5 Weeks Post Op

I am happy to say that I am continuing to make progress.  Last Friday marked my 4th week of physical therapy so my therapist did a one-month assessment to document how I was doing.  We saw significant improvement in my range of motion and strength in almost every measurement.  I was particularly happy that my hips are getting stronger since that seemed to be my weakest area coming out of surgery.

Last week I started working out at the gym again and doing therapy in the pool.  Doing exercise in the pool is great because I have much more range of motion than normal so it allows me to properly perform the exercises I have a hard time doing.  Working out at the gym has been interesting because there are some things I used to do easily in the gym that are now quite challenging.  I never realized how much the extra tone from the spasticity was helping me to do certain exercises such as squats and leg extensions.  Needless to say I have months of strength training ahead of me.  On the flip side, there are exercises that I have unsuccessfully tried to do in the past (such as using the rowing machine) that I can do!  I also feel muscle soreness in some new areas while I am exercising.

Yesterday I picked up my new shoe inserts to correct for my leg length difference and the second I put on the new orthotic and started walking I felt very awkward.  Apparently it will take me a few weeks to adjust since the insert has an arch support and I am flat-footed.  So I am going through the experience of adjusting to a new feeling when I walk again

I was hanging out with some friends this past weekend and walking around the city.  As we walked one of my friends mentioned to me that he always used to have to walk slowly when he was with me before I had the operation.  However, he mentioned that I am now able to keep pace with him.  I believe this is from a combination of increased stride length and my ability to walk more quickly.

I have a new video this week of me walking 5 weeks post op; for comparison I am also including a video of me walking before the operation as well.

5 weeks post op:

Before the operation:

One Month Post Op

Last Friday marked 4 weeks since the operation. Thus far everything is still going well.  It’s very rewarding to continually notice gains in strength and flexibility; these rewards serve as my fuel to keep working hard. Even as I make this progress I have to say – I find the mental aspect of trying to activate/isolate certain muscles to be very difficult. Not being able to directly control certain muscles is very frustrating.  In spite of the mental challenges; I am still amazed at how quickly things have been changing.

Beginning next week I am going to drop down to physical therapy 3x a week and start working out at the gym again.  I am very happy about this since I have been dying to return to the gym.  It will also give me the opportunity to start rehab in the pool which should be beneficial.

Since the last update I feel more confident on my feet and no longer use a walker.  I have been going for walks almost daily and my gait feels more fluid and smoother than it has ever been.  Tomorrow, my therapist will have me practice walking with a cane to see if it makes a difference.

This week I woke up one morning and noticed that my legs were even more loose than before which was a bit of an odd sensation.  After consulting with my friend Todd who had the same operation a few months before me he told me that this will continue to happen over the next few months.  It’s great to hear that I can expect this but it also means I have to adjust a bit each time it happens.

Finally, I have two new videos this week:

The first is a short video of me walking at physical therapy.  One thing I noticed, and my therapist Kristin confirmed, is that I do not bend my left leg when I am walking.  Kristin believes this is to due to hip weakness.

The second video is me going up and down stairs.  I get more comfortable tackling stairs a daily basis and see continued improvement in the level of control I have going down stairs.

Weekly Progress Update

Physical therapy was great last week.   There is a noticeable increase in my strength.  The big achievement is that I am now able to do straight leg raises, which I was unable to do just a week before.  Since things are going well my therapist (Kristin) has given me a new home program and we will move on to more ‘advanced’ stuff in PT.

There are a few things that have become apparent in PT that need work:

  • My hamstrings are very weak.  The right leg in particular.  I cannot perform hamstring curls with the right leg
  • Core strength
  • I do not shift my weight to my left leg when walking

Yesterday I went out for a long walk.  Since I love tracking results I downloaded RunKeeper for my phone to track the distance. I walked 1.8 miles (with the walker).  I have nothing to benchmark that against but I am happy with these results.  I woke up this morning expecting my muscles to be a little achy today since that is the most exercise I have done since the operation but everything was fine and I did my home therapy program this morning with no issues.

Like many people who have Cerebral Palsy I have one leg that is slightly longer than the other.  This can be an expensive to contend with — you either have a shoe maker build a lift into the sole of each pair of shoes or sneakers that you own ($60 per shoe) or have an insert ($75) made that you slide into your footwear.  The downside of the latter option is that I have to buy shoes that are too big for me in order for the insert to fit.  My leg length difference is about 1 cm (there is some controversy on the exact measurement) and I am going to an orthotist today to get fitted for a custom shoe insert.  The hope is that the custom insert will balance out my legs and have a noticeable impact on my gait.

