Showing posts with label walking. Show all posts

I'm just going to go ahead and make the assumption that you, dear-questioner-of-my-walking-abilities, has no concept of what "little" actually means. I'm so glad you asked because I'm more than happy to explain!

Little isn't something that can really be measured in inches or feet, so much as it is lived in years as someone who is a mostly-functioning 3ft tall adult. Little isn't something that can be sized up in your weird corner-eye glance, it's something that needs careful scrutiny on an x-ray for that tiniest sliver of a fracture. Because that tiniest sliver can actually be causing a very big pain. Little isn't something you can purchase and wear when you buy clothes from Gap Kids as a college student, it's just a paradigm and a frame of mind that we decide to put on ourselves. And just trust me on this one - this frame of mind isn't really a one-size-fits-all garment. Actually, you need to be a very big person to understand what "little" really means. It's kind of like how you need to experience sadness to understand what happiness is all about. Get it?

The first time I walked I was around four years-old and had already read my first beginner's chapter book: Amelia Bedelia! As I stood between the metal railings, feet planted in "proper walking position," legs strapped into my braces, and my physical therapists' hands on my waist - I had no concept of what "walking a little bit" meant. I understood walking, I understood standing, I understood that mom and dad were - needlessly - nervously standing by, because as I understood it: walking is something everyone does and this is not a big deal. So I walked: one foot in front of the other, the way I had seen my older brother and my parents, and my friends at school walk. I copied what was around me because that is how children first learn. As far as I had observed at that point, no one around me was concerned about walking "even a little." They just did it.

That first time I walked a few steps and then a few more, all the way to the end of the railing when I fumbled a bit to turn around. Did my upper body turn and cross over first? Was I supposed to reach one hand over to the other side of the railing? Or did my feet turn sideways first? Actually - back up. Wait a minute. Before all of those questions of "how do I turn around? And what do I do now?" came careening into my brain, I thought "Wow cool! I just walked!" My palms were sweaty, I probably looked a little robotic in my uncertain positioning, and even though I couldn't see my physical therapist behind me - I knew that she was beaming. After that first session was over she probably wrote in her physical therapist patient chart: patient walked with the assistance of bars and long leg braces. Distance covered: 5 ft. 

I'm pretty confident that she didn't check off on her charts:
X  Patient Walked A Little.        Patient Walked A Lot.
But I'm not a physical therapist so what do I know?

So as you're standing there in the aisle of the airplane or bus, or if you're standing in front of an amusement park ride, or maybe you're on the deck of a swimming pool, or you're standing at the foot of my hospital bed, or you're on the dock in front of a boat - and you ask "Can you walk even a little?" Please don't be offended when I look back at you baffled. I just don't understand your question. I mean, I get what you're asking - but I don't actually * get * it. Maybe it's because you are uncertain of how to transfer me, which is fair and I would be happy to help guide you. Maybe it's because you don't want to assume that I can't walk at all because for many people translates into I can't do anything at all. Or maybe you are uncertain of how much help you should offer, and don't want to come off as intruding on my stubborn independence. Thank you, I appreciate it.

(Don't even get me started on how it must feel for those of my friends who can't walk even a little! This is one of those rare moments in the world when something "even just a little" is not taken as an easy feat, it's not taken as anything even close to 'cute,' it's probably not even taken as anything little at all! For someone who can't walk, your 'little' question may be an unwarranted reminder of a BIG 'failing.' Your question may have just driven a big awkward spear into where you meant to inflate a raft). 

But for someone who has never put her steps forward (or backwards) in life in terms of little - I hope you understand why your question comes off as slightly jarring and a little awkward. Does it make a difference to you whether or not I can walk a little after having rod surgery? Or a lot after breaking my femur? Are you going to record the "little-ness" or "big-ness" of my walking ability in a patient chart I don't know exists? Why should we put a 'size' on our steps at all? Why can't we just accept it without the vague restrictions and fuzzy borders?

