Beans, Bullets, Bandages & You
Beans, Bullets, Bandages & You
Episode 167: Rehab
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Salty and Spice talk about some basic information about rehab and recovery from injury. Go to Beans, Bullets, Bandages & You by clicking HERE!
spk_1: 0:01
Hello, everybody.
spk_0: 0:02
Everybody. Welcome to the show. The big show. Little is critically acclaimed. An important podcast that is recorded in our car. We're doing a little night recording here. Were on the way home from an event that we went to, and we're gonna be doing a little podcast. We're going to talk about something a little bit different tonight. We've never talked about celebrities before, but tonight it's all about movie stars. And, you know, I'm already I'm bad with names. That one guy. Oh, that one guy. He was in that film that was real big last year. The action film? Yeah, he just went to rehab again. It's just like his third trip to Rio.
spk_1: 0:40
You're making that up. You don't even know any guy and any movie. Just know it's got to be true because it's true sitting Dauphin.
spk_0: 0:49
That's right. I saw it on TV. Yeah, he's in rehab. He's gonna go there for some kind of drug problem or alcohol. I'm not really sure what he's rehabbing for this particular time, and I really don't care. So yeah, um, that's that's like that's rehab, right?
spk_1: 1:09
That's not kind of rehab. I care about
spk_0: 1:12
you don't care about his re cab?
spk_1: 1:13
No, but I can tell you one thing about rehab. You see that patch of of dead and dying snow over there? That's like ice right now. Yeah, rehab stinks over there cause rehab It stinks on ice.
spk_0: 1:28
Oh, yeah. Uh, sister Sister, preach it.
spk_1: 1:34
So what we're talking about today is sadly, we're assuming that somebody has had an injury that takes him down for a while. And how do you handle getting back to full physical ability without doing further damage?
spk_0: 1:53
Now, here's the prepping tie in. Injuries were gonna happen, especially if the stuff hits the fan and people get hurt without as much availability of medical doctors injuries, they're gonna linger. So one of the medical skills that people need to start learning is how to conduct rehab for injuries that they have. There's no medical help available, and that's what we're talking about.
spk_1: 2:29
This is one aspect where outcomes today are expected to be a heck of a lot better then the outcomes from similar injuries 200 years ago if both groups were given the same really primitive medical care,
spk_0: 2:45
right? Because rehab matters way
spk_1: 2:48
have matters and it's generally not high tech.
spk_0: 2:51
No, it's more of a matter of get done. The dirty you gotta D'oh!
spk_1: 2:55
Yeah! And thinking about how to rehab injuries has undergone a seismic shift in the left 30 ish years. Yes, and that comes her way, way better than they used to be. Things that used to be permanent, debilitating injuries are now seeing, in some cases, 100% recovery, but in all cases, a heck of a lot better recovery.
spk_0: 3:21
We have personal examples to use from this from from my loft, injured past, actually, and she's had some some major surgeries as well, but I have several serious injuries that have had to react. In fact, right now, I am in the process of getting ready. Actually, I'm not getting ready. I've actually started started. So, free ab, um and this is all part of this is kind of what puts it in our mind right now in a walking boot today I was I walked around, I walked up a set of I was only four stairs, but they were pretty Stephen, pretty narrow. There were white on the White Open, but they were still you.
spk_1: 4:02
But that's a bad things. That means there was nothing to lean on. Er rab
spk_0: 4:06
I walked up them without there being a stair rail and, you know,
spk_1: 4:12
harder yet down them. Yeah,
spk_0: 4:14
hard yet down them. But this is part of what I have to do. So I need to be able to go up and down stairs. And part of you know, part of my rehab is going up and down stairs and not only learning how to do it, but learning how to do it without hurting myself. So and putting him and part of my rehab is putting more and more weight on my broken leg in a fashion where it may hurt, but it won't injure. I'm formerly two broken. She's gonna get into that a little bit more about the different stages of rehab. She's gonna talk about that. I'm gonna turn this over her and let her shoot the info right out of her brain, right into your ears
spk_1: 5:04
right out of my brain, which is not the brain of a physician or a physical therapist or an occupational therapist. I am not a professional in I don't help people rehab. I'm not a medical professional. This is not medical advice. I do know some things about how the body works,
spk_0: 5:22
and she does know and what she has been trained by, people who are.
spk_1: 5:27
Yeah, and I've also had really life contact with a whole lot of people undergoing a whole lot of rehab. That happens when you play in a collision sport.
spk_0: 5:37
And also, when you have a job like yours that you run into a lot of people who are injured,
spk_1: 5:43
Yeah, I've seen it with my car or anything. Let's just be clear. I just have interaction with a lot of people who who are in the process of rehabbing. So I've seen a lot of it. I kind of distilled some of the basic concepts of what is driving the recommendations that people are being given in general by the people who do know the most about these things. And it is totally aligned with the physiology of what makes sense to do in those cases. So that's what all this is about.
