Chapter 26 : Rehabilitation

“I didn’t know how far from total recovery I was but it didn’t matter because I felt good and appreciated every step.”

 

My first rehabilitation session was now due and I was looking forward to it. The idea of being more proactive with an exercise routine, seeing professionals and being surrounded by people who had been through the same torment, felt reassuring. It could be a positive environment to be in, helping each other to get well, I thought.

I was hoping to be able to connect with them as they had been through something similar to me, so they would know certain things that I couldn’t explain or relate to people. I knew everyone would be a lot older than me, but it didn’t bother me. The nurses seemed to think it would be an issue as they wouldn’t want to communicate with me; I struggled to think why, on a logical basis of other than my age, as there would be a lot that could be discussed. We had a shared experience and that’s what was important.

The programme was scheduled on a rolling basis for every six to eight weeks and would focus on the same group of people.  I was greeted at the sports centre by Manuel and signed in.  We had a room on the ground floor that had been allocated to us and it was large, with mirrors from floor to ceiling on two walls and a series of long, thin rectangular windows on another side to allow anyone to see in before entering the room. On the fourth wall was a projector screen, a set of speakers and cages on the floor containing various bits of equipment.

Right down the centre of the room, from one side to another, was a stretch of monkey bars spaced at different distances from each other, fastened along the ceiling. Looking at the bars I pondered on when I could have bounced up there and swung enthusiastically between them pulling myself up with ease.

Next to the wall with windows there were chairs lined up for us to sit on and wait for everyone to arrive.

Two older gentlemen, who barely acknowledged me as I said hello, were already there.  I sat down next to one of them who was quite large and seemed bothered to be there, almost in a huff as if he had better things to do with his time. I introduced myself and after a moment of silence leant across to him and said: “that operation was fun eh?!” hoping to ease into a conversation or at least get a smile.

He looked at me puzzled, frowning as if he had no idea what I was talking about and turned his head away, ignoring me. I said nothing and didn’t take it personally. Perhaps he found it hard to talk about the procedure and was still going through his own emotional journey of recovery.  I was a stranger and very young by comparison, after all. We waited and a few more people arrived.

The fitness instructor in charge specialised in After Operational Medical Care, and she took us through the first set of exercises. She was from New Zealand, the slight twang in her accent gave it away, and in her late twenties or early thirties.  She had a slender build, brown hair and a very attractive bum in tight joggings, which no doubt helped. Quite the opposite of Manuel who was short and slightly overweight.

We did simple stretches with some movement and walked in circles, like horses in a ring on a lead rope, round and round with the instructor at the centre.  We would switch directions and then finally do some more stretches.

To say it was basic doesn’t even come close, for anyone else it wouldn’t have even been a warm up.  The hardest part was a standing up press up which involved standing facing a wall and placing both arms out with our hands against it, then leaning in and pushing ourselves back again; it was a press up standing up. I could feel the lack of strength and wanted to stop after a few repetitions.  Even a simple movement like that was hard and tiring.

The muscle pain was evident, but I didn’t mind. I was happy to be away from home, taking part in an activity and knowing I was getting stronger every moment. I was happy to feel like I was living.

We also had 0.5-2kg weights for arm pumps of thirty seconds each. Even these felt heavy and after a few movements of raising my arm up and down a kilogram soon turned into a tonne. The main point of the routine was to build the heart rate up slowly over a period of time and then slowly bring it back down again. It was a long warm up and cool down process; a gentle hill of exercise gradually sloping up and then down again.

We took our heart rate and blood pressure at the beginning and end of the session for a record to be kept throughout the course and to see the difference at each session. Placing our first and middle fingers on the wrist facing upwards and feeling for a beat, then counting it for fifteen seconds and multiplying it by four to get the rate for one minute. Some of the other members struggled to find their heartbeat, and looking at them throughout the session I could see why. They were frail and old. The results were quite interesting and varied due the medication and also different amounts of it. Some of the heart rates were very slow thanks to the beta blockers; I was very thankful to not be on those anymore, I remembered how exhausted they made me feel, which makes sense if your heart rate is forcibly slowed down.

