9 February 2005

I had another appointment with Gavin at Epworth this morning. I didn’t have any other appointments this morning so I caught a taxi an hour before the appointment to allow for traffic. I got there about 10.30 a.m. (half an hour before my appointment). The receptionist told me to go straight in the physio gym. Gavin greeted me and told me to sit down on a physio couch. He said he wants to do more assessment today and then we can start on some ‘real’ work. I brought my notebook(I’ve been writing notes after each physio session since my in-patient MECRS days so I can refer back to it when I need to – a bit like attending a lecture or tutorial) and Neil and Rosemary’s exercise book with me to show Gavin. Last time, he asked me what do I do all day and Neil and Rosemary’s exercise book will answer the question. Neil set up such a system that I record all my exercises in that book and I get to tick them off every time I’ve finished one.

Gavin looked at them and told me that he will get me to work harder there. He did the assessment first. Similar to the ones Fiona has done, he timed me walking over certain distance and also walking backwards. After the assessment, he got me to do some exercises – standing on my toes – like those plantarflexion exercises. He then set up a mini trampoline (like to one Fiona used yesterday) and got me to do the same on the trampoline. It’s very hard stand tip-toed on the trampoline and push off. My left leg was very shakey. Gavin said it’s a good sign when it’s shakey because it means I’m pushing myself to the limit. I will learn to control the leg eventually.

He then got me to get on this machine – looks a bit like the gym equipment you do the leg press on. Well, I found out later that it is a bit like a leg press except I have to do it on alternate leg. So I push it off with one foot and land it on the other one – a bit like running while lying down. When I watched Gavin doing it, I thought it looked easy enough, I should have no problem doing it. I thought he said he’ll get me to do harder exercises! It’s not until I lied down on the bench and trying to push off my feet, I started to realise how difficult it was. I was able to stablise my right foot but my left foot was everywhere. In the end, Gavin had to hold my feet and try to get my feet to push off in slow motion – a bit like when Tim was teaching Lillian to crawl (a few months ago, Tim was a bit concered that Lillian wasn’t crawling and he was trying to teach her crawling in slow motion).

The final challenge is to go up and down the stairs without any support (no rails or stick). While the OT at MECRS was trying to get me carry Lillian up and down the stairs using a baby sling (ie, compensating for my weakness), Gavin thought there should be no problem for me to do that without the sling – I should train to go up and down the stairs without using the rails. I was trying to follow the ‘good foot goes to heaven and bad foot goes to hell’ strategy (when going upstairs, step up with the good foot first; when going downstairs, step down with the bad foot first). Gavin wouldn’t let me do this. He wanted me to do the way one would normally do – step up and down continuously – when going up, step up with one foot and the other one over the the next step. I have been stepping up with right foot first and the left foot up on the same level as the right foot, not over to the next step. Going upstairs without the rails was not too bad. I probably stuck my butt out a lot to keep balace but at least I did it! Going down stairs was a real challenge. In the past, I would step down with my left foot first and then the right foot down on the same step. Gavin wanted me to step all the way down with my right foot. This is very hard with holding the rails. I felt my left ankle was a bit unstable when I tried to step down with my right foot. I was trying to get away from doing it but Gavin wouldn’t let me slack off. He asked David to come and help out. It must looked funny – the two of them trying to get me to go down the stairs and my body was just resisting it! Gavin was trying to push my right foot down but my body was fighting against it. He told me to straighten my right kee and keep my weight on the right leg but I just couldn’t do it. When we finally reached the last step, he said the problem was not my left leg – I was having problem with my right side when I was going downstairs. He thinks the problem is more sptial perceptual. I suspect I had that problem even before the operation – I have always been hopeless with parking, especially parallel parking!

Gavin told me that they will check with my private health insurance and work out the funding issue and get back to me for my next appointment. He said once that’s sorted, he will talk to MECRS about it. I told him that I’m a bit concerned that MECRS will discharge me if it finds out that I’m having treatment at Epworth. Gavin asked me if this really matters because he thinks my time will be better spent at Epworth than MECRS. I told him that I’m currently getting two sessions of physio and two sessions of hydro each week. He told me it depends on how much my health insurance will fund but he doesn’t think hydro is that crucial for me now. He thinks I can work on a lot harder things on land. He said I could have a physio session once a week and the other 4 days I can go to a gym and work on my fitness. This sounds really positive. When I got home from physio this afternoon, I felt really tired. It's the first time I felt really tired after a phsio session - it's the first time a physio worked me very hard. I think I have finally found that ‘cockroach in that energy drink commercial’!