Tag Archives: PT

stravaRide002

Standing to Pedaling

Before I begin this post I have to make it known that I am typing this entry, in full, with my laptop in my lap, using both my left and right hand and with a timer running. I am doing this in place of my New Year’s resolution of typing my OT, Vicky Whalen, one email a week with the my stopwatch’s time featured in bold at the bottom. So, that’s what the random bold type will stand for at the bottom of of this entry, and the posts to come.

I don’t know how many of you use the app Timehop, but I’ve done a blog post about it before and you can learn exactly how it works by clicking the link in this sentence. Anyways, while perusing my past social media posts, via Timehop, on Monday last week, 1/16/17, I was humbled to find that I had posted the video below, from now slightly over three years ago, my first time standing on my own with no hands OR any assistance from anyone else, on pretty much every social media account I have!

Standing up on my own, no assistance from anybody or my hands!

A post shared by Anthony Macchio (@amacchio) on

With the thought of me accomplishing such a milestone in my #slowlybutsurelyTBI recovery process I started thinking about what the most recent milestone that I’d accomplished might have been and/or what the next one can be. I, of course, then started thinking of how awesome it was that I can now pedal around on a trike that I’m fortunate enough to call my own. BUT, my cycling skills are definitely not up to the quality that they very well could be. Because of seeing my standing video though, it encouraged my brain and body to ride with their upmost precision…for a TBI survivor that is. During my ride on Thursday (1/26) my mom, dad and nephew Tyler were all nice enough to accompany me by walking along side me as I pedaled. There were quite a few things to highlight while on this family outing of a ride/stroll around our neighborhood!:

1. My left arm’s flexor tone never felt the need to kick-in and pull my left hand off of the left handle bar…even though it had insisted on doing so on every late afternoon ride prior.

2. On top of my left arm’s flexor tone not making itself known, neither did my leg’s extensor tone. I was mostly surprised that neither of my hemiplegic extremities’ tone had made themselves known due to the fact that I had an audience, of sorts, following me around and spectating my every move. I say that because when I’ve been in the spotlight in the past my first sign of nervousness came out in said tone in both of my left extremities.

3. After getting to the end of our first lap I asked everyone if they’d be willing to go around for a second lap, and they thankfully said yes! The second lap went just as smoothly as the first one and I could have pushed my luck on a third one, but figured it would be best to call it quits after my first go at two laps. Upon me getting back to our starting point (our house) I stopped my Strava cycling tracker and was MUCH more than happy to see that my first go at two laps around our neighborhood was just a mere 1 minute and 41 seconds added onto my, then, triking record of 15 minutes 45 seconds for just ONE lap!

With all of the above accomplishments having been achieved after just my Trike Ride #4, I can only assume that the recovery process via my trike will not exactly follow my recovery hashtag and soon to be new recovery blog’s new primary URL, #slowlybutsurelyTBI. 🙂

⏱ = 1:35:46

metrikeride001

Trikin’ It!

The mom of all moms, my mom, has been telling both my brother and me that we need to be sure to have our Christmas list ready by Thanksgiving day, at the VERY latest. At first this was equally as difficult as it is each and every year. Then, one day, during an OT session my therapist, Vicky Whalen, and I started talking about bike riding because another neuro patient at therapy was busy practicing riding a harnessed bicycle. I would peek over at her with my jealous eyes without being able to hide it and that enticed Vicky to bring up the fact that the other patient was rather big into biking before her accident and invested in a trike for home use.

After hearing this it made me think, “TRIKE! That’d make a PERFECT big present for my birthday (12/21) + Christmas present!” Upon returning home
I texted both of my parents about the idea and they suggested for me to
call around and see where in town we could find a good one. I agreed that that was a good idea and was sure to call my “go-to” bike shop in town, thesantatrike Trek Bicycle Store of Mt. Pleasant. Also known as, the store where the bicycle I was riding during my accident came (which I had also gotten for Christmas one year). After relaying the heads-up that they fortunately had an adult trike in stock both of my parents agreed that we would be going up there that Saturday! With all of the anticipation of getting to try and pedal a legitimate bike setup  the following three days of the week were truly going by slowly but surely. BUT, when that day finally rolled around I had no problem waking up at a decent hour…even on a Saturday at that! Upon walking into the Trek Store we coincidentally started talking to the store’s “shop mom” and she took us back outside, where the trike was being modeled for the world to see.

