A PT Primer

You know what they say: write what you know. As it turns out, I know a lot about physical therapy. I have been an off-and-on participant for nearly 25 years, so here are some tips to help maximize the benefit.

First, I should disclaim: in my opinion, physical therapists, the good ones anyway, know far more about recovery than doctors do. Physicians will tell you: six-to-eight weeks for bones to heel; or two weeks till the stitches come out; or three-to-four weeks after surgery before you need to check in. What they’re actually telling you is how long it will take for a bone to knit or a surgical site to heal, not how long it will take you to get back to living your life as if no such physical insult occurred at all. For instance, count on a full year post back surgery and just about as long after a serious knee injury. Case in point: I broke my ankle — a clean break of the fibula that required no surgical intervention — in October. My doc told me 6-8 weeks for the bone to heal. But then he ordered twelve weeks of PT for a total, fun-filled recovery period of a minimum of five months. I say minimum because rarely does one graduate from PT raring to go. There’s that pesky, insanely boring but necessary home exercise program. So, once again, I must figure on the best part of a year given over to getting over this injury.

Tip #1: Do not assume that all physical therapists are equally competent. Even if your world-renowned surgeon presents you with a list of recommended PT practitioners. They are not.

Tip #2: If you sign on with a physical therapist or PT clinic and are unsatisfied, know you can change. You can have the order transferred to another outfit or get a fresh one from your MD. Remember: you are both the patient (which doesn’t mean you have to be) and the client. You are the consumer.

Tip #3: Resist the urge to buy your therapist a holiday gift. Making a friend of your therapist is trickier than you might think. They are good people, they are helping you, you learn about their children and their hobbies over the course of your therapy. A relationship is formed; you like as well as need this person. This can be very seductive and lead to a) dragging your therapy on well past its therapeutic benefit and/or b) wasting limited sessions on too much chat.

Tip #4: The moment that you learn you are a candidate for physical therapy, start shopping around. Word of mouth, especially for similar recoveries, is probably the best way to find a good therapist (caveat: just so long as the recommending mouth isn’t guilty of the aforementioned affection blight)

Tip #5: Book your first visit immediately on learning PT is in your future and even before you have the order from your doc. It can take valuable recovery weeks to get that initial appointment and you want to begin the second you have the go-ahead. If the doc delays your PT, simply change that appointment to accommodate the setback.

Tip #6: Unless you are 25 and have a straight-forward, simple injury, avoid at all costs assembly-line PT clinics. How will you know? Well, they look like this: after the initial evaluation (which lasts an hour), you are passed on to a young minion who oversees your PT program but must defer to the evaluating therapist for progressive changes. In other words, you’re paying (or your insurance is paying) for a professional you may hardly glimpse after the first visit. (Caveat: one noteworthy exception is the New England Baptist Back Boot Camp. This is an enlightened program of exercises sculpted to your needs and conceived to be as close to real-world back use as is possible. Once your program is established a minion will follow you as a kind of quality control — correct form, weigh adjustments, etc)

Tip #7: Some PT modalities are assigned in a kind of pro forma fashion. Electric stimulation, ultrasound and massage are three examples. Make sure to ask what benefit you should expect to experience from each modality and if you do not experience that benefit, say so! PT sessions are only one-half hour. It’s up to you to see to it the therapist makes the most of that time. Not all modalities work for everyone. Massage, for instance, feels wonderful but is it the best use of precision minutes of PT time?

Tip #8: Whenever possible identify and sign on with the top therapist for your specific recovery. You don’t want a generalist if you’re recovering from back surgery. You don’t want a knee guy if you have a neck issue. You don’t want a twenty-something, gung-ho buff male if you’re a 70 year old woman with arthritis. OK, you may want him but not as a therapist.

Tip #9: Whenever possible find an established practitioner with his or her own private practice. Some of these folks don’t take insurance but the one-on-one expertise is worth it if you’re wallet can take it. Some, though, do take insurance, even Medicare. Take it from me, there is no better PT experience than one-on-one.

Tip #10: PT is hard. It can be painful. The home exercise regimen can be boring in the extreme. Don’t cheat. Don’t cut corners. Soldier on, knowing it won’t last forever. And in that fact lies the ultimate motivation: you’ve only got so many sessions. Make the most of it. Or rue the consequences.

— Belle Songer

Lamb bone soup

One of the sure signs of recovery from anything is that get-up-and-go feeling that eventually (often very eventually) seizes you, sometimes prematurely (as is regularly the case with me), sometimes just in the nick of time, seconds before you think you might as well jump off the nearest bridge as cope with whatever the infirmity is for another single day.

