354. How and Why to use an AlterG Anti-Gravity Treadmill

Using an AlterG | Ann Ning Learning How

I’ll refer to an AG Treadmill simply as an “AlterG” bc in my mind it’s like how “Band-Aid” is considered synonymous for an adhesive bandage. The only other kind of AGT I’ve used is a ZeroG (the giant Baby Bjorn) at Planet Rehab. I don’t know of any other ZeroG’s anywhere else so for convenience I’ll talk about the AlterG. I’m not affiliated with this company – I’m just providing information I wish I’d known before I started.

I have spent 2.5 years perfecting my outpatient persona – e.g. to accept the Therapist assigned to me, learn whatever I can, and make his/her day go by fast. I’ve tried not to be picky. It’s been easy bc I have consistently been given real winners. I made a genuine effort not to harbor unreasonable expectations (esp. after M37) but one of the marks of God’s care for me throughout this process is that everyone keeps on being a highly proficient practitioner. So now as I near the end of my outpatient career I’ve gotten choosier.

I’ll get back to the AlterG in a minute – this is related, I promise. As I transitioned to Medicare via Kaiser I chatted with a Rehab Receptionist to set up my eval and told her I needed someone with an appropriate skill set. When I went to The Gym I indicated that my work ethic would be strong but I needed my trainer to know what (s)he’s doing. When I started talking about core strength during that initial “interview” Trainer D’s eyes almost fell out of his head in a retrospectively hilarious moment of resonance.

33.  *Are you using your core?!?!?*

33. *Are you using your core?!?!?*

This is a central tenet of long-term Recovery: signal to the market. Let people know you’re in this to win it by having the forethought to indicate what you want, what you can do, and what you need. Making your intentions clear increases the likelihood of getting your goals met and (if an issue) gives the organization a chance to assess the risk-level they are taking on when you come in.

84.  I Come in Peace

84. I Come in Peace

I did this with Coach R. It paid off bc while I was expecting a simple transaction (time rental on the AlterG) I ended up signing an important ally for ORFR. I told him I was going to get picky simply because at this stage in the game I can and if I was going to get treatment it was going to be from him. When advising me on what to do, I think Coach R used the phrase, If you want to do this right… We’ll work on balance, strength, and spatial awareness so I won’t always have to depend on an AlterG. But while we’re working on it I am SO thankful to have the opportunity to use the equipment available to me. This is why and how you can, too:

Why to use an AlterG

  • Choose the body weight % you want to load (20%-100%)
  • Great for rehabilitation of injured athletes, or those who wish to keep training (e.g. pregnant marathoners) without high-impact workouts
  • Eliminates falling risk (!!)
  • 59.  I'm not doing that.

    59. I’m not doing that.

    There are harnesses you can put over a treadmill making it impossible to fall out, but most do not have anti-gravity/unweighting capabilities. Even if it does M37 explained that a harness allows the practitioner to move your legs for you if you need it, but the AlterG requires a higher level of mobility bc your legs are sealed in the bubble – training is eyes-only. People usually peer through the large “windows” around the bubble and offer feedback. Some machines come with cameras and a screen in front so you can watch your feet. I used to watch mine all the time at The Southern Gym (the PT practice where I used the AlterG last summer) bc my left leg strays beyond the confines of the belt when tired. I must rein it in intentionally.

How to use an AlterG

  • Find one: Go to AlterG.com. On the top right and side-bar there are zip code fields that yield a list of local AlterG’s. (I think this is a U.S.-based service presently – sorry, international friends!)
  • Weed through the list: Many of the places will be clinics requiring you to be a patient with an Rx – the machine is not for public usage. Some boutique gyms or running stores have an AlterG. Sports teams might have one, too, but this is not helpful for most. I prefer PT practices that rent time on the AlterG. If you can’t tell from their website, give them a call: 1. Confirm that they have an AlterG on site. 2. If yes, do they rent AlterG time to the public?
  • Make your initial appointment and think of the package you’re interested in – e.g. # of minutes per week. Some places give you an initial training on how to use the machine (this could be an extra fee). Others have their own people always on hand to help you in.
  • Be prepared to wear funny shorts. Some places ask you to purchase your own if you’re going to be a regular user (around $75) and others keep an assortment of sizes on hand for your use. They are like neoprene bike shorts with a narrow rubber tutu around the waist that you slip over whatever you’re wearing. The tutu has a zipper around the edge. When you step into the deflated AlterG you’ll step into the circular hole in the middle. They’ll pull the frame up to your waist (Coach R prefers it to sit slightly lower to allow for greater freedom of movement in the arms). It locks into place and then you/they connect the zipper on your shorts to the one on the AlterG. Now you’re zipped in to the bubble.
  • Turn the machine on, or your practitioner will do it and advise you on arm placement to promote an accurate weigh-bearing calculation by the device as the bubble inflates. Choose your % load, speed, and enjoy your walk/run!