Upon sitting on the bike my nerves decided to show themselves by allowing the extensor tone in my left leg to shoot out and my left arm to contract-in via my flexor tone. I had honestly come to terms with the fact that such a thing was likely happen because although my brain was familiar with the act of riding a bike, it just hadn’t experienced the real thing in 3+ years. Not to mention that I was feeling a slight case of anxiety because I only had that one chance to give it a go. As well as the fact that I was in front of the “shop mom”, who I had never met before and my dad who had his phone out to use as a camera to show the world that I was back to my usual pastime of pedaling around.

trekstoreAfter being unable to keep my left foot on the pedal and almost
running into one of the building’s exterior columns (not pictured in this image) due to my left hemiplegia I decided to call it quits on this highly anticipated event… When I did so the “shop mom” indirectly revealed as to why they refer to her as that and stated that she was sure that she could talk the manager on duty into allowing us to take home the trike on approval for a “test drive”. At first I didn’t allow myself to get my hopes up, but sure enough the “shop mom” did what all moms tend to do and did not give false hope! My mom and I had ridden up there in her sedan and my dad met us in his magazine distribution van, which obviously tends to be FULL of magazines, so neither vehicle was able to take it off site right then and there. We all agreed that my dad could pick it up that next day, Sunday, 11/30. In the meantime “shop mom” convinced the repair guys to replace the default pedals with racing bike type pedals that had toe straps that wouldn’t allow my left leg extensor tone to cause problems with my foot slipping off the pedal.

That Sunday, when my dad rolled the bike in the house it had noticed that one of the rear tires had unfortunately become flat somehow. That drove my dad to do something he’s been meaning to do for his own personal beach cruiser for awhile…buy a bicycle tire pump. None of us really had a chance to try and pump the tire back up until the following Thursday after I had therapy when I realized that’d make a good goal for me to try and pump it up on my own and, more importantly, the fact that I did not want to overextended the favor that Trek was oh so generous to grace us with. I was successful in my attempt in pumping the tire up, but the air maintaining its place in the tire not so much. I once again texted torkertristarboth of my awesome parents with the not so awesome news of the incompetent tire. My dad had, thankfully, agreed that he would be able to run the tire up to Trek to have them replace the tube. After hearing that I called Trek to assure that they would be cool with that and they were!

When my dad returned home with a tire that had a new tube that was able to remain fully inflated it was a relief to see. With that being said we immediately put it back on the trike! I felt inclined to ask my parents if they would mind spotting me on a trial run right then and there. I then decided I’d better not ask because I know that they would have just made the very reasonable point that it was dark outside and it would have been only my second time trying to attempt pedaling around since my accident, so I managed to fight my drive to get back in the swing of things.

There unfortunately didn’t turnout to be a good time for us all to take the trike for a test run the next Friday either. Although, my mom and I did make a commitment that evening that we would DEFINITELY take it out that next day, Saturday, 11/5, before I left for plans with a friend at 1 p.m. and my dad also made the commitment to return the trike to Trek that following Sunday!

When waking up that Saturday I once again had no issue getting up…for the trike’s sake. I got ready on my own that morning, like I’ve been doing everyday for at least the last two years, but this time MUCH faster than normal in anticipation of getting another chance of pedaling around completely on my own! After eating breakfast my mom and I went straight outside and I gave the trike a second try!

The first thing I noticed different about riding it around our cul-de-sac was that I felt under MUCH less pressure so much so that I was able to think about step one, mounting myself on the seat. With that being said I figured out that approaching the bike from the lefthand side allowed my left leg to remain planted and my right leg to go through the trouble of going up and over the frame. Step-two should have been me pulling my left leg up into the racing pedal cage that Trek was nice enough to install. I have to admit that I honestly didn’t have the patience to fight my left leg’s tone to get it strapped in there, so I had my mom help execute that step. I then helped to stretch my left arm up to the handle bar, took the parking break off and began pedaling! I was a little surprised that my left arm wasn’t forcing me to turn the whole trike to the left, but the fact of the matter is that it wasn’t!  Although, when I went to take an intentional turn to the left I experienced the only real problem of that ride. That issue was that I think the seat might have been a notch too high because the handlebar insisted on butting into my left knee while trying to get a little more oomph into a full u-turn. I thankfully managed to still turn around safely/efficiently though and started coasting back to the house like it was no problem at all!

