When you walk in, there is this automated check in system. It's kind of like when you get a paper with a number on it at the deli. Your number gets called out on the screens displayed there and you are directed to a registration desk. They obviously have a high patient volume because that system is pretty advanced.
My therapist came to get me from the waiting room and took me back to a patient room. I showed him my progress report from my old clinic. He was glad to have some background information on me. He re-measured a couple of angles and said that they were the same except for dorsiflexion of my right foot. It has tightened up a bit in the last few days. That is what happens when you miss therapy. I haven't been since this past Friday.
His philosophy for my treatment is to get me to being barefoot tolerant. He doesn't want me relying on braces, orthotics, or stability shoes. I am not sure if that is a realistic possibility for me, but we can always try to get there. I explained to him that I am a compliant patient and that whatever he wants me to do I will do. I am all in.
At one point in the appointment, he said, "I want to get you to your goal of running." Based on the look on my face, he said, "That is your goal, right?" I hesitated, but agreed. It wasn't until later that I realized why it took me so long to respond. Running is my dream goal, there are many other more important and realistic goals for me to hit before that, like: being able to stand (in the shower, to brush my teeth, to dress myself, to cook), to not need my walker around my apartment, to be able to walk around the grocery store in peace, to be able to go shopping in a mall without worrying about how I am going to get from store to store, to be able to teach a full class without sitting, to be able to go up and down stairs without hesitation, to drive long distances, to swim, to ride my bike outside, to be able to walk longer than 20 mins, to not have to park in handicapped parking spots, to not have to wear tennis shoes at all times...you get the point.
My first goal is to be able to do activities of daily living and not have to wear tennis shoes every day, or use any assistive devices inside or outside my apartment, to no longer be disabled.
My second goal is to return to an active lifestyle (swimming, biking, going to the gym).
My dream goal is to run and race again.
Next, he asked me about the exercises I have been doing. I filled him in. It was a really long list since I have been in therapy for so long. He was happy to hear that I already have such a strong routine. He wants me to keep doing the same at-home program I have been doing (ABC's, foot circles, plantar and dorsiflexion stretching, band exercises, balancing on one foot, toe exercises, seated heel raises, etc), except for adding a few new "toe yoga" exercises. He says that I need to have good control of my big toe, separate from my other 4 toes. Basically, I have to lift the big toe, while pressing the other 4 toes down, and vice versa. When he had me try this, I couldn't lift either big toe off the ground, another sign that my neural connections are fried. He says these exercises will help strengthen the intrinsic muscles of my arch and foot.
We didn't do any actual therapy exercises today. I really wish we had, since my next appointment isn't until next Wednesday. The last few weeks, I have had 6 hrs of therapy across 3 sessions per week. This week, I only had the one 45 min appointment and we didn't do therapy. He only wants me to come see him 2 x per week, and each session at this clinic is only 45 min-1 hour. My therapy time will be decreasing significantly. When I walked out, I was frustrated when thinking of my serious reduction in treatment time. Going to therapy frequently and working really hard at all of my exercises is why I have been improving so quickly. I had this sense of doom come over me while thinking about how much my progress will slow. I am trying to keep a positive attitude, but I can't help but think where I would be today if I were still in my previous city and had already completed 4 hours of therapy this week. This therapist already said that I have loss some dorsiflexion in my right foot. This sucks.
I know that there is an adjustment period with every transition in life, so I am going to keep a positive attitude and hope that my first real therapy session with my new therapist will go well next Wednesday. I can't predict what my future experience is going to be off of this initial appointment. I know that he is a great therapist. I could tell that right away. I just have to learn to trust him like I did my previous therapist.
When I got home, I became motivated to take my therapy into my own hands. My former therapist prepared me really well to do exercises on my own and would be mad at me if I let a small setback like this stop me. I went straight to the gym in my new building and got on the bike. I rode for 15 mins before doing squats, knee raises, leg abduction/adduction, shrugs, dead lifts, clean shrugs, and front and lateral step-ups. After, I walked for 5 minutes on the treadmill at 1-1.5 mph, and finished with 10 more minutes on the bike. Back in my apartment, I did my entire at-home exercise program including the new toe yoga exercises that my new therapist added.
Since I am on my own right now, I have to take an active role in my treatment and keep progressing myself as my former therapist would have. This is one of the few times that it is beneficial that I have been through this all before. Even though I know that I can do this, I can't help but miss working with my former therapist.
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Reflection
I have come to realize that...
YOU have to want it for YOURself.
YOUR commitment to YOUR recovery and YOUR exercises is what will make the difference in YOUR ultimate outcome.
Rain or shine, YOU just have to put in the work. Every damn day.
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