Those are my questions to you and when you've answered me all of those, then you can answer for me this question: "Can YOU walk even a little?" And let me know how it feels.

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It didn't really occur me to that it was "a big deal" until I started Kindergarten. At home it wasn't a big deal because I was accepted, and expected to crawl around on the floor or use my wheelchair. And in pre-school it wasn't a big deal because most of the other kids were in wheelchairs or used other mobility aides too.
The difference was apparent on that first day of school in Kindergarten when I noticed that this wasn't really the way things were supposed to be. More specifically, you weren't the way things were meant to be. It took a class filled with other screaming, singing, running, jumping, squirming, nose-picking, and jacket-struggling kids to make me realize: the two appendages below my hips were not the norm. And even more so, there was nothing I could do to get you to work the way you're supposed to.

Around that time I began learning how to walk. With the help of my parents or physical therapists I'd strap you into clunky leg braces, and like monkey-see monkey-do I'd try to mimic what I saw everyone else doing. I could tell that you didn't like it, and to be honest most of the time I didn't really like it at first either. In fact most of the time - during those early stages, I felt like the puppet master and you were my marionette dolls. Except mom and dad had already told me that my puppet would never come to life, it wasn't going to be like in Pinocchio when he springs to life. So I labored on because that's what the adults in our world said we had to do. I continued to learn which strings to pull, I learned until over the years we came to be as close to "Pinocchio-like" as we could. It took a lot of frustrating moments, lots of tantrums thrown, hundreds of sneakers, many more leg braces, fractures, and corrective surgeries before we got to a comfortable place - but the point is we got there together: now, unlike my four year-old self, I know that you do work the way you're supposed to.

I hope you know that I don't mean to hurt your feelings when I say things like "I'd rather break my legs than my arms." But it's the truth. And I hope you realize that even though my wheels have more or less replaced you these days, I don't ever take your presence for granted. The hundreds of fractures we've been through together have taught me more about rehab and healing than what most people learn in an entire lifetime. You're my silent option, my quiet reminder of hard work, of staying humble, of being appreciative, of persistence, of there always being an alternative way. 


At the airport you're the reason for the scan, for National Security to sound the alarms - and then everyone settles down when they realize you're just a harmless reminder that everything is not as it seems. "Just metal from the rods and screws in my legs.." And when my brothers began cracking their toes, you're the reason that told me that I can try too - successfully. In public bathrooms you're the reason why I can stand on the footplate of my chair, or else I'd never be tall enough to reach the sinks. When we're at the mall, you're far too tempting to not want to visit the shoe sale. Your quiet insistence that each pair of shoes I buy is a long-term if not life-long investment usually wins me over. In middle school you helped me grow tougher skin when kids pointed at the snaking scar tissue that traveled down the front of your face. Let's not forget about the Mickey Mouse roller-skates we risked our neck putting on. Or the victory we felt when we talked mom into letting us onto the ice rink!

Sometimes sitting on the sidelines while my friends ran laps in P.E. class made me feel guilty about you. There they were being tortured and hollered at "DON'T CUT THOSE CORNERS!" While we were just chilling in the shade, helping out by writing down times each time they ran past me. It was moments like those where you seemed to get heavy with guilt too, with a feeling of uselessness that I hated and resented you for harboring. Settling for second best is something you taught me how to do with grace, and only when no other choice is available. With that said you also taught me that giving up, no matter how bad or hopeless things look - is simply never an option. You might not be able to carry me around in life, but in too many more ways you're able to carry me through a lot!

...Needless to say, you and I - we've been through quite a bit. And there's no doubt in my mind that I would never trade any of those adventures together for a pair of legs-that-work! You're worth my time, attention, effort, sweat, and worry. Please don't walk out on me, okay? 

