Dr Carol Helfer of Canine Peak Performance took this little video of Ali last week during his weekly underwater treadmill session. This day marked the one-year anniversary of Ali’s second spinal surgery. To think about how far he has come in the past year…truly amazing.
Filed under Milestones/Progress, Underwater Treadmill
This is our first update from our new city! We have been in Portland now almost two months and much of this initial period has been dedicated (both in terms of time and mental/emotional energy) to getting us settled into our new home and establishing new routines; besides the fact that we moved to a place where I barely know anyone (change enough!) there have been many additional changes for Ali. (True to form this blog post is going to be about Ali, but just in case you are wondering: I love Portland so far and am very happy here. I think it was a good move for both Ali and me.)
There was definitely an adjustment period for Ali after the move, but he is now settled in and doing quite well in his new surroundings. We are plugging along with the physical therapy, and I thank my lucky stars every single day for Ali’s continued progress, good health, and his amazing joie de vivre…and of course, his companionship. If you are new to this blog, you may want to check out the first post. Alec has come so far since those early days and weeks after surgery that it is easy to forget how amazing, how vast, his improvements have been. In eight months he has gone from being completely paraplegic and unable to urinate on his own to, well – how he is today!
He is getting around quite well by himself in the apartment and at the office, “walking” with an abnormal gait where he often drags (or “knuckles”) his back right foot, but walking nonetheless. This “walk” is not quite ready for prime time and he still uses his doggie wheelchair and the walk-about harness when we go outside. Because of the knuckling, I have to be very careful about him injuring his back right foot, which he has done several times, from scrapes to ripped toe nails (our use of “soft claws” nail caps have helped solve the latter problem). But I am encouraging him to practice walking, and my main challenge is to maintain balance between letting him practice bopping around (especially in the office, where he has a lot more room to explore than in our little apartment) and making sure he does not overdo it. Compared to the challenge of expressing his bladder all by myself, which I did for the first several unforgettable weeks after surgery, this doesn’t even qualify as a challenge! At the recommendation of his new rehab place, we are also using a sciatica wrap on his right leg for a few hours every day, which helps him to take steps and not knuckle (this is basically a wrap that goes under his foot and up around his ankle and helps keep his toes up when he walks).
As I mentioned, there have been plenty of changes for Ali above and beyond what a “normal” dog would face upon moving to a new place. Ali has moved many times thanks to me, and he typically handles it very well. But compared to previous moves, this one involved more adjustments. First, there was the matter of finding a new rehab facility where Ali could continue his underwater treadmill therapy. We started going to a veterinary rehab facility here called Back on Track, about which I have mixed feelings, but I am trying to keep an open mind. After a few initial setbacks on the treadmill, which could have been due to the fact that there was about 3-4 weeks between sessions during the move, Ali seems to be back to where he was before we left California. We are continuing to do the treadmill sessions once a week. We were lucky enough to be getting a break at our last rehab place, which is not the case here, and the weekly sessions cost more than twice as much ($55 vs. $25). There is one doctor and the rest are vet techs (or possibly training to be vet techs; there are so many I’m not sure) and they don’t even have the same person in the water with Ali each week, so it is much different from California where we primarily worked with Juli. But my main concern– and everyone I talk to thinks this is weird – is that they have loose dogs running around the facility, usually several. They have to whisk them away into side rooms when Ali comes down the hall (because he’s a bad shepherd!), but whoever heard of a rehab place with loose dogs running hither and thither? They also have two treadmills in the room, which means there is usually another dog on the other treadmill at the same time Ali is in there, so of course that is distracting. However, I think the treadmill is important for him and we are making it work so far. He is doing quite well with the chaotic situation, all things considered. There is only one other rehab place in town and I may give them a try at some point too.
