23 November 2005

I have been going to the gym on a regular basis. Tim and I went there together on Saturday morning before picking Lillian up from my parents' place. I visited the gym 4 times last week - twice with the personal trainer and twice with Tim. Monday was the first time I went by myself. I think although the personal training sessions I had with Mary haave not been as affective as I'd hoped but at least I got used to going to the gym and now I find going there by myself is not so daunting. I don't think I felt as self-concious as I previously felt. I have to admit one thing I don't like about the gym these days is that they are building aa new roof and the scaffolding bloked the rails and the wall. This means I don't have anything to hold on to when I go up or down the steps at the entrance of the gym. Going there is not so much of a problem but when I go home, I must walk down the stairs without anything to hold on to which is a bit tricky especially when I'm feeling quite exhausted. I went there again this morning, the 3rd consecutive day. I had personal training with Mary this morning and I went there 30 minutes earlier and did a lot of cardio exercises before my session with her. By the time I went to see her, I was drenched in sweat already. I think this is a more effective workout for me. Otherwise, she doesn't work me very hard in the session and I walk away with a false sense of security - that I have worked enough because I had personal training. I met up with Neil after my gym session and he walked me home. i told him I was really happy to see him there today (I'm always happy to see him anyway) because I needed a bit of help to walk down those steps when there's nothing to hold on to.

Neil had to go back to his office to finish marking students papers and I was in a hurry to go out to lunch so we didn't have much time talking. I caught up with my colleagues at a cafe near work. The place is on Mt Alexander Road and I had to do this dreaded parallel parking in front of the cafe or there's nowhere else to park. After two failed attempts, I realised there was a spot a bit further away that I didn't need to reverse in and parked there. I was lucky that I could find such a spot but it also made me realise I need more practice on reverse parking.

I had an appointment with John Olver, the rehab specialist at Epworth, on Monday afternoon. I wish I never had the meeting with him. The first thing he said to me when I sat down was 'I know your husband wants you to have a 100% recovery but we really can't guarantee that and it's unlikely you'll fully recover.' I really don't see the point of telling me this. I didn't even ask him a question and this is what he said. I felt like telling him I don't want 100% recovery I want 120% recovery.
I don't really know the function of a rehab specialist because it seems to me all they do is feeding the patients with negative ideas and prognosis. I think in some ways I have recovered more than 100%. For example, I couldn't really cook before and we were having takeaways at least once a week and dined with my parents once a week. I'm cooking a lot more than before and is game enough to make something that's more complicated. In my mind, that's more than 100% recovery. I remember the kitchen stool I borrowed from MECRS when I first came home from the hospital and that's long gone now. In the beginning, I couldn't stand for a long period of time while doing all the preparations and to use the kitchen stool for little rests. I haven't had the need for the stool for a long time now. To me, from being unable to sit up from the bed by myself to standing in the kitchen for long period of time cooking is a big improvement. If only John can see the difference, who cares about what he thinks. Besides, they will almost always get it wrong anyway. The specialist at MECRS told me I may never be lift up my left arm above my head and the physio there predicted it would take me 2 to 5 years to drink a cup of tea with my left hand. Thanks to Neil and Rosemary that I can do both in less than 18 months. It's very hard not to have bitchy thoughts sometimes. I felt like asking John if he has a mother or a wife or a daughter and if this has happened to one of them would he still say the same thing to them.

18 November 2005

First diary entry for the week! I think I'm in panic mode at the moment - counting down the number of days before I go back to work. From today, I only have 9 days left before i go back to work - on a graduated basis. I'm really worried that I won't have enough energy to do rehab work or even go to the gym.

Tim and I joined the gym last week and for the first time, we went to the gym together last Saturday morning while Lillian was with my parents. I remember Gavin told me it's good to warm up with some cardio exercises and finish off with cardio exercises to make me feel I have worked. We started with the step machine and then my gym program. I don't really have a gym program yet and I was just going by my memory - something i did in personal training. Going to the gym with Tim made me realise how inadequate my personal trainings have been. Tim kept telling me to hurry up while I was on the machine. He said people do the exercises quickly and then they move on to the next and they come back and do everything again. Due to my mobility problem, I find it difficult to get on and off the machines and it takes me more time to move from one machine to another. Tim kept hassling me and asking me what next whenever I just finished with one machine. I had to think hard for the next machine. It also made me realise that I didn't do very much in personal trainings because I ran out of exercises very quickly. After the 'gym program', we finished off with the ellipticals. Tim found two machines side by side so we could do it together. He set the machines to 30 minutes except I felt like stopping after about 5 minutes. He wouldn't let me get off and pushed me right through the 30 minutes. For the first time, I felt knackered after a gym session. It made me realise how unfit I have been and I think personal training gives me a false sense of security - I felt because I went to personal trainings already so I didn't need to do as much at home. I think Gavin is right in saying that I don't need a personal trainer, I just need a good gym program. He said if I really want, he can recommend another personal trainer who has more experience with brain injuries but the Melbourne Uni gym has an exclusive contract with the personal training group Mary belongs to and wouldn't let me bring my own trainer so I have to ditch that idea.