I’m coming off a broken ankle and seven weeks of non-weight-bearing. What saved my sanity was a kneeling scooter but I digress. That’s a story for another blog. Then suddenly last weekend, I popped back up on both pegs and was raring to go. A sure sign my sanity was still impaired: I spent the weekend cooking up a storm. Let me preface what’s coming with a simple statement of fact: I am not a cook. But there I was, standing, walking around and it just happened to be in the kitchen. Six inches of snow outdoors secured my location.

A quadruple batch of hot fudge for holiday gift-giving around the neighborhood was my starting project. Then I quickly moved on to my mother’s unbeatable corn chowder and a signature gift of hers to me, lamb bone soup. Couldn’t be easier. Or tastier. Cover a lamb bone, preferably one with lots of garlicky bits and extra meat, with tomato juice. Throw in two bay leaves, some celery and an onion. Simmer for an hour. Pour off soup. Save the bones. Pick and shred the meat back into the soup. Season to taste with S&P. Serve. Though, like some many soups and stews, it only gets better with age and it freezes well.

I played Christmas music and let my ankle ache its little heart out as I dirtied every pot in the place and spilled like a chef with a twitch. And, of course, I thought of my mother. I have lived longer without one than with. Back in those mother-filled days, I thought of her as my best friend. Indeed, we have oodles in common. Or had. Have? Which tense to use? People who remember my mother (and they are few and far between) say I am my mother. Same love of words, same build, same hair, same voice, a Lauren Bacall-y sort of voice.

That voice. Given that it’s purportedly exactly like mine I thought I’d know it anywhere. That it was forever in my mind’s ear. I thought, if I had to lose her, and we all do, our mothers, I would always have that. But some years ago I learned that’s not the way it necessarily goes.

Years ago my brother decided to use his then new toy, a tape recorder (this would have been 1964), to record a telephone conversation with our parents.  He and his fiancé called his folks to tell them they were engaged. A permanent record of the happy announcement was secured. Time passed. Tape recordings gave way to CDs. My brother’s children got born and grew up, and one decided, when she was an adult and the tape fell into her hands, to have it converted to the more modern format. She then kindly gave CD copies to her father and his siblings, me among them.

I recognized my father’s voice instantly. By then, he too was dead but it had been much more recent, only a matter of a few years. But the other voice on the telephone? I deduced it had to be my mother chiming in with her good wishes to the happy couple because the woman on the phone was on a house extension with my identifiable dad. But I did not recognize her voice. Partly I was stunned to find out she had a southern accent but more critically,  hearing her speak again was far from familiar, far from comforting. That was not a voice I knew.

Boy, memory can pistol whip you sometimes.

So, thinking about this while I was revisiting my mother’s recipes, coincidentally at Christmas-time, lamb bone soup took on new meaning. I guess you are never too old to miss your mother and it would be reassuring to think I’d know her if I saw her — or heard her — again. But that’s an illusion that won’t work for me.

What does work every time is pulling out those handwritten recipes and savoring the familiar flavors of the comfort food she rustled up for the years we did co-habitate on this earth. Positively heavenly.

— Belle Songer

Homograph of the year

Let’s start with the obvious: a homograph is not a bell curve having to do with sexual orientation. Which makes it a fun word right off the bat. A homograph is a word that is spelled the same as another but does not necessarily sound the same and means something completely different. Words like affect, commune and entrances.

Turns out 2016 is the Year of the Homograph for me. In fact, I am the unwilling and seriously annoyed poster child of homography for this sixteenth year of the 21st century. I have been converted, but am not a convert, to a verb. Recover, and I’m not talking about reupholstering the furniture, is my middle name. Actually, it’s Cope and I’m doing a lot of that this year too. As in, Cope is my middle name. But ‘recover’ is my activity of record (not to be confused with an LP).

How is it that this homograph came to own me in this, the Year of the Monkey? Indeed animals do play into it. Last April a 100lb vizsla (a hunting dog) plowed into my knee. He was running full bore toward the puppy playmate right behind me. I was in the way. Best way around that unseemly obstacle? Bowl it over. Flattened me, tore my MCL and bruised both the femur and the fibula. That put me into a big honking hinged knee brace for 10 weeks (good-bye spring), then a soft brace and PT (good-bye summer) for weeks thereafter. [In the end, I won a golf tournament which is proof that nothing in this world, including my year as a whole, is too crazy to believe. Witness this presidential election, if you need more evidence.]

