Family Meeting & Outlook

Thomas and Natalie had a meeting last Friday with Thom’s team of doctors, therapists, head nurse, and case manager to talk about the progress he has made thus far, and what the goals are, both upcoming and long-term, for his rehabilitation.  Here's a look at much of what they talked about.

PHYSICAL THERAPY
The current focus of physical therapy is to increase the strength in Thom’s shoulders and upper body.  The long-term goal is to help him become more independent, so he can do more for himself (feed himself, lift things, get dressed, etc.), and eventually transition from his power wheelchair to a manual one.

PT is also focused on helping him regain balance.  He can now sit balanced with his legs crossed at “contact guard level,” meaning he only requires someone spotting him.  Another exercise helps him balance with his legs stretched out in front of him and his arms outstretched behind him.  So far, he can do this exercise at a 50/50 relationship with the therapist, meaning the therapist does 50% of the work.  Achieving good balance is critical for many of PT’s long-term goals, including being able to assist in transferring to a wheelchair or bed, getting dressed, etc.

Late last week physical therapy introduced a stimulation bicycle into his routine. This motorized bicycle operates his legs like he is riding a bike, while electrodes are place on his legs that send shocks in an efforts to “re-train” his brain.  He said that it feels really good.

OCCUPATIONAL THERAPY
Occupational Therapy sessions are currently focused on dexterity and upper body coordination.  They are working with him on learning how to roll from side to side and so far this relationship is about 50/50 (again, meaning the therapist does 50% of the work).

Thomas has successfully learned to operate his own power wheelchair and can get around the rehab facility quite well!  Their long-term goals include helping him be able to feed himself post set up (meaning after the meal is prepared and set up for him), dressing himself with limited assistance, and some personal grooming as well (brushing teeth, etc).

NURSING
The nursing team is closely monitoring bowels (including re-training), skin, and pain levels.  SCI (spinal cord injury) patients are especially at risk for skin breakdown and pressure sores which can be incredibly serious and, if incurred, would ultimately halt rehabilitation until healed.  They will be teaching Thomas how to check for signs of breakdown on his own.

OUTLOOK
Looking ahead, the doctors anticipate that Thomas will be living at rehab for the next 6 weeks before being released to come home. (It can be extended to 8 weeks, based on his needs and therapy goals.) While the idea of living at home once again is exciting, rehabilitation certainly doesn’t end. The doctors hope he will be a candidate for the day program at rehab, which would provide the same therapy routine per day, but would allow him evenings and weekends at home.  Following that (for however long it is needed) Thomas would transition to out-patient therapy. More will be know as they go down this path; there is a long journey ahead.

Housing was also discussed, and unfortunately, the newlywed’s current living situation will be impossible for Thom. The quest for a handicap accessible apartment is now underway and will need to be expedited so that medical equipment (wheelchair, etc) can be ordered and arrive in enough time to be ready for his discharge.

Note: if any of our local readers have recommendations of DC apartments that are handicap accessible (elevators, roll-in showers, etc.), please email us at the blog address.

Their case manager is currently compiling additional documents for Natalie to help them with all of these next steps. Much of this depends on what insurance will pay for/allow in terms of length of continued stay, how many days covered for the day program, out-patient rehab etc. Please keep this in your prayers, as well.


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