Long-story short, I’ve officially narrowed my big Christmas present down to asking Santa for one of two different makes and models of one-speed adult trikes that Trek recommended, but both will need aftermarket racing caged pedals added! In reality though my parents can feel free to get me which ever bike I have on my list as both a birthday AND Christmas present seeing as my birthday always has been, always will be, close to Christmas on 12/21. Not to mention that neither bike is inexpensive, so I’d rather not come off as a spoiled brat by getting the trike as just one rather MASSIVE gift. SO, if anyone would like to go for a ride around the block shortly after Christmas I’ll be more than ready to join you!

Edmundo

Endomondo Goal #1

I once again have not had any time to reconstruct my recovery blog’s web presence this month (September 2016). BUT, I do have rather decent news to announce though!

I have yet to be able to meet my longterm goal of getting my gait pattern (walking pattern) down to the typical stride of a healthy human-being while using my Jawbone, step/distance wristband tracker, that the Bullingstons were nice enough to send me. Having not met that goal (yet) I decided to scour the Apple App store for the best free running/walking stopwatch app that I could find. After weeding through a few different ones I found one from UnderArmor called Endomondo, that I first mentioned in this year’s July entry. Endomondo keeps all of the data collected stored throughout the week no matter how much it is used. Which was one of the key issues that I found while testing other apps. After finding this I am able to start the clock upon standing up/walking and pausing it upon sitting down. At first I was having trouble remembering to start and/or stop it when doing so, but I’ve now got it down like clockwork (pun intended). Upon me getting in the routine of keeping track of both my standing and walking times with said app I then decided to take a screenshot of my phone every Sunday and make it a goal of mine to try and reach higher numbers, all around, the following week.

The image below is a series of four consecutive weeks. You’ll see that I have managed to  meet said goal (for the most part)! Not to mention, that I’ve managed to escalate my gait speed up in the second two screenshots!

edmundoweekly9-24-blogpost2

P.S. This past week’s timer is not showcased because I had under the skin toenail removal on both of my big toes due to a bad case of ingrown toenails on both of my big toes. With that surgery it made my toes more sensitive and has prevented me from walking. : / But, I’ll be good to go soon! …slowly but surely. 😀

Neuro Nerds

As I’m sure many of you know, I received the majority of my therapy since returning home to Charleston, SC at Roper St. Francis’ Downtown location. Roper St. Francis’ outpatient therapy became my home away from home after going there for physical and occupational therapy four days a week for almost two full years. My parents and I then decided it was time to get some new/fresh eyes on my recovery process.

My Shepherd Center therapists brought this strategy to light for the three of us after seeing them use this tactic themselves. I had my regular Occupational, Physical, Speech and Recreational Therapists team, but would periodically have sessions with different rotating registered therapist, or even Physical and Occupational Therapy Assistants, in order to allow a fresh set of eyes to view my weaknesses/strengths. This showed great results on all ends of the spectrum!

With that being said, after going to Roper St. Francis for so long, 12/13-10/15, we decided it’d be best to ask the MUSC Physical Therapy Neuro Professor, Dr. Sara Kraft, what local therapy gym she thought had the best neuro focus.MUSC logo She told us that MUSC had recently reopened their gym in Mt. Pleasant with the plans of having all disciplines included to focus specifically on neurological issues. After hearing that one of Dr. Kraft’s former PT students, Eric Monsch, who had worked at Vanderbilt Stallworth in their Neuro inpatient Rehab department in Nashville, TN, was there I switched gyms to MUSC Mt. Pleasant right away. I had my first appointment with him on 10/21/15. After seeing his neuro nerd knowledge in-person I was very happy that we decided to get some new eyes on my recovery process! Although, there was an initial hiccup in the
move because they hadn’t yet acquired a neuro Occupational Therapist. The MUSC Rehab Manager, Ann Benton, was quick to inform us that they were going to transfer one of their own OTs out of their inpatient department very soon.