I have a doctor’s appointment in couple of weeks with my orthopedist to discuss why my knee still hurts. That malady, however, is suddenly moot in the light of what happened last week: I broke my ankle. And my driving ankle at that. I will, of course, keep that appointment, and won’t he be surprised when I present a whole new injury for him to fix? In the curious way of compound injuries, I don’t notice the knee pain at all anymore. So, in a seriously ironic turn of events, a broken ankle has told my sore knee to shut the @#$%*^! up.

For the record, I had absolutely no fun, as I had no fun in April, acquiring this new notch in my injury gunstock. I merely stepped out the side door. And SNAP! Yes, I heard my twig of a fibula break in two.

So, now I am in a big honking boot for 6-8 fun-filled, absolutely inert — not allowed to weight-bear (bear as in ‘to carry’ not as in grizzly), doncha know — weeks. I am indebted to Netflix and On Demand. I am indebted to cheesy books I’d never read otherwise. I am indebted to a husband who is working on his Boy Scout saint badge. But I am not indebted to the crutches that are tearing up my shoulders. Nor am I indebted to the timing: on Saturday we’re throwing a dinner dance for 100 friends and family.

Cancel! you say. Boogie on! I say. I will dance at this party, come hell or high water or even only one good leg. To whit: I have purchased a kneeling scooter. By Saturday, I will be more than mobile; I will be doing wheelies on the dance floor.

This is my way to recover this year. I will whip the shroud of doom, gloom and self-pity off my wounded self and don an action hero cloak. Wasn’t Clark Kent a nebbish who transformed himself into a spring-loaded, aerodynamic doer of good? I can do this. I really can. With my reality-busting Flashdance cape of good hope.

—Belle Songer

 

In defense of sharks

I’ve never met a shark I didn’t like. Okay, okay. So before I met them I might have thought they left something to be . . .avoided. By dint of their reputation, by misrepresentation, by their toothy, ice-eyed grins. Based as my fear was on disinformation, my reaction to sharks — before I began associating with them — might be the very definition of prejudice, no?

The other day, on the news, was video of a great white shark writhing, bloodied, out of a cage meant to protect divers observing their behavior. Well, turn about is fair play, if you ask me. That shark was baited. Sharks do not have a reverse gear; if they are swimming full bore toward something, realize it’s a) an obstacle, b) a trap, they cannot do anything about it except swerve. The bait was just to the side of the dive boat. He had not time to alter course. When he barreled after the bait, he barreled into — indeed right in to — the cage. Trapped in its tiny confines, the shark panicked. Thrashed and eventually threw himself out of the top hatch and escaped. The diver was unscathed, and of course has a story to tell that his progeny will carry through the ages.

But all the media sympathy was for the diver. Mine went whole-heartedly to the shark. The clip played over and over. Blood leaching from the creature’s gills. Injured, terrified and lured into both. Sorry, guys. Bad judgment on the part of the dive operation. Mean-spirited thrill-seeking fools at the expense of another sentient creature.

So let me regale you for a minute with some personal shark stories. Stories that find the majesty as well as the mystery in these ocean predators, the beauty as well as the beast. Apart from harmless nurse sharks sleeping peacefully in 60 or 80 feet of water under a coral ledge in the British Virgin Islands, my first genuinely thrilling encounter with sharks was in the Galapagos. I was on a live-aboard dive boat in the northern most islands, Darwin and Wolf. I only had 25 logged dives when I embarked on this adventure for ‘advanced’ divers. I was, in so many ways, in over my head. We were at 100 feet, give or take, with a perceptible current when we encountered three different types of schooling sharks. Sharks, in other words, filled the sea around us. White-tipped sharks, Galapagos sharks and the weird-looking hammerheads. A heart-stopper, I can attest. But my dive buddies were more experienced. When they found a handhold on the volcanic ledge, the three of us held up, more or less crouching behind a rock. Why? In order to entice these timid gentle giants to come closer! And they did. When we were still, their curiosity was peaked. They circled around us, came in close then swerved away, swam above and below us. Not a single shark gesture of aggression, and there must have been 50 of them. Just curiosity to match our own. Both species wanted a closer look at the other.

Years later, diving on the Great Barrier Reef, again on a live-aboard, we were offered the opportunity to take part in a shark experience.  In 60 feet of water, giant cages were in place to protect nervous or inexperienced divers. Those with more than 50 dives under their belt could, if they wished, if they dared, simply lie on top of the cages. That’s what I chose to do. A barrel of chum (fish bits and pieces) was lowered into the water about 50 feet from us, and we waited. But we didn’t have to wait long. They soared into feed. It was dramatic, even violent, but with 20 or more of them fighting for food, no blood was shed, shark or human, and when it was over — and it was over very quickly — they vanished as suddenly as they had appeared. Proof they were not remotely interested in us? When they swam directly over me, they were close enough to buzz me with their wake, maybe even a brush with a dorsal fin. I felt them pass over me. I was not frightened; I was awestruck.