PS. The title picture is me at The Southern Gym with my niece Hannah. Ai Ai was reluctant to let me walk the 50 feet inside the building to the Southern Gym but occasionally allowed H to accompany me – but she had to hold my hand. I haven’t held Hannah’s hand since she was 3-4 and we’d zip around town and have fun in general. I had no idea my sister took this picture. I was too busy looking at my feet on screen.

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353. Team Tanimal

Team Tanimal | Ann Ning Learning How

Obviously, Ed Blueberry is Captain.

My Post-Rehab Recovery Starting Line-Up has a new name: Team Tanimal.

There are no benchers or subs on Team Tanimal.  If you’re here plan on working hard.  We’re playing for keeps and I will extract every ounce of your expertise.  I have ways and means.

“Tanimal” was a nickname from my first job.  I only heard it once (to my face) but I thought it was hilarious.  I showed up one day to visit the Maryland Brokers (I used to work in corporate real estate) and as I walked in I heard, Here comes the Tanimal.  I used to click around the office in heels and pearls, wearing very Washingtonian twin sets etc.  But they could see beyond the cover and knew I would not be leaving until I got what I needed.

These days I’m not always sure what I need – so I gather knowledgeable people around me.  To that end, I successfully recruited Coach R to join Team Tanimal last week.  Coach R is the one who wanted more info on the atrophy thing he saw going on with my left side.  But when he asked me to do a squat I was convinced that Team Tanimal could use him.

This is how my squatting skills have developed:

June 2011:  RIO (3rd Hospital)

A(2) :  Let’s do some squats!  (enthusiastically)

Me:  snicker snicker

A(2):  What’s so funny?  (in the usual longsuffering voice)

Me: Umm….I don’t think I could do those in normal life.

October 2013:  The Gym – entry evaluation

Trainer D:  Can you do a squat?

Me:  Pshaw! (scornfully) Can I do a squat?

Trainer D:  It was a theoretical question!  (I was already halfway off the table – I interpreted the question as an order.  That’s how it usually works.)

February 2014:  The Running Gym

Coach R:  Do a squat.

Me:  I need to hold something – (looking around) – do you have a kettlebell? (Realizing Coach R wouldn’t give me anything – now he hands me a weighted ball) Will you demonstrate first?

Coach R:  No.  I want to see how you do it.

Ummm…hello?  I have a brain injury. Tough crowd.  PS. He was not satisfied with my plié.  But for once it’s not Trainer D’s fault – I did a plié in protest when Coach R declined to demonstrate.  Heh heh.  The last time I saw him he upped the ante by producing a tension belt, holding one of my arms, and informing me that we were going to do standing single-leg squats.  I burst into spontaneous laughter.  And then I looked at his face and realized he was serious.

But really, Coach R is super nice, so in the following week I pondered whether I should rent time on the Alter G (the anti-gravity treadmill) or sign up for Post-Rehab sessions with him.  I decided that given the concerns voiced by my PT and CMD, my parents’ interest, and my habit of getting too excited about new pursuits when left to my own devices I’d do well to recruit Coach R in an official capacity.

So, unlike Trainer D, I gave Coach R a choice – and he said Yes, he’ll help me.  YAY!!  A couple of things he said on my first day – the “interview” – really intrigued me: 1) You could run on the Alter-G first and then when your muscles are fatigued it will be a better challenge to do the exercises after.  2) If you are able to attend to the deficits (e.g. in my hips – he had identified them within 10 minutes) you will see dramatic changes in your gait.