I also found Ruth, the physio who is treating me in Gavin's absence, is not bad at all. She found that the reason I still can't run is because I still have a lot of weakness in the hip flexors - which help in lifting up the leg high so she has written up an exercise program for me to do at home. I noticed in my physio session on Tuesday, she got my file out and was writing copious notes as I was doing my exercises. I commented that I've never seen anyone writing notes in physio. She said she's writing down notes so she can compare my progress from week to week to see if the exercises are affective. She looked at my gait on Tuesday as well and was trying to correct it for me. It's a bit depressing to find that there are still so many things wrong with my gait. It made me wonder why Gavin never mentioned it before. It reminded me of when Tim and I were training for ballroom dancing. We had this Latin dance teacher who gave us this really facy Samba routine. Samba is probably one of the harder Latin dance to master and it really requires good Latin basic or it just looks terrible. For a while, Tim and I had this wonderfully fancy dance routine but we looked terrible because we never grasped the basic. I told Tim that it made me feel Gavin is a bit like that dance teacher we had, he got me to do a lot of high mobility stuff like running, jumping and bounding. I was threw into the deep end with all the running practice. I think it has definitely helped me in walking faster. I know it will probably take me a while to fine tune everything. I think Ruth has made me realise that I need to revisit the basics and have a more solid foundation of basics - such as core stabilities and strengthening of certain muscle groups before I can improve on the 'style' of walking and running.

10 November 2005

I have been feeling quite tired ever since my meeting at the office on Monday. In fact, I was so stressed out about returning to work and I couldn't sleep on Monday night. I have felt so anxious since I left chartered accounting firms. I was just worried if i go back to full time work I won't have time for rehabiliation. I was glad that I spoke to my GP about this right after the meeting because i think Alana tried to contact all the relevant people after the meeting. After speaking with my GP, she agreed to put me on 4 hours a day and one day per week for 2 weeks and then increase it to 2 days a week from the 3rd week. I have also contacted my case manager, Jo, about my concern when she mentioned that they're trying to get me back full time in 3 months. She said on average it takes people 3 months to return to full time work but it's ok if it takes me longer. They will be in contact with my doctor to work out what's the best for me. I feel a bit relieved after that.

I panicked so much on Monday so I also emailed Gavin to find out what's my physio plan for next year to see if my return to work plan will interfere. I was surprised that he replied straight away. He indicated that the plan is to wind down my physio to once a week and then once fortnightly over the next 3 months. He said I need to have a very good gym program so he's emailed to various people to organise it for me. When I went to physio on Tuesday, Ruth had a chat with me. She is a bit concerned that I have nobody to advocate for me in respect of returning to work. That's true and I always thought ATO Health and Safety or my case manager should be on my side but then again they might be acting for the employer rather than the employee. I was getting a bit suspicious after my Monday meeting. I found out about ATO Health and Safety from my insurance company. They found out the contact for me through an OT and advised me to get in touch with this person. Their agenda is obviously to get me to go back to work so they can reduce their cost. Tim thinks they are just trying to help but after what I have been through I don't think I'll trust anyone,especially not the insurance company. Ruth said they probably won't start reducing my physio until early next year. She also set up a home exercise program for me to work on my hips and abs. She said it's difficult for me to run because I can't lift up my left leg high enough and it's because of weakness in my hip flexors. She is going to contact the Melbourne Uni gym manager for me to see if I can bring my own personal trainer - the one that Gavin recommends.

