Monday, December 23, 2013

Learning to Walk

A friend has a new prosthesis.  She's been using mechanical supplements to locomote since she was a very little girl.  As the decades passed and research and technology caught up with one another, the capabilities of her lower leg improved.  The changes have not always translated to better ambulation.

We proved that today on The Loop.  Well-signed and well-paved and well-traveled, this multi-use path circumnavigates Tucson.  We met at one of the parking areas, leaving a space between our two little white cars for a baby, should our vehicles choose to get to know one another on a deeper level.  We hugged, she gave me baked goods, we hugged again, and then she showed me her new equipment.

It's an elegant piece of machinery which allows her to use all the toes and to swivel on the ankle. These are new experiences for her. I oohed and aahed and tried to absorb the description she was sharing.  She's matter-of-fact about the whole thing; I'm constantly amazed.  The foot is a bit small, and only fits in one pair of shoes.  After laughing about the utility of a non-sweaty-foot in socks, we ventured out onto the path.

Neither one of us possesses a smooth gait.  We were rocking and rolling and covering ground, I trying to use all the bones in my feet and ankles, concentrating on keeping my hips level and my shoulder uncocked.  I moderated the size of my steps to meet hers as we watched puppies play in the wash below the path. She's a real animal person; every dog we passed looked and sniffed and offered itself up to her for petting and love.  They studiously avoided me.  As I said, she's an animal person.

Her hair was curly and sparkly and caught the sun as we descended and ascended and complimented ourselves on managing the change of elevation. We're talking about going down beneath an overpass, not climbing the Alps, but we were just as proud of ourselves as if Heidi were on the other end of the rise, calling to Peter across the mountains.  When small steps require many thoughts, tiny distances become minor miracles.

All the new tricks are giving my friend's brain a great deal of trouble.  At first, when the signals to her brain were announcing that the ankle swivels and the toes respond, there was a party in her cranium.  The first few minutes, she walked smoothly, gliding not lumbering, crossing the prosthetist's floor with grace.  Then, her brain kicked in, remembered her old patterns, and there she was, rolling side to side, not using everything available to her.

She didn't know how.  Her brain was comfortable in its old patterns and had no interest in changing.  With all those new sensations, her brain was overwhelmed, uncertain, incapable of control. The new prosthesis could strut its stuff without interference.  Once her brain calmed down, though, it resumed its role as master of the universe, and her old patterns reemerged. Now, walking requires concentration.  Every. Single. Step. Must. Be. Thought. Out.

Every. Single. Step.

It's exhausting.  I know. I'm supposed to be doing the same thing.

If I concentrate, I can make my right leg move from the ground up.  If I just walk, the action is all in the hips and upper body.  I thrust myself along instead of letting the appropriate body parts do their thing.  I've trained myself, over the last three years, to locomote.  It's not ambulation, but it gets me where I want to go. It doesn't look pretty, it takes more energy than it ought, but I'm moving.

In the beginning, that was enough.  After fourteen weeks on the couch, I was finished with the sedentary life.  Form was sacrificed to function, and function got me where I needed to go. My family winced as they watched, but I was moving and that was enough for me. Now, months and months after the novelty has worn off, I'm ready for a smooth gait.  It's not entirely clear that my brain is on the same page.

She's had the same trouble that I did finding a physical therapist who can help her retrain her brain-body connection.  The capabilities exist.  She carries them in her shoe.  She's just having a hard time figuring them out. I feel that pain, too.  Engaging my adductors, lifting the arch of my foot, pressing evenly through all my toes, pushing off with force, utilizing my glute-hamstring pathway to empower my movements... if I think about them I can do them all at once.  Of course, all that concentration means I can't carry on a conversation or take in the beauty which surrounds me.  I have to think about putting one foot in front of another.

I know I'm making progress; my arms now swing of their own accord.  That was not the case twelve months ago, when I held my upper body rigidly, protecting my achy hip from distress. There is less distress and more freedom of movement as time has passed, but I'm still rolling from side to side as I try to go from here to there.

We shared laughs and stories and thought about the disconnect between our bodies and our brains. We know we are lucky to have what we have.  We're not pitying ourselves.  We are trying to get the most out of what we have, and we're having a hard time with that.  I'm going to put her together with my physical therapist and see if there is something that she can do.  Perhaps the vibration platform would wake up the pathways she needs to properly utilize her fancy new appendage.  Perhaps walking with straps-hanging-from-the-ceiling-secured-under-her-armpits on the treadmill will relieve the pressure and allow her to practice without fear of falling.  I don't know for sure, but it's worth a try.

After all, The Loop has 55 miles of connected trails just waiting for us.  I'm waiting for the day when we can stride out, heads held high, hips parallel to the ground, shoulders neither rising nor falling but following gracefully as we put one foot in front of the other. I can close my eyes and imagine it.  I know the reality is not far behind.

1 comment:

  1. I'm going through a similar process as I re-learn to walk after a broken ankle. 2.5 months of "Don't let your foot touch the ground!" suddenly became "Walk!" and my brain says "How?!" We won't even talk about a gait yet. I'm lucky to be able to stand up at this point!


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