Sharks get a bad rap. Warming waters are forcing species out of their comfort zones, like the great whites appearing as far north up the eastern seaboard as Cape Cod and the islands (the setting for Jaws at a time when great whites were never seen in those waters). The Chinese misbegotten idea that shark fin soup will increase their sexual prowess results in the criminal butchering of live sharks for their fins alone; then they are thrown back to die. Surfers, kayakers, boogie boarders and swimmers occasionally run afoul of sharks, often because they look like their favorite food — seals. Moving objects on the surface, especially if wetsuits are worn, can look to a shark’s less than perfect eyesight like a seal. But worldwide, the average number of fatal shark attacks is 4.2. This is not to say there are no rogue sharks, any more than one could say there are no bad dogs. But they are rare.

And whether you like them or not, fear them irrationally or with cause, sharks play a critical role in our ocean ecosystem. They are at the top of the food chain. When their numbers decline precipitously, other marine creatures are negatively impacted. Sharks are crucial to maintaining the delicate balance that makes for a healthy ocean that is achieved when all players, from the smallest zooplankton to the blue whale, are in full and vigorous play.

I don’t think sharks are cute. They certainly are not cuddly. But they are majestic, graceful, sleek. I admire them and I most assuredly respect them. And I welcome the opportunity to be in the water with them where their interest in me is matched by mine in them. Just so long as I’m at depth where I cannot be mistaken for lunch on the surface.

Indeed a prized possession are a pair of tiny shark teeth I scavenged from the bottom after my Great Barrier Reef shark encounter. Perhaps it was the original owner of these teeth who stirred the water just above my back. And so I had them made into earrings.img_1950As I said, I’ve never met a shark I didn’t like.

—Belle Songer

Crossing over

The work we do as a team, Cajun and I, so often is of the unremarkable. We work for two therapy dog organizations, one that allows us to choose our venue; the other that places us every week at the local hospital.

But let me introduce you to Cajun. She is a chocolate field lab rescued from the wilds of Louisiana, a state so entrenched in inhumanity to animals that they are routinely discarded — tossed into dumpsters, thrown out of trucks along roadsides, abandoned in the woods, shot, starved, abused for sport. There, in the deep South, there are no leash laws and no one spays or neuters their dogs. Or cats. These animals are merely dispensable. If they don’t hunt, get in the way, are an obstruction to a new life, or any life, or produce unwanted pups on your watch, they are dispatched in the most expedient way possible.

So Cajun was observed for weeks by her eventual savior chained to a tree in a white trash trailer park. No food. No water. Then, one day, she ate her way through that chain — a survivor at any cost — and made her way to the very road from which she had been observed. Free at last, she was picked up immediately and given a second chance at life. That observer figures Cajun was being held to become a puppy mill mamma. That bad luck changed to golden opportunity with her rescue. Two months later, she was crated and place in a box truck and thereby made the exodus out of the South to us in Massachusetts.

Fast forward to now. Cajun is seven. She has worked as a therapy dog, brightening people’s days for the last four years. It is our way of giving back. On one notable occasion we are visiting a group of seven or eight girls in lockdown. This means, Cajun and I are escorted through as many as six steel doors to get to them. For one half an hour, 30 short minutes, they are children playing with a dog. All thoughts of loneliness, anger, abandonment, rage vanish before a dog rolling on her back, exposing her stomach to them in a gesture of extreme trust, and they forget. Forget why they are there, forget why it is they are supposed to be angry and simply play with a dog.

These are all ‘special occasions’ for us. That 30 precious minutes of abandon. But there are, too, magic moments where we know we have connected in a very special way. In one of these groups of children was a girl who no longer wanted to be thought that. She had changed her name to a boy’s name. As we did introductions, the others in the circle chided her, made fun of her wanting to be a him. But we, Cajun and I, accepted her new ‘me.’ I called her by the name he wanted to be called. And Cajun simply nuzzled him with the love she gives unconditionally.

But the most profound difference we know we have made, Cajun and I, happened at Emerson Hospital this summer. We arrived on the floor we visit weekly and were asked to go first to see an elderly man who was agitated and unhappy. It was clear to me the nursing staff was grasping at straws to comfort this man, and perhaps, maybe just the thing, was a visit from a dog.

With his permission, Cajun hopped up on his bed and lay down beside him. I don’t know how it is she knows but she absolutely does know when a human really needs her. A dog lover from way back, he immediately began to smile and rub her ears, and she, in turn gave him gentle kisses. I did not see an agitated, miserable man. I saw a guy engaging with an animal he loved instinctively, and the two of them, old gent and aging dog, bonding in a hospital bed.