I just discovered something very odd on the weekend. I remember last year I attended a series of upper limb sessions at MECRS and they talked about sensory retraining in one of the sessions. Apparently it's common for people who had sensory loss in their hands, they also loose the ability to tell the tempature. The first thing I did after I got home from the session was to test whether I could feel the tempature by dipping my hand in cold and then in hot water. I was glad to find out that I could. I never thought about this until on Saturday I cut up some pineapple for Lillian. The pineapple had been in the fridge so it's cold. When she picked up a piece, she obviously felt the cold but didn't know what it is. We have taught her about hot so she doesn't burn herself in the bath - if she thinks the bath is too hot she'd let us know. We haven't taught her about cold so she obviously felt the tempature but didn't know what it was. I think this also proves that senses are in a way, learnt. I picked up a piece of pineapple with my left hand and told her it's not hot, it's cold. I just realised at this point that I couldn't actually feel the cold in my finger tips. I was so shocked and started trying different spot and found out that I couldn't feel the cold with my finger tips but I could feel it on the back of my fingers. Maybe that's how I could feel the tempature by dipping my hand in the water. I don't know what this means in terms of my chance of full recovery. I also tested out with a hot cup of tea and found that I could definitely tell something is hot from the finger tips.

I went to MECRS to see Dale, the social worker, this morning. I saw him a few months ago at the carpark of Bakly Square and told him I'd drop in to say hello but he was still on long service leave and was due back in October. I have forgotten about this until yesterday and so I called him and told him I'd drop by on my way to Barkly Square. I parked right outside the hydro pool - somewhere I used to park when I attended the self-help hydro group. There is a staircase that leads to the building where Dale's office is but I've never been that way before. It felt very strange to be there again but this time just a visitor, not a patient. I was a bit worried that I might bump into some people I don't want to see. Fortunately, I didn't see any of them. Dale was still busy when I turned up at the door so he grabbed a chair and told me to sit down for a while. I didn't recognise anyone else in that office but I guess the OT and the physio in the home based team tend to rotate after a few months. On our way to the cafe, Dale said he'd go and let Kerry know that I'm here. Kerry is the OT who helped me when I first got home. She was the one that took me on my first grocery shopping trip after my operation. She was really surprised to see me. Both of them were commenting on how much taller I look now. Dale explained that I seem to be standing taller and straighter and also walking taller. I wonder if it has anything to do with the walking stick. I may have leaned on the stick too much in the past and that made me look shorter. Dale mentioned that Fary (the rehab specialist) said hello to me and Tim. He must have told her about my visit. That's nice of her but I'm not sure if I'm ready to say hello back. I still have a lot of anger over how I was treated there. Dale suggested that we take a short cut to the cafe - I have seen the physios going that way to get coffees but I've never ventured out that way myself. It's a narrow stairway with rails on the left. I had to use the wall for balance when I was going down. I know I could go down even without touching the wall with the finger tips of my right hand but it's a bit quicker and safer when i do. Even so,they were both so impressed by this. I guess when I first left MECRS back in March I was still using the walking stick and that's how they remember me. After the stairs, there is this uneven ground off the footpath that leads to the cafe. No wonder I've never been that way, it would have been too difficult for me. Dale reminded what I was like when he took me to CERES for the first time - even with a stick, I was very scared by the uneven ground. When we sat down, Dale mentioned I'm a good study for the ward. I didn't understand what he meant. He said they had a lot of problem dealing with me but he thinks they should be able to deal with any kind of people. Apparently they had problem with me because they felt I didn't tell them everything. I told Dale it's not in my nature to be blunt so even when I was unhappy I didn't tell them. Apparently, they didn't know how to deal with that. That episode just seemed so far away from me now. As we were talking, Dale said he noticed that my hand is recovering really well because as I was talking, I was using it more. That's interesting, I didn't know I was using my left hand gesturing. I guess that must be a good sign. He asked me if i have an exercise program for the hand at Epworth. I told him I have been mainly working on high mobility stuff such as running. He's surprised that my hand improved even without a program. I guess I have been using my hand a lot more these days - typing up the blog, cooking gourment meals such as wrapping up various ingredients with proscuittos and sometimes I pick up things from supermarket shelves with my left hand. I told him my biggest problem at the moment is not being able to look after Lillian such as taking her to or picking her up from the childcare and I wish there is an OT who can help me learn to do this. He said he can enquire for me to see if I can have physio at Epworth but still access their service. He said there is some change to the funding system so they may be able to do this for me.

7 November 2005

I forgot to mention in my previous blog that there was an incident last week when Tim and I went to the cinema. We were waiting for Paul and Claudia so Tim suggested we go to the cafe and wait in there. As we were walking to our table, I noticed a lady from the next table was staring at me. I didn't actually take much notice on the way she was looking at me but she must have been pretty rude because Tim actually told her off. I think it must have been the first time that Tim has come to my defence. I must admit I didn't notice she was being particularly rude. Maybe I'm just used to people's stare now.

