Therapy? Yes, Therapy?

I’ve had a complicated relationship with occupational therapy for as long as I can remember.  Or, since I started remembering things again.

Cover of Therapy?'s "Nurse" album.
Therapy? Yes, Therapy?

Physical therapy was always fun, what with the robotics ‘n’ all.  The improvements it generated were obvious.  You can’t really get the benefit of OT before your body’s somewhat functioning again.  When half of your body is broken, you really have to throw yourself into PT. And physical therapists seem to be a jolly lot, whether it’s because they’re so used to having to be upbeat for the damaged, or because, in my case, they’re getting to treat someone with a decent upside.  Who can be occasionally hilarious — don’t let the blog fool you,

Speech therapy was OK too, after a while. If a little odd, for the victim of a right-hemisphere stroke.  No aphasia, y’see.  But…

After the daily frustration of having to dig so deep for the day and date in speech therapy every morning, once my brain started working a little better, we would work on logic puzzles and discuss the merits (or otherwise) of the monarchy and the BBC.  Much more my scene.  Much of the time, one’s speech therapist is happy to hear one talk and express occasionally organized thoughts.  And, as you’ll be gathering, I’m happy to hear myself rabbit on (audibly or internally) at great length.  And when I was presented with pun-based quizzes, I promptly expressed my delight, and they became a regular highlight of the day.  To misquote and misattribute, as Wilde said, “puns are the lowest form of humour, but the highest form of wit.”  Finally, regular readers who have functional memories may remember that, when I was visited by the speech therapist from the Visiting Nurse Service, that just turned into an excuse to run into a long monologue about the Continuity and Internal Consistency (Or Otherwise) of Doctor Who (1963-2012).

Magnus Magnusson, the former host of British TV quiz show, Mastermind
“Your specialized subject is being a huge geek. You have scored 28 points, with no passes.”

[While we’re on the subject, Magnus’s Scotland: The Story of a Nation, which we’ve recently started reading, begins remarkably well, and so far, I’d recommend it.]

OT, on the other hand….  Practicing my ADLs (getting in and out of the tub/shower, making scrambled eggs in the microwave) in the days before my release from the Hospital for Joint Diseases was clearly beneficial, and kind of fun.  But some of the other OT activities, not so much.  Calling in the restaurant delivery order for one of the therapist’s birthday’s — to which I wasn’t invited — kinda harsh.  Using the internet to book a pretend week-long vacation out of the country, on a specified budget…?  Kind of a fun little fantasy, but the sort of thing that, back in the day, could easily fill over half of a workday.  Then, when I proposed a trip to Edinburgh, and staying at my dad’s place, that wasn’t allowed.  I was livid!  What about the need for “flexible thinking” that I was always being told about.  Not being able to fantasize about a nice little trip to the homeland with my girl was a bit cruel, to say the least, when all I immediately had to look forward to was dropping my useless 300-pound block rubber left arm on my head again that evening.  So, yeah.  The occupational therapists were less jolly.

And the pattern seems to have been continuing in outpatient therapy.  PT is kind of fun.  OT leads to a lot of questions about whether I’m doing my exercises at home often enough.  But this week, it was pretty interesting, and some strides are being made.  As soon as outpatient OT kicked off, only recently, with my intake and assessment appointment, the weakness and awfully restricted range of movement in my left shoulder were identified and measured. As was an almost total deficit in recognizing temperatures in my left arm.  Which I suppose could be pretty dangerous.

Now, a weekly OT session starts with a heated blanket around the shoulder before a fairly lengthy (15mins?) and intense session of manipulation.  I’ve also been given a number of related exercises to do at home, ranging from self manipulation…

Frankie Howerd in Up Pompeii
He’s ba-ack!
“Oo-er, missus. Self-stimulation? Sounds naughty.”

to therapy putty…

Rick Moranis and Slimer in Ghostbusters II
Ricky does some therapy at home.

… to flipping coins and pens and using scissors (with supervision!) and the like.  Between all this, there was a little more looseness in the shoulder this week.  After that part of the session, we went on to sensation work.  One box (around 6″ x 6″ x 12″) was filled with little, smooth plastic balls.  A second was filled with gravel-like material.  Picking up fistfuls of the stuff and transferring them to a jug, while recognizing the associated sensations, was fine.  The shocking part came when small plastic disks were added to the mix.  Like tiddlywinks.

A circle drawn on a crumpled piece of paper, from The Hudsucker Proxy
A tiddlywink. You know…. For kids.

At this point, I had to pick the tiddlywinks out of a fistful of the other material.  With my eyes closed!  I was amazed at how difficult this was.  There seems to be a sequence whereby a particular left-body part is so effed that I don’t even realize that there’s particularly anything wrong with it.  “Left-sided neglect“, I guess.  Then, at some point, it feels….  Well, there’s hardly any way to describe it.  It’s not “sore”.  Or “tingly”.  Or “nervy”.  It just feels… “weird”.  Finally, the affected body part starts to return to normal.

So, when my palm couldn’t even remotely recognize the tiddlywinks, it was shocking.  I thought my hand was doing OK.  As it turns out, it seems that the tips of my fingers — which I thought were a bit useless, because they felt a bit, yes, weird, are doing most of the feeling work.  I pointed this out to my therapist, admitting that I seemed to be using coping strategies to counteract the gimpiness of my hand.  And she didn’t seem in the least concerned.  Seems like I’ve found an occupational therapist who’s going to be a bit jollier….

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