spk_0: 6:22
Okay, I would like to throw in one thing first. That was not on your list way Pretty talked about this before. We did the podcast unusually for us. One thing is not on your list, but I wanted to bring out because I think it's the single most important part of any rehab, and this is from somebody who's been through several of them. And that is the number one thing you have to achieve before you could really do. Much of anything else is you have to have buy in from the injured person to do the rehab. If you don't have the buy in from the injured person, you can have the best techniques in the world, and it's not really gonna work very well.
spk_1: 7:01
They're the person who has to do the hard stuff right, and a lot aren't
spk_0: 7:05
a lot of the hard stuff is gonna be when nobody else is watching.
spk_1: 7:10
It's hard. It's frustrating. It's two steps forward, a step and 1/2 back a lot of the time. Some days it's two steps forward, three steps back. It takes way longer than you think it should. Here's the thing, though it does in the long run, often end up way better than you suspected it would at most points of the process. So if you have the will to stick with it and do it well and do it carefully. You can have some really amazing outcomes for this. So the first aspect, of course, is you do the first date and care of the injury, and part of that is getting everything realigned and getting joints back in their sockets. We're not gonna go into that a whole lot, because if you do not know how to do this, you are not gonna learn it from a podcast,
spk_0: 8:07
right? Yeah, and that's that's just yet. This is part where you really need somebody who knows what they're doing. But obviously, medical help when it's available is the way to do it. You go see the doctor on this sort of thing when it's available, because, you know, that's just what you do. And my caveat here is, and then you listen to what they're saying and see if what they're saying holds water. Just because they're a medical person does not mean they know what the heck they're talking about.
spk_1: 8:40
Experience with particular kinds of injuries is important. Salty was almost permanently lamed by a bad, um, decision making tree by the first person who saw serious injury.
spk_0: 8:54
Hey, Almost. I mean, it was Should I not had one of the literally one of the best doctors in the world? I would be lame today, and everybody thinks they're doctors. The best. My doctor left after my operation to go be the doctor for the U. S. Women's Olympic soccer team. Flew off to the Olympics when he got done with my surgery,
spk_1: 9:19
like 10 minutes after two minutes. Salty surgery.
spk_0: 9:23
So what I'm saying the best guy in the world, I mean, hey, is he is the knee guy for a major SEC football team. I mean, this is this guy's good and without that level, athletes. I live in Missouri, professional athletes from the Cardinals and the Royals go to this guy, they call him in. So this is what I'm talking about. Good. And he could barely put it back together again. And he was not convinced that it would work really well once a day.
spk_1: 10:01
It worked great. After actually rehab. For that, it was a dice roll. Oh, yeah. It was not
spk_0: 10:07
become good friends. I'm still friends with the the rehab specialist that did by physical therapist, physical therapist. She was great, but she was using some of the new techniques that were controversial. Could this have been many years ago? At the time, they were just really coming into the into being so. But yet my first, my first doctor just I mean blew it. I could have completely missed nationalistic cleaners on malpractice, but that's not how I roll. That's not my thing. It wouldn't have done any good. Yeah, I literally could have. And probably if I had been lame, I probably would have just because I had trouble learning like income from there on. Um but even still even that this last I'm not trying to digress too much. Is this You cannot You need to know your stuff. Even with this last trip I made to the emergency room when I broke this foot, they will, obviously, I broke the fun. It was not displaced, Apparently broke. The bone was non displaced. We looked at the x rays, we could see it, but even still, I did not like the answers I was getting out of the e r position. I don't think I even had his full attention use. It was like Yeah, yeah, yeah What? Can I put weight on it? Well, you know, I don't know. Maybe I love to look that up. I don't know. I know that's not what I want. Yeah, well, we'll, uh We'll get you some some guy hearing, Donna. No, I'm going back to the best. Thank you. But
spk_1: 11:54
in the kinds of situations we're talking about, from a proper point of view, you may not have a choice. That's one aspect is in the acute phase. When you're getting everything put back in to position, you want the most experienced person with that kind of injury you can get. I have seen what four different shoulders put back after dislocations.
spk_0: 12:21
This was at the event. I mean, during the game.
spk_1: 12:24
Yeah, they are Team Doc, who is an amazing human being in all respects made it look easy, but I know it is not.
