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Thursday, December 26, 2013

Rehabilitation - an SPDer's Next Frontier? (Rehab #1 - Vestibular)

A few months ago, my mom - in an effort to help herself overcome a post-concussive state - began vestibular rehabilitation therapy at a well-known physical therapy program. Her issues are not too dissimilar from mine - although hers focus on trouble with balance only while mine span the sensory gamut - but when she described her super-SPD daughter to the physical therapist, it was clear that all parties thought I might benefit from some vestibular and proprioceptive exercises.

Who knew that there were specialists trained to strengthen the senses? I sure didn't have a clue. I was under the impression that occupational therapy was the nexus of SPD treatment. Don't get me wrong, I am a huge fan of occupational therapy for the improvement of SPD symptoms. It was the place where I received my SPD diagnosis, used my first Wilbarger brush, and learned that my urge to fling my body against all sorts of surfaces was "normal" (for an SPDer, at least). It helped me establish definitions crucial to my current state of self-understanding: "proprioception," "fidget," "shutdown" - to name a few. It helped me learn to function in the world in which I exist with the condition that I have. And yet, I felt like the treatment was lacking an unnamed something. This could have been because as an adult, I couldn't use the tiny swings and spins and wheels and mats designed for small bodies. I had no real way to strengthen those neurological connections that all resources promised me could be strengthened.

Enter rehabilitation.

I attended my first session of vestibular rehab on a Friday a few months ago. Nervous as I always am to travel anywhere new, I felt a bit out-of-sorts as I waited for my appointment - early, per usual. The physical therapist was a calm, friendly woman, and she whisked me through a quiet corridor into a private OT-meets-doctor's-office style room. The fluorescent lights were off, and the room was saturated by the sun alone. For the first hour, all we did was talk. Although I've been in psychotherapy since I was 14, and have told my SPD tale of woe many times to anyone who will listen or read (hello, like you!) - the entirety of my SPD life poured out from deep within over the course of the hour. I tripped over myself relaying every minute detail. I laughed. I sobbed. The PT took extensive notes and asked very pointed questions related specifically to my issues of balance and proprioception.

She gave me an exercise to try, and I stood in the corner, arms crossed across my chest, eyes open. I learned that we use our sight, as well as proprioceptive input, to stabilize our balance, and so to make the exercise more challenging, the PT asked that I close my eyes. I instantly felt a shift in my balance. Nothing overtly significant, but it felt as if my ear and brain were forced to work harder to keep me from tumbling onto the floor. She then told me to open up my eyes, and to stand on a squat blue pad closer to the wall. The ground underneath me became squishy and I felt completely disoriented. I learned that by taking away direct proprioceptive input (the firm ground), I was challenging my vestibular sense. The PT asked me to close my eyes, so that my vestibular system had to work completely alone, without visual or proprioceptive support. In an instant, I could not tell if I was standing or laying down, and it felt as if my brain was flipping back and forth between the two options, discombobulated. She had me step down off the pad, and I marveled at how connected I felt to the ground - a rarity for me with my proprioceptive issues. I was told to do the first exercise twice a day until our next appointment.

Since the summer, I've been to see my vestibular rehab specialist twice. My balance and proprioception issues are showing improvement, and aside from a classic SPD crash-fest I had earlier this week (in less than 24 hours, I dropped a steak knife into my foot; broke a beautiful glass wedding photo frame; and lost my grip on a full cup of water, which spilled onto two computers - I blame a rapid, unnatural shift in temperature and air pressure), I am feeling much more grounded and have noticed significantly less bruises on my arms and legs. My sessions are spaced out much further than most who visit this center - they have acute brain injuries from accidents, and I just have a differently-wired brain. My rehab specialist posits that tiny steps across a larger span of time will be more effective for me in the long run.

I now have newer, more challenging exercises. I have to walk a long corridor daily while turning my head left and right, as well as up and down. A quirky soldier in an army of one, I march each night, focused, surveying our only hallway while challenging my eyes and ears and joints to become stronger. On the couch, my husband nonchalantly sits watching TV. He's used to my evening meanderings in the dimmed light of our living room, my noisy slipper steps echoing against our wood floor. When I finally join my husband, I must first stand, mummy-like and glowing against the flickering of the screen. I count - one Mississippi, two Mississippi - until my work is done, and I can be released to his waiting arms.


4 comments:

  1. Great post Rachel you continue to shed light on the dynamics of SPD for all of us, thanks for being so generous and sharing your story.

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    1. Thanks for your kind words, Sonia! As always, it is my honor to share my experiences and remove some of the stigma that surrounds adults with SPD. I hope you keep reading!

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  2. I'm a vestibular sensory seeker, hypersensitive to noises,touch,lights
    and have proprioceptive dysfunction I'm not sure where to go for therapy all the OT I have heard of is for young children the I have a swing in my house at the moment sound childish I know but i'm really confused I cant drive of live independently cause of SPD like common i cant even wash my hair!

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    1. Hi Zoe, I had the same issues with OT, but if you make a few calls, you should be able to find one that will also treat adults. SPD is unfortunately (currently) a kid's world, and we adults need to keep working towards making treatment available to all ages. It sounds like you could use some OT, though, so I hope you keep searching. They will help you feel more sensorily-centered, and take away some of the extreme negative feelings of sensory input. I also always recommend psychotherapy for adults to work through some of the emotional issues of having SPD. And hey, I have a trampoline in the bedroom and a weighted stuffed animal on the couch. We do what we have to in order to feel well :) I'm glad you've found my blog, I hope you keep reading!

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