Prior to this I’ve been working on protecting my energy  But now I’m facing more scenarios that will require significant up-front energy  investments, and a robust chi as time goes on.  So building stamina in this context first is good.

Furthermore, it’s only lately that people (that means Trainer D) have proposed the idea of targeting certain muscle (groups) to help me reach specific goals.  I haven’t been ready to focus on isolated strengthening before this.  It’s been more about – use your eyes…walk…walk better…stay vertical…don’t lean to the side…  But now I’m praying I’m finally ready to attain a higher level of fitness beyond not falling down.

BTW when I say “run” I mean a very gentle jog on the anti-gravity treadmill.  It’s impossible to fall out, I can choose the body weight % I wish to use, and I only trot for 3-5 minutes at a time.  ORFR is an experiment to help manage my stress levels as they’ve increased lately.  That’s another reason I’m praying my body is ready for this – exercising really helps me feel better but I’m also half-waiting for something to happen.  My legs could already be showing signs of this new level of usage (it’s only been 3 weeks) – but that’s why I’ve got Team Tanimal – part of their function is to tell me if I need to go get checked out again.  (Please pray that I don’t.)  I feel like I’ve been building momentum since beginning acupuncture etc. last year, but I know from experience that regression happens and it’s disappointing but it’s a part of RecoveryLand.  My progress has been largely driven by people simply asking or just expecting me to do things – e.g. sit in a chair upright or do a plank.  So I have been busily recruiting people to do the asking and who can also teach me how to do things if I need to (re)learn.

Oh yeah – now that you’ve met Coach R fyi his name might change.  I call him “Coach” to differentiate him clearly from Trainer D, although Coach R’s certification is as an Athletic Trainer.  I’m going with “Coach” for clarity, but I’ll take his feedback.  However, the names Dr. Frankenstein, Gargamel, and Mr. Miyagi, are all taken. So I hope his heart was not set on any of those.  Otherwise, the sky’s the limit!

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352. Ed says, “Well that backfired, didn’t it?”

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I’m getting kicked out of Therapy. It’s Trainer D’s fault. I did clarify that “I BLAME YOU” = Thank you,” but this is too important for me to say in any other way than code except this once. That moment has passed and I’m back to feeling happier when I hold him personally responsible for this.

I’ve not been discharged yet. I’m downgraded to 1x/week, and then 2x/month after March, with discharge as the end goal. In Q4 ’13 I told my PT I’d need as much notice as possible pre-separation. At that point her answer was You stay here as long as I say so. And I say so. I’ve avoided writing about PT in order to protect the identities of the innocent – but let me assure you that there is a LOT of laughing and the whole crew produces oodles of entertainment.

Trainer D is also highly entertaining and I have no hesitation when writing about it since he generously gave me free reign here. The reason I know this is his fault is because I actually felt a difference after ~3 months of training. No other variable has changed in my Recovery. This is an example of sensitivity analysis. If you build a model and are considering the impact of a cheaper supplier or a more expensive marketing firm you change one variable at a time. The extent to which your bottom line shifts is traceable to that specific variable.

87.  No Modeling in Public

87. No Modeling in Public

I walked into Rehab one day and my PT called from across the room, You look really good.

So I put Leo the cane down and asked her to watch me for real. K (the Speech Therapist) passed by and saw a difference, too.

Notably, the gait deteriorates with fatigue. I saw M37 that weekend right after church so my walking wasn’t looking that great. Overall, my score on the walking scale is still only a 5-6. I asked R (I’ll introduce you formally tomorrow) last week. It looks like I’ve had a hip replacement or something (per my request this was accompanied by a hysterically apt imitation) but it would be hard to notice if just passing me in public. I’ll take a 5-6. That’s better than the (low) 2-3 C gave me when she did my Planet Rehab eval.

117.  AVM Metrics

117. AVM Metrics

My PT also treated Mommy last year. Helping Baker Smurf is enough to secure my loyalty, but our PT has exceeded my personal expectations. She told Mommy upon discharge, …we’re going to take care of your daughter. Accordingly, she has interrogated me regarding my regimen. When I told her I ran she said, WHO WATCHED YOU? (Subtext: I need names.) So she’s added more accountability to RecoveryLand, where parental vigilance already demands that the people I work with be top notch. (Side note: I originally took the title picture of Ed for a post on transitioning from Physical Therapy to Personal Training. I now understand that Trainer D is not representative of the general Training population, so that post would likely not be helpful. I blame him for this, too.)