My second goal was to find a safe accessible place where I could continue to take Ali swimming on a regular basis, an activity that in my opinion has been invaluable for him both physically and psychologically. I spent a lot of time during our first few weekends driving around to scout out possible swimming locations, after quizzing many random Portlanders and searching online to get ideas. After a few initial trips to less than ideal spots, I believe I have found our regular spot! George Rogers Park, recommended by my colleague Stephan, is in the town of Lake Oswego, a 20-min. drive south of Portland. This park is right on the Willamette River and is completely accessible. There is a steep staircase leading from the parking lot down to the river, which almost made me turn away before I noticed the long handicapped ramp, with about seven switchbacks, snaking back and forth, bisecting the steps leading to the beach. Unbelievable! I was so happy when I saw that on my reconnaissance mission, because it has been hard to find places on the river that Ali can actually get to using his wheelchair. The beach itself is flat and sandy and the water is calm. There are usually other people and some dogs there but not too many and we have not had any problems yet (knock on wood!). The park also has trails that I think a lot of people take their dogs running and hiking on. Since it is the cold rainy season, fewer people are down by the water, which is good for us. This morning was our fifth trip there. As I have written here before, I never took Ali swimming without a “buddy” in California, just because there are too many things that can go wrong. However, because here I lack the social network I had in Calif., I have no choice; it’s either brave it alone or he doesn’t swim. The latter simply not being an option, I now take him alone and am nervous every second doing it, but just hope for the best! I also have some pepper spray in case of errant dogs or people. I am never happier than after a successful swimming outing. Ali just has so much fun, and he can really let loose in the water and chase the ball at top speeds, which he obviously can no longer do on land. It is very satisfying for me to see him having fun in this way, getting to engage in one of his former favorite pastimes: fetch!
The third big adjustment was our new office and the surrounding downtown environment, which is different in many ways from ALDF headquarters in California where we spent the last three years. I will write more about that soon, but today is Thanksgiving and it’s time to start preparing the vegan feast: Tofurkey roast, cranberry sauce, stuffins, sauteed rainbow chard, garlic smashed potaters, lots and lots of gravy, and something special for Ali too! But first I want to say THANK YOU to everyone who has left nice comments for Ali and me on this blog. I am incredibly grateful for your support and encouragement, and I have appreciated your kind words. I am thankful for so much, but most of all I am thankful to be spending Thanksgiving with my best friend, and thankful for every single second we have spent together since that happiest day when he came to live with me five years ago. Happy Thanksgiving!
Yesterday, Ali took steps with his right leg in the cart for the first time without knuckling. He did it a few times at the park by Kevin’s house. I couldn’t believe it! We had taken him swimming the previous evening in the American River. Then last night, after we drove home from Sacramento, we met friends at the Russian River for another swim session. After swimming, while Ali was standing up on the blanket, he took 2-3 steps independently with his right foot! Everyone saw it. We all whooped! It’s amazing. First a couple steps in the cart and then while standing on his own…all of this happened in one day. His right leg is waking up! I really think he is going to walk again. I have never said that out loud before, but I said it this morning when I saw him take a few more baby steps on his own, while placing his right foot. I have always been afraid to say anything like that because on some level I must admit I am superstitious about doing or saying anything to “jinx” it…whatever the hell that means. It doesn’t make sense, but that doesn’t stop these irrational beliefs from taking root in my psyche. But you know what? It felt good to say it. It has been exactly seven months since his surgery. I remember because it was the day before Valentine’s Day.
Filed under Milestones/Progress, River Swimming, Underwater Treadmill
Ready to go!
Note the rubber ducky in the corner. It squeaks; Ali likes!
Those who have been following along will remember that after Ali’s first successful session in the underwater treadmill a few months ago, he balked the second time and refused to walk, so we decided to give it a rest for awhile. In the mean time we continued with swimming therapy in the river and our standing exercises at home. Well, as I mentioned in my last post, we decided to try the underwater treadmill again and I am happy to report that Ali has decided he loves it now! Last week, he was so excited he tried to climb into the tank while still in his wheelchair, which is great. It’s cute how enthusiastic he is now about going to the Animal Care Center for these weekly appointments. I think we have done a good job of making it fun for him. And it doesn’t hurt that he has such a good attitude about everything! He is such a sweet, happy boy. People remark on it when they see us on the street or in the park. First they notice and ask about his wheelchair, then they say, “He looks so happy!” And he is. We both are. I’m happy because I know how lucky we are; he’s happy just because. And isn’t that one of the cool things about sharing your life with a nonhuman animal: this zen-like just because? Not to digress into turgid sentimentality, but sometimes when I look at this dog, as am doing now over my laptop screen, in addition to the usual feelings of fierce love and quiet admiration, every now and then my heart melts, turns to liquid, and I feel it rush to my feet. This isn’t as unpleasant as it sounds, but it can be an overwhelming feeling at times. It makes me feel helpless. What do you do with such a strong feeling? You recognize it and honor it as best you can with your actions, I guess. What else is there?
