The Physio Heroes

I have written before about how much Marc looked forward to his daily visit from the physiotherapists. Not only were they fresh faced and happy to see him each day, they symbolised the route to his escape from the hospital, and he knew it. I rarely came across them as they usually saw him in the mornings, but I remember the first time I met Katie, Marc’s main physio. She greeted me politely and began to talk about the work she and the other physios were doing with Marc. It felt very strange to speak to someone who was working so closely with my husband and yet know her so little.

I think the physios liked visiting Marc. He was a very enthusiastic patient, mainly because he was extremely eager to regain his mobility and get out of the hospital. He didn’t complain, he worked as hard as his weakened body would allow him to and he pushed himself to achieve a tiny bit more every day. Again, to begin with I think they did a lot of simply lifting him out of the bed on to the chair, allowing his body to adjust to a sitting position and the different muscles this utilised. Each day they would increase the amount of time he spent out of bed in the chair. he was given long, stretchy, colourful pieces of rubber which he had to pull to strengthen his arm and leg muscles. The physios showed him how to use them to do different exercises, supervised him while he got the hang of them and checked that the supportive pads his legs were placed on were doing their job to ensure that the blood supply to his feet was sufficient.

Getting out

I met Katie fairly soon after Marc moved into Ward A5, and Marc was fairly immobile at this point. It surprised me, therefore, that she immediately began talking about Marc getting out of hospital. She was the first person to do so with any kind of seriousness, and I appreciated the optimism that this gave me. It also, however, absolutely terrified me. She talked about what Marc might need when he came home, mentioning a bed located downstairs, a wheelchair, a shower seat. These were all alien concepts to me, and while I was massively looking forward to Marc coming home, I was also given a glimpse of the kind of support Marc would require, and the fact that there would mostly only be myself there to cater for him.

Still, she reassured me that it would not be for some time yet, and for the time being, I tried simply to take in what she was saying and look on the bright side. She also vaguely mentioned the idea of Marc being transferred out of hospital and into some kind of respite care until he was stronger, explaining that he was not ill enough to require a hospital place but perhaps too weak to manage at home to begin with. The idea of this gave me even more to think about, and the prospect of visiting Marc somewhere else, possibly even further away from the hospital, was not one I relished.

Major Progress

But the major work was going on with Marc each day while no one but the physios were there to witness it. I remember some of the nurses on the ward commenting to me, when they had the time, how well Marc was doing with his physio, and once he was on A5 he did seem to make major progress quite quickly. He was given special surgical shoes for the first time, and allowed to move a few steps with a zimmer frame, laughing at how he felt like an OAP. His feet, still recovering from the massive damage caused by the deprivation of blood during the initial stages of his illness, frequently bled during these walking sessions, and it was a running joke between Marc and Katie how she regularly ‘made his feet bleed’.

It sounds horrific, but he couldn’t always feel what was happening (the nerves in his feet were so badly damaged) and I think that anyone who works in a hospital needs a healthy sense of humour to be able to deal with the awful sights they see each day. Luckily Marc can take a joke as well as the next man, and I imagine he made fun of Katie as much as she and the others teased him during their different sessions together. They became quite friendly, and I honestly believe that she was a major part in him wanting to wake up each day while he languished on A5, unable to do anything for himself unless the physios were there to support him. Katie was planning her wedding at the time, and I know she and Marc talked a lot about it while they spent time together, because she and her fiance were to be married at the same hotel that Marc and I were. I think it made him feel connected to her and helped with the exercises, as they could distract themselves while they chatted about Katie’s wedding plans. It allowed Marc to relive our wedding a little, a happy time for him, and this must have taken his mind off how difficult the physio sessions could sometimes be for him.

