Eric Galvez Keynote QA Session at 2012 SHARP Road to Recovery Conference
SHARP Memorial 2012 Road to Recovery Conference QA session
rehab
“t’was the night before surgery” playlist
Whoa, I found my old iPod mini! On it, there was an old playlist titled “10-25-05.”
I actually got a call from the hospital the night before major brain surgery. They wanted me to come in early before surgery. This was quite an unexpected turn of events! I scrambled to get things in order. I issued this statement on my blog right before I was admitted,
“I know a lot of you wish you could be here with me. I’ll strike a deal. This is the playlist I’ll be listening to tonight on my iPod. Just play one of the songs and you’re there with me.”.
These are the songs I listened to the night before day that changed my life:
Lose yourself -Eminem
Mr. Brightside – the Killers
It’s so Easy – GNR
Breakout – Foo Fighters
Higher ground – Red Hot chili peppers
Gold Digger – Kanye West
Jesus Walks – Kanye West
Ready or not –The Fugees
Superstition – Stevie Wonder
In the Air Tonight – Phil Collins
A little Respect – Erasure
The promise – When in Rome
Only You – yaz
Don’t Stop Believing – JOURNEY!
Blaze of Glory – Bon Jovi
THE FINAL COUNTDOWN – EUROPE
I’m not sure who actually listened to those songs, but I never felt alone on the scariest night of my life. Thank you.
I admit it now… I was scared. I didn’t know if I would survive the surgery or what kind of impairments I would have afterwards.
- I could have little go wrong – smooth sailing,
- I could be on a ventilator for the rest of my life to help me breath, or
- I could even pass away on the operating table!
An Advanced Directive, is something I was familiar with through school, but not something I enjoyed thinking about. Pretty serious stuff on my mind! I listened to these songs alone in my hospital bed after my family left. Kinda crazy knowing that my life would literally be in the hands of the surgeons. Well, I’m told surgery was 8 hours and I was in the intensive care unit for 8 days. I was in a coma for 6 of the 8 days in the ICU. It is so weird that I have no memory at all of that whole week! I spent a total of 6 weeks in the hospital.
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I want to THRIVE not just SURVIVE!
The American Physical Therapy Association had their annual Combined Sections Meeting (CSM) in San Diego this past week. This year was of particular interest because the programming in the Oncology Section really hit home for me. I got to attend a session on pediatric brain tumors. It made realize how lucky I am with the location of my tumor. Things really could have been a lot worse. I feel very blessed to be as high functioning as I am. We reviewed the function of the both the brain stem and cerebellum
Those are two very important structures in the brain. There could have been many other complication from the surgery that could have left me on a ventilator or even unable to stand. I also learned about posterior fossa syndrome. VERY Intimidating stuff. This is rare in adults, but I have a tendency to ignore the statistics both negatively and positively. I was “blessed” a tumor that is most commen in women in their 60s and 70s… I’ve stopped wondering “why” a long time ago. I’ve always been different, but I’ve learned to embrace it. I have learned its actually kind of fun being different if you find people who want to be different with you! I learned this early on in high school because my friends didn’t care if we were part of the “cool” crowd. We just made each other crack up! In college, I finally embraced my Filipino American and Asian American heritage and learned to be proud of what I am. Physical Therapy school prepared me for all the physical impairments I was left with after surgery.
I always enjoy going to CSM because it reminds me that I’m still a physical therapist at heart. I always come back from CSM with a renewed sense of purpose. I still believe that physical therapists can be prime players in post tumor/cancer treatment. No other health discipline has taken ownership of post treatment survivorship health/wellness issues. I can see post-treatment physical activity rehab programs being created at cancer centers similar to cardiac rehab the hospitals. Post tumor/cancer treatment ”Thrivership” is not only nessassary, but can redefine a lifestyle for a patient and their loved ones.
“Thrivership” refers to a healthy lifestyle post treatment:
- being physically active,
- eating/drinking healthier,
- a positive mental attitude,
- exercising your brain, and
- becoming a leader in the war on ALL FORMS OF TUMORS/CANCER,
Many people fight for their lives to become a tumor/cancer “survivor”. I believe that the potential is great for ALL tumor/cancer survivors to become tumor/cancer “thrivers”. Ultimately, it will the “Thrivers” who will become the leaders in the war on tumors/cancer.
My Adventures in Public Transportation
Yesterday, I took public transportation for the first time by myself to my physical therapy appointment. I left my place early in the morning to account for unforeseen issues that could possibly arise. My plan was to take the trolley and ride my scooter 1/2 a mile to the clinic. It did not go as smoothly as I had hoped.
- The side walks in La Mesa are not always paved. I ended up scootering on the shoulder of a road. Prob not the safest thing to do…
- The terrain is very hilly in La Mesa. I had to prime the battery a few times on a few steep hills to reset it. It took me a while to figure out how to do that. (Note to self read the manual before relying on some thing.) I def pushed the limits on that little scooter. The thought of me being stranded in an unfamiliar place without a way to be mobile and move around independently freaked me out!
- It took me twice as long than expected to get the the clinic and was still 20 mins late for my appointment!
- I hate not being on time!
Anyways, I finally did make my appointment and we focused on weight shifting in standing, eyes open/eyes closed. I understand the reasoning of why we are doing things. I also noticed that I subconsciously compensate to complete simple exercises. My core muscles are not stable with movement. I cheat without even knowing it! I have developed a lot of bad habits. Some time I catch myself and can correct things. I really have to focus on them to correct them. After my appointment I decided to take the bus to the trolly station. For someone not used to waiting for things, this was very strange. I almost took my scooter on another crazy adventure, but the “wise-Dr. Galvez-in me” talked me into being patient. Actually, the bus/trolley was much easier to manage this time around! My eyes have definitely been opened to the things that are easily over looked… Anyways, got some cool stuff in the works next month! Stay Tuned!
