Friday, October 1, 2010

Last Day for Vestibular Rehabilitation

Physiotherapy symbolImage via Wikipedia
Well, I have finished my last day of Vestibular Rehabilitation with AllCare Therapy.  We have worked on a number of things together including eye scanning exercises, physical exercises to strengthen the hips,  a bit of the Interactive Metronome and a little bit of work on Activities of Daily Living. 
John has a background in physical therapy as well as occupational therapy and has spent time in a hospital setting so it is interesting to contrast his approach with that of the A Total Approach who come at things from a learning disabilities/sensory integration perspective.  They both are interested in sensory integration but use different modalities from their different experiences. 
The eye scanning exercises we did together were more of the same eye exercises I did in vision therapy.   My scores improved from finding my letter pairs in a crowded field from 1 minute 30 seconds to 30-45 seconds.  So I guess I can pick out things easier.
I didn't do as much with the Interactive Metronome at All Care Therapy as I would have liked as their sessions are only 1/2 hour long and we were doing many activities in addition to the Interactive Metronome.  From my limited perspective,  all the therapy notes I can find on the Internet point towards having 15 sessions of 1 hour each on the Interactive Metronome.   But then, I am not a trained therapist.  My scores did go down on the Interactive Metronome although not as dramatically as they did with A Total Approach where I was doing Interactive Metronome and only the Interactive Metronome for fifteen one hour sessions.
On the other hand, I think that AllCare Therapy  was correct in building up my hip and core muscles to enhance my balance (vestibular system).   Also, John noticed that my feet were pointing outwards and that would affect my balance.   Having him and the neuropsychologist point out the implications of not having  my feet aligned properly led me to go see a podiatrist. 
Looking back at things, if I had the Great Big Uber-Doctor to direct the course of my therapies, I would have had sinus surgery (so I can breathe through my nose properly) and then  worked with a podiatrist to get my feet aligned first, build up the hip and core muscles to enhance my vestibular system, and then started work with the Balametrics therapies with A Total Approach.  But, I didn't have anyone to direct the therapy, just myself.  And, all things considered, it would have been a big jump for any physician to go from the complaint of  "I can't pull my life together" and then "I'm having problems with organization and time management" to "drill out your nose" and "straighten out your feet" as first steps. 
Also, when you are changing things in a complex system like the body has been changing as I have been doing therapy, you start to uncover new problems in the process.   I have seen this happen while trying to fix large computer systems.  You start with the symptoms of the problem and those symptoms often lead you to far distant reaches of the computer system.
Thinking about complex systems, the human body and therapy gives me pause.  I wonder how many properties of complex systems relate to the human body and to myself.  Like complex systems, the body:
  • Changes over time, and prior states may have an influence on present states
  • Components of a complex system may themselves be complex systems
  • Has many local interactions and a smaller number of inter-area connections.
  • Emergent Behavior that needs to be studied at a different level
  • Non-linear relationships:  a small change may produce a big effect (butterfly effect)
  • Relationships within the system may have feedback loops amplifying or diminishing properties of the system.
So, I am wondering about how all these changes that I am making to my body parts affect my body as a whole, my mind, emotional state, and psyche.   There are no journals that really address this holistically.    There are some write ups in occupational and physical therapy journals talking about the effects of therapies on executive function, mental illness, and mental states.  There are a few studies carried out by vision, physical and occupational therapists that talk about different  how different sensory dysfunctions affect mental state but there is nothing in the psychological journals addressing these issues.  So it is hard to know what is correlation and what is causality since the psychologists are not looking in this area, at least to my knowledge.   I could be wrong and not looking in the right places but I can't find anything.
But, it is a lot for me to think about in regard to my own personal circumstance.  What emotions are triggered  by the body, what has been triggered by society when people around me don't realize what is going on, and what is just me being me wholly independent from my physical issues and social condition?  I don't have the answers to this yet and will be pondering  this anon.

But back to therapy.  So what will I do next?  I will take a break from therapy except for seeing the podiatrist this month.  The podiatrist will be taping my feet for several sessions to see how much the body will correct by itself.  However, I probably will still need orthotics to correct my feet.   I have a lot of home exercises to do from vision therapy, vestibular rehab, and podiatry.  Late in October, I will have sinus surgery that will address lack of sense of smell.   My eye doctor and audiologist are also interested in having the surgeon examine the sinus that are involved with vision, hearing and the vestibular system. 

After I heal from sinus surgery, I will be doing Brain Fitness by Posit Science at home.  My audiologist doesn't want me to do anything more hearing therapies until after the surgery. Brain Fitness is an audiological program so I will need to wait on that. 

Also, in October, I will be pondering what doctor visits to get in while before the end of the calendar year when my insurance resets.  I also still have some occupational therapy visits that I can burn up before year end.  I don't want to abuse the medical system but I do want to plan the most effective use of my medical dollars. 

Also, I would like to come to an end of my journey and get on with other things in life. I feel like I have been a bit egocentric -- picking and poking, fluffing and folding myself.  But, I think it will have all been for the best so I can do the things that I want to do.

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