.  And now that my shift is over and I am writing about the experience in hindsight, I think I am still in the process of recovering! 

The perky physical therapist arrived bright and early on Saturday, shortly after "V" had finished her breakfast, used the commode and gotten dressed (all with assistance, of course, but nevertheless AMAZING progress from the condition I last saw her in less than a week ago).  

Actually, it wasn't that early.  10:00am to be exact.  But when a ninety-five year old woman is recovering from a hip replacement, every single activity, however small, takes a great deal of time.  To her, and to me (a former night shift worker), 10:00am is early!

When the Physical Therapist arrived, first introducing herself because she was not the same person who had been performing the therapy during the week, I could see "V"s expression tighten into a bit of a frown. 

"Already?" "V" asked, the weariness returning to her voice.

"Yes!  Time to get up and going!"  The Physical Therapist explained that she would be walking next to "V" down to the gym, and my curiosity was instantly peaked.  "A gym?  What would a ninety-five year old hip replacement patient possibly do in a gym?"  I wondered.  That silly slogan went through my head again, and I knew I needed to stop wishing and wondering.

"You have a job, too!" the Physical Therapist said pointing at me.  "You get to roll the chair down!"  Aha!  There it was!  The explanation for the state-of-the-art reclining chair complete with wheels!  And don't for a minute think that just because a thing has wheels, it rolls easily!  Me and the magical mystery chair struggled down that looooooong hallway all the way to the gym.  I completely forget how "V" was doing with her walker.  This was difficult!  I'm sure all of the staff members must have been quite amused at my inexperienced antics, as they had all rolled the beast before.

Once in the gym, I was instantly in awe of all the equipment and gadgets.  Parallel bars (was "V" training for the Olympics?).  Giant, colorful rubber balls (what fun!).  Cushioned mats placed strategically throughout the room (in case a nap is needed?).  A bicycle made for only the arms (now that looks kind of fun!).  All sorts of "toys" (that's what the therapist referred to them as!) that were brand new to me.  I liked this gym!

My fascination turned to consternation quite quickly, however.  This was a house of horrors!  At least for someone five years shy of a century! 

I stood near the doorway and carefully observed the Physical Therapist's actions with "V" from start to finish.  Some of them didn't seem too difficult at first glance.  Laying on the mat and spreading each leg out.   Lifting each leg up and bending at the knee.  But twenty times each?  That was a lot!  I could see "V" growing tired by ten, and struggling to continue by fifteen.  I could also see a great deal of pain in her face.  These exercises must have been excruciating for someone who just had a hip replacement! 

And yet she persevered, diligently counting off each number with the therapist until she reached twenty for every single exercise.  After the mat, "V" was offered a cup of water and a rest in an arm chair, and she eagerly accepted both.  She looked over at me, and I gave her a broad smile and a big thumbs up, but I'm not sure that was exactly the boost she needed to complete the session. 

"You're doing GREAT!" I softly yelled across the room, and she smiled wearily letting out a deep sigh at the same time.

Next up were the standing exercises, done at the parallel bars.  My heart sank for "V".  Standing for a length of time was difficult before the injury, so I could only imagine what it would feel like after the surgery.  Luckily, the Physical Therapist placed a chair behind "V", just in case. 

Since I was standing as well, I decided that I would participate in the activities along with "V", so I would know what they felt like.  I didn't have parallel bars to hold, but I was able to find two sturdy chairs to steady myself in between.

"You're going to raise yourself up from your heels to your tip toes," she explained to "V", who was clutching the bars tightly.  "Twenty times."

Okey Dokey.  Here we go.  Up and down.  Up and down.  After a couple of ups and downs, I concluded that this wasn't all that strenuous. 

I soon realized that I had jumped to that conclusion all too quickly.  My legs began to feel the strain at around ten ups and downs.  My first thought was one of embarrassment at my pitifully poor physical condition.   That swiftly turned into my second thought, which was how horribly difficult this exercise must be for "V". 