I had another landmark achievement on the weekend. I went to the grocery stores on Saturday and it was the first time I went without a trolley. I had a bag of scallops and prawns in my left hand and I had to carry a busket with my left hand so I could pick the fruit and vegies with my right hand. I then carried one bag in each hand to the car. This is the first time I've done it. I normally put everything in the trolley but I've already visited the supermarket on Friday night so I didn't bother getting a trolley. One thing I told Prema that I want to be able to do is be able to carry shopping bags and walk. I think this is just the first step.

I had a meeting at the office with Peter,my manager, Jo, my case manager of return to work program and Alana, an OT contracted by the ATO, this morning. It's the first time I had to wear my business suit since the operation. I thought about wearing my gym wear but then I thought it would make me look too unprofessional and a meeting like that I need people to take me seriously.

I was quite anxious this morning just trying to get ready and put on some makeup. I wasn't going to put on any foundation but for some strange reason I had rashes all over my face so i had to put on some foundation just to cover the rashes. My meeting was at 10 a.m. and by the time I was ready, it was already 9.35 a.m. Fortunately, there was not much traffic on the road so I got there just in time. I parked at the carpark right next to the office, somewhere I used to park when I went to work. I was quite surprised that the parking attendant still remembers me and he said when I start working again, he can reserve a spot for me right next to the entrance so I don't have to walk that far.

When I got to the entrace of the building I stopped at the revolving door for a moment and thought about how to step into the door in time without being hit or caught. I missed a couple of time but I caught the third one was in. I still have a buillding pass so the security guy at the front desk told me to put it on so he doesn't need to issue me a building pass. Alana, the OT, was already there. She said she's waiting for Peter and Jo. It's really strange being there after all this time. The place changed a lot from the renovation.

Jo turned up a few minutes later. She looks a lot different from what I expected. I thought she'd be younger. I know from the email she sent me that she'd booked a room on the ground floor but she doesn't know where the room is and she thought I might know.

Finally, Peter turned up. I haven't worked with Peter before. I know he specialises in motor vehicles and prior to GST came in, he used to work in Luxury Car Tax. They put me in Peter's team because apparently they go out a lot less than other teams.

The meeting went on for over an hour. Basically, Alana was running it. She was setting up plans for me such as the number of hours per day and the number of days per week. The first week I will work two days a week and 4 hours per day. This will go on for 3 weeks and then it will be increased to 3 days a week. I told them that I will need to fit in physio and gym as well. Alana doesn't think I need that much physio, I should know better, given that she used to work at MECRS. I told them that my phsio thinks I will still need treatment for at least another 12 months and i don't think I can go back full time in the short term. Jo said they cannot stretch out the program for so long, they are hoping I can return in 3 months. I asked Peter if it's a problem if I just want to work part-time. He said he doesn't know because there are procedures for this and he will need to consult with higher authority and apparently it's quite complicated. In the end, Jo suggested that I try it out first and see how I go. I felt really tired after the meeting and the thouht of going back to work sort of stresses me out. I think Tim is right. He said my life is cosy because I spend most of my time doing my hobby - cooking and reading recipes, and I do a little bit of exercises. The danger of having a cosy life is that I might become lazy.

I felt really tired and stressed when I got home. The thought of no time to do rehab stresses me out. I then thought life is too short to worry about this. I guess if I can't drag out the time to stay part-time, I could probably return on a full time basis and then ask to become permanent part-time. I guess it's their job to get me back to work but it's not their job to see I have a full recovery.

4 November 2005

This is the first diary entry for a while. I have been so busy with Tim's BASs and tax return in the past few weeks. Fortunately, they are all finished now. Technically, I shouldn't mention that I have been helping with Tim's accounts because if I'm well enough to do those, the insurance company would think I'm well enough to return to work. One thing I always remind Tim is that he is so lucky to have me helping him with the accounts, I remember doing the accounts and BASs for him at MECRS a month after my surgery. I couldn't even walk back then yet I managed to drag myself out of bed and sitting in my wheelchair, typing with one finger on my laptop and finished the accounts and BASs for him. I cannot guarantee the accuracy of the accounts but at least they were done.

I had physio at Epworth this morning. I had a pretty good session with Ruth. I must say I have been feeling a bit depressed about my progress lately. I felt I haven't made much progress ever since Gavin went on leave. I had a different physio on Wednesday because Ruth wasn't there and I felt terrible(emotionally) after my session. I only had 45 minutes session there because the physio claimed I was there early anyway. I think changing physio is as bad as changing accountant. I remember when I worked in accounting firms, it usually took a while to get to know the client's business and tidy up their accounts or system. It's very hard to work with a physio who doesn't know my situation. I remeber telling Tim after my Wednesday session that I'll probably never run again.