spk_0: 12:36
To be fair, this guy's as 40 years of experience is a surgeon, so yeah, yeah, definitely the kind of guy
spk_1: 12:44
and had started as a battalion surgeon for active military units. So he he had seen lots of different kinds of injuries and had actual experience, but it looks really easy when somebody knows how to do it, does it. And it is the hardest thing in the world if you're just going on theory, so experience matters. But speed is also of some import. If you don't get these things put back in, they start to cement in the out of place position, and it gets harder and harder to get a good realignment.
spk_0: 13:23
What's his? Used my injury As an example, I had a non displaced broken tibia and wear a fibula on. We went down and it's, Ah, the ankle guy at the place we go to and he came in and he had this weird look on his face. I hate it when the doctor comes in. Has a weird look on your face. This was after I got X ray shot there. I didn't take my old X rays because they want their own X rays because they want they want to have their own way of doing. He came in. He's like, Well, I don't know what they told you to expect. Does that look and I made his stash. I have no expectations. They told me some stuff, but I didn't trust what they were saying, which
spk_1: 14:14
is good because they were gonna be there. I
spk_0: 14:16
gotta clean field to tell me what's really going on here. I had some some ligament damage. I had a piece of bone broken off. You know, that's beside the point. But I had to have surgery, okay? And you know, but you could tell this guy was used to giving people bad news. That's different from the previous doctor they've just seen. So that's part of it. You know, when you go to a specialist, they're going to know a lot more about what is this now again, when we're in a proper situation? If I were with Spice and we were just on our own, we would have just had to split this thing and hope for the best.
spk_1: 15:04
It was not displaced. It is clear that it wasn't displaced badly. Yes, Given that there is no way on the planet, I would have marked with it. I would have hoped it was not displaced at all and hope for the best in the absence of other information, because the chance of my mucking it up by an experience would be enormously greater than the chance of my fixing it if it were a little bit displaced,
spk_0: 15:30
by the way, just to be clear, we are G rated show. She did used to say, she said, mucked. M U C k
spk_1: 15:36
look, as in the nasty gunky mud that lives in the
spk_0: 15:39
bottom of that. What it's all it was way
spk_1: 15:43
our monk divers, which is what you call it when you dive in places that it's really hard to see. You blow it up because there's junk floating all over the place
spk_0: 15:54
that's mucking it. Buck you up. Yeah, so just to be clear, so yeah, anyway, so you get past that, you know, just stabilized.
spk_1: 16:05
You're in the acute phase of the injury, then the plan is to keep it nice and aligned while it starts healing. And for the first while, and you'll know because the symptomology changes, the focus is on keeping the inflammation to a reasonable level. You keep it elevated above the level of the heart as much as you can. You keep it, um, compression on it with a spanned edges or something if you keep an eye on the fingers and toes sticking out at the other end to and make sure they're not turning too much of funny colors and losing sensation, because if they do that, the pressure is building up too much and damaging things. You have to let the pressure off at that point.
spk_0: 16:53
Now, I will say, having had a whole bunch of different kinds of entries, swelling is different in different parts of the body. Some injuries swell a lot worse than others With one that I have actually is one of the swell your ones. You get a lot of swelling with.
spk_1: 17:08
You have a lot of swelling problems with it. It doesn't actually swell to a very great degree, cause there's no space there. There's just no space for the fluid to go, so the pressure builds up very quickly and becomes troublesome very quickly.
spk_0: 17:22
Well, it
spk_1: 17:23
is not actually a lot of swelling. It's just the swelling is very problematic in that kind of area, and in other places it won't be as problematic. In some cases, it'll be worse than others, but they pretty much always go with compression. For example, the recent injury they put a cast on it that had a a split and that was had elastic wraps holding it in place so it could expand the take the swelling if the thing insisted on swelling. But there was always some compression on it from the outside to discourage the fluid from building up there.
spk_0: 18:01
I have you. I have that thing on me for two weeks, two of the most miserable weeks of my entire life. It was awful. I saw the stitches and I had to take that cast off and they put a permanent cast on which, in some senses, which
spk_1: 18:17
means it was gonna be there for a month
spk_0: 18:18
that was there for a month,
spk_1: 18:20
Didn't have a split.
spk_0: 18:20
And where we are, we are doing the both make giving it time to heal and making sure that
spk_1: 18:33
controlling information as much as possible
spk_0: 18:35
and cast itself will control the inflammation s
spk_1: 18:39
so that those 1st 2 weeks were all about inflammation control, not moving the joint at all to give it a chance to start knitting together while it was in the proper position. Um, so that's the acute phase and as soon as the swelling actually throughout the whole process, but more so when the swelling starts to back down. Starting to move things right away is the new paradigm. They'll have people who had surgery one day up and walking a little bit down the hallway in the hospital the very next day. In many cases,
spk_0: 19:17
I was shocked that they were when I was doing the casting switch over. She's having removed my ankle. They wanted to check my range of motion. So I like it's broken. You want me to move it? Yeah, she wants me to do it. That surprised me.
