“That’s not uncommon. We can adjust your prescription dosage if it’s becoming problematic.” Dr. Casteel continued her examination, moving to the left leg, testing sensation with light touches and pinpricks at various points.
Mary answered each question. “Yes, feel pressure, not sharp, though.”
“Your injury is still classified as incomplete, which means there’s potential for some recovery of function, though at this point, almost three years post-injury, we’re unlikely to see dramatic changes. However, maintaining your current level of function and preventing secondary complications is crucial.”
“I understand,” Mary said, hiding the sigh threatening to escape. She’d heard variations of this speech before, and while there had been a time when the word “unlikely” had devastated her, she’d made peace with her reality. She wasn’t going to walk again. But she could live a full, meaningful life anyway.
She was taken to the physical therapy gym where her PT, Marcus, was waiting. Marcus was in his forties, built like a former athlete, with the kind of practical, no-nonsense approach that Mary appreciated.
“Hey! Ready to work?” Marcus asked with a grin.
“As ready as I’ll ever be,” Mary replied, unable to keep from smiling.
The PT session was more physically demanding than the doctor’s examination. Marcus had her transfer to a mat table where he put her through a series of exercises designed to maintain her upper-body strength, core stability, and flexibility.
“Let’s check your hamstring flexibility,” Marcus said, positioning Mary on her back and lifting her leg. He slowly raised it, watching for the angle at which her muscle tightness would limit the movement. “Good. You’ve been doing your stretches.”
“Most days,” Mary admitted. “Sometimes I skip when I’m tired.”
“I’d rather you do five minutes of stretching every day than thirty minutes twice a week,” Marcus said, lowering her leg and moving to check the other side. “Consistency is key for preventing contractures.”
They moved through the routine of hip flexor stretches, trunk rotations, and scapular-strengthening exercises. Marcus checked her transfer technique, making small suggestions to improve her efficiency and reduce strain on her shoulders.
“Your upper body strength is excellent,” Marcus noted as Mary performed a series of wheelchair push-ups, lifting her body weight off the seat to relieve pressure. “How often are you doing pressure reliefs throughout the day?”
“Every thirty minutes or so when I’m sitting for long periods,” Mary said. “More frequently if I’m wearing jeans or anything with seams that might cause pressure points.”
“Perfect. And skin checks? Any areas of concern?”
“I check every night before bed. No pressure sores, no redness that doesn’t fade within twenty minutes.”
Marcus nodded approvingly. “You’re doing everything right, Mary. A lot of people with spinal cord injuries develop secondary complications because they don’t stay on top of the daily management. But you’re vigilant, and it shows.”
The praise warmed Mary’s chest. She’d worked hard to learn how to take care of herself, to understand her body’s new limitations and needs. Hearing that her efforts were paying off validated all those nights of careful skin checks, all those mornings of stretching routines, and all the times she’d done pressure reliefs even when she was tired or busy.
After the PT session, Mary transferred back to her wheelchair and made her way to the waiting room. She spotted Bert immediately, and his gaze landed on her. His book was open in his lap, but his attention had been on the door she rolled through.
“All done,” Mary said, rolling up beside him.
Bert’s gaze roamed over her face as though to see deep inside her. “How’d it go?”
“Good. The doc said everything looks stable, no complications. Marcus tried to kill me with exercises, but that’s pretty standard.” Mary started toward the exit, and Bert fell into step beside her. “Sorry that took so long. Almost two hours.”
“Don’t apologize. I got three chapters read.” Bert held the door open for her, then walked beside her toward the SUV. “Can I ask questions, or would you rather not talk about it?”
Mary considered as they reached his vehicle. Bert had already moved to open the passenger door and then lifted her into the seat. “You can ask anything you want.”
Bert folded her wheelchair and loaded it in the back with the kind of careful attention that he always showed. Then he climbed into the driver’s seat and turned to face her, his expression open and genuinely curious.
“Is it always the same routine? Doctor examination and PT?” he asked.
“Every three months,” Mary confirmed. “Dr. Casteel monitors my overall health and any changes in the injury. Marcus keeps my upper body strong and ensures I don’t develop any secondary complications, such as contractures or muscle imbalances. It’s maintenance, basically. Making sure things don’t get worse.”
“And the incomplete injury thing the doctor mentioned—that means there’s still some nerve function?”
“Some,” Mary said. “I have sensation in my upper thighs, and I can feel pressure and temperature. But from mid-thigh down, there’s no sensation and no voluntary movement. An incomplete injury means the spinal cord wasn’t completely severed, so there’s some communication between my brain and the lower part of my body. It’s just very limited.”
Bert nodded, processing. “And the spasticity—is that painful?”