Maybe it was around the time I started jumping, skipping, and running in my walker that my physical therapist decided to switch to crutches. Mind you it wasn't the kind of crutches that dig a deeper pit beneath your arms but the kind you slip your wrists through, and then grip. I'd had my red walker since I was in Kindergarten till the fifth grade, and very rarely did the arm rests need adjusting (maybe once every 3-4 years?). My red walker was like my own mini-fort of safety, confidence, and independence. There were four prongs, the front two were wheels and the rear prongs had rubber stoppers. There was a front piece to it that served to connect everything together, and in my mind also served to stop me from falling over or from otherwise getting hurt. I used to turn around and sit on that front piece (even though it wasn't really a seat, and even though my P.T. said it wasn't safe). I could put my entire weight on that walker! I was able to lift it just enough off the ground to be able to turn corners, or even do a full 360 turn-around. Suffice to say I felt safe in that walker, it was with that piece of equipment that I learned to take my first independent steps in.
So when all of the safety, comfort, and security was stripped away from me I got nervous. Immediately the first thing I noticed while wobbling in my crutches was: there is nothing in front of me. My face could see the immediate floor in front of me. I then noticed how much of my weight I had distributed throughout my forearms with the walker. In crutches all of my weight seemed to be leaning on to two metal extensions, resting on rubber stoppers that were never completely flat on the ground - but instead always at an odd tilt, this made me nervous. What if it slipped? All I could see in my head was the replay of me face planting onto the pavement, crutches flying with arms and legs pointed in every which direction - kind of like a cartoon dog slipping about on ice skates.What if I forgot which I was supposed to move first - my leg or my arm? With the walker everything seemed so basic, so intuitive, it seemed like I had to relearn and reteach my body how to walk again. Had I really taken steps towards my independence? Or was I now just re-inventing the wheel?

"Okay, so which do you want to use today?" My middle school physical therapist had both my red walker and my new silver crutches in front of me. Without hesitation I pointed at my red walker.
"Well let's do some walking with your crutches first okay? And then we can play soccer in your walker, does that sound good?" 
"Fiiiine-uhhh" I grumbled.
Slowly and with a lot of patience from my physical therapist my body became used to the crutches. I found that I was able to stand with a lot more ease, move quicker, and suddenly my movement seemed to flow a lot more naturally. I was no longer pushing and jerking myself forward. Everything seemed so intuitive after a few weeks: I knew just how much to put my crutch forward without over-extending myself, I could match where my foot stepped to with where my crutch was, I understood the cross-rotating pattern of left-right-left-right-crutch-foot-crutch-foot. The weight on the palm of my hands where I gripped loosened over time, I was no longer as nervous, I was no longer scared of my new boundary-less independence.

It became clear to me that I became comfortable in my crutches when I used them on my own, at home. I knew that I preferred my crutches when I chose them over my walker when my physical therapist asked. And most of all my crutches soon became a natural part of my school day when I felt comfortable enough to walk with them around my friends at school. I was no longer limiting my use of the crutches when everyone else was in study hall and the pathways were safe for me to exercise in. I'd use them to go to lunch, I used them during P.E. class, and sometimes during the day when I was tired of sitting in my wheelchair.

The decision to switch from a walker to crutches reminded me of how resilient my body is despite its genetic fragility. It still shocks me how adaptable we are and how with practice even the most challenging and daunting experiences can become second nature to all of us.

I could name all the major bones in my lower limbs before learning how to walk. It was around pre-school that I had my first long-leg braces (KFO's) made. They are remembered with great disgust: the plastic was always sweaty against my skin so I would wear tights underneath, my sneakers always looked overly bloated as I tried to jam the foot piece in, and the clunky contraptions seemed to weigh about the same as a newborn elephant. My doctors and parents tried to make them more appealing: When I complained about how hot they always were they cut holes into the braces, then they printed cartoon characters on them - the left foot had Tweety bird and the right foot had Road Runner. Still I would dread putting them on once a day before school and rip off the velcro coverings the second I got home - relishing the feeling of carpet and the denim from my jeans against my skin.

