Bone on Bone
[ Issue 39 ]

Bone on Bone fascinates Emily Bronto

Permit Bikwil to acquaint you with the fascination of Bone on Bone

Bone on Bone

Part 2 it is, and Tony Rogers at last stops talking about his operations.

As I've mentioned, the physio-hydro roster varies from one day to the next. I have reluctantly come to believe that this is no accident, nor, despite appearances, ungrounded in reason, but a carefully planned tactic mounted against boredom and complacency. You can deduce this from the hospital brochure, which quite openly warns that prospective visitors should always ring the patient the night before, in case they arrive when you're exercising.

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Bone on Bone — Tony Rogers


[ Part 2 and conclusion of an essay begun in the last issue. ]

I haven’t made it explicit, but the physiotherapy department at my rehab hospital conducts both a standard exercise programme and a hydrotherapy one. These supervised programmes — run seven days a week — are designed to improve your strength, balance, mobility and endurance, and comprise the centrepiece of your stay in rehab.

Apart from regular walking, which you’re expected to do several times a day in the ward corridor, there are two types of physio exercises. One group you perform lying on a bed, the other you do standing, holding on to a horizontal bar.

I can’t speak highly enough of those physio and hydro exercises. Without them you’d be wasting your time and may just as well have gone straight home from the acute-care hospital.
I remember, for instance, the first time the physiotherapist asked me to do a set of abduction exercises. Abduction in this sense means that, lying supine on the bed with your legs straight and together, you slide your operated leg out to the side away from the other, and then back.

Well, when I tried it, I couldn’t move the leg a single millimetre, such was the wastage of the muscle in question. Now, of course, after much regular exertion I’m quite adept at it — not great (no ballet dancer, believe me), but acceptable.

Not that I can point to a day when I had the Eureka experience with that exercise — or any other for that matter. Such is your progress through a course of physiotherapy: no dramatic revelatory moments, just imperceptible improvement.

The physio department (including the two pools) stood in a different building from the main one housing the wards. This meant that for those of us not yet strong enough to do the distance on our crutches, “porters” were at hand. It was their job to ferry patients back and forth in wheelchairs to the physio room or the pool.

One of these young porters turned out to be the most popular member of staff. Always cheery, he made a point of addressing every patient by name — and he remembered it. I asked him if he’d always wanted to work in rehab, as he seemed to have a natural talent for it.

“Oh no, Mr. Rogers, working in a hospital is something I always swore I wouldn’t take on.”

Anyway, here he was, and making everyone’s day happier. He was so helpful, he often volunteered to work at other duties when there were staff shortages, even delivering meals or polishing floors.

I asked him if he lived close by. “You always seem to be here.” He told me that he lived on the premises.

This came about in the following way. Originally he’d been driving 35 kilometres to and from the hospital, but then he discovered the ancient disused psychiatric ward. He made some enquiries, and then an extraordinary proposal. If he could sleep in one of the rooms there free of charge, he would clean and paint the building’s interior.

The management agreed and he did paint the walls and he does sleep there.

The miraculous thing about hydrotherapy is that in the water you are able to perform movements that would be far too painful on land. Something as simple as walking around on the pool floor uses your leg muscles in a way you wouldn’t be able to do in the normal course of events for weeks and weeks.

Even so, there’s a surprise in store each time you use the pool. As you emerge (by ramp or ladder) you find your body becoming heavier and heavier. Almost unbearably heavier the first couple of times.

Lest I leave you with the impression that everything at the rehab hospital revolved around joint replacement patients, let me record here how my days in the physio room and the pool brought me face to face with two poignant examples of an old saying.

One of these I saw in the physio room. This is a large room with about eight beds, plus other equipment. On this particular day a stroke patient lay strapped into a special bed in the corner and the bed was tilted so that he “stood” almost upright. And there were his wife and adult daughter throwing a ball to him, which he had to try to throw back. A sad but inspiring sight.

The other, equally moving, example was the case of young man with cerebral palsy, whom I encountered several times in the pool. He was a day patient who came regularly with his quite elderly parents for muscle and co-ordination treatment.

Indeed: you don’t have to look far to find someone worse off than yourself.

Before I forget, I’d better return to that bizarre exercise timetable.

As I’ve mentioned, the physio-hydro roster varies from one day to the next. I have reluctantly come to believe that this is no accident, nor, despite appearances, ungrounded in reason, but a carefully planned tactic mounted against boredom and complacency. You can deduce this from the hospital brochure, which quite openly warns that prospective visitors should always ring the patient the night before, in case they arrive when you’re exercising.

What the powers-that-be do is clear away the dinner things, ritually scratch their heads, assign people to times (perhaps randomly) and then print multiple copies of the roster sheet, one for each bedroom, highlighting the names for that room. Naturally they’re always running late, and sometimes it isn’t till after nine pm that they’re pinned up in the rooms. This means that some patients actually have to be woken up to be told their schedule. And as for the visitors . . .

