True Life Story: Physiotherapy As Important Mentally As Physically.

Things were looking up in the summer of 2003…A year earlier, I graduated from Queen’s University with a B.Sc. in Biology and biked across Canada. I was almost finishing my second term, Masters of Public Administration (MPA) at the University of Victoria (UVic), and I was doing well academically. I secured my September-April work term placement with my first choice, a federal government job in Ontario, close to a friend of mine from undergrad. I and some friends from the triathlon team planned to cycle to Mt. Hood in Oregon a week later, but plans changed in August 1, 2003, while cycling down a hill, I swerved to avoid something or someone on the road and flew head first into a tree, shattered my helmet and ended up in a coma.

Two weeks later, I was out of ICU and on the neurosurgery floor of Victoria General Hospital. Family, friends, and physiotherapists were my regular visitors. Not that I remember much, but thanks to my friend Suzanne, who had a notebook of ‘memories’.

Physiotherapist Deb and PT assistant Trig would come into my room, use a large crane-like machine to to lift me out of bed and put me down in a wheelchair. The point of this session was simply to try to build my strength to sit. Making matters more difficult was the double vision I had since the accident (which persists today). I was confused, disoriented, but still confident that I would be walking, or running in no time.

By early September, I was medevaced across the country to St. John’s, where I could possibly spend the rest of my time in hospital and inpatient rehab close to my parents. After an operation to replace a bone flap in my skull, removed to relieve pressure on my brain while I was in coma and had a hematoma, I had several physiotherapy sessions. Then, in October, there was a bed available at the local rehab hospital. I was so excited to start what I thought would be a smooth, steady, and quick, road to complete recovery.

I was told it wouldn’t be smooth. There would be some ups and a lot of downs. Unfortunately, there are no definitions for what different people mean by “some” and “a lot”. When you expect smooth, steady and quick progress,  “some ups” means “only ups”  and “a lot of downs” means “only ups”. I’m not a physiotherapist, I have not gone through the training, but I would like to think that getting patients/clients through the downs, and guiding them through the ups, must be the most difficult, yet under-appreciated job of a physiotherapist. 

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In December 2003, while in inpatient rehab, Grant, my incredible physiotherapist helped me get to the point where I took my first steps on my own, with no support, something I had not done since the morning of August 1, and something my parents had been told I would never do again. When I went home for the holidays, I was able to take a walker home to practice. I also developed an apathetic attitude towards falling, so I primarily tried not using the walker.

Finally, seven months after my accident, I was out of rehab/hospital. I was home and immediately started an intensive outpatient program, an extension of my inpatient therapies, but limited to Speech, Occupational Therapy, and Physiotherapy. Jen was exactly the physiotherapist I needed, with the attitude and personality that inspired. I would walk in the door using my walker, and after ensuring that she or her assistant was there to help, the walker was taken away, not to be seen again until after my therapy for the day. This continued every day for almost nine months until December 2004 when I was discharged, and began at a different, but connected, outpatient program, with Penny.

My physiotherapy did not end there. I went to outpatient OT and physiotherapy until September 2005, then, it was back out to Victoria to finish my MPA at UVic. While out there for eight months, Wendy at Victoria General Hospital was another amazing physiotherapist who has been an indelible influence on me.

Although the therapy is, by definition, physical, the effects it has had on my mental state are as important. Needless to say, I was upset, confused, and lonely after my brain injury. Physiotherapy gave me something to focus on, a goal, an ideal, however lofty. This has stuck with me over the years. I have often tried to tell physiotherapists that they have been such a help, such an influence, that they have gotten me to where I am now. They all respond the same way,  “You did it. It’s all you”. It’s that selflessness and dedication that brings me to truly admire them, and that has probably had the deepest influence in my life.

That attitude seems to be present in all of the physiotherapists I have met, and it’s likely not a coincidence that people with that attitude fall into the same career. Not entirely. It’s more likely, a little from column A, a little from column B. The attitude help create the career and the career helped shape the attitude. Where this was so important for me was during those numerous times therapy didn’t go as well as I’d hoped, when I was tired, when my body was nott reacting quickly.

Far from being one-off events, these episodes – of poor performance at therapy, or slow translation of therapy/practice to real life – would sometimes last for weeks, even months. Those periods felt like permanence and I would start to think, “Maybe this is as far as I can go.” Luckily, my physiotherapists always showed me, and instilled in my rehab that I could keep improving if I stuck at it. That was important because it showed me that they believed I could improve, and they never shied away from the truth, even the disappointing truth.

 

It was great to hear that I could improve, but it was still up to me to do it, and my physiotherapists helped build my confidence, continuously encouraging me that it would happen if I tried. Those episodes of poor performance, the stubborn lack of translation to real life, those things are bound to happen. It is tough, yes, but it is not the end of the world. These words, “You did it. It’s all you”, allowed me to place all expectations on myself, and, despite the circumstances, to believe I would meet, or exceed them.

That being said, it was never entirely me. Just as the physiotherapists will not admit the importance of their role in my recovery, I cannot admit the entirety of mine. I worked at it, the physiotherapists taught and trained me, and we were fortunate to meet in the right circumstances at the right time. There were many people who worked just as hard as I did, had incredible physiotherapists, but they were not able to progress in their rehabilitation.

I started swimming again in 2005 and, after completing my MPA in 2006, I worked at Export Development Canada (EDC) in Ottawa from 2007-2010. In 2010, I returned home to work for the Provincial Government of Newfoundland and Labrador for a year and a half. In my first two years at EDC, I wrote articles and updates about the geopolitical situation in different countries, and although I wasn’t writing about my brain injury, I found writing to be a great way to focus my mind and to get some thoughts and ideas out. So, in 2010, I started Concussion Talk, a blog about brain injury from my perspective, that allows me to write, and get some thoughts down about concussions and issues being faced by those who have had a brain injury.  I then wrote an ebook, Detour, about my experiences cycling across Canada in 2002 and my brain injury in 2003.

After completing my manuscript, with my sister’s and physiotherapists’ encouragement, I tried Pilates. It fit my mindset perfectly. I was looking for another way, apart from swimming and the gym, to stay in shape. Pilates brought my mind back to physiotherapy with its focus on movement, specific muscles, and most importantly, the mind-body connection. Playing different sports subconsciously introduced me to that connection, and physiotherapy and Pilates really drove it home. I enjoyed it so much that in 2014, I did my Pilates teacher training certificate at Body Harmonics in Toronto. I also began practicing yoga a few months ago, another great way to focus on the mind-body connection.

In 2015, I began thinking of other ways to encourage discussion and recognition of brain injury. So, early last summer I started Concussion Talk Podcast. I have done 17 episodes to date on iTunes, GooglePlay, SoundCloud, and YouTube and I have the intention of doing many more.

I am also looking forward to the opportunity to speak publicly about brain injury; rehab, recovery, and what that means to different people.

 

Nick Mercer

www.concussiontalk.com

concussiontalk@gmail.com

 

 

Nick Mercer

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