Today I don't remember how many times a week I went to physical therapy at Children's Hospital in Boston, but I would guess at least twice a week. I don't remember much about the sessions except that I seemed to not mind having to put my leg braces on for my first P.T. After all how could I? Her name was Sandy too. Vaguely I remember taking my first steps, ever. She had showed my parents how to properly place my legs inside my braces, making sure my heel was firmly at the bottom of the foot plate. She showed them how the velcro straps were to be snug but not too tight, and the way the metal locks on the side of each brace worked. A little piece would slide up to lock the knee in place and back down when I needed to bend my knee freely.
Sandy the P.T. had dark brown shoulder length hair and it wasn't long after that I asked for the same haircut. I wanted to be exactly like her! It didn't matter how short of a period I would stand for, how high I could lift my leg up by myself, or how much I shook and hesitated in her hands when I made my first steps - her smile stretched a mile long and I knew that if I could I would want to walk every centimeter of it. For that first time, after putting the leg braces on, she picked me up and stood me between two low metal railings. Instinctively I knew I was supposed to grab onto the two sides and as I did so she nudged my back straighter, and positioned my feet so my toes would always "point like a compass!" She dropped the locks on each side of my legs down and held my waist in her hands.
I don't remember if she told me how to pick up my leg, how to crook my ankle just so, and then bend my knee, and roll the bottom of my foot from heel to toe. Something tells me she didn't. Even though I couldn't walk on my own, I knew how to. I had watched my friends, my brothers, my parents, everyone around me was doing it - all I had to do was mimic the motions. It took me a few tries to understand the rhythm of which foot to move when, and then which hand on which rail that I held onto was supposed to move next. Sometimes I would alternate left foot first, and then left hand, followed by right foot and right hand. But that didn't seem natural to me so I alternated between foot and hand, left and right. Sandy the P.T., never criticized the way I walked, the weird shift in body weight that I would do with each step, or how my shoulders were so tense I looked like I was in a permanent shrug. She just let me go for it, and over time would correct my positioning, encourage me to try this or that.

Sandy taught me that physical therapy is more than just rehabbing your body. It's more than recovering from an injury or re-learning how to perform a certain task. The motions are slow, steady, and progressed according to each person and muscle. There's an aspect of exploration to P.T. that I looked forward to as a much younger child, it was during these sessions I knew Sandy would never hurt me - that she'd catch me every time I was afraid or uncertain whether or not my body could handle something. The curiosity that every 3-5 year old has for their physical boundaries was finally something I could delve into without fear or shock of any pain.

Physical Therapy/Early Walkers Suggestions:

• I remember when my mom was instructed to practice the P.T. routines with me at home she became less my mother and more my physical therapist. It was always one of the few times when she would let herself allow me to try standing on my own or balancing on an exercise ball without resorting to "BE CAREFUL!!!!"
• Sometimes saying "I know you can do better" can be interpreted as not fulfilling mom or dad's physical expectations. Instead, saying, "do you think you can try again?" Puts the expectations back on the child, letting him or her choose the bar to reach for the day.
• When I reached elementary/middle school age I would do P.T. during school hours. Friends and teachers would see me practicing walking in the halls; for some kids this is okay and they don't mind the questions or the look of awe when classmates first see them walking, but for other kids it might be too startling or not the right environment.
• It seemed like the moment I had figured out how to walk with my walker, I had suddenly launched into leaping, skipping, and jumping with my walker. Though I was always having a boat load of fun doing these antics, the adults in my life were frozen with fear. Expect the child to figure out how to do things other than plain old boring "walking" !
• I remember in elementary school that some times friends would join me for P.T. sessions; this was a great way to inform other kids of what I was doing and also allow me to feel less isolated when I was pulled out of my regular routine in school.
• After leg injuries sometimes walking just won't feel the same again, or it will take awhile before getting back into that groove. There have been several fractures I've sustained that make bending my knee all the way too painful or the weight I put on one leg more painful than the other. Understand that just because fractures are totally healed doesn't mean that every other function has returned to normal again as well.