I had another epiphany in Physical Therapy today! I’m not using my left leg enough when walking. Actually, more accurately I’m not initiating any walking with my Left hip and Left knee. We did a couple exercises to recruit the dormant muscles in my gluts and hamstrings in the L leg! The results were amazing! I actually felt more “normal” when taking a few steps! I am more aware of recruiting underused muscles and bearing weight on my left leg (with a bent knee of course)! Walking was really tiring, but it’s a start. I was recruiting muscles that have been underused for the past 6 years! I think it is a question of muscle recruitment not weakness! When those muscles were isolated, I noticed a BIG improvent in the quality of walking. It is not perfect, but it’s a start! The next few months should be VERY interesting! It left me pretty winded, but that’s something that will improve with repetition. Things are going to get interesting… stay tuned!
A single leg is an “offensive attack” in wrestling. This is the kind of approach I want to take to my own personal rehab! I had an epiphany in PT yesterday! While the weight bearing is impaired in the left leg. I have a desire to keep BOTH legs on the ground when walking resulting in quick steps and limited stance time on a single leg… especially with crutches. I cannot bear weight consistently on one leg while taking a step. When taking a step with my right leg, the left stance leg does not accept weight very well. This results in a quick right step… I just don’t trust my left leg to hold me up. The strength is there, but the confidence in in the left leg isn’t. Left foot placement/position are the biggest factors. I also need to consciously remind myself to “heel strike” first since I have a tendency to “reach” with my toes with foot placement of both feet. Repetition to build up my comfort level is probably the best strategy to take! It is time to go on the “offensive”…
PT shop talk and rehab26 May 2012 12:53 pm
“heeling”=”healing” for me. I finally realized something in therapy this week… heel strike in both legs is impaired… Especially in the left foot with ataxia. It has finally gotten to the point where I can start to control the placement of my left leg. We were focused on foot placement for so long, that I can now fine tune the movements. Placement is not 100% yet, but I have enough control know where I can focus on what used to be minor details… In the normal gait cycle, a definitive heel strike is necessary for proper/efficient loading on the stance leg. I had a tendency to throw my left foot out in front of me and launch myself off a stiff left leg (stifler”). No control of weight-baring/ loading at all on the left leg. Now I’m realizing that I need a more controlled left heel strike to load weight on the planted left leg. We’ve also noticed that: I need to make sure the left knee is not stiff, my trunk is not rotated too much to the left, and I need to maintain a narrow base of support by activating my hip adductor muscless. Things are making more sense now! Consistency is the key! there are so many things that I still have to consciously think about! Things are really getting interesting! Stay tuned… I need to consistently practice this…
Had another eye open session of physical therapy this afternoon. I’m not spending enough time on my L Leg in the gait cycle, always resulting in a quick R step. I have a tendency to rush the through the step, neglecting the weight bearing through the L knee (Stiffler should be gone and I should be spending more time on a bent knee.) I have a tendency to rush through everything, so we are working on slowing everything down and spending more time on the L leg… L leg placement is still a little bit hard to control, but I can feel a difference already! (Need to focus on preventing L foot IR) L hip control definitely is being addressed more. We revisited lateral weight shifting in sitting. Lateral weight shifting in my hips is definitely lacking and has not been addressed in a while. I typically walk with a wide base of support. I just need to keep it narrow! I guess I can refocus on it now! Narrowing my base of support when walking is something I can work on! This is something that I’ve been told numerous times, but now I have a strategy to practice it!
PT shop talk and rehab03 May 2012 11:52 am
Dude! I’m a HUGE FAN of 90′s cheesy songs! HAHAHA! It is only fitting that I integrate it into my personal rehab. (btw “Lisa Turtle” from Saved by the Bell is in this video!) Today in therapy, we refocused on increasing the weight bearing on my L leg (“Stifler”.) This time we focused on spending more time on the L stance leg and not take a quick R step vs what I should be doing… a controlled R step. The L stance leg appears to be the limiting factor in my gait cycle. I realize now there needs there needs to be:
- more L hip lateral control/ (slight) hip adduction lateral movement,
- narrower base of support/ foot placement
- more bend in the L knee in the stance phase (no more “Stifler”), and
- longer weight bearing/stance time on the L LE with bent knee.
I can feel myself slowly recognizing how to walk again. I have a tendency to speed everything up, so I’m definitely going to try to slow my gait cycle down! Things might get interesting the next few weeks!
PT shop talk and rehab26 Apr 2012 06:53 pm
Had a great session in Physical Therapy today! We realized today that I’m not spending enough time on my L LE in the stance phase of gait. My L LE has not been bearing much weight when ambulating. Consequently, my L hip does not shift correctly laterally to the L. The movement is very slight. This is something that can be addressed through practice. Practicing to walk with out an assistive device seems much more productive than before! We are focusing on loading the L hip when walking instead of my typical quick R foot placement with little L LE weight bearing! This pretty much makes the reciprocal movements of both legs feel more natural. I can’t believe that I never really thought much about lateral hip movement/weight bearing because it is such a minimal movement in normal gait! It made a HUGE difference. I suspected something was up with my hips: Hip Control 2/7/12, The Hippy hippy shake 1/12/12, Rehab update 11/16/11, Hip Strategy 5/17/11. I have so much going on that is hard to focus on just one aspect of my gait cycle. Everything points back to the Hip, Knee, and Ankle strategies. It is starting to make more sense to work on the proximal joints then worry about the distal joints later. I do have better control of the distal joints than one year ago, so Hip Strategy is now the top priority. Things are going to get interesting…
