Surviving Rehab with Tips - Physical (not Drug) Rehab

By Lloyd I Sederer MD

While one (Physical) Rehabilitation Center will be different from another, trust what you see. 

Trust when you feel staff are treating you and other patients with dignity and respect, are explaining their program to you in a way you understand, invite and answer your questions, and place your care before the financial interests of the facility you are in.

Trust yourself, as well, when you come to believe you need to get out of the facility you are in. Not to end your rehabilitation. But to transfer to another facility where you (and your loved ones) will have confidence in its ability to help you rebuild your life. 

Alarm Bells for you to know: I am a physician, and know that medical institutions (including Rehabs) must meet specific standards of safety and clinical care to earn the license for the facility they seek to operate. 

But you don’t need a medical license to conclude that leaving a patient on the floor after a fall, not wearing sterile gloves even for a minor procedure, and not answering a call button for ½ hour are failures to provide good care, and thus likely licensing violations. 

In one facility I was admitted to, I saw all 3 of these problems within hours of my arrival. With the help of my family, I was at another Rehab about 4 hours later. 

Trust what you see and their implications for your recovery.

Absent these “alarm bells”, what happens next? 

With some differences, you can expect the following:

1) Soon after admission you should be informed (often the next business day) about the “evaluation” sessions planned for you: physical, occupational, speech, swallowing, and other relevant specialty therapists will be assigned to you. They are constructing a functional “map” of your body to determine where and how each therapy can help you recover functions you have lost, in whole or in part.

Tip #1: Don’t be shy or silent. Ask about what you did not understand or want to. These therapists need you to be an active participant in your rehab. Asking is one way by which you can do that.

2) Within days, you will be explained in some detail what you will need to do to recover your lost functions. Your treatments have begun. At this point in your care, you may be distressed to learn what you did not known. Why would you not? What counts is how you will be treated to improve these problems. 

Tip #2: If you hear new or confusing information, take a breath. Ask for more professional information to clarify what you have been told. Seek support from a trusted family member or friend. When reassured, keep going.

3) You will have further informative conversations with your therapists. In some instances, you will receive a written care plan.

Tip#3: This Information is usually the best way to feel reassured. Speak up when unclear or concerned. Many people are helped by having a family member or friend listen as well. There is no prohibition against having this support.

4) You still may be feeling severe pain and functional limits. That is very common. You also have had a lot of information that needs to be processed.

Tip #4: Talk with your physical therapists, other patients as well. Many nurses, bless them, are very good listeners, informed, and supportive. After over 50 years in the hospital business, I love nurses. 

There are good medications to help you get through this phase, like opioids, anti-depressants, and psychostimulants. Usually not a good idea to try to do without them. 

5) Then a day arrives where you don’t hurt as much. You begin to see hope in your future. 

Tip#5: This is a blessing. But often not one accompanied by immediate and significant physical relief or functional improvement. That is because recovery starts slowly and is not linear. You may be “turning a corner” but still apt about to encounter another challenge – and one you can overcome. 

6) Your family and friends may remark that you’re doing “...a lot better“. But your pain and physical limitations seem to be telling you otherwise. 

Tip#6: Those that care about you are right. You may be the last to see your gains. Try to believe. Try, it helps, at least a little.

7) Your recovery trek is not over. 

Tip#7: You will need your stamina, support, and keeping hope alive to get to “home plate” (aka as discharge from Rehab). The kindness and patience of those who love you will help, so let them give you what you need. 

8) Then to your surprise, the mornings become easier to bear; these are a litmus test, for they often have been the hardest.

Tip#8: Again, recovery is not linear, not every morning will be better. But consider your trajectory, which is linear when you draw a line through it.

9) Momentum builds. 

Tip#9: You are not fooling yourself. You are getting better. Your appetite improves, pain diminishes, you don’t need the same dose of opioid, you find yourself smiling, even having a laugh from time to time. If you pray to a Deity, keep going, it’s working.

10) This is big: you have begun to see the sun, without looking out the window. 

Tip#10: Believe it. Take pride. You may not be “well”, but you now are part of the “living”, no doubt about it

11. Then the calendar shows only seven days left to discharge. You’re working hard to get all the discharge assessment boxes checked. They are meant to determine whether you are ready for discharge, ready to walk out the front door, rather than escape from the back door.

Tip#11: Don’t forget to pack all the clothes and other things you accumulated at the Rehab. For when you exit the front door.

12. Make gratitude your daily prayer and behavior. 

Tip#12: This speaks for itself, just be mindful to express it. 

13. Beware of thinking going home will be a cakewalk. You have not lived in your home, slept in your bed, showered, ate home cooking or take-out, etc. for weeks, maybe months. The first week home is going to be hard, just as was the first at Rehab. 

Tip#13: Nothing prepares you for those first weeks at home. No different from your family, who also are feeling the transition. You will need to relearn how to care for yourself, to the extent possible. Be kind and patient with yourself, and grateful to those who are continuing to help you

14) Double check your room with help from family and staff to recover and pack all your belongings. 

Tip#14: Not a bad time to give clothes to Good Will. And an essential time to give a hearty “thank you” to the people at the Rehab who have helped your recovery happen. Flowers and candies are the icing on your cake of good bye’s.

15) You have reached your Exodus from the 8 x 10 medical container called your room, which you have lived in for way too long. You enter your home front door, often seeing a paper sign sincerely saying, “Welcome Home”.

Tip#15: Let your gratitude flow for the kindness, patience, and love to those who were so helpful in your recovery. If you need a reminder of the meaning of “Let there be light.”, you now have it. 

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NOTE: My depiction of Physical Rehabilitation, or any person’s experience, is not meant, cannot be universal.

If my comments or tips are not useful to you, you must have a ‘circular file’ or, perhaps, someone for whom they might be.

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Lloyd I Sederer, MD is a psychiatrist, public health doctor, and non-fiction writer. He has been a patient in several physical rehab centers for musculoskeletal problems, and the beneficiary of that care.

www.askdrlloyd.com