spk_1: 19:35
They want you to start moving it in safe ways and in controlled levels as soon as can be done. And in some cases that's the day after the injury
spk_0: 19:50
of some cases.
spk_1: 19:51
In some cases, it's couple weeks after the injury. It's usually not longer than that. It's kind of kind of the range of plausible can.
spk_0: 19:59
I had a really were not a weird, but I was in a really weird situation. I didn't move that knee for three months. I did not move
spk_1: 20:06
for the first injury.
spk_0: 20:07
Yeah, because of the type of injury it was. It was oh blown patellar tendon that didn't get fixed right away and they had to basically use come along to put it back together again.
spk_1: 20:16
You had to pull the bone down far enough to get standing there imaginatively
spk_0: 20:20
put like a zillion suitors in it to get it to hold. And then they lacked it in place and I couldn't. I didn't put weight on that leg for six months.
spk_1: 20:29
Yeah, he had a big, very big, strong muscle attached to the surgical repair that could have easily pulled it apart. That was even
spk_0: 20:36
still with the With the brace they gave me. They started slowly screwing in, um, angles of degree that they wanted me to bend any. Well, I couldn't take the brace off. Even I couldn't put weight on. I started. They started me spending the knee within two or three, but a few months. It was after the first month where that was hard. So, yeah, that sells what to start working with Physical therapist on.
spk_1: 21:08
Here's the reasoning. First you want the whole the person's whole body moving as soon as possible after surgeries, because when people lay around a lot, their blood is not moving around with its usual speed, especially through the extremities. And if you let blood sit. Still, it tends to clot, and that's especially true. There's inflammation going on. And if you get blood clots in your veins, in your legs or arms or whatever, they start traveling in the flow of blood, and the next thing they land next place they land is the lungs, and you've got yourself a pulmonary embolism, and those suckers could kill you, so they want youto keep moving to the greatest extent. You can do so with safety.
spk_0: 21:48
And there are less scary things when it comes to the the to the movement than just getting an embolism. I mean, that's that's pretty pretty far on the scariest. Another thing that happens is you get the swelling and stuff like that and the fluids and stuff like that. It returned back up into your body through the lymphatic.
spk_1: 22:11
There's a general bloodstream through the latest Yeah, and most of contraction is what drives lymph flow.
spk_0: 22:18
Exactly. So you're attracting the muscles, then you're not sending the limp back up into the into the system. That's one of the things they had me do as part of my rehab was to do. This is actually his advice came from my old
spk_1: 22:36
therapist physical therapist, even while he's still in the solid cash
spk_0: 22:39
stole the salt, gets to start doing wiggle my toes a lot and
spk_1: 22:44
clench and release with the muscles. Not trying to move the ankle, but just tense. Released, tense release. Tense. Released to drive the lymph out. It helps reduce the swelling.
spk_0: 22:54
And then Thio do some lakes that with called lake sets, that we clinched the fi and loosen up, um, die sets. So she had me do that, and the whole idea was just simply to keep keep the limp flowing. And then also, the spice was able to, you know,
spk_1: 23:17
do some sides toward
spk_0: 23:18
art therapy as much as could be done with the cast on to move the limp out of the out of the leg and get it moving again up to into the hallway. So that helps to reduce the swelling because that's willing has got to go somewhere before it can go away. And also what elevation does, too, is it lets you the fluid drain into
spk_1: 23:37
yeah, gravity, encouragement of the fluid moving away from that spot. If you've got ice, you do a lot of icing of it half an hour to time. Take it off.
spk_0: 23:48
And if you can't access the injury area, there's other things you could dio like. For example, my injury. I was a broken right at the ankle. While there's a cast on it, you can't put ice on the outside of the capital. You did. We actually tried. It doesn't work very well, but you could put ice like right behind the
spk_1: 24:06
D. We're the major blood vessels that go to the lower leg bash their
spk_0: 24:10
works. I was surprised how well it worked. You put ice right behind the knee and it, you know, So there's all these tricks that you can D'oh,
spk_1: 24:17
so acute phase. You're starting to move it already. You're compressing it, you're elevating it. You're not compressing it so much that you make fingers and toes turned purple and fall off
spk_0: 24:31
and they have seen purple toes. I've seen purple toes. Yeah, we'll do it.