After about a month and a half of seeing Eric, MUSC had brought an OT neuro nerd, Vicky Whalen, over to the outpatient side of things. I had my first session with her on 12/1/15 and realized that she’s REALLY ON TOP of the neuro rehab game. So much so that it wasn’t till after the first two months of seeing her that we repeated something we had done together. Even more surprisingly, she had so many tricks up her sleeve that we did exercises that I had never done with any of my other OTs in the full 2.75 years I had been in therapy. This came as a big surprise to me because I had been saying, jokingly of course, that I could basically become any discipline therapists I’d wish to become because of the amount time that I’ve spent observing all of them. So, thanks for proving me wrong Vicky, thanks a lot. I’m kidding but that is really how much neuro nerd knowledge she has…

LSVT BIG LogoEric and Vicky made an awesome new set of eyes. Then, come mid-January, Eric has some unfortunate-news that he was going to change departments at MUSC and use his neuro skills in the MUSC Research Department. When he left at the beginning of February I had PT with Laurie Woods, who specializes in LSVT Big. It was once again GREAT to have yet another set of eyes on my recovery process. Especially from a therapist that specializes in a very particular neuro strategy for Parkinson disease, at that.

I only saw Laurie for just about a month because Mrs. Benton hired the first neuro nerd I had met when starting therapy in Charleston, Katherine Bennett! Katherine was my initial Physical Therapist when starting at Roper St. Francis, but she then had her first baby on March 4th, 2015. After her three month maternity leave was over she tried to get a part-time position at Roper, but they unfortunately did not have such a position open. Seeing her in a therapy environment again feels like a meant to be kind of scenario. I say this because after her not seeing me for almost a full year she has a fresh set eyes on my recovery, yet she is familiar with my typical patterns.

Katherine and me walker

Walking into MUSC therapy on my walker.

MUSC’s neuro gym has been a great choice overall, but they’ve only been able to see me two days a week from the get go. At first this was a little discouraging to my recovery process. That negativity ended up having a reverse effect and ended up showing me two perks of less therapy. The first being that it entices me to do my at home exercise program on my floor exercise mat, at the very least, two days a week. I’m even able to do my exercises on the floor when I’m by myself and even GET UP OFF OF THE FLOOR BY MYSELF! …which I’m obviously really excited to say I’m able to do. The other part of my home exercise program is for me to use my walker while at home alone. At first this had me a little worrisome, but now I’m walking and standing for 3 hours of the day while home alone. The second perk I’ve seen with less therapy is the fact that I’m able to focus on my love for design much more than I have been able to since my accident!

My 3rd Re-birthday!

Today marks the 3rd anniversary of my accident, or my 3rd re-birthday. I am very thankfully that I’m still making progress, slowly but surely, as I stand up at my new stand up desk at home alone. I once again have to say that I could not have done/continue to be making such progress without all of your prayers and support, so thank you all very much!

sanFranSign3years

Timehop reminded me of this photo I took as I got off the CalTrain before I got on my bike the night of my accident.

Home Alone

Since I posted that photo of my friends and me from two years ago at the beginning of this month I’ve felt that I should update the blog with an actual entry as opposed to just a picture, so here we go…

I’ve very fortunately progressed to the point where I can stay at home alone comfortably & safely now, and have been doing so since the end of May! Before I felt comfortable doing so I looked into the prices of Life Alert and Lifeline. After getting quotes from both of those providers I began brainstorming alternatives. And BAM I noticed that the Apple watch was available for preorder! The Pops and I went to the Apple Store to preview the watch before preordering one. I found that they have a band that is always attached in a circle form and loosens up by a magnet which was a great option for me seeing as I’m hemiplegic and don’t have full range of motion in my left arm, the wrist that I’ve always worn a watch on. So far I haven’t fallen while at home alone (or even at all, knock on wood), but always having a way to call someone for help if need be gives me a sense of ease. Plus, the Apple Watch has already paid its self off if you compare the price of the watch to Life Alert or Lifeline’s setup and monthly charges.

Mirror | mirror is the recent logo I've developed for a client.

Mirror | mirror is a recent logo I’ve developed for a client.

There are a few downsides to being home alone though, the first being that my buddy from thirdgrade, Michael Onorato, is no longer with me during the week to hang out with and go do different things. As well, without him at home with me I can only do speech and arm exercises. As to be expected, I initially didn’t feel too comfortable doing standing exercises with no one at home to spot me, watch or not even watch me at all. Recently though, I have gained much more confidence in standing alone while doing household activities such as brushing my teeth, shavingmy face or empting the dishwasher for my mom. I have also been transferring from my wheelchair to one of our living room’s wingback chairs by myself to work on my computer for client work…or writing my blog update. I have been very grateful for the fact that I have fully retained all of the design disciplines, as well as the depths of the programs I learned while at Full Sail University.