Yet she still persevered.  All the way to twenty ups and downs.  Then the Physical Therapist had her sit down in the chair and drink some more water, which she gratefully did. 

As for me, I leaned up against the wall trying to disguise my panting as regular breathing.  Granted, I do have Asthma, which sometimes is affected by a lot of movement, but still...  It was only twenty ups and downs!  It wasn't as though I had done laps around a track or anything!  

"2014's New Year's Resolution," I thought to myself.  "GET IN BETTER SHAPE!"

At this point, I truly hoped that the session was over for "V", who looked so very tired.  Wrong again.  Apparently, the crafty Physical Therapist had saved the best for last.  In fact, I hadn't even noticed this particular "toy" when I first entered the gym.  But there it stood distinctly in the far corner - a set of stairs.  Three going up, then a little platform, and another three going down.  Of course there were railings on both sides of the stairs, which would be absolutely necessary for "V".  Even so, it seemed to me that going up and down steps after a hip replacement, even though there were only three, was a wee bit too much for someone in their tenth decade of life.

It didn't matter what I thought, however.  What mattered was "V"s sheer willpower and absolute determination.  And it was mighty darned strong!  My admiration for her increased with every step she successfully navigated up and down.   This was a tough as nails woman who desperately wanted to recover from her trauma and get back to living in her own home.  My eyes swelled as I watched her, and I was filled with an extremely well-justified sense of awe and a rather odd feeling of pride, as though I was seeing my own Grandmother complete the exercises.  Absolutely amazing!

The Physical Therapist snapped me out of my near trance when she declared, "You're all through for the day!  Time to go back to your room!"

I could see "V"s face relax as a smile slowly slipped through her lips.  "I'm glad that's over!" she said, a tone of great relief in her voice.

"Here's where you come in," the Physical Therapist added, pointing at me.  I had hoped that she may have been pointing at someone else, but unfortunately for me, other than "V", there was no one else in the gym.

"If she needs assistance getting back to her room, you can help push her," she continued.  She pointed again, only this time it was to the state-of-the-art reclining chair, complete with wheels!

"Oh no!" I thought selfishly.  I looked like a buffoon the first time around, and that was with an empty chair!  I'd no doubt look like an absolute circus clown with someone in it!

I then realized that the state-of-the-art reclining chair complete with wheels was another "just in case."  "V" started her trek down the long hallway completely on her own, using only her walker.  The Physical Therapist, whose skills I had grown to truly admire over the course of the past hour, slowly walked beside her, guiding "V" gently. 

And holding up the rear, of course, was me... and the chair!

"You can sit down if you need to," the Physical Therapist softly told "V". 

I was amazed that this woman, who, after all, had been the one responsible for inflicting all those painful exercises on "V" had such a compassionate side.  That's when I also realized that hers was not at all an easy job.  She needed to be seemingly "tough" on her patients in order to motivate them to complete the often difficult physical activities that would make them stronger.   I don't know if I would be able to successfully balance being both a Drill Sargent and a Social Worker, depending on which role was needed.  What I do know is that I don't have anywhere near the training and expertise it takes to successfully utilize so many varied physical therapy techniques.  All of the pieces of equipment in the gym were not toys at all, but rather skillfully crafted devices designed to ensure optimal recovery to specific body parts.  And in "V"s case, the outcome was incredible.

She didn't need the state-of-the-art reclining chair, complete with wheels to make it back to her room at the other end of the hall.  Not in the least!  She walked down that long hallway all on her own, using only the walker for support, along with a spirit full of sheer determination.  This was a woman who was clearly motivated to get stronger, so that she could return to the level of independence she had before the fall.  The Physical Therapist had definitely done her job!

As I watched the various hospital staff members perform their very distinctive duties throughout the rest of the day, I was filled with a sense of great respect and pride for all of the people who choose the Human Services field as their vocation.  It is not an easy job. 

And I was filled with an even greater sense of respect for the amazing woman that I had been chosen to care for. 

How grateful and proud I am to be a part of "V"s caregiving team.