spk_1: 24:39
So that's the acute phase. But as the thing goes on, you try and give it more and more movement. The reason they keep the braces on for so long, even after they have people start putting weight on it. They're not really worried about normal stepping because right now, for example, Salty is starting to put weight on that foot. If he did not have that walking boot on at least 99% of the steps he took without that, walking boot would be just fine. But that one bad step out of 100 might re break something. So the point there is to stabilize the injured part enough that it is protected from the Otto hard shocks in bad directions while letting it get as much of its natural motion and natural use as possible. Because here's one of the core ideas of physiology, we see it in a 1,000,000 different faces. When you look at how bodies work, your body is always remodeling. It's not like you build a house. You put a two by four study on the wall. That same stud is the same one that's there when they take the house down. That is not how you are built. Sure, you've got a bone in there, but the individual protein molecules and salts that make up that bone are not the same ones that are gonna be there five years from now, 10 years from now, 50 years from now, the bone might look the same on an X ray, but you're always adding little bits and taking away little bits. You're always remodeling yourself bones, muscles, tendons, blood vessels, every dang thing, and you remodel in response to recent stresses.
spk_0: 26:32
That's why when you lift weights, you get sore. You don't just get sore because you lived with know what that is doing is you're tearing out and rebuilding parts of your body stronger than what it wa
spk_1: 26:44
Yeah, the lift to actually tour individual muscle fibers. And they're sore the next day because they're inflamed because you tour stuff up. But the healing process itself is a trigger that encourages those cells to rebuild themselves stronger than they were the first time
spk_0: 27:01
because it obviously wasn't enough the first time it has to be stronger. And then other factors come into play like, you know, testosterone and and you three
spk_1: 27:11
greatest rehab. Cheat in the world is testosterone.
spk_0: 27:15
Big guy
spk_1: 27:15
Thio, Faster rehab. A guy who are It ain't fair because testosterone encourages the remodeling and encourages the lean tissue building, which is at the heart of good remodeling. so we women have an inherent disadvantage in remodeling speed and efficiency. But all the same basic principles still apply. You stress it in the ways you want it to be stressed, so that as it's remodeling and rebuilding itself, because healing is just a remodeling project, as it's doing that it's going to remodel itself to be able to take the stresses its feeling. And if you're putting the stresses on it, it rebuilds itself stronger. If those stresses are in the appropriate movements and directions, it builds itself to be good at taking those movements and taking those directions
spk_0: 28:11
Now. Conversely, if you do not do this if you take the stress off of the system, uh, you get the opposite effect. Even though the rebuilding won't take all that, it won't be that sudden. But it is a small part of why you know your muscles start to atrophy.
spk_1: 28:34
It's a big part of why your muscles
spk_0: 28:36
right? Because it is a short term kind of, you know, he's like if
spk_1: 28:41
you lost a good third of his calf diameter and injury in October
spk_0: 28:44
for a bike. I'm a cyclist, so I have a pretty big,
spk_1: 28:48
big robust. Caf on on the side. He's still been walking on, and the other one has shrunk by a good third in diameter.
spk_0: 28:54
Puny little things.
spk_1: 28:56
Yeah, it may be down to half. It'll come back. Yeah, but the difference is market. And it's only been a couple of months here, so you're good.
spk_0: 29:06
I'm not stressing this other. Why wasn't I mean I was being good. I was taking, leaving
spk_1: 29:11
the total weight off it for the first
spk_0: 29:14
time. I was very good. I have been down this road before, and I realize that if you do what you're supposed to do, which includes not put weight on it when you're not supposed to put weight on it and do the rehab in all this stuff, it's gonna work out much better Then if you just regard the medical advice and just do your own thing and hurt yourself again and again, you could be stealing with this thing for months and months, months, which could have been done with it if you'd just done what you're supposed to D'oh! Because these recommendations the doctors in the medical community have they're not pulled these out of the air. This is their job. This is what they do. They know what works, especially on a common injury, like a broken like, you know, work. This is not This is not cutting edge neuroscience science. It's a broken bone. People have broken bones for hundreds millions of our around years,
spk_1: 30:07
but they used to recommend you not use him again until the cast came off. They would hard cast everybody, and that hard cast would be on for three months. And then they take it off and you'd have this withered little limb that took four times as long to get back to full strength if it ever did, and in many cases it would not, because it's going to remodel. And if you hold a joint in the same position for the whole time it's trying to remodel. It freezes itself in that position. That's actually why a lot of people with arthritis have fingers that looked kind of like claws and that they can't straighten him out all the way, and they can't grip him down all the way there just partly contracted all the time. That's because when it hurts to move him, the people are not using them through their full range of motion. If you don't use that full range, you lose that range. So the idea is to start using the range as much as possible. And it's it's not fun guys, because you're pushing it. You don't want to push it toe outright. Pain is how it's been described to me. But you do want to push it toe outright. Uncomfortable
spk_0: 31:21
you What object is two? Hurt yourself, not injure yourself?