CMD also provides accountability, noting changes in the way my body is acting and charging me to make sure other people are watching too. When I met him at the Running Gym R asked me how I like acupuncture. Love it, I answered. She keeps me on a real short leash.

I tried to explain why this is a big deal to Trainer D but he has exhibited zero remorse. ARGH. “Absolutely terrifying” = unambiguous language!! Rehabilitation is the only thing I’ve known since I woke up. There. I said it.

So now I’m facing the prospect of being truly cut loose. I anticipated this, which is why I joined the Gym in the first place. But I didn’t realize it would actually hasten it. Oy. That plan backfired, didn’t it?

298.  Somebody - PLEASE just tell me what to do.

298. Somebody – PLEASE just tell me what to do.

So the way I’ve decided to console myself is to learn how to run, I told Trainer D. And you’re going to help me.

We’re picking up where M37 left off when I had to leave Planet Rehab (sniff) and pursuing Operation Run Forrest Run (ORFR) aggressively. I asked him to think about what he’d be comfortable with (there are no harnesses hanging from the ceiling at The Gym, a non-(neurological) rehab environment)– how I have no interest in creating a liability sort of situation, etc. But his indication of complete comfort with any and all running scenarios was so instantaneously enthusiastic I was like,

Erm…I guess this is the part where I trust you. But we’re going to have to work up to that.

I don’t know if M37 is familiar with the concept of “working up” to something. The second day I saw her she told me we were running, and after she saw me run (it was more like fast shuffling) once in a harness she dispensed with it entirely on land and just stood behind me, holding my belt, when on the treadmill. (Then I favored the Zero G so I wouldn’t elbow her in the stomach.) Confidence begets confidence. She didn’t hesitate so neither did I.

I guess I’m more nervous in a non-rehab environment. That’s why I found the Running Gym and recruited R to help. There are no harnesses there, either, but it’s a sports-rehab sort of place and I can tell R knows what he’s about. So I’m working on running with him every week but I’ll also work on the same type of movements in a “real life” environment at The Gym with Trainer D. So far he’s easing me into treadmill usage in a non-scary way, which is good. This is still in the very early stages so I’m not sure how this is going to pan out, but I’m sure I’ve enlisted the right kind of assistance.

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343. Strength and Honor

Strength and Honor |Proverbs 31 | Ann Ning Learning How


I have gotten to the point where I hesitate to tell CMD and Trainer D that I’m hurting bc I know what happens next. I’ve actually taken to hiding my hands in the folds of my shirt when on the acupuncture table in the fond hope that she’ll forget about them. But last week I was hurting so much I decided that I shouldn’t try to evade treatment and I should take the help where I could get it. My next appointment was at The Gym so I emailed Trainer D and asked him to spend some time specifically working on my problem areas and educating me about my muscles.

The first time he really got into the Mr. Miyagi thing (formerly he had primarily used an elbow but made cryptic references to other methods) was a couple of weeks ago. “How’s your hip?” he inquired. “It’s kind of bothering me, but I’m not really caring right now,” I said. That was code for Ain’t nothin’ need adjusting over here, thanks. Let’s lift some weights.

He didn’t get, or pretended not to get, my meaning. And so both sides ended up getting treated. I then voiced the growing concern that my shoulders are completely different shapes and asked if he could fix that. I was thinking we’d do strengthening on the left. I was wrong. The immediate plan of care was to break down the weird muscle tissue that has taken up residence on my right shoulder since it has been compensating for my left side’s weakness. The muscle tissue build-up is abnormal enough to be of great interest to Trainer D, who is fascinated by this sort of thing. He actually had me move from the table to a chair at the Training “reception” desk so he could achieve greater leverage. That weekend I kept on checking to see if there was a handprint on my back. Ouch! I mostly felt the pain and just had to accept his reassurances that this was for my good on faith and based on past experience.

But a couple weeks later on Thursday I couldn’t sleep except for about an hour around midnight. Part of the problem was that my right shoulder was really bothering me. It was so bad I immediately emailed N2 (my new neurologist) for a new script and asked for help at the Gym again but prefaced it with, Hey, D, I know I asked you to do this and all but if I pass out we’re going to have a very long discussion when I come to.

