4 August 2006
I went to Epworth for physio this morning. I decided to write up another blog because I was able to clarify some queries I had with Gavin.
I always wonder why I find walking continuously at a certain speed very hard. I told Gavin that one day on my way to the gym I was trying to follow a girl in front of me walking. She was walking at a constant pace and I thought if I can just keep up with her, it's porbably a bit like walking on the treadmill and it may be a good practice for me. I started about 5 metres behind her but after a while I just couldn't keep up. I'm sure she was walking at a constant pace but I just couldn't keep up walking at that pace and eventually she was further and further away ahead of me. I asked Gavin why that's the case. Why is it that I can't keep up. He told me it's to do with endurance and it's the same why some guys can't go running outdoors because they don't have the endurance yet. I asked him how to build up the endurance and he told me everything that I do in physio will help. And also things like elliptical and step machine at the gym. I guess I just need to do a lot more of those at the gym then.
Another question I had was whether in rehab it's harder to treat lower limbs than upper limbs. I told him that I didn't have much formal treatment with my upper limb but it seems to me that my upper limb is recovering quite well comparing to the leg. He said no, it's usually the opposite. He said often it's much harder to treat the arm than the leg and I'm lucky that my arm is not severely affected like my leg. I didn't want to argue with him but I didn't think you can be affected differently in the leg and the arm if you have dense hemiplegia. I suspect the difference was I had early intervention on the arm with repetitive practice - thanks to the help of Neil and Rosemary. The leg was being treated when I was at MECRS but the intensity was not nearly enough and there was no strength training introduced at all so I'm still paying the price of large muscle groups severely weakened by the paralysis. I think Mary Galea is absoultely right in saying that the arms are often neglected in rehab. I didn't have much of treatment in the arm when I was at MECRS. They spent all the time on the leg. I guess that's the quickest way of getting the patients out of the hospital. I'm still upset by the fact that they wouldn't let me walk around ward even the day before I was discharged because they were worried that I might fall over. I guess their mentality is as long as i don't fall over at the hospital, it's not their problem. It's ok for patients to fall at home or anywhere else but the hospital.
I had often wondered if I would have recovered better had I gone to a private hospital like Epworth in the first place. I think Gavin is an excellent physio who has a very positive attitude. However, when I looked at most of his other patients, I think I might have the best of both public and private system. I think it's possible that I would have recovered better in my walking and running if I were there from day 1 but definitely not with the arm though. The rehab system is a bit strange because upper limb is often classified as belonging to the OT department and not really in the area of physio. Maybe that's why it's often neglected in rehab.
I remember when I first met Mary Galea at my local church, she mentioned to Tim that they want to do another research on whether early treatment is crucial or the timing of treatment doesn't matter. I see her at the church sometimes and I'm always very tempted to tell her that from my own experience I think the timing of treatment is crucial because when I look at many guys in the running group that they can all run faster and better than I do but their affected arms all look a bit funny.
I always wonder why I find walking continuously at a certain speed very hard. I told Gavin that one day on my way to the gym I was trying to follow a girl in front of me walking. She was walking at a constant pace and I thought if I can just keep up with her, it's porbably a bit like walking on the treadmill and it may be a good practice for me. I started about 5 metres behind her but after a while I just couldn't keep up. I'm sure she was walking at a constant pace but I just couldn't keep up walking at that pace and eventually she was further and further away ahead of me. I asked Gavin why that's the case. Why is it that I can't keep up. He told me it's to do with endurance and it's the same why some guys can't go running outdoors because they don't have the endurance yet. I asked him how to build up the endurance and he told me everything that I do in physio will help. And also things like elliptical and step machine at the gym. I guess I just need to do a lot more of those at the gym then.
Another question I had was whether in rehab it's harder to treat lower limbs than upper limbs. I told him that I didn't have much formal treatment with my upper limb but it seems to me that my upper limb is recovering quite well comparing to the leg. He said no, it's usually the opposite. He said often it's much harder to treat the arm than the leg and I'm lucky that my arm is not severely affected like my leg. I didn't want to argue with him but I didn't think you can be affected differently in the leg and the arm if you have dense hemiplegia. I suspect the difference was I had early intervention on the arm with repetitive practice - thanks to the help of Neil and Rosemary. The leg was being treated when I was at MECRS but the intensity was not nearly enough and there was no strength training introduced at all so I'm still paying the price of large muscle groups severely weakened by the paralysis. I think Mary Galea is absoultely right in saying that the arms are often neglected in rehab. I didn't have much of treatment in the arm when I was at MECRS. They spent all the time on the leg. I guess that's the quickest way of getting the patients out of the hospital. I'm still upset by the fact that they wouldn't let me walk around ward even the day before I was discharged because they were worried that I might fall over. I guess their mentality is as long as i don't fall over at the hospital, it's not their problem. It's ok for patients to fall at home or anywhere else but the hospital.
I had often wondered if I would have recovered better had I gone to a private hospital like Epworth in the first place. I think Gavin is an excellent physio who has a very positive attitude. However, when I looked at most of his other patients, I think I might have the best of both public and private system. I think it's possible that I would have recovered better in my walking and running if I were there from day 1 but definitely not with the arm though. The rehab system is a bit strange because upper limb is often classified as belonging to the OT department and not really in the area of physio. Maybe that's why it's often neglected in rehab.
I remember when I first met Mary Galea at my local church, she mentioned to Tim that they want to do another research on whether early treatment is crucial or the timing of treatment doesn't matter. I see her at the church sometimes and I'm always very tempted to tell her that from my own experience I think the timing of treatment is crucial because when I look at many guys in the running group that they can all run faster and better than I do but their affected arms all look a bit funny.
posted by Teresa Liu at 9:48 PM
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