spk_1: 31:31
Yeah, What you're doing is you're you're tryingto take that thing that you had immobilized while it was so inflamed, and you're starting to move it to get that full range of motion back, you actually have to tear off some of the tightest fibers that were part of that healing process. Those you're leaving the ones and encouraging the ones that were looser. But you're breaking the ones that were the tightest, and that hurts.
spk_0: 31:58
It hurts. And there's some weird stuff that goes on to you do that. It sounds like you got a needful of gravel, if that's what you're doing. And I remember talking my doctor about that. It was six months. It was actually a year after my injury and still felt like I had a knee full of gravel. And e. I don't think you realize how much scar tissue you have in there, and that's gonna be that way for a while. It will eventually go away, and it eventually did.
spk_1: 32:26
But it took more than a year.
spk_0: 32:27
Yeah, Palace. Good couple years. Yeah, the world. The story is I did everything I was supposed to, and I regained 99% of the use of that way, which is
spk_1: 32:38
awesome for that level of injury,
spk_0: 32:40
which was catastrophic injury. And there's only one thing I can't do with that leg, and I just don't do it. I mean, I can't kneel on it because it just can't. It just does not work.
spk_1: 32:53
Yeah, it's like me trying to do push ups with my elbows close to my body. I had my whole chest reconstructed at one point, and no, the muscles just start attached the right way to make that happen anymore. But after that, I I couldn't lift my elbows up to shoulder height. For months after the surgeries,
spk_0: 33:10
we were at a mandatory fun Christmas party, and this was not too long after
spk_1: 33:16
it is only a week after the surgery was my first time out.
spk_0: 33:20
She was gone, and I told her not to go. She was getting it out.
spk_1: 33:23
I was ready to get out.
spk_0: 33:26
Yeah, she was ready to get out of the house. He hot is if you ever been bed bound, I want to get out. I want to do something that's like like the two cultures sitting there. Uh what? Looks like the other patient? Heck, let's go kill something. But she was ready to go. So anyway, we're sitting next thio somebody They asked her to pass the pass. The potatoes.
spk_1: 33:50
Actually, they politely asked, Can you pass the potatoes?
spk_0: 33:53
And you're like
spk_1: 33:54
And I looked at them for a while and I said, Well, actually, no. What? I literally can't pass the potatoes because my elbows cannot get that far from by side.
spk_0: 34:12
Then it was the She just had, uh, just surgery. Oh, of course. Poor guy felt like he was two inches tall, but, you know
spk_1: 34:24
Yeah, I
spk_0: 34:25
Yeah, she didn't get full. Just like Durant. A sore arm
spk_1: 34:28
movement back in my shoulders for more than a year after that,
spk_0: 34:32
I remember
spk_1: 34:32
and I was I was pushing The rehab is hard as I could push the rehab. I was
spk_0: 34:37
You forget about things too. I was We were walking somewhere. I don't remember where we're walking. We're walking somewhere. And I started swinging that swing My arm It will come clean off. You'll flam me on my back is welded there. Yeah, Yeah. Get weird, Boy, We have way. We've had a life.
spk_1: 35:05
And that was You know, I had that major surgery one day and I walked out of the hospital the next day. That's how soon they want you to be up and moving is they didn't even make me ride in the wheelchair. I thought they would make me a ride in this stupid wheelchair, but they let me walk out. It's like you're gonna break. Yeah, I had chest surgery, so I need a wheelchair. What? Hospitals, But no, actually, love
spk_0: 35:32
you. You're so
spk_1: 35:33
actually let me walk out there. So next up, um, the curve of the recovery of the injury is that a lot of times when you first get the injury, it doesn't seem like it's gonna be that bad, and then it starts swelling and getting all inflamed. So it seems like, Oh, this isn't gonna be that big a deal. I can't even put some weight on it in Salt e's case he could with his broken ankle,
spk_0: 36:05
right when I just got it
spk_1: 36:06
right when he just got it. But then it'll continue to get worse as it gets more inflamed. And absolutely if you do something stupid in that just after the injury phase, it's going to displace it. Maur. And then it gets wait worse in a big, fat hurry. Don't do that. There's a dear Let's stop and not
spk_0: 36:25
you jump Charters gonna stand there? Yeah,
spk_1: 36:29
she's gonna trot off Casual little thing here As many deer have been shot in this county in the last month at Iran. If I were her,
spk_0: 36:37
Yeah, I just drove by myself. They weren't in the room. I knew I had to get a word in German. Knew something needed to be checked. But, uh, you know, it is what it is that really probably the pricing of the world. But I had to walk in the walk in the door.
spk_1: 36:54
No, actually, I came out and got you. Are you
spk_0: 36:56
going with the wheelchair? That's right.