I have just realised that another thing I’ve not yet mentioned is food. How could I have been so remiss? What better topic could there be to chronicle when reliving one’s adventures in a sanatorium?

Actually — and I know this is going to be an offensive disappointment to those of you who have already experienced tasteless hospital mush — the food was quite good. There was something for everyone, from fruit-salad-laden lunches to cholesterol-rich egg-and-bacon breakfasts.

Have we stumbled upon the start of a trend here? Is this the “stretched forefinger” of a sign-post to the future? Have all hospitals seen the error of their ways?

I doubt it, but with any luck we won’t have the opportunity to find out.

There’s one tradition in the kitchen I found peculiar. It concerns the choices you make when you fill out your menu the day before. You see, it contains a devious trap for the unwary. I fell into it myself, not once, but a couple of times, and I saw other patients do the same. Of course, you don’t find out the bad news till the next day (when you’ve forgotten what you ordered), so it’s all the more mystifying.

It all relies on the kitchen staff’s training: they’ve been taught — allegedly on pain of instant dismissal if they use their initiative — to take everything you tick absolutely literally.

For breakfast, say, you might forget to tick “milk” for your cereal. Sure enough, the cereal and its bowl are delivered — but no milk. Now the following conversation ensues:

“Excuse me, I didn’t get any milk.”

“Let’s see your menu . . . ah, there’s the problem: you didn’t order it.”

“But . . . but . . .”

“No. You see, some people like the orange juice on their cereal.”

This business happens most with breakfast cereal, but can occur with any meal. So, for dinner once I ordered roast lamb with mint sauce. Both duly came, but no vegetables. I’d forgotten again.

I was tempted to try writing “two slices of carrot and one pea” next time, to see what would happen. Better sense prevailed, however.

By the time you come to the end of your exercise programme, there are two further tasks to learn. The first is to master ascending and descending stairs.

If you have never had leg surgery you probably aren’t familiar with the mnemonics associated with negotiating stairs. They’re considered necessary because people on crutches or walking sticks have to be sure of putting the correct leg forward first, to prevent accidents. And it’s one leg first for going up stairs, and the other for going down.

All those years ago, in that previous broken-leg life of mine, I was taught, “Good leg to heaven, bad leg to hell”. In other words, when going up use the uninjured leg first, and when going down the operated one.

This time I learnt a new mnemonic — “GBS” (George Bernard Shaw). That’s for going up: Good, Bad, Sticks. Going down you use the reverse, “Swinging Benny Goodman”.

Always an intimidating lesson, stairs, especially descending.

Your final hurdle is to learn how to get into and out of the passenger seat of a car safely. It’s connected with that “90 degrees” rule, since bucket car seats can be quite low.

Meanwhile, we had arranged to buy or hire all the goodies you need as recovery aids — high “lounge” chair, raised toilet seat, dressing stick, reaching and grasping aid, sock aid . . .

Came the day of discharge and the physio department supplied me with a list of exercises to do at home. Rigorous these are, and religiously must they be performed. According to all I’ve read, continuing the exercise programme after leaving hospital is more important than taking regular walks.

My departure was low key, made more so by another of my futile attempts at irony. After thanking the nurses, I declared, “Well, I’ll say goodbye now — the novelty’s worn off.”
Furrowed brows, then a lukewarm smile or two.

In the sixth week after the operation I visited the surgeon in his consulting room and had an X-ray taken.

“Progress good. Try a walking stick now. Be careful. Stay away from uneven ground. Confidence will gradually return.”

It was liberating to put away the crutches and take up the stick. The same sense of freedom arrived in week nine, when I was first allowed to sleep on my side. By week twelve I was able to start sitting in progressively lower chairs.

Yes, the recovery process has been slow and inconvenient, one that’s plagued my dignity now and then, but it’s been a journey not without its merits and certainly of more than theoretical curiosity.

Some examples:

I’ve learnt that the question “Are you a Hip or a Knee?” might conceivably serve as a party ice-breaker, but it’d have to be a dreadfully exclusive gathering.

I’m the proud owner of a fifteen-thousand-dollar artificial hip joint, which, I’m reliably informed, will outlast me at the crematorium.

I have a top-secret 22 cm scar. Reality TV beckons!

I may still have one leg shorter than the other (the rack was getting repaired just when I needed it), but whichever way you look at the whole experience, the hip arthritis pain is gone.

Whether or not I “never look back”, I know I won’t easily forget one particular episode.

Yes, you’ve guessed it: our imperious milady in full cry after her evening throne.

But enough of these rollicking reminiscences. It’s time I was off on my daily walk.

Hang on! Who’s got my fish-net stockings?

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