At the end we sat on chairs and Manuel started to talk about all the different types of heart operation, the signs that lead up to them and also what to look out for.  After a while I couldn’t help but ask: ‘’why are we going over all this?’’ Continuing with, ‘’everybody in the room has had symptoms, seen a specialist and then had an operation. I’m confused about why we are going over all the signs when we have been through it. We are on the other side of this, shouldn’t we be be learning about recovery tips?’’

She didn’t seem to understand what I was saying so I rephrased the question pointing out that this is old news for us and you become a bit of a mini expert throughout the surgery process, so learning about the symptoms didn’t make sense, to me at any rate.

Manuel stood in silence for a moment, I was half expecting ‘’que?’’ to come out of her mouth.

‘‘It’s what we’re told to do and have always done at the start,” she said.

With that response I realised I wasn’t going to get anywhere so I remained silent and let her continue.  The last procedure she went over was valve replacement surgery.  She summed it up quite well and when she got to the decision that patients have to make regarding a tissue or mechanical valve she said: ‘‘you would only go for the mechanical valve as it’s silly not to,” and glossed over the entire subject as if it was completely irrelevant.

If I hadn’t had the previous meetings with her and affectionately dubbed her Manuel, I imagine I would have reacted strongly at this point and challenged her opinion. Instead I realised that she simply hadn’t bothered to contemplate both scenarios and was relying on her medical notes or script to get through the presentation and interpreted them in this way without thinking for herself. 

‘Why would you willing go through another operation again?’ was the limit of her understanding. I chuckled to myself in disbelief, did she even read my notes?

Later I learned that the other people on the rehabilitation programme had been through a different operation to me. Most had a stent inserted into an artery having suffered either a heart attack or angina. The stent was inserted with an injection in the thigh and pushed up through an artery to where it needed to widen a blood vessel which was narrow. They would have been in and out of hospital in under twenty-four hours with no major trauma.  I suddenly realised this was why the larger gentleman had given me an odd look, it wasn’t anything to go through compared to open heart surgery. 

It then dawned on me that I would have to carry on not being able to relate to anyone or share my experience with them.

Despite all of this I still, I looked forward to the classes as it was a time when I would be exercising beyond the normal day-to-day routine and I could feel myself getting fitter and stronger. For some reason we only had two talks after the exercise classes in the end. The other speakers either couldn’t make it or there was a mix up. I was disappointed but didn’t let it bother me and focused on the physical side of improvement.

About half way through the eight-week programme, the New Zealand fitness instructor was swapped for another lady who I instantly connected with. She was older, probably in her mid forties and resembled more of a mother figure. Kind, understanding and always smiling I seemed to be able to talk to her easily; she always had time.

She took us through the last few sessions and then up into the gym.  On the last session I managed to jog gently on the treadmill and I couldn’t stop smiling on the inside and out. I never thought I would be able to run again or even want to, and here I was jogging!  I knew for certain if I had gone for the mechanical valve I wouldn’t have been able to, that choice would have been made for me because of the risk of bruising, but here I was with the freedom to choose for myself.

Throughout the whole process of getting stronger I always felt good. The sense of achievement at doing the smallest thing was so rewarding.  Every week I could do something I simply couldn’t in the previous one.  Each day I would get up and make sure I did just that little bit more than the day before; one more step on my walk, a deeper breath, anything I was doing I improved on what I had done previously.

Throughout the third month of recovery I felt the happiest I had ever done in my life. I was feeling well and could really sense the progress I was making. I had nothing to do but get up, feel good and carry that with me throughout the day.

It was a wonderful period of calm and joy, the simple discovery of just feeling well was all I had and that brought tremendous peace and presence into my life.  The simplest tasks were a joy and I did everything with the utmost care and attention, partly because I was still taking time to do things but also because I could. 

I didn’t know how far from total recovery I was but it didn’t matter because I felt good and appreciated every step.

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