spk_1: 36:57
Yeah, he called me as he was driving in.
spk_0: 37:00
I wasn't sure I was gonna get into the door.
spk_1: 37:03
So I grabbed the wheel turn when I get it. So it gets the worst as it swells. And it's likely to keep getting worse for a couple days as the swelling gets worse, even if you don't do any further injury to it, and then it stays pretty bad and starts to ease off a little bit and ease off a little bit. But once you start rehabbing it, the worst of the Latin loss of function goes away pretty quick once you start rehabbing it, but than the pace of improvement slows way down and it feels like you will never be yourself again because, yeah, the 1st 2 weeks of rehab, you regain 25% of your function. And in the last two weeks of rehab, you've regained an extra 2% of function. You know, many weeks into the process, you start to feel like it's never gonna be right again, and it could be very discouraging. It could be very easy to give up and quit working on it. because it's still uncomfortable and it's frustrating. And by then you found some work arounds, so you can avoid doing a lot of those things. If you try to avoid doing those things, it's really tempting to slack off on it then. But if you keep at it, the pace of improvement slows way down. But it does keep improving, and it keeps improving for many serious injuries. It is a full year before you know how much you've really lost. Sometimes it can be even longer than that. Usually it's not. But it's often a full year before you know where you're gonna be after my cancer journey that I didn't feel anything like my original strength and vigor for the first whole year after treatment ended. But then, the year after that, I tried to ride Katy Trail, which is a 230 mile bike trail, in one day it is now. It was to 30 at the time. They hadn't added that last bit. I thought I was trying to ride well at that particular day. I was trying to ride to third. I only made it 100 65 but still
spk_0: 39:26
only made 100 and 65 miles in a day on a bicycle on an unknown Hey, trail.
spk_1: 39:36
That was my celebration of I'm back.
spk_0: 39:42
Yeah, strings for you. I believe you would have made it. I do believe you would have made it. Except for the wind. Swift winds change and she got hit by a 25 3 mile hour headwind. That
spk_1: 39:53
expletive brighter fried me like a bad egg. Yeah, okay,
spk_0: 40:01
that was He made it 30 miles into that wind. Funny go. Nobody got a very lively night out here in
spk_1: 40:09
the way that one, too.
spk_0: 40:12
I could tell you it's quad sense. By the way, I could not remember. Yeah, well, you have a quiet sense of what I still do. Those to this day, Even though you know my knee is fine, I still do them because there are good things to d'oh. Yeah, and you know, there's other things. There's other parts of the rehab to There's a little bit of its equipment, but not much. There's a couple of things that you can have equipment wise that it just really great for rehab, but they're also great to get in a little bit of exercise. If you've been driving in the car all day long and you need to get the blood moving a little bit those those bands resistance bands. Yeah, they're great. Fantastic.
spk_1: 40:52
Yeah, I throw set of those in my luggage whenever I travel because I get restless if I have to sit all day long.
spk_0: 41:00
But now, to be fair, she's a workout fiend. She's a fiend, doesn't get her workout in. She gets really well, Let's just say I like her to get her working. Um, I am a lot of users going on that sort of thing, but I don't like sitting around all day either. Um, I'm actually looking forward to when I can go to the gym and hopefully it will be next week. I thought, Honestly, I thought it would be before now, but this is my first week of off really putting weight on the leg. Even though I'm only a partial right now, I'm still using heavily the weight bearing apparatuses. Uh, next week I'm hoping to graduate to just plain cane or canes,
spk_1: 41:53
so those are cheap, invaluable rehab tools, and so are the various kinds of splints we're actually going to get a second walking boot Or maybe maybe three more. Maybe a couple of my sizes, too, hoping we never need them.
spk_0: 42:08
Right? But they're very handy. Yeah. And you know, though they'll double is a cast if you really need it too. A walking boot and a Spanish will pretty well immobilize anything. So you know, it is what it is. And then you've got other other equipment that can help you with rehab. That isn't really technically designed to be re M equipment. I know one of the things that I used before for a different entry. This'll was problems I was having with my Achilles tendon. It was didn't require any surgery, anything like that ahead, not fibrous knots forming in my Achilles tendon. And basically, I had to do a kill. You stretches. So what I would do is I get on, are coming a recumbent exercise bicycle get good quality. One could actually crank pretty hard with my legs. They're pretty strong. And then just backpedal and use that to stretch my stretch, My attendant and doing that man, it wasn't a month that was cleared up. I also plan to what I can get out of the boot and into a shoe. I planning on doing that a lot to work on my range of motion
spk_1: 43:27
because it's a controlled thing where there is no risk of slipping and accidentally putting his whole body weight on it. Right? Don't want d'oh.
