Rudimentary, bare-bones, everyday living is a no-brainer for the average person, even taken for granted.  Not so for Matt. With few exceptions, everything was a significant undertaking. Mental fatigue and the concentration required to hold a conversation—listening, processing, and responding—taxed him as much as the many physical demands. If his threshold was exceeded, his eyes glazed over. Acclimating to the increased stimulation and activity of life at home was enough to manage the first week. Therefore, Matt's outpatient therapy was postponed a week, allowing him time to adjust to being at home.

Then, life began in earnest. His calendar quickly filled with twice-a-week, back-to-back physical therapy (PT), occupational therapy (OT), and speech therapy appointments in the outpatient clinic where I worked. Stepping into the therapy gym was sobering. It was an ah-ha moment, shining a harsh floodlight on Matt’s extreme level of disability as he sat meekly in his wheelchair, dependent on my legs to propel him forward. In our isolated home environment, my measuring rod compared Matt's current state to the first day in the ICU—he was undeniably better. However, walking into my workplace and seeing the other patients, getting around on their own steam, exercising, practicing with a cane, and easily interacting with therapists and others, offered a less favorable perspective. Matt easily won the low man on the totem pole.

The unexpected intimacy of working with my coworkers significantly eased the transition to outpatient therapy. Matt received extra special attention flavored with compassion for our entire family.   They interacted with Matt professionally and personally. Each therapist paired their unique knowledge, skill set, and experience to identify the strategy that would best motivate and engage Matt, draw him out of his cocoon, and facilitate his recovery. It was nice to have their years of expertise at our disposal. Mike and I were always welcome to observe, assist, and offer suggestions. The ability to keep my fidgety hands and mind engaged in the process gave me purpose and expanded my view of Matt’s potential and future.

In addition to traditional therapies, we were fortunate to have a local optometrist, Howard Kushner, DO, who specializes in Vision Therapy, to work with Matt. Matt’s eyes had difficulty converging and scanning his environment, and his peripheral vision was restricted on the right side. Additionally, his brain had difficulty processing and responding to visual stimuli. The vision tests had to be modified because Matt didn’t recognize letters on the eye chart and struggled to follow instructions, respond to questions, and coordinate his arms to point at a requested item. Dr. Kushner skillfully modified tasks and verbal cues to obtain baseline test results successfully and create a meaningful treatment program. Weekly sessions and a home program focused on exercises to strengthen eye muscles and the necessary coordination to complete each task effectively. 

On the home front, Mike and I were uniquely positioned to help implement their therapy strategies and suggestions. Not only as physical therapists, but our extensive background in interactions with occupational and speech therapists, as well as rehabilitation nurses, over 40 years of practice has benefited us. We used our years of experience to help Matt care for himself and participate in daily activities as soon as he was able and had the necessary strength and endurance.

Matt’s therapy programs and at-home were never stagnant or repetitive. Interventions were regularly modified. Changing exercises, repetitions, resistance, or adding a new twist facilitated reaching the next level of performance, even for healthy athletes. In the ensuing months, PT included neuromuscular reeducation, strength and power training, core stabilization, balance and gait training (for example, walking on flat surfaces, uneven surfaces, and stairs), and functional movement patterns. After running a battery of tests, the speech therapist identified and targeted the most essential communication skills to address first. She provided a home program to help strengthen and stretch his neck and throat muscles. These would help him to speak louder and swallow without choking. They also worked on identifying objects, numbers, and colors. The OT addressed arm and hand strength, coordination, and dexterity, as well as cognitive tasks, problem-solving, and functional retraining, such as cooking, folding laundry, or walking while carrying an object. In vision therapy, Dr. Kushner addressed visual skills ranging from scanning and recognizing letters and numbers to alternating between seeing near and distant objects and, very importantly, learning to follow instructions readily.

Every service was invaluable in knitting together a comprehensive effort of Herculean proportions to restore Matt’s life. The combined staff effort would serve as a living tribute to their dedication and, ultimately, to Matt’s resilience.

© 2025, Sarah Watkins