The AED [defibrillator] is right over there, he informed helpfully.

[Thanks, Buddy.  So glad to know you’ve got my  back.  Incidentally, I verified that he knows how to use one.  “With my eyes closed,” was the comforting reply.]

The end result is that I have some residual soreness but overall my shoulder feels SO much better. It was the right decision to ask for help. Maybe I’ll stop hiding my hands at acupuncture…Well…maybe I’m not ready for that yet.  [Update:  I went to CMD Monday morning and hid my hands shamelessly.]

One day when we were busy building my good muscles instead of breaking down the bad ones Trainer D used the phrase “strength and honor” a couple of times on me (presumably from his mental database of motivational phrases – thankfully, this one was in English so I actually understood it). I couldn’t help laughing out loud bc I recognized the line from Gladiator and it has always tickled me pink. It’s what the gladiators say when they grasp each other’s shoulders right before they walk out into the arena.

I love that “strength and honor” are the two values that made it into a major Hollywood film as the motto of extremely manly men who are forced to fight for their lives. It’s funny to me because I think of it every time my shoulder hurts and remember that the phrase originates in Proverbs 31 – the chapter about ideal womanhood.

“Strength and honor are her clothing;
and she shall rejoice in time to come.” (Proverbs 31.25 KJV)

Much has been written on the topic of Biblical womanhood from all kinds of perspectives. But for me the fact that “strength and honor” are valued is the bottom line.

169.  The Treatment of Women [Why did people like *Kate & Leopold?*]

169. The Treatment of Women [Why did people like *Kate & Leopold?*]

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330. WHERE do I find these people?!?!?

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I like to tell M(37) and Trainer D/Mr. Miyagi about each other since I think they will be entertained by our shenanigans (the things they make me do).  BTW it is one of the great and unexpected joys of my life that I still get to see M (37) even though she’s no longer my PT.  The fact that she is a fixture in RecoveryLand ranks right up there with how I get to “talk” to M, my friend from RIO.  Fun Times, people, Fun Times.

59.  I'm not doing that.

59. I’m not doing that.

Anyway, I recently asked M(37) if she remembered the post, “I’m not doing that” and if she recalled saying that I tell her a lot of jokes.  Answer:  no, she did not remember saying any such thing.  So I gave her an illustration.

Example:  “I want to lie down.”

That’s not funny. 

That’s just true.

I told Trainer D that one.  He quite liked it.  I’ve had occasion to use similar lines on both of them.  E.g. one day I was doing squats or something in the parallel bars, and I called to M, who was sitting on a stool on the far end,

Hey, M – remember that time you said you were going to be nice to me?  [Subtext: Did you forget?]

PS she really did say she was going to be nice to me that day – I think I told her I wasn’t feeling well.  Her sympathy waned as the session progressed.

Trainer D has openly admitted  [warned me] that his accuracy at counting reps probably isn’t the most reliable.  Mm hmm.  You’re telling this to the girl with the brain injury who can’t keep track anyway.  Great.  I told him about how A (6)’s seconds were longer than human seconds (when he wasn’t looking at his watch and was telling me to do something and hold for X), so D often uses a stopwatch so we’re clear – but when counting reps all bets are off. I’m not the best counter at this point, and really, do I have to do everything around here?

One day I was hauling some kettlebells around and Trainer D said that this was going to be the last time I had to do this.  He also promised to find some bales of hay so I had something to look forward to.  :/

I dutifully started walking, heavily weighted, while he pointed to the space right in front of him and said encouragingly, Right here!  I was like, Ummm…I know – I’m trying.  I can see you and I’m aiming for the middle, promise.  Maybe if I didn’t have to carry all this it would be easier.

At the end of the line we turned around and kept on walking.

Hey, D, I called, Remember the time you said that this was my last set?

We both laughed and he took the kettlebells from me.  Mission accomplished.

Last week while I got to rest after the kettlebell gait training exercise I told him about my latest conversation with M (37).

Me: I always see lots of people lying down at PT…why is that never me?

M37:  We’re working on your endurance.  (Side note:  I am grateful to be able to build endurance but sometimes I’d rather just take a nap.)

