I had an appointment with my physical therapist this morning for assistance and training in the use of my walkers. It was a very helpful session in that it reinforced most of what I had come to expect in operating my walkers. It was less helpful in planning for the future which was my second purpose for the appointment.
You see, I feel that as I progress from nothing to cane to walker that the next device will either be a wheelchair or a motorized scooter. But both my doctor and my physical therapist keep saying they don't want me to go to a motorized unit because once I do I'll never go back. As an example they ask me if I'd ever go back to just using a cane now that I have a walker. I admit that I can't imagine going back to just a walker. They seem to assume that I went to the walker when I could just as easily kept using a cane and that I would go to a motorized vehicle when I could just as easily keep using a walker. When I try to explain that I can't go back to a cane because it's no longer safe for me, they act like I didn't try hard enough.
That's an interesting but very biased viewpoint. I hope I'm wrong because such an attitude does a disservice to their patients and doesn't reflect the best options for a person with a steadily decreasing motor function. As I understand Parkinson's my muscles are no longer "learning" in the sense that actions practiced long enough become automatic. So once a cane became non-useful, no amount of cane "training" or cane "exercise" can make it useful again. It seems to me that persistence on trying to "hold back the degeneration" will just aggravate the patient's feeling of helplessness and isolation.
Arnold, I agree with your assessment. When you need the next step their is no use trying to hold onto the previous state! But, once you are in a power chair or scooter you will probably not walk much because it takes so much more work. I absolutely need the power chair to move about in a timely manner. But I could still exercize by walking in the hall after going to the bathroom. Allyn just cut the wall between the hall and the bathroom to enlarge the doorway so it is big enough to get my powerchair in--I was on the brink of falling too many times just getting from the chair through the door and onto the toilet and back! So I don't know how safe it would be to walk the hall, and haven't tried it. The big downside for this behavior is that we lose bonemass more quickly. Mom can't stand up without falling down and must use a sliding board to get from the recliner/lift chair to the cammode to go to the bathroom, and a sliding board to get from the chair to the scooter to get to the bathroom to the shower (and the board again to get from the scooter to the shower bench!) She is 84, and started limping at 62. She fell several times when not using the scooter--once to get to the bathroom from the bed, and another time to stand up to get the mail outside the door. Healing from the complex fracture took a long time, which had her off her feet. Another fall from the lift chair to the camode broke her hip. So weight bearing exercize, as well as extra vitamin D and the vitamin K found in deep green vegetables helps the bones and balance. (Vitamin D helps for so much more than "just" bone strength--it also helps with balance, muscle strength, and immunity.) I don't know if those initial breaks would have occurred if she had done regular, planned exercize. But any exercize needs to be safe.
ReplyDeleteOn another note about bone loss--it is not restricted to females only! It tends to show up later in males, but often that is because males have been more physically active. If you can't walk much, or if you are on prednisone for another disorder, you will lose bone mass just as quickly as Carolyn would.
Cousin Marilyn
Can't imagine how frustrating this must be. Wish you the best at this time of challenge in your life. Think you are handling it well. Your positive attitude is commendable.
ReplyDeleteMy guess is they are trying to be helpful, and not really succeeding. Perhaps most of their patients are more discouraged and less objectively observant than you are?
ReplyDeleteI can't imagine how I would respond to a condition like yours. I walk the neighborhood most days, not because our neighborhood is that attractive, but because I intellectually know that if I don't exercise and walk that muscles will atrophy, bone mass will go, balance will fail, etc. Just getting older is a trial without a debilitating condition. You have talents beyond mine and I appreciate your sharing them with me. I could never sing without your help and I know that the months that I stayed away from music cost me voice and musical skill which I shall never regain. Hang in there!! Go motorized when you absolutely have to, but not before.
ReplyDeleteI appreciate all your comments of support and advice. As far as I know, we only get a chance to live life once so it is certainly helpful to learn from others.
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