It was 8:00 a.m on a cloudless day, as I stood at a gas station ordering a Cuban coffee. The young woman behind the counter, handed me my styrofoam cup with a smile; her wide set, dark eyes so bright for a Monday morning, and her jet-black hair tied back in a net. I knew her seemingly unchanged face. It had been 18 months since I’d ordered this special treat for Patrick, but in this moment, it was as if no time had passed at all.
Driving down the street, we turned into the gate marked “Miami Jewish Health Systems,” and I felt my heart begin to flutter. The excitement of what was ahead was flooding my nervous system. We’d forgotten our handicap-parking placard, so we had to park far away. But as I pulled the walker from the trunk, I couldn’t help but remember all the times that I’d lifