By Trish Bogucki
A few months ago, I noticed that my balance was deteriorating so I mentioned it to my GP at my annual physical. He immediately ordered a CT scan and more Physical Therapy. The CT scan showed nothing was amiss with my shunt but the new round of PT made a big improvement in my life. Below are some tips I’d like to share from this part of my NPH journey:
- Speak up and seek help
One of the classic symptoms of NPH is a loss of balance. That was very much the case with me three years ago, and though my balance improved after shunt surgery and my initial round of Physical Therapy, it was never really strong again. And it was not what I needed it to be to pursue one of my new hobbies – line dancing -which challenges both my memory and balance. Line dancing involves a lot of turns, and I just couldn’t manage them. I also noticed occasional loss of balance while taking a walk or doing routine chores around the house – especially anything that changed the level of my head or line of sight. I mentioned all of this at my annual physical, and my GP prescribed more Physical Therapy and gave me a list of recommended therapy centers.
- Be as detailed as possible in describing your problems
When I was evaluated at the new PT place I stressed how much I wanted to focus on balance and not spend time on general strength exercises that I could do at the gym. I was fortunate to find a very creative and accommodating physical therapist – Katie Finn of Excel Physical Therapy in Mahwah, NJ. Katie asked me to give her as much detail as I could describing the circumstances where I had balance problems. I was happy to spend some time coming up with a list of those, and I also included some of the therapies that helped in the past. Based on this information Katie designed a program of balance exercises that worked on my problem areas.
- Try lots of things
Some of the exercises were relatively easy and comfortable – e.g. chin tucks while seated on an inflated ball – and some were very challenging – e.g. standing in tandem position on a foam pad with my eyes shut. A few didn’t seem to help much, so after some tries they were replaced. I always greeted Katie’s announcement that she had something new for me with a mixture of joy and trepidation. New moves frequently were difficult, but we both noticed that my brain seemed to adapt – most of the hardest exercises got easier after just a few sessions (but that tandem stand with eyes shut still needs more work!).
- Up the ante
One exercise that seemed like a keeper was a little too easy – standing toe taps on a cone – so we thought of a way to make it tougher – doing the taps while moving in a circle around the cone, changing direction once in a while. Another favorite exercise that I had learned at my earlier therapy was what I irreverently called Old Lady Dodge Ball – I jogged around cones while an aide tossed a ball at me. Katie upped the ante on this one by having two people throwing a ball from different positions and angles as I jogged around the cones. We dubbed this one Double Dodge Ball. We even tried Triple Dodge Ball a few times but it was too much for my always-weak catching skills.
- Prepare for PT to end
After a month of appointments three times a week I started seeing significant improvement in all the problem situations I had identified but thought I needed a bit more work. Katie and my doctor agreed, so my PT was extended for another month during which the improvements continued and became the norm. I agreed that we could stop after the second month but wanted a list of the exercises so I could continue the work at home and at the gym. I had been doing a few at home for in between sessions, but now I am doing 20-30 minutes of balance exercises 5 times a week. And my goal of being able to do all the turns at line dancing has been achieved. I feel like I am finally back to normal and it feels great!
PS – I am so pleased with the fast results on this round of PT that I’d like to thank Katie Finn and all her colleagues at Excel Therapy for a very positive and effective therapy experience!