One small step…

The distance between Marc’s bed and the door to the bay his bed was situated in was probably around six of my usual steps. I distinctly remember the day when Marc managed to get to the door and back to his bed with the assistance of the zimmer frame. It was momentous! Twelve little paces, but he managed them by himself, and the freedom promised by this tiny walk must have felt enormous. The famous phrase ‘one small step for man, one giant leap for mankind’ comes to mind: if he could manage twelve steps today, think of what he could be coping with in a week, a month, three months! The fondness with which Marc was regarded was clear from the pride with which the nurses on duty reported his progress to me that day. I didn’t even see Katie, but mentally wished her a thousand thank yous for giving Marc the confidence and building his stamina until he was able to manage that tiny journey.

Dependent

The hardest thing about the weekends on A5 for Marc was the fact that the physios didn’t work. From Monday to Friday he was pretty much guaranteed at least one physio session per day, two if he was lucky. But on Saturdays and Sundays, when Katie and her colleagues didn’t work, he pined for them. On the weekend of the bank holiday in August he had to manage three whole days with no physio, and it nearly killed him! I could always tell during our visits at the weekend that he had not had a session that day, as his mood reflected it. He had almost become dependent on the physio: he really needed to feel like he was making progress each day, no matter how small, and having no physio session made him feel like he had wasted a day.

I also remember him telling me once that he had missed his physio on a weekday, because he had fallen asleep during the morning when he was due to see Katie. When she passed by later he called her over and asked why she hadn’t been to see him. She explained that he had been fast asleep and that sleep was as vital to his healing process as the exercises, but he was still really annoyed about it. This turned out to be a good lesson: even now Marc gets tired if he doesn’t allow himself the proper amount of time to rest each day. Sometimes he has to go to bed with the children at 8pm because his body simply can’t take the build up of tiredness over a few late nights in a row. He is nowhere near as bad as he was when he was in hospital, but I think his body now needs rest more than it ever did, and this was the first sign of it. By leaving him to rest when they did that day, the physios were listening to Marc’s body, which was clearly telling them he needed the morning off. It didn’t stop him being frustrated though.

An injustice

Writing this I feel like I’m doing Katie and her colleagues an injustice. I want to be able to write more about them. I know how much they did for Marc when he really needed them to. They helped him in ways that I could never have done and he is now able to walk and be completely mobile as a direct result of their work with him. But whereas on ITU I knew the staff well due to the hours and hours I spent there, in A5 I was barely there for an hour each day and never when the physios were on duty. So this post will have to suffice to tell that part of Marc’s story which was almost invisible to me.

Be certain though, that all the physios who worked with Marc both in ITU and on the ward are definitely among those other hospital staff placed on the ever groaning shelf in my head marked, simply, ‘Heroes’.

Happy Families

Once we had established a new routine for visiting A5, life began to settle down a little. We began to get to know a few of the nurses and the sisters, and our visits became more pleasant because Marc could ‘join in’ a little more each day. Having the children with me at many of the visits was both a blessing and a curse. They were certainly a distraction for Marc, and I’m certain that seeing them more regularly helped spur him on when his physio was difficult and painful, or when he was feeling useless because he couldn’t manage things for himself. But they took quite a bit of entertaining on the visits and were often bored.

Not that they were really much trouble – they are both pretty well behaved and I’m certain that they realised that the hospital was not a place to behave badly, but the ward was not a particularly exciting place to be, especially once they had visited once or twice and worked out how limited their options for entertainment were. We were only ever there for an hour at a time. Part of that time was taken up with the inevitable search for chairs which would hold all three of us: visitors chairs are often in short supply in the evening and the early bird catches the worm! Once we had located two chairs and pulled the large chair by Marc’s bed into a position from which the sitter could see and be seen, we would begin by asking Marc about his day.

Routine

There was never a huge amount for him to tell us. His days were pretty routine, and although he was making progress with his physios, it was very slow going. I knew that they visited him every day, that he would sit out in the chair for up to an hour or two now, which was great, and that they were beginning to get him moving, but other than that he really just ate meals, slept, received medicine and waited for us to visit. Interestingly, I never actually got to see him out of bed until he was leaving the hospital. I don’t really know the reason why, except that they sat him out of bed in the mornings, when there were no visitors to get in the way, and that he was back in bed by the time we visited in the afternoon or evening, and usually fairly lethargic because of the effort he had put into his physio.

