Thursday, November 5, 2015

Perri Rehab - Week 3

Today marks three weeks of active rehab for Perri's MSI injury.  That feels like a Big Deal because it means that we are halfway towards our 6-week recheck.   I have no idea what sort of progress, if any, that Perri might show at that point...but it is a milestone that I am focusing on.  And even getting halfway there feels like we are getting somewhere!

This has become a lifestyle, Perri's rehab.   She is being amazing about being confined to the office all of the time.  We love our 15-20 minutes of allowed leashed walking.  We try to do her exercises and stretches twice per day and not a day has gone by that we have not done them at least one time.  When we started, it took me an hour top to bottom to complete Perri's exercises (the heat pack alone is supposed to be left on for 15-20 minutes.   Followed up by a 10 minute tricep masage.)   I usually let the heat on for five minutes and play around on my iPad or read a book, then start massaging under the heat pack.  If Perri is cooperating, we can get the full workout done in 45 minutes.

I have learned to have good treats for Perri's stretches, and a variety of them.  Both Perri and I would probably be happy if we never had to do another "cookie stretch" and I think that is because they take up a lot of time and they are redundant.  She has to stretch her head side to side, then nose to each rib and nose to hips.   A lot of reps!  I try to do five on each side, for each stretch and that is thirty stretches. If Perri is not in a good mood she does not "track" the cookie into the stretch well, or she will come out of the stretch early and refuse to be enticed back into it.  She will just stare at me or into space.  Lots of deep breaths and counting to ten, lots of praise for Perri.  I have learned to have two different types of treats available, switching back and forth helps keep us from getting into a mental rut.

We are using any treat under the sun.  We started with Puperoni which is totally junky and BHA-containing but Perri stretched consistently well for it.  We used Plato Small Bites purchased with my worker coupons at an agility trial - much better ingredient list and the proper length and width that I can tear one longways into two pieces and do a stretch on each side for one treat.  I found these AKC Chicken Filet treats at Big Lots and Perri really likes them and works hard for them.  They smell rubbery and artificial but I will probably get another bag for enticing her out of a stubborn stuck mood.  I plan to get a Natural Balance roll and cut it up and see how that goes for us, something a little more nutritious.  Perri does her strength building exercises for Charlee Bears without complaint!  Walking backwards, low cavaletti poles and down to sit, she is happy to do those FUN! things for a lower value treat.  As I said in my prior post, meal time has become even more of a dance than usual because of Perri's rehab and a lot of that is because she is not hungry.   She is filling up on treats and ham!  (I often enviously think of how Molly would do every single exercise for kibble.  She would!)  For some reason it helps me to count out the amount of treats that I need for a given exercises, so that I can keep track of how many reps we have done and see how close we are to being done.

Just yesterday I had the idea to put music on while Perri and I do her stretches and exercises.  (Mumford and Sons station on Pandora Radio is my favorite.)  That really helps my mood and patience.  Doing these exercises twice a day with a sometimes sulky and unwilling dog, sometimes when I am in a hurry, sometimes when I am so exhausted from a long day I could cry, sometimes when we have run out of time in the morning because of Perri's exhaustive breakfast eating or outdoor pottying is very very hard to be patient when she says "Nope." and stares off into space.  At times, before we even start, Perri utterly refuses to lay on her right side for her heat pack and massage.  She will stand stock still like a statue.  If she lays down it is in a square sphinx down, staring stubbornly forward and resisting my attempts to gently roll her onto her left side.  Perri has been a mind game for me from the very first day, and this is absolutely no different.  The music helps me to relax.  My decision process for when to skip a workout or shorten it has improved.  Dulling the frenzy of "We have to do this!" and accepting that I Am Doing My Best.  Sometimes my best is just two rounds of Perri's cookie stretches (I asked Dr P on a phone call last week what is the most important thing to do if I am very short on time, without hesitation she said the dreaded Cookie Stretches.)   I have learned that, to get Perri onto her left side for her heat, massage and tricep stretch, that I need to get into a play bow and call her to me.  I have to make kissy noises and growly noises.  Without fail she wiggles into me and presses her face against me.  Without fail she will go into a non-sphinx down and I praise her and pet her all over and get her rolled onto her left side.

I am learning a lot.

It has felt impossible, and therefore frustrating, for me to tell if there are any improvements with Perri physically.  One thing I did start to notice about two weeks ago was how Perri offloads onto her left significantly when she stands from resting.  Even if it would make more sense to get up by pushing up from her bad side, she would make an effort to use her left front to push herself up.  Over the last few days, just very recently, I have seen her do less of this exaggerated off loading, she seems to get up more evenly.  One time she even rose from rest pushing off of her right side.  The other place that I think that there is improvement is in Perri's tricep stretch.  (The tricep stretch is Perri laying on her right side, elbow is to be flexed and gently push the elbow forward and stretch the tricep muscle.)  Initially she was very very tight in this stretch, to the point it almost scared me to do it.  I would stretch her but we did not get a lot of ROM out of the stretch.  Very often, Perri would push out of the stretch after not even ten seconds.  Just over the last few days we are getting better ROM than we had and she is letting me hold the stretch up to 15 seconds.

Perri is up to 16 minutes on the underwater treadmill.  On our Tuesday night visit, Perri was looking very great on the treadmill, strong and even.  We will increase the speed next week!  And next week I can actually get Perri there for two sessions on the uwtm, I am happy about that.  My schedule has only allowed one time per week until now.  Perri seems to do best if I stand to the side of the treadmill and give her treat bits.  When I stand at the front of the treadmill she comes forward too far and "cheats" (puts her forepaws off the belt so that only her back end is walking.)  More treats: right now we have a bag of soft peanut butter Buddy Biscuits and Perri loves the "house special": Bil Jac Gooberlicious. 

That's just about it.  The day after day, accepting every round of completed exercises as a victory, figuring out what works, being proud of every day's end, accepting that me and Perri are doing our best and we are Getting There.  One day at a time.

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