Me:  But really, lots of people are lying down.

M37:  It could be for several reasons – e.g. they’re working their core on the mat.

Me: (pressing the issue) No, but really – I mean like with a heating pad.

M37:  Because they’re in pain.

Me:  I’m in pain.

M37:  Mm hmm.

When she just smiled and said, Mm hmm, I was like, Why do I even bother?  And Seriously?  Where do I find these people?!

And then I remembered – as soon as I was able to understand what was at stake I began asking God to send me the right people to help me.  It just so happens that the “right people” have all been fantastic, although I’ve been trying over the past several months not to have unreasonably high expectations…But they just keep on being good at what they do!  Before I was able to ask He just lined up a bunch of highly proficient practitioners for me to meet as I got acclimated to life in RecoveryLand.

You gotta be careful, M joked, you might get more than you ask for.  I am so thankful that I have.

321. Emotionless

This is the most relaxed I've ever been.

This is the most relaxed I’ve ever been.

I have many funny stories from my days at The Place. Many of them involve A(6, Dr. Frankenstein), and I talk about them more – although my days in OT and ST produced many memorable moments – since PT stressed me out the most and therefore yielded the funniest situations. The thing is that A (6) didn’t think they were funny at the time. Nor did I. A’s demeanor was always very matter of fact. In retrospect his delivery was unintentionally deadpan.

Example: Near the end of my outpatient stint we were doing a monthly evaluation and after the strength testing etc. (Me: Is this the part where I beat you up? A(6): No. Me: Oh, okay – I was just checking to see if anything changed.) it was time for standing balance. I stood in front of him (I forget if he told me to put my feet closer together so I had a narrower stance – this might have been too advanced at this point) and A said in a “thinking out loud” sort of voice that indicated we were going to stray from the usual path a little,

“…Close your eyes…I just want to see…[if you can keep your balance.]”

At that point in my Jedi Training I was following instructions (almost) without question so I immediately closed my eyes.

One second later I felt my shoulder hit something. It was A. My awareness of where my body is in space was even worse then so I didn’t know I was falling and didn’t realize I had fallen until I felt A prop me up.

15.  I have no idea where my body is in space

15. I have no idea where my body is in space

Okay…no,” A said in a voice completely devoid of emotion.

Ba ha ha ha ha!! Sorry. Maybe you had to be there, but it was just SO classic A. It was also very classic Rehab because all of my therapists have tried hard to say things with zero trace of judgement, e.g. if I ever stumbled or displayed sub-par motor or visual skills it was always encouragement, never horrified gaping that my body parts are as far gone as that.

These, days, though, I’ve graduated beyond the world of highly controlled responses to my (non)ability to remain on my feet. I have realized that Trainer D has a much higher tolerance level than any of my PTs for the length of time he’ll allow me to fight for my balance before stepping in. In fact, he hasn’t actually had to catch me yet. Whereas my Therapists have always been hyper vigilant regarding any deviation from the prescribed movement and will intervene at the slightest unruly motion Trainer D, while attentive to my gait pattern, will allow me to struggle (while carrying something heavy) take a couple of missteps, and cheer me on as I regain my footing. I’m okay with this since I’m sure Trainer D’s cat-like reflexes probably give him a higher time threshold knowing that he’ll make short work of helping me out of a tight spot. If I did not have this confidence we’d have words about it, but as it is the situation is funny.

I enjoy the contrast between A’s emotionless, “Okay…no…” and matter of fact way of propping me up and Trainer D’s vocal but hands-off support. Both approaches are appropriate for their context. When I was A’s patient I was barely aware of my surroundings and in control of myself enough to look people in the eye (S|OT6 made me) and it was safest to act like my deficits were run-of-the-mill. I wasn’t ready to understand the depth my injury or its long-term ramifications. Now I’m well enough to have built up some emotional robustness and can afford to look my deficits in the face.