Today's session with Ruth was much better. She said she's spoke with Gavin and he told her that she needs to push me harder over the next 2-3 months. She's decided to let me wear my ankle brace so she can work me harder without the risk of injuring my ankle. I asked her if that's going to prevent me from running without a brace in future. She said it shouldn't. I think after speaking with Gavin, she just wants to get me to run first and then worrying about running without the brace.

I'm not sure what 2-3 months means because I thought he is only away for 2 months. I'm not sure if this means he won't be treating me anymore. Someone was telling Gary the other day that Gavin has applied for some research grant and will probably only work part time next year. He is probably trying to offload his patients so he can get on with his research. I think I have taken him for granted after a while. I thought all the physios at Epworth are good but now I realised he is exceptionally good and it's very hard to find another physio like him.

Ruth got me to practice on the trampoline for a while. I know I need to concentrate on lifting up the left leg higher, land on my toes and stay shorter on my left leg but I can't do all three things at once so I asked her if I can just focus on one thing at a time but she said all those are important so I can't really practice them in isolation. She then got me to run on the floor in the hallway. It's very quiet today so we had a clear runway. Chris, an exercise physiologist, walked pass and Ruth asked him for his opinion. She said Chris is also a running expert. He watched me running a few times and then Ruth sent me back on the trampoline. I don't know what he thought of my running because they were discussing about me in a different room and I couldn't hear them. He then watched me running on the trampoline and told Ruth something which I didn't really catch. He then went away and came back with a sling attached to some kind of theraband and belt. I don't know what it's called and I don't know what it's supposed to do until they put it on me. Since I have problem lifting me left leg up high enough, by using this apparatus, it helps me to lift up my left leg. In fact, it's actually hard to keep my left leg down when this is on me.

He also told me that I have to keep my trunk upright when I run because I have a tendency to bend over. I think I'm going to practise running in front of a mirror at home.

I must say I'm feeling a lot more positive after my physio session today - a feeling I haven't had since Gavin went on leave. I think with the help from Ruth and Chris, I should be able to run.

Something I should mention is that my personal trainer, Mary, has just updated her profile recently. I noticed that she is now also experienced in rehabilitation and 'neural' exercise therapy. She explained to me that she also has another client who has neuro disease but she insists it's not in a bad way. I'm not sure what neuro disease her other client has. I was very tempted to ask her if it's MS or Parkinsons. I just thought it's funny how she put 'neural' exercise therapy instead of 'neurological' exercise therapy. I suspect it might be because when I told her about neuro (short for neurological) physio, she thought it's neural. I sometimes feel a bit guilty for not pointing this out to her but then again if someone who is looking for a personal trainer who specialises in neuro, they probably shouldn't go to someone who specialises in 'neural'.

I have been feeling a bit unhappy with Mary for a while but unfortunately, I just found out from the gym manager a few days ago that I cannot bring my own trainer to the gym because the gym has an exclusive contract with the personal training group there. I was hoping that I can try out the trainer Gavin mentioned and if he is good, I might swap my trainer. Tim thinks I'm using Mary for the wrong purpose because she is not meant to be a physio. I know she is not a physio but for someone who claims to be an exercise physiologist and personal trainer, she should know her muscles pretty well. I had an argument with her about calves and tib ante (tibialis anterior) yesterday. She put me on this machine to work out my calf a few weeks ago and she told me it's working the gastrocnemius, which is the most prominent calf muscle in the leg and it's the one I need for running and jumping. I didn't suspect anything until I spoke to Ruth and realised that I was working on soleus, not gastroc. I told Mary about this but she blamed her team leader, Mike, for this. She said she always gets confused which machine works the gastroc and which one works the soleus and he was the one who told her this machine works the gastroc. I thought it should be easy to remember because the machine that works the gastroc, you have to do it standing with straight knees and the one that works the soleus has to be done in sitting with flexed knees. It's easy to remember because you must bend your knee to stretch the soleus and straighten the knee to stretch the soleus. I got a bit annoyed with Mary when she told me she wanted me to work on the soleus because it can help me with heel strike when I'm walking. She said when I walk I tend to land on my toe instead of heel on the left foot. I told her I think it's tib ante that does it because I need to dorsiflex to get a heel strike. She was trying to tell me that it's the soleus that does it and I had to tell her that it's the tib ante that does the dorsiflexion. I appreciate that she takes notes of my gait but when she started talking rubbish, it just really irritated me. I think I might be a difficult case for her because most of her clients would probably believe her and she can just say whatever and wouldn't even question her. I took interests in learning all these because initially, I didn't trust the staff and MECRS and later on, I just found it interesting.