- - - - -
He appears headless from behind. Literally. Ankles plantar flexed. Knees flexed. Hips flexed. Kyphotic thoracic spine, flexed. The whole thing, orthopedic nightmare, culminates in a neck and head stuck forward like a weepy Dr. Seuss tree.
We've been working with Ron (fake name) for months. He wasn't always like this, not before weeks of bed rest for a pulmonary complication left every joint fragile and locked tight, perfectly fit for a soft couch.
Lay him down on a treatment table. Massage the neck muscles. Apply traction, and pull that baby back. Pressure under his jaw and pull back. Out and back, out and back, out and back. Crank on the ankle and lower leg while pushing down just below the knee. Throw a whole leg over the therapists shoulder and lean in, again bringing force to straighten the knee. Drop the leg over tables edge to open a hip. Extend and rotate the spine.
Each position is held twelve or twenty times. Every single repetition feels like stretching a piece of wood. Who knew these Dr. Seuss trees were oak?
The entire sequence is repeated on the other side.
More than half an hour later, Ron has gained some mobility. Maybe five or fifteen degrees, depending on the joint. It all adds up to a slightly looser, longer Ron. It's time to rise. In less than a minute, about one fourth of the time it takes him to gain his feet, it all falls apart. Ron strains hard to look you in the eye, standing right in front of him.
The therapist strains hard to look Ron in the eye. It hurts.
Ron needs to gain strength and postural stabilization to maintain the effects of all the discomfort that he (and the therapist) just endured. It is easier to climb Everest. His posture has annihilated various braces and corsets that we have tried.
Kim, my sweet assistant, treats Ron like a king. Jokes with him. Patiently waits fifteen minutes for him to walk from the rest room to the pulley system he tugs on. Purchases Easter eggs from Ron's steadfast, beautiful wife.
I think Kim prays for Ron more than I have.
Ron takes it in stride. Slow, short stride. He's awfully kind and gentle for someone that spends so much time looking at the floor. Ron's posture isn't the only thing that other patients notice. He's joyful, even.Yes, king Ron.
Ron chooses to keep pushing. Rehab gives him hope, if nothing else. I don't think that qualifies as skilled, medically necessary health care. Surely we are part of the reason why Ron can live independently at home without other medical issues. I don't feel too bad about those Medicare dollars.
We push with him, fighting gravity with his frail body, fighting despair with his strong mind. He'll eagerly show up for the fight and enjoy the therapists efforts and company, for as many days that God and Medicare "authorize."
I tend to think that number may be one and the same.
- - - - - -