The stakes are even higher now – as time progresses I get further away from the likelihood of [fill in the blank] – but I’m strangely more relaxed. While I was at The Place I’d ask doctors questions like, “…at what point do you become concerned…” – it was very timeline driven. But now I kind of don’t care any more. Although I know the biggest gains come in year one I’ve also heard that recovery doesn’t stop until you stop. So I’m continuing to pursue Recovery more aggressively on the assumption that I’ll get well to the extent that God has planned for me. Sure, I have an opinion on what I hope the nature of that recovery will be like, and I do what I can to exercise and do rehab at home – but knowing that the ultimate control isn’t mine takes the pressure off and I am free to enjoy this process. I have progressed from the safety of emotionlessness to being able to lose control momentarily, regroup, and laugh, too.

129.  Ed says, "We're going with Plan C"

129. Ed says, “We’re going with Plan C”

318. Confident

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One of the first things I learned in Physical Therapy is that you never assume your wheelchair is behind you. You feel it on the back of your legs and then you sit. This is one of the habits that has stuck with me, except I’ve added visual confirmation to the pre-sitting routine. At first I was like, Seriously, Mommy is following me around with my wheelchair. I’m PRETTY SURE it’s going to be there when I sit down.

mommywc

Except I kept that commentary internal.

Until now.

But it’s a good practice to verify the position of anything on wheels before you sit on it or use it in any other way for stability. The time has come, though, for me to build confidence in things that don’t move.

Last week Trainer D introduced me to his friend the kettlebell. (Me: Have I mentioned that I’m disabled? MMiyagi: No.) I was deadlifting it (there was unintentional swinging but nothing untoward happened, PS lifting kettlebells etc. is aimed at functional activity – he likes to explain the mechanics of movement and how doing a certain exercise exemplifies how I should lift things in real life) and at the end of the set I was supposed to sit down. “Don’t look!” Trainer D told me. The first couple of times I couldn’t help it. I looked to make sure the bench was still there. The third time I resisted the urge for visual confirmation and just sat.

You have to trust it’s still there, he explained. It’s an inanimate object. It didn’t get up and walk a few inches to the side. It’s also important to remember I sat down (almost) a few moments before while holding a kettlebell – I could do it again unweighted without incident.

Fair points, I thought. I was also instructed to have more confidence in my left leg at Therapy last week. I did some side-stepping over some cones in the parallel bars (picture above) and I’ve never had such a good view of how my legs (especially on the left) don’t want to do what I’m telling them to do. Normally people just make a strong fluid motion and plant their foot where they want to without thinking about it. But I saw my left leg wandering hither and yon before I managed to get it on the side of the cone.

This is the same reason why I have to wear shoes when I climb stairs. I can’t put my feet where I want to so I feel the step in front of me with my toe or the back of my heel. Unless I’m wearing proper footwear it hurts. I was frustrated during the parallel bar-cone exercise, but my PT told me my leg looked pretty good. The main things for me to concentrate on are weight-bearing on the left and building confidence in general.

It was M (37) who first called me out on the leaning to the right-thing and explained how my brain mistrusts my left side so it favors the right. It’s gotten a better since I was at Planet Rehab with her but recent polls indicate that I’m still leaning a little.

I’m thankful to have progressed to the point where we can get pickier about form and aim higher in terms of my gait. For a long time no one told me I was leaning to the right. Mommy explained she was just glad I was walking. But now we’ve got our sights set on the higher end of my self-devised walking scale.

117.  AVM Metrics

117. AVM Metrics

In addition to attention to the finer points of the 10 tips this is going to take some confidence. I used to have a LOT of confidence since I didn’t know any better – I didn’t believe anything had happened to me so of course I could do XYZ. Now I do know better but I often forget that my body is different now, or a new deficit will surface that I haven’t accounted for, and I’ll try XYZ when I should really be more cautious. That’s why I need professionals to decide on appropriate activities for me and to ensure their safe execution.

220.  I've Got this

220. I’ve Got this

What I’m talking about now, though, is not misbegotten confidence like I’ve had in the past. This is about using my head and remembering that, like the bench at The Gym, some stuff doesn’t change. But even when the pathway is uncertain and there are changes ahead you’d never expect I love the language of the Psalms about “hinds feet.” It’s not the path but the feet and even the steps of the Psalmist that get Divine attention. PS. In case the language of this psalm is a little too martial for your taste look at verse 35, “Your gentleness makes me great.” How’s that for counter-intuitive? At least it’s counter-intuitive for me. I’d expect something about God’s omnipotence here, not a reference to His gentleness. But that’s what makes Him so approachable – I can approach the throne of grace with confidence since I’m sure of a favorable reception there…and I’ll thank Him that I can walk. Now I’ll ask Him to please help me walk better.

