When my mother-in-law first started losing muscle strength and tone, going from a walker to a wheelchair to not being able to feed herself to “total assist,” in the physical therapist’s parlance, it seemed as if her muscles were getting limper and weaker. Now some of them are getting strong in the wrong way. When muscles are disused, they can get contracted. She received physical therapy for a few weeks in the nursing home until she “plateaued,” got to a place where they felt they were not going to see any more improvement. The aides were supposed to continue range-of-motion exercises, but being overworked and understaffed, this was neglected, especially during time she developed an pressure sore and had to remain in bed for weeks. We didn’t realize the extent of the need nor the neglect until she already started contracting. We didn’t know to keep on top of it because we thought they were doing everything they were supposed to do. When she was released from the nursing home, her legs would no longer straighten out completely and both arms tended to be drawn up to her chest.
She received physical therapy at home for four weeks, which helped, but the PT told us it was unlikely that her limbs would get completely uncontracted. They did improve, but she still keeps her left arm pulled up tightly to her chest most of the time. That makes changing clothes and cleaning hard for both her and her caregiver. The aide who stays with her weekdays continues to do range-of-motion exercises with her.
A new problem developed in the last few weeks: two fingers on her right hand began contracting, called Dupuytren’s contracture. It is extremely painful to even have the fingers moved. We have a home health nurse who comes out once a week, and she arranged for an occupational therapist to work with her fingers and arm. Of course, he has to gently but persistently open her fingers, try to stretch them out, and massage the offending tendon in her palm, and of course this about sends her through the roof in pain. She was cooperative the first time he came and even laughed and joked a little, but each visit seems to get a little harder. When she sees him she knows it is going to hurt, so she tenses up in anticipation, which makes it worse. The OT and the aide spend most of the therapy session encouraging her to relax. She can relax her arm and fingers, and when she just relaxes and lets him work and works with him, the whole session goes much better and isn’t nearly as painful. But it is hard to get that across to her. The last time the OT was here, her muscles were tensing before he even got started.
I have to admit it’s very hard to watch her in pain, especially when she looks at me like, “WHY don’t you do something?! Why are you letting him do this to me?” I’ve even wondered, “Is this worth it? Should we just let her be?” But without some intervention she would get more contracted and in more pain. Plus the crease in her elbow and her closed hands are more prone to skin breakdown and infection if they are not opened up. Even now the aide has to be careful to wash her hands often because she gets a sour smell in them from their being closed up.
A brace is supposed to be on order (sometimes it takes a while to get things through the doctor, insurance company, and Medicare) which will help keep her hand open naturally and hopefully help over the long haul.
I’d appreciate your prayers for her about this, especially for her OT sessions.
There were some lessons for me, though, in my mother-in-law’s latest therapy session. My mind often goes into, “What’s the worst that can happen?” scenarios. If I am catching a cold, it’s probably going to turn into strep throat and lay me out for a week: if someone is late coming home, maybe they were in an accident, etc. I’m much better about that kind of thing than I used to be, but my mind still runs in those tracks sometimes, scaring myself to death with “What ifs?” I wrote an earlier post titled “When Afraid to Surrender” about the fear we sometimes have that if we truly surrender everything to the Lord, He might ask us to undergo some great trial. He does do that to people sometimes. Just ask Job, or Joni Eareckson Tada, or any number of other people. Even knowing that God has many purposes for allowing suffering doesn’t make us look forward to the prospect.
But He doesn’t want us to live in rigid anticipation, waiting for the other shoe to drop. Whatever He allows – and I am convinced every Christian undergoes trials of some kind, whether physical ailments, relationship or family issues, financial struggles, or something else – we know He has a purpose in allowing it and has promised to be with us and to give us His grace as we need it (not before it is needed).
Perhaps you’ve heard of someone who fell or was in an accident that was made worse because they threw their arms straight out ahead of them to brace themselves, and their arms or wrists were broken. I had a tumbling class in college P.E., and our teacher said if you are about to fall, the best thing you can do is roll with it. That tense rigidity only causes harm. It lessens the joy in life we should be experiencing now. It hinders whatever God is trying to do. Like the occupational therapist, He has to gently, patiently, and persistently work with the very areas that are the most painful in order to accomplish the needed good. Tension against His working only makes it harder and more painful: relaxing into His care allows Him to accomplish His purposes with much less pain and fear. He is not just a therapist: He is a loving Father who wants our good.
“Knowing this, that the trying of your faith worketh patience. But let patience have her perfect work, that ye may be perfect and entire, wanting nothing.” James 1:3-4