I am now a little over 3 weeks post op and so far I have absolutely no regrets.  I am progressing faster than we projected and any pain or discomfort I have experienced is far outweighed by the gains I have experienced so far.  This makes me feel great because all of my doctors strongly advised me against having the rhizotomy.

I took some video on Friday but it’s messed up and I cannot upload it. In lieu of video of me check out this video I found on YouTube that gives you a glimpse of the how Dr. Park performs the operation. Jump to the 3:10 marker in the video for the relevant segment.  When you see how the nerve testing is performed it’s pretty amazing.

2 Weeks Post Op Update

This past Friday marks 2 weeks since I had the rhizotomy and I have made some significant strides. Saturday, out of nowhere, I stopped using the walker in the house and I have become more comfortable without it over the past 2 days. I will still use the walker when I go out, however, this is great progress.

Over the weekend some friends and family came by for a visit and this was the first time any of them have seen me since the operation. To say that everyone was amazed is an understatement. One of my sisters said the difference was astonishing and a few other people said the change was unbelievable.

Given the speed at which changes seem to be happening so far my physical therapist and I have worked out a schedule to take video every Friday to document my progress. So I have 2 new videos below:

First we have a short video of me walking from a side view:

Note how fluid my gait is and that there has been a dramatic reduction in how much I lean back to balance myself.

The second video is me going up and down some stairs:

The most striking thing here is how much I am able to bend my knees on each step. I did not the flexibility to do that before the operation. I also continue to feel some “new” muscles activate whenever I use stairs. It tends to be at the top of the motion of lifting my leg to go up stairs. I also have more control when going down the stairs. A week ago I had to really focus my mind on not just dropping my leg; that happens more naturally now.

When I compare these 2 videos to the previous videos I took shortly after the surgery the difference is amazing – this is only one week later and with 4 PT sessions.

I am extremely happy with my progress. I was told that I should expect to see major changes during the first 6 months after the rhizotomy and then some more additional gains after that. Thus, I know there are more good developments to come.

A couple of other notes – before I had the rhizotomy my body was extremely stiff when I woke up every morning. All of my muscles felt like they needed to marinate in WD-40 for me to get up and get going. Now, I wake up and can just hop out of bed – no pain, no discomfort! Finally, I tried to ease into doing some light working out by doing push ups on Saturday morning. During the first one I felt some pain around the incision area and that, as they say, was that. I will give it another week or so before I try again.

It’s Not Like A Movie Where Things Happen Overnight

Yesterday I had my second physical therapy appointment.  This was the first “real” session that involved doing some exercises.  Over the course of the hour we did the following:

  • Five minute warmup on the bike
  • Exercises focusing on strengthening my core
  • Bodyweight squats

The warmup on the bike was great.  I have always enjoyed biking around NYC and Central Park but have never been able to go that fast and would often struggle on hills. I look forward to biking around this spring and taking my riding to the next level.

This next part of PT was the most difficult and frustrating part of the day. My physical therapist (Kristin) noticed my core muscles are very weak and this is affecting my gait.  So we started with a core activation exercise followed by side planks.  These 2 exercises were not so bad.  The next exercise had me flat on my stomach – I had to focus on tightening my core muscles, activating my glutes, and then lifting one of my legs up while holding my abs and glutes tight.  Coordinating the activation of 3 muscle groups was very hard and a bit frustrating. I have never been able to isolate the use of any of these muscle groups before.  It’s at this point that it dawned on me how challenging this will be.  I know that I will succeed in the end, however, my impatient nature is struggling with how hard it is right now.  I keep reminding myself of what a friend of mine told me earlier this week:

“It’s not like a movie where things happen overnight.  It’s all a slow progression.”

It will take some time rewrite over 30 years of “programming” with respect to how I operate my body and I need to internalize this concept.

Finally, we did some bodyweight squats to close out the PT session.  I have been doing squats for years as a part of my workout routine.  Never, not once, in years of doing squats, even with heavy weights, have I ever felt my glutes activate the way they did yesterday.

Strengthening exercises are the easy part of rehab in my opinion. It’s a formula – you do the necessary exercises with a high level of discipline and regularity and you will see results.  The really tough part is going to be breaking my muscle memory and learning to do things the right way.

This week I noticed that I can know keep my feet flat on the floor when I bend my knees.  Something that I could only do intermittently and with assistance before SDR.  As inconsequential as this may seem to some of you.  It’s all these small little changes that I use to fuel my fire my fire and keep pushing forward.