Instead, we would try to tell him about our own days. We would take turns, and I would prompt the children to let their dad know about whatever small things had been going on for them at school or in their clubs that day. This process was by no means easy: if you try to talk to younger children you will know that often they struggle to speak to someone on the phone. You put the phone to their ear and the adult speaking to them has to prompt them with lots of questions, to which the answer most often is simply ‘yes’ or ‘no’. It is quite an art to get a young child to be chatty on the phone. And the ward was similar: a new environment that they were not used to at all. And they simply didn’t understand how the tiny, ordinary things that had gone on in their day might be of massive interest to their dad, who had been lying bored in bed looking forward to their visit all day. It took a lot of skilful questioning on Marc’s part and suggestive prompts from myself (‘Have you told Daddy about the…?’) to get any kind of conversation flowing.

Bored

However when I tried to start or continue a conversation with Marc, the children became quickly bored. This in turn led to them inevitably misbehaving, not terribly, but enough to affect the other patients on the ward, who also had visitors, and to require me to tell them off or gently remind them that we were in a public place. Part of me longed for Marc to be put back in the private room he had first occupied in the ward, although I knew that would isolate him even more during the long hours that we were not there. We did begin to take our shared family iPad (the only one we owned at the time) into the hospital and let them play on it, taking turns, for some of the visit. But I didn’t want this, my children’s only contact with their father, to take the form of them sitting silently by his side with their eyes glued to a screen and their ears plugged with headphones, simply to keep them occupied.

Our saviour eventually came in the form of Morrisons. Over the summer they had been running an offer which gave a away free packs of card games with every spend over £40 or so. We had picked up a couple over the past few weeks, the children taking turns to select which game they wanted, and we ended up building quite a collection. They were all very small and portable, travel sized games which we were capable of playing fairly easily in the limited space of an incredibly cramped hospital bay. Monopoly, Happy Families, Guess Who, had all been transformed into mini-card-game versions (some more successfully than others) and we discovered that if the children were playing games then they were far better behaved, and far less likely to run around or start arguing loudly.

Chair hustling

So our visits became more routine and settled. The children knew what to expect, as did Marc and myself: arrival, chair hustling, rearrangement of Marc’s bedspace and the small cupboard by his bed, playing card games, both children needing to be taken to the visitor’s toilet one after another (I thought this was quite nice as it was another distraction and left one child to sit and talk to their dad alone for a while), 5 or 10 minutes each playing games on the iPad, some talk of what had happened during our respective days before there was a replacement of chairs and a flurry of goodbyes as we left until the next day.

I did not take the children every day. I don’t think they could have coped. I don’t think I could have coped. Sometimes Marc himself was extremely tired and far less able to cope with two very active children and it became almost a battle, something to be endured all round. The children didn’t exactly look forward to going. Not that they didn’t love their Daddy: they just wanted to be able to see him somewhere other than a very public place where there were so many rules about what they could and couldn’t do. But this wasn’t possible, and they had already spent so long without him in their lives that I didn’t want them to become used to life without him in it.

Fragile

To begin with, Marc seemed completely inaccessible: he had the machine supporting his legs and making sure that the blood flow was consistent throughout his lower body, preventing blood clots. He seemed quite fragile and far away, and was certainly not able to extend his arms out towards us, nor did he have the strength for bear hugs. Slowly though, the machine was removed, he began to regain strength in his upper body and was more able to be cuddled. I remember the first time he suggested that one of the children sit on the bed with him. It was probably out of necessity: we had arrived too late that evening to grab enough chairs to have one each. But Marc suggested that one of the children sit up on the bed with him and, extremely gingerly, I lifted one of them up to sit beside him.

At first they both felt a little awkward, too long without any real contact with their dad had made their relationship seem awkward and strange. I was also terrified that they might hurt him, and we were terribly cautious around him to begin with, but ultimately this became a habit too: we would fetch one less chair and the children would take it in turns sitting with Daddy on the bed. And thus, through healing hugs and games of Happy Families, we began to rebuild our relationships.