Psalm 18.33-36

33 He makes my feet like hinds’ feet,
And sets me upon my high places.
34 He trains my hands for battle,
So that my arms can bend a bow of bronze.
35 You have also given me the shield of Your salvation,
And Your right hand upholds me;
And Your gentleness makes me great.
36 You enlarge my steps under me,
And my feet have not slipped.

317. Quizzical

The Diagram in CMD's office

The Diagram in CMD’s office

For the first time in almost three years I’m being asked to process information and reproduce it verbally upon request. Well, actually, no – I had to do this sort of thing for my neuro-psychs during cognitive evaluations. (Heh, heh. Try again, buddy. Heh heh. Try again.) But the context I’m thinking of now is a non-rehabilitation environment. When I go see Trainer D it’s like a quiz show. In the future I have hopes of filming a new reality series on my phone – we just need to recruit his trainer friends to be cast members.

But for now I’m the only contestant on the quiz show we like to call Personal Training. Trainer D will talk, use some big words for different muscles, point to parts of the weight machine, and then ask, “So what are you supposed to concentrate on?” If I’m having a good moment I’ll offer something like, “Ummmm…don’t arch my back?” More often I’ll cast my eyes blankly about the room and say something like, “Umm….don’t fall down?”

Happily, Mr. Miyagi is knowledgeable but not picky. He will accept whatever answer I give him graciously, and then he stands nearby to make sure my arm doesn’t snap off etc. Or at least he has promised to catch it on the way down. A few weeks ago he was doing the usual, can you feel XYZ muscle firing? and I told him, “You’re asking for a whole lot of self-awareness…” (I didn’t fall down, did I? What more do you want from me?!?! 🙂 ) Self-awareness is not my forte presently. Oftentimes I can’t sense things properly and my vision and hearing can play confusing tricks on me. When I do sense things I’m not always able to judge whether or not an activity is an appropriate challenge –e.g. tall kneeling – I think it’s supposed to hurt that much. So I often need my peeps to be able to intuit that I’m in distress or I just need a rest, since it’s not likely that I’ll be able to offer such feedback on my own.

127.  How to Enjoy the Rehabilitation Process

127. How to Enjoy the Rehabilitation Process

In return, they like to know that I’ve absorbed the information they are sharing with me – e.g. quiz time at The Gym. CMD also likes quiz time. Leading up to my summer vacay she’d ask me to demonstrate the acupressure facial self-massage techniques she showed me so I could do them while I was away. I got it wrong three weeks in a row. I’d be rubbing my face, touching what I thought were appropriate points, and a couple minutes in she’d be like…Okay…you can stop now. And then I’d go study the diagram in her office some more.

These days no one’s going to argue with me if I say, “My head hurts and I’m going to go lie down.” Indeed, I often omit the “head hurting” part because it only twinges a bit, and I do not want to alarm Tanpo since I know the danger is past but it is still fresh in his mind. One of the blessings of being cognitively intact, though, is the ability to be stretched mentally. Sure, it’s funny when my brain is floppy and I can’t remember anything other than “don’t fall down” and I forget how to do the right facial massage on my crooked smirk (PS. It’s getting better!) It can be a little frustrating, too, when I can’t process all the information I want to, but it also forces me to boil down everything getting tossed into my pot of Recovery Soup so it’s reduced to the most salient points: e.g. don’t fall down, use your core, and breathe.

149.  Why I Choose Therapy

149. Why I Choose Therapy

This is why I surround myself with experts in RecoveryLand – they have special knowledge that I need. It took me a while to figure that out, but I’m fully bought in. I have been blessed to work with several highly proficient and truly caring practitioners since I got sick. My method has been simple: once I understood the importance of what was happening and the value of a skilled professional, I started asking God to lead me to the right people. (Before I thought of asking He just gave me people I needed even though I didnt know I needed them.) This method actually works in every context, though. It’s always a good idea to build a network of individuals who are smarter than you are, especially in areas you wouldn’t call your “strengths.” You never know when you’ll be calling on their expertise.

56.  Expertise

56. Expertise – What are you good at?