Alright, leaving crazy I-love-my-dog-so-much-it-makes-my-head-hurt land, during the last couple treadmill sessions, Juli has noticed some further improvement in his back right leg. Between two sessions she said his right leg had more movement than the week before, which is pretty exciting. The last two weeks he has been able to move his right leg on his own, whereas the week before she had to bend over the whole time and complete each step for him. He is still “knuckling” on his right foot when he steps, but last time he placed his foot once on his own, which Juli said is a milestone. She also said the muscles in his back legs were less tight and more supple this week, which is cool because during the last week I have been massaging his legs during standing exercises at home (per her recommendation to relieve some of the tightness), so it seems the massage is helping. After a week of not being able to swim (nobody to help), Ali has gone twice this weekend and we are going out to the Russian River again later today to meet Steve. So he has gotten some great exercise this long holiday weekend. I just hope the Labor Day revelers do not make the river too crowded today! It is always more difficult with lots of people and dogs around. Swimming Ali regularly is an ongoing challenge, but a necessary one to tackle because it is so incredibly therapeutic and the benefits for him are invaluable. Okay, now go forth and hug your companion animal and appreciate the unsettling yet not unpleasant feeling of your own heart melting.
Photo: Yesterday, Ali stood up and took a couple steps off his bed when he noticed I was getting his peanut butter Kong from the freezer. He has been doing this more lately – standing up on his own and taking a couple baby steps without falling over.
It has been six months since Ali’s surgeries and he continues to make functional progress. We are back at Animal Care Center doing underwater treadmill therapy once a week. Although Ali balked at the treadmill the second time, he is doing okay with it now. We think it is probably because his confidence level is higher as he is much stronger and has more mobility in his hind limbs. I have also worked hard to make it fun and not stressful for him. It’s not too difficult. He is so social that he loves going there and seeing people, and I just make sure I have lots of treats on hand along with a tennis ball to distract him. He has been walking 6-10 minutes on the treadmill each time. In the water he takes independent steps with both legs, but needs assistance with placement of his right hind leg.
Out of the water, he can take active steps with his left hind leg and his right hind leg is showing motor function down to about the knee, according to Juli. I think this is amazing considering his right leg was barely moving at all a few weeks ago. I don’t know if it’s a coincidence but it was when we started acupuncture that I noticed his right leg started to make subtle movements; now it is moving quite a lot in the cart! We also raised the cart about an inch and now he can take active steps with his left leg while in the cart. Before he was not able to clear the ground and place his left paw – he would “knuckle.” But with the added height he can take actual steps, which should be good for him. (Although the added height has caused us to have to make some other adjustments to the cart involving foam and duct tape – looks pretty DYI but we need to make sure the added height does not pressure his front shoulders too much. It’s challenging to get the correct balance.) The right leg is moving some, but not making complete steps. He continues to stand up on his own and it seems much easier for him now. I think is making great improvements with his balance. He can almost take a few steps on his own and he is really good about catching his balance if he starts to sway – he is able to reposition his left leg pretty well to catch himself.
We continue to go swimming as often as we can, which usually is not more than once a week, but ideally I would take him every other day if I could. There are just no good swimming spots around. The Petaluma River, close to our house, is really an estuary and as such is subject to the ocean tides. If it is low tide it is very treacherous to try to swim Ali there (speaking from experience – Ali and I have both sustained minor injuries on the exposed rocks. Luckily, I haven’t face planted on these jagged rocks yet, a fact Maggie was marveling at last time we were there. It’s only a matter of time, though, if we keep turning up there at low tide, and it will be extremely counterproductive if one of us gets seriously injured!). It is really only safe to go when the tide is high, but it only happens occasionally that the tide is high enough either after work (but before dark) or on the weekend during daylight hours. Plus, I am dependent on Maggie’s schedule and availability because I cannot take him out without assistance and she is my only friend in this godforsaken little town. Even more rarely we make it out to the Russian River, about an hour’s drive away. I go whenever I can, though – which means whenever one of my two friends who live out there can accompany me and Alec. I try to make it happen as often as I can because, although it’s hard trying to coordinate, I think swimming is the best thing for Ali to do regularly. I really think it has contributed immensely to his back strength, and I’m sure coordination as well.
