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Mom's Boot Camp (June)
On the first of June, Matt sat alone on the bed (with me at the ready) for a whopping 5-10 seconds. It might seem insignificant, but our equivalent might be attempting to stand that long on a tightrope. Several times, when he started to lose his balance, he used his hand to stabilize on his knee or flailed his arm enough to right the ship—a common balance reaction any of us might use when rescuing ourselves from an impending fall.
I noted this and other small changes in my journal, such as “Sitting up, Matt can extend his left knee to within 30⁰ of full range,” or that a week later, “Matt raised his left hand close to his face as if trying to scratch an itch,” and “He occasionally moves his right thumb and can move his right leg a little when he walks.” Each accomplishment became the baseline metric moving forward. Sharing these details on Facebook kept a supportive group of family, friends, and new acquaintances apprised of Matt’s progress and gave us all an ongoing reality check—this could take a long time. Still, over the passage of months and beyond, each milestone became a time to commemorate collectively and motivated us to face the next hurdle.
Matt and I worked on facial expressions: opening his mouth wide, trying to say "ee" and "ah" and smiling, and I even had him blowing into a Recorder—all of which needed lots of coaxing. As his father’s birthday approached, we routinely mouthed singing Happy Birthday as his surprise birthday gift. Not wanting to be a comic sight—with me exaggerating the words for him to mirror and his face contorted in his effort to comply—we withdrew to the far reaches of a parking lot to practice. We sang songs like Michael Row Your Boat Ashore, Twinkle, Twinkle Little Star, and other childhood tunes, hoping to trick his vocal cords into joining us. Once, hopefully, I heard two undecipherable but loud sounds—but still no talking.
(Left to right) Ee, Ah, & smile.
Now, that's more like a smile.
Efforts to increase shoulder function had plateaued. Although Matt could raise his left arm up lying down, he could not do so sitting up because his strength was inadequate to overcome the increased resistance gravity applied to the weight of his arm (approximately six to eight pounds). This is similar to the effect the moon’s gravitational force has on a man’s body compared to that imposed by the Earth—the difference is substantial. Overcoming this transition was a hurdle, and Matt was stuck here. I rigged up elastic exercise bands overhead to offer just enough elastic lift to assist in raising his arm while letting his muscles do the bulk of the work. Over time, the plan was to swap out these bands and offer less assistance until he reached the point of being able to do it himself.
We also utilized therapy bands to add resistance to other muscles, as is more common. He continued to exercise using dumbbells for the elbow and hand and a two-pound cuff weight for left knee extension. Matt often completed one to two sets of ten repetitions—yet he remained unable to extend his right leg or wiggle that foot.
Once, when given the choice to watch a DVD, read Harry Potter, or stand up with me—he indicated the latter. I liked that answer. If I goaded Matt to do more and expect less from me as he got out of a chair, life played out in slow motion as he contemplated, aligned, and activated the required muscles and movements to complete the task. Standing, he concentrated on preventing his left knee from buckling while I took charge of the right knee and held his upper body erect for one minute before we pivoted from one chair to another—just the two of us doing a little dance. Eventually, using the bed rail for support to stand, he was able to keep a straight posture for two minutes before fatiguing. In addition, I might intervene with extra assistance to challenge him to stand a few minutes longer. In time, we stood together in the parallel bars. As I hesitantly withdrew from blocking the right knee, I optimistically made a mental note that, for brief instances, Matt stabilized his right knee and kept it from giving way. Finally.
As summer approached, Boot Camp spread to the therapy gym, where we were given access to the space and equipment during off hours: mat tables, weights, an exercise bike, and parallel bars to walk. Sitting in his wheelchair, Matt could now reach overhead with a one-pound dumbbell, seven-pound weights for elbow and wrist exercises, and six pounds for thigh muscles. Sometimes, he kicked a ball and batted at a balloon while sitting on a mat table, incorporating balance, eye-hand or eye-foot coordination, and timing.
And finally, at last—can you believe it? We elicited a very weak contraction of the right quads using the principle of overflow. In this technique, energy generated from resisted leg extension on the opposite side augmented or boosted his attempt to maintain the right leg in an extended position momentarily. In other words, I tricked the muscles into showing themselves—hey, whatever works. My next great challenge was to evoke the same response in the right upper arm. Offering variety and carefully observing how his body responded helped me to identify what worked best at any point in time and build upon it.