Progress

One of the most amazing things of being here is seeing the progress people make. It is truly miraculous. When I first came here, the woman in the room across from me had a severe brain injury. She must have had a trach, which they removed, because she had a bandage over her throat. She was unable to feed herself. She could barely sit in the wheelchair. She couldn't follow commands, and she didn't speak. Her outlook looked grim. I could not see how she would ever be prepared for anything more than a nursing facility. Today, as I was doing pt, I noticed the physical therapist working with her on one of the mats. She was sitting on the edge without the aid of anything. She wasn't being held or supported by anything to keep her upright. This in itself was amazing, but then she got up and stood using the walker! I was absolutely blown away. I couldn't believe it. Had I not seen it with my own eyes, I wouldn't have believed it, knowing how she had been initially. I felt like crying tears of joy.

Later today, I saw another miracle. One of the guys that had been admitted last week for brain trauma was in the pt room. When I first saw him it was obvious that he had a tbi (traumatic brain injury). He was hooked up to oxygen through a trach mask. He had a neck and back brace. He was strapped into the wheelchair to keep him upright since he wasn't capable of holding himself upright himself. Today, not only was he no longer hooked up tho the oxygen, thus must be going through the process of capping or has been decannulated, but he wasn't strapped into the wheelchair. He still wore the neck brace, but not the back brace, and most miraculous was he was not just standing, but walking, walking without the aid of anything. He was just walking around the gym, with his physical therapist only holding onto his gait belt as a precaution. He didn't seem to need a lot of assistance. He walked one time completely around the room. I feel so blessed to have the opportunity to have seen this, to watch the progress of other patients.

While it is easy to see the progress and incredible improvement others make, it is much harder to acknowledging my own progress. I do recognize that I have made a lot of progress while here. I have worked incredibly hard, and it shows. The goals set for me when I came here were to be completely independent with the use of aids by the time of my discharge. I had to be able to be completely independent because at home I really don't have any help. There isn't anyone at home to help me with daily activities. I live with my dad, but he doesn't provide any care for me. Though I could be independent with the use of aids such as walker, wheelchair, or cane, I must be able to complete my daily activities without the assistance of another person in order to be ready for discharge. When I was first told this, I thought this would be easy. I couldn't imagine needing any aids by the time I was discharged. I expected that I'd have full functional ability - able to walk unassisted. I thought that I might need a cane for longer distances, as I had before, but never imagined that I'd need a wheelchair of walker. Granted, I hadn't really acknowledged the extent or severity of my issues. I thought it was just weakness, in which case I'd do exercises and get stronger. I remember the first day when they put me up to the parallel bars. It was expected that with the use of the bars, I could stand unassisted. This wasn't true. I couldn't even pull myself up. Looking back, I do recognize that I have made a lot of progress. No, I am not where I'd like to be. I am not back to normal, but I am greatly improved. As my goals had stated, I am able to care for myself independently with the use of aids. I am able to walk short distances and stand for short periods of time using the walker. I am able to get around using a wheelchair.

I have made progress in other areas as well, not just walking. When I first came here, I wasn't able to bathe myself. Showering was an extreme challenge with my trach. The first shower I took, took over an hour. I needed help dressing myself. I could barely stand long enough to pull up my pants. I would stand, hold onto the walker, and the aid would help me pull my pants up. I had to take frequent rests. Now, I am able to basically shower and dress in ~1/2 hour. Before, I'd need a nap after showering because it was so physically exhausting that I needed to rest. Now, I bathe and dress pretty much without help. I am able to stand for longer periods of time and can do so without being completely exhausted after. Don't get me wrong, showering and dressing is still rather tiring. Though my legs were the area of greatest weakness, I have also been able to work on the strength in my arms. When I first came here, I needed to be pushed in the wheelchair because I was too weak to push myself. Now I am able to push myself in the wheelchair and able to get myself around.

The area that I have seen the most improvement, however, is my speech. I came here unable to speak at all. I was beginning to be able to talk over the trach, but I could only say a few words. I still had to write most of what I wanted to say. Talking was exhausting and at times unpredictable. I could never be sure that when I went to speak, I would have a voice and sound would come out. Often I would go to speak, but no sound would come out. I had little control over when I was able to speak or not, which was very frustrating. I was not able to tolerate the pmv at all. Once we discovered the problem with using the pmv and got me one that worked properly, I made huge progress with my speech. I am so proud of my voice. I enjoy showing it off. I worked very hard to talk normally, and now, for the most part, just by listening to me speak, you wouldn't know I have a trach. My speech is pretty much completely normal. Occasionally, I can be hard to hear. Sometimes I have difficulty speaking, but for the most part, my speech is normal. Not only have I met all of my speech therapy goals, but I no longer need speech therapy.

It's funny what you come to see as an accomplishment and progress. Before the trach, I never thought about the things I did every day. Most people don't think about their ability to speak or do other things such as shower and dress themselves, but having to relearn everything is a challenge. Even the little things in life become accomplishments. The important thing to remember is that it is progress. You need to take baby steps and be proud of your progress. Be patient and kind to yourself, knowing that it is one step at a time, one day at a time.