We also continue to do acupuncture, once every 1-2 weeks, as well as standing exercises at home.
Alec’s official status at this point is “ambulatory with assistance; mild-moderate pelvic limb paraparesis.” Paraparesis means a slight paralysis or weakness of the hind legs – as opposed to paraplegia, which is complete paralysis of both legs. After his surgeries he was classified as “non-ambulatory and deep pain negative” and then “ambulatory paraplegic.” So parapetic is the proper word to describe his current condition, not paraplegic. In case you’re interested in the fine points. I am.
The neurologist had noted on his three-month evaluation report that “peak recovery may occur at 3-6 months post-injury; however recovery continues through a patient’s lifetime.” So this six-month mark is a little scary to me. I know it shouldn’t be, but as long as these improvements, incredible improvements, really, occurred before six months had passed…I don’t actually know. I just know I heard myself saying proudly several times when people remarked on this or that improvement he had made: “And it hasn’t even been six months yet!” Well, now it has been six months and part of me is afraid that he will stop progressing. I mean, that has been my fear all along. And it is not an ungrounded fear; nobody knows what will happen. The physical therapists talk a lot of being “realistic” but also “optimistic.” There are no guarantees in this field, and I remind myself of that a lot when I realize how far he has come and how grateful I am for that. I just really hope his right leg improves the point his left leg has, but that is not a given. Mobility could stop at the knee. But I guess I need to focus on the optimistic part of the equation. I feel like I have done a good job of balancing the realism/optimism equation thus far (of course, Ali’s amazing progress has helped with that!), and I know the six-month mark is just an approximate guideline; of course I know that. Juli has a client whose dog is two years post-surgery and just started walking on her own. So, we won’t give up! Bring on the next six months…I’m ready. And really thankful for how far he has come in just six months.
Each week since, I have taken him to Johnson’s Beach on the Russian River in downtown Guerneville, usually with a friend or three in tow, to swim for about 20 minutes. The Russian River is much better suited to the purpose of therapeutic swimming; it is flatter with a sandy bottom. Once we arrive, I load Ali up in his wheelchair and let him wade around with his wheels in the shallow water for a few minutes. Then I take him out of his wheelchair and, holding onto his “float coat” (life vest thingy) with one hand and rear harness with the other, I walk him into the water until it is deep enough for him to not touch, and then I toss a tennis ball until he seems like he is getting tired. At first we did this for 10 minutes but I have gradually increased the time to 20 minutes. I always expect him to crash after all that exercise and I need to be careful he does not overdo it, but surprisingly he never seems tired afterwards! Juli says anything that gets his back legs moving is excellent therapy, and swimming is great cardio and good for him psychologically. So that is Plan B. Out with the treadmill, into the river…stay tuned!
Both Dr. Tieber and Juli were happy with Ali’s progress at his re-check appointment on Friday. Dr. Tieber thinks he definitely has some pain sensation and this is good. She did not seem concerned about the cross extensor reflex. She said this is just a sign of a severe upper motor neuron lesion but does not mean he will not recover motor function. We put him in the underwater treadmill and he did well. When the tank filled up with water and Juli (who was in the tank with Ali) let go of him, he was able to stand with the weight of the water helping him. Although he wasn’t able to walk by himself on the treadmill, his left leg was definitely moving. Juli said he was not strong enough to break through the water on his own, but he was initiating movement and then she would help him complete the arc of a forward step. The right leg is his weaker and though she did not feel it moving she thinks there is “something there.” I am going to bring him back for hydro-therapy appointments once a week moving forward. He will only be in the tank for about 5 minutes each session until he gets stronger. Combined with the exercises we continue to do at home, it is my fervent hope he will continue to improve a little each day. I know he can do it!
Filed under Physical Therapy/Rehabilitation, Underwater Treadmill
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Alec's Story 