spk_0: 43:37
But it's still lets me leverage safely leverage the amount of Bend I want into the ankle and then that little bit extra that I don't really want. But I need
spk_1: 43:48
rehab is all about using it, but not abusing it right and the splints and things and doing it on the exercise bike. Those are old tools to prevent more motion than it's ready for. But you want to use something that lets you get lets you use it as much as is appropriate at the moment.
spk_0: 44:10
No, you may be asking some questions now, so I'm gonna try and pre pre do. Ah frequently asked questions of those Question one. Okay, you're talking about injuries before I do when I have an injury like a broken leg, a potentially a broken leg or a severe sprain of an angle, and it is the situation where I can't reach a doctor. What will I? D'oh! Well, the number one thing we recommend is, you know, having good training material on hand with you and our favorite book, where there is no doctor. We've mentioned it many times, has a full section on what to do about broken bones. We can't tell you this. This is beyond our expertise. And we're not doctors, okay? And we literally cannot tell you what to do because we don't know.
spk_1: 45:12
You know, what I've been trying to do here is just basic principles of rehab. So you you've got an idea of where you're trying to go. So if you have to make stuff up, you have a good guess.
spk_0: 45:23
But for things like getting that bone, getting it sat, making sure that the bone is not broken or is broke. That's just you. Yeah. Can't help you on that.
spk_1: 45:37
I will say that some people think that if you can move the joint fairly normally, the bones not broken. And that is not an accurate representation of reality. It may mean nothing is seriously displaced, but it does not mean that there is no break
spk_0: 45:55
right like this. This particular entry I have, you might think, Well, I could stand up on its Won't like it, Stand up on it. It's not broken. Well, no, it's not a week bearing bone,
spk_1: 46:04
and you might think a sprain is not as bad as a break. And in many cases it is as bad or worse because it's a terror of the connective tissue that holds the joint together. So when you sprain, that might mean that the bones can slide sideways relative to each other when they're not supposed to, and that's a real problem. So sprains are not necessarily different from breaks in. This discussion is how you treat him.
spk_0: 46:38
Okay, there's there's another one we haven't really hit upon. But it's something that is really important as nothing whatever to do with the injured person it has to do for the injured persons caretaker. Not only does the injured person need to follow the doctor's instructions and be very, very conservative and trying not to injure themselves further, but if you're the primary caregiver from a person who's dealing a lot of help, you need to back off the dangerous stuff you're doing because frankly, you know it's bad enough to have one person who can't walk in the household. Having everybody in the household who can't walk would be a really bad saying.
spk_1: 47:36
It's one of the first things I did after it was clear how badly salty was hurt is I've with regret told my team that I would not be practicing with um Until at least he was able to drive again because we could not no go down to zero drivers in the household. And right now I was the only driver.
spk_0: 48:01
Now I'm dry. I drove us to Iowa today and I'm driving us back. So we're good, we're back, and I'm perfectly comfortable driving now. But this is the first week of me doing this.
spk_1: 48:14
I would you mind? I wouldn't have. I did not stop getting exercise. Don't get me wrong, because that would be.
spk_0: 48:21
But that that's a rough and tumble
spk_1: 48:22
that would be negative. It It's a sport where I could have been my ankle on that X ray.
spk_0: 48:29
It was the common. This is, Ah, anybody who does plays, sports on on skates. This is very common injury or skiing or snowboarding. That's a very common injury for all those sorts of things that I was not doing any of this. I was actually skiing, accident
spk_1: 48:49
and skiing down the stairs. We
spk_0: 48:51
go. But anyway, so, yeah, Not only is it important that the person who's injured be really conservative, but it is not. It is not ever time for a major Kerry. We're gonna run right over train. Uh, is never time for a major caretaker to use the phrase hold my beer and watching this? Yeah, that is not the time to be doing that.
spk_1: 49:22
So it makes sense to dial back on the exceptionally high risk activities. If you need to be the primary caretaker, if you can't. Yeah, in my case, Not good.
spk_0: 49:39
Okay. Anything else you need,
spk_1: 49:44
don't get your dauber down. It's frustrating. It's annoying. It takes a ridiculous amount of time. It's very wearing on the spirit to be limited like that, as well as all the pain that's involved with it. And it takes a whole lot of will to do it. But it does. It can come back much better than you can imagine At some points in the process, if you hang in there and do it right, that's my last word.
spk_0: 50:15
Okay, I'll leave you with this. When it comes to doing this stuff, you do what you can. But you actually have to two what you can. And just because you don't I think you could do it. Doesn't mean you can't do it. You can try as long as you're not doing something dumb. As long as you're not doing something that's going to injure yourself, you can try. Don't leave it at that.