A week later when we returned to the hospital floor for our regular visit, the nursing staff took me aside and told me what a gift Cajun had been to that man. Within an hour or so after Cajun’s time with him, he peacefully slipped away. Cajun, the staff told me, had given him the peace and comfort he needed to relax and let go.

Hocus pokus, you may well say.

But I am reminded of a tee shirt a friend once gave me and which I wear on all our therapy dog missions. It reads: Angels are Sometimes Disguised As Dogs.

— Belle Songer

 

Grimspound

Stonehenge is vastly over-rated. By far and away, the standing stone circle of Callanish on the Outer Hebridean island of Lewis far outstrips Stonehenge for both majesty and mystery. It helps, too, that the buses and tea shops and gift shops have yet to invade the windswept furthest recesses of this outer Scottish island. Neolithic. Bronze age. A site of prehistoric religious activity for 1500 years,give or take. Walk among them and it is impossible to deny the eerie sense of Time, stood still, stood on end, and someone watching.

But it was in Devon last month that stone circles took on dramatic new meaning for me. On Dartmoor alone there are more than two dozen of them, about which virtually nothing is known except they are stone age, they were erected deliberately by men, granite boulders and plinths weighing tons upon tons. In addition, there are lone menhirs — gigantic single stones set on on their ends for what purpose no one can say — and clapper bridges (more on these shortly).

Our mission was to take a walk upon the moors and, oh, see what we could see. The first thing noted on our map was Kestor settlement. Vocabulary lesson #1: ‘tor’ means a pile of granite rubble blown clean of vegetation and sandstone by millennia of wind blast, atop a hillock. On the top of a smooth hummock, an outcropping, no, an uprising, of craggy granite. Below this tor, a circle of piled, not standing, stones, a permanent encampment where guys without tools assembled these boulders to form an enclosure for their rubble huts and livestock.

A mile or so further on, we came upon our first clapper bridge on the moors at Scorhill. Arguments abound over the etymology of this word but it’s either from the Anglo-Saxon (cleaca, meaning ‘bridge of stones’) or more likely from Medieval Latin (clapus, meaning a ‘pile of stone’). Neither origin does this structure credit. A clapper bridge is a gigantic lintel of granite, weighing, say, in one case,  eight tons or more and measuring 6.5feet wide by 13feet long, put in place over a brook or river. From bank to bank or on piled ‘posts’ made of stacked stones. Their simplicity is gorgeous, their engineering incredible. The two we ran across bridged simple grazing streams, making possible cart travel from one side to the other. But men without tools, without machinery, but probably lots of free labor, managed to manhandle these goliath stones to fit their will and purpose.

220px-postbridge_clapper_bridge_2005-07-21

No much further along we stumbled upon a standing stone circle. Far more primitive than either Stonehenge or Callanish but manmade, man-purposed and monolithic. Who built these circles and why are questions begging answers that will never come. These moors, once densely wooded, were clear-cut by those stone age laborers so thoroughly that now the soil is too acid to promote any growth other than sheep forage. So acidic, indeed, that all traces of ancient man have been literally dissolved — bones, hides, pottery eaten into oblivion.

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Days later we actively sought out another Bronze Age site called Grimspound. Vocabulary lesson #3 — pound as in compound, as in impound, as in dog pound. An enclosure. Build on the slope of a hillside, this vast circle, maybe 100 yards in diameter and up to nine feet thick, was, like the Kestor settlement, an encampment. A community. Within the tumbledown circular wall that remains today, a collection of smaller rubble-foundation huts. Fodder for imagining the unimaginable: how did they manage to construct this, move these huge stones to their will, place them on top of each other or upright? Once a large and vital community of herders who surrounded themselves with this formidable wall of stones, they sought not to keep things out but to keep themselves and their animals in. Safe. Together. A granite embrace.

grimspound_bronze_age_settlement_on_dartmoor

We are so smug in our 21st century selves. So sure of our cultural and technological and engineering superiority. But what of us will remain to ignite the imaginations and awe of onlookers three thousand years from today? What of our world will so survive?

—Belle Songer

 

 

 

Leaving’ on a jet plane

Leaving’ on a jet plane

Don’t know when I’ll be back again

Oh babe, I hate to go

Well, no I don’t. Hate to go, that is. I love to go. So I’m going. Grabbin’ a jet plane this evening. Next stop Paris. Then on to Bordeaux, Nimes and Avignon. Finally to London, Oxford & Devonshire.

Leaving’ on a jet plane

Don’t know when I’ll be blogging again

Oh babe, can’t wait to go