Physiotherapy with Shymo

Gylian

Being Shymo’s physiotherapist, she asked me to write a blogpost. My name is Elsa and together with my colleagues from the SMC we have been treating Shymo for over two years. With this blog I’ll try to explain what we actually do for Shymo.

The first intake with Shymo was on the 15th of November 2017. During this conversation we spoke about her ability to function, limitations and targets. After that, during her physical research it became clear that she could walk with crotches as her right leg was functioning well. The power and directing of the left leg was a lot less. Her main goal was to be able to walk without the crotches, and to pass for her high school exam. With lots of dedication Shymo passed for her high school exam that year. Despite all of the hospital visits, periods that she was feeling weak, and all of the time that she has spend on physiotherapy, she reached that target. Unfortunately it did not succeed to pick up her diploma without crotches. But she was capable of standing straight without the crotches, even tough this took a lot of energy.

We started with two sessions a week but quickly intensified it to three times a week and it even became a part of her daily life. Shymo always looks forward to come to us. But sometimes she has a bit of a mood in the morning. Fortunately she forgets that quickly as we start with her exercises and during that we have lots of fun.

During our sessions in the beginning we mainly focused on core stability and stability for both of the legs. Despite that her right leg was functioning quite well, you don’t want to overload it. She still needed that leg in order to stand and walk.

After a period with a lot of practice, it became a lot harder for her to stand on two legs, as well as the walking with crotches. The control and the feeling of her right leg started to become less, and the number of spasms increased. The consequence was that the trust in walking and standing decreased and it became harder to cope with. We did continue to find her limit. First without splint, later with a splint and brace. The goal of our exercises was to keep the functioning at the present level, improve stability of her body as a whole and to keep her bone density. To have a proper bone density it means there has to be pressure on them. Eventually it was possible for Shymo to stand for 15 minutes with support. During these 15 minutes there was enough to talk about like serious, but also less serious topics. But when Shymo had to laugh a lot, her muscle tension decreased, during which her supervisor needed to have a good reaction time.

Unfortunately Shymo remained in the hospital for two weeks during August. During that period she heard that the tumors have grown and that her paraplegia increased upwards. The consequence was that the functionality of her body changed and that Shymo had to be taught new methods to continue to function as good as possible. Both at home and at the practice. After a period of home treatments where we trained here core stability and mobilized her legs, Shymo was finally strong enough to come to us at the SMC. Cycling was not possible anymore and Shymo had to start using the arm bicycle. Not her favorite, but a good exercise for core stability and her shoulders. The creativity of the exercises is continually being tested and beside that the exercised need to have a goal, we like to keep it fun as well. That is why we circulate the arm cycling with boxing, bal throwing, sit balance exercises, abdominal exercises or push-ups. These are only a few of the exercises which Shymo is still very capable of.

Three times a week physiotherapy, one up to one and a half hours of training and mobilization. It has a lot of impact on Shymo and her life. And not only on the life of Shymo, but also of her family and friends. Because whoever brings her, it means that they’ll be there all morning. Leaving her house at 9, to be home around 12. In the meantime Ilonka decided to her workout as well at the same time. Something she has never done before.
After the session, Shymo needs a rest. If we know that she still has stuff to do in the afternoon, we try to take that into account for her workout.

We understand very well that this is not easy, but despite that she has to do physiotherapy, we do try to make it as fun as possible.

At this moment we’re in her second period of home exercises and we are getting Shymo ready to start with her ‘favorite’ arm bicycle at our practice. Until that time we will visit her at home where the exercises are focusing on mobilizing, stabilizing, and now as well detonating the shoulder- and neck-muscles. With detonating I mean that we try to relax the muscles as much as possible. Her neck- and shoulder-muscles are constantly working, because these are the muscles that Shymo can move around with.

I hope that you have gained some insight in Shymo’s physiotherapy, and how hard she is working to get better. We will, where possible, continue to fight with her to make her physically as strong as possible. Shymo is amazing!

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