Something I’m not too grateful for is the blasted heat that Charleston experiences in the summer time. I say this because when it was cooler outside I would do my walking exercise with no assistive device around a neighborhood pond with my dad there spotting me, but 90+ degree weather will really get to me. Since my accident my internal body temperature will escalate much more, kind of like I’m a cold-blooded reptile. The good thing is though that today is the Fall Solstice, so we can only hope that means that temperatures will go down for walking’s sake.

My first nuero PT while in SC with her new babyand her husband after walk in and out of church.

My first neuro SC PT and me with her family.

Although I haven’t been walking with no device, except around our house a little, I have been using my single pole offset cane to walk in and out of church, restaurants and a variety of other establishments. The cool part is that I’ve seen my gait pattern’s pacing increasing by minutes at a time, slowly but surely, by using a free app that tracks the position of your phone via GPS and tells you exactly how far you’ve gone in how much time. The reason I feel it necessary for me to use my cane while in throngs of people is that I feel intimidated and scared that someone might bump into me, or something of the sort, and the cane gives me that little bit of security to move forth.

 

Come next week, I’ll be helping out in another one of Dr. Sara Kraft’s neuro classes with different PT students. She’s also told me about a video that she would like me to be the neuro patient in to help educate every discipline of therapy learning about Neuro Rehabilitation. I will be sure to post about that experience in my next post. While on the topic of videos, I will commit to finish editing the video from the one hour talk I gave to Dr. Kraft’s 2nd year neuro class’s PT students in April before the end of the year and share it on here!

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Oh, How the Tides Have Turned…

The photos featured are one of my brothers and me recreating a photo from almost two years ago. He and his wife were visiting Charleston for the first time in a pretty long while and his wife showed me the first picture at dinner their first night in town earlier this week. That’s when the idea struck me “We have to change places now”!
Before & After

2 Year Anniversary

I forgot to update the blog about my 2 year anniversary post last Sunday, February 1st, 2015. I am still making substantial improvements day in and day out, slowly but surely. Couldn’t do it without everyones’ continued prayers and support, thank you, I couldn’t do it without you all!

Two Year Anniversary

Home Again Home Again

One of the first things we did when we returned home to Mt. Pleasant, SC was to interview at-home caregiver businesses to take me to therapy whenever I would have it and provide in-home care. We were not having much success in finding the ideal situation, but, then my buddy Michael Onorato stepped up to the plate. Michael agreed he would take me to therapy everyday and hang out with me in my off time. I was, and still am, very appreciative that my elementary school buddy would do such an awesome thing for me! My parents and I initially went to East Cooper Hospital on September 11, 2014 for a PT, OT and Speech Therapy eval, as recommended by Shepherd Center’s outpatient facility. After my PT and OT appointments we heard the unfortunate news that insurance was no longer going to cover Speech Therapy. After hearing that my heart dropped, but the East Cooper Speech Pathologist, Katie Edwards, was nice enough to give me a free eval while my dad contacted both our insurance case manager at the time and Shepherd’s Pathways. East Cooper’s PT therapist, Suzanne Rodgers, was also nice and told us that she didn’t think that East Cooper rehab would be the best therapy source for my TBI related injuries and specific therapy needs, so she referred us to MUSC and provided us with MUSC’s outpatient therapy’s number.

Walking on the elbow platform walker at MUSC.

Walking on the elbow platform walker at MUSC.

Once we got into therapy at MUSC I was registered with all three disciplines, which were once again covered by insurance, even Speech (thankfully). I started in PT learning how to scoot down a mat, which doubled as my bed, while sitting on the edge and walking on an elbow platform walker, focusing on lifting my left leg fully. In OT I would put a heated pad on my left shoulder’s pectoral muscle to help loosen it up before stretching it and trying to open sealed containers myself. For Speech Therapy I was mostly focusing on the letters my tongue was having troubles producing like ‘K’, ‘G’ and ‘CH’. Unfortunately, MUSC was unable to schedule therapies more than one or two times a week. With my injuries I needed to work as hard and often as I could to achieve the best outcome for my recovery. So one day while I was at MUSC my dad did some investigating and found Roper St. Francis Rehabilitation Hospital who said they could give me all three disciplines three days a week.

Katherine, Michael and me during a PT session

Katherine, Michael and me during a PT session.

I am now attending Roper St. Francis and have been since December 9, 2014 (almost a YEAR!!). My PT is a recent graduate from MUSC, Katherine Bennett, who is all about nuero-cases and has recently gotten her nuero-IFRAH certification. We have been working on everything from isolated muscle strengthening to walking with no support or assistance. I initially started PT for 1 hour 3 days a week, but am now doing 2 hours 4 days a week because Katherine saw my potential and enjoys working with me! My OTs, Tara Murphy and Lindsay Deane, are awesome as well. We are currently focusing on getting more range of motion out of my left arm and I’ve already learned how to put on all of my clothes myself. One of my OTs recommended I should get tendon release surgery on my left finger joints because they want to fist-up and we’ve already tried everything we can do to get them to relax, so I am having surgery to relax my fingers in a few weeks, December 3, 2014 (right fingers crossed). I was released from Speech Therapy at Roper around May 2014 because the therapist ran out of ideas to help me gain anymore speech intelligibility or to help my dysarthria. Since May I started with a few new Speech Pathologists at East Cooper Hospital: JoAnn Fischer, who previously worked with TBI cases in Baltimore, at the Kennedy Krieger Institute; Katie Edwards, the one who had been nice enough upon my return home to give me my initial speech eval; and Kaylen Alford, a recent graduate from App State with her degree in Speech Therapy. I just finished 6 weeks of LSVT (Lee Silverman Voice Therapy) to help get the volume of my voice up to a higher decibel in everyday conversation. And while doing my ‘ahh’s I got them up from 3 seconds while at Shepherd Center all the way up to 19.5 seconds with the help of East Cooper! So that’s my story so far. I will make sure to keep you all posted on big obstacles that I overcome and how my surgery goes on December 3rd!

Stage 2: Inpatient Rehab

First Step

My trunk failing to support me on my attempt to take my first step.

I started remembering what was happening and going on around me 2 weeks after ICU. While at Kentfield Rehab, in Marin County, California, the Speech Pathologist was working very hard on getting me to move my tongue and get some kind of sound out of me, but had no luck. In Physical Therapy I would mostly stand up in the standing frame and 23 minutes was my record while there. I also tried to take a single step but failed miserably, with my trunk collapsing. For Occupational Therapy I would do a board with different sizes and shaped pegs with my right hand because the left side of my body was completely immobile and still does suffer muscle tone. Meanwhile friends and family ran a fund raising party for me back home, Mt. Pleasant, SC, while my mom was staying in California with me and until I got home. After the fund raiser my dad had accumulated $15,000 (Thank you everyone!) and the first thing he did was buy my mom, a traveling nurse, and me first class Delta tickets to Atlanta because they would be bigger seats than coach and way cheaper than renting a private jet. So they took my trache (surgical opening to restore normal breathing) out on April 19, 2013.  Then on April 21, 2013 we then caught a 5am flight to Atlanta to continue inpatient rehab at Shepherd Center.

 

My first full day of therapy at Shepherd Center I said my first word ‘hi’. I then worked on my memory, both long term and short term. Within the first week I was there I did a swallow study to determine how well I was swallowing. I passed my swallow test the first week I was there and was put on a level 1 diet (pureed food) and eventually level 2 (honey thickened liquids and fine foods). Another thing I did in Speech Therapy was practice yelling out ‘ahh’. The typical, healthy, person can yell out ‘ahh’ for 20-25 seconds, but while at Shepherd I could only get mine up to 3.5 seconds tops. In Physical Therapy I was first started on serial casting to get rid of my ballerina feet, then moved on to mat exercises, walking in a platform walker with Bioness (remote estem device), graduated from the hoyer to heavily assisted transfers, and practiced getting into a vehicle for my parents’ sake. Occupational Therapy consisted of arm stretching, getting the first movement out of my left arm, and the FES bike (pedaler for OT and PT that consist of estem).

'Pedaling' my way to the city on the FES arm bike.

‘Pedaling’ my way to the city on the FES arm bike.

While there I got a Baclofen Pump to help reduce tone in my left leg and had surgery in my left ankle/achilles tendon to correct the ballerina feet because the serial casting didn’t help as much as everyone hoped. Graduated 4 months after being at Shepherd and I was then invited to their outpatient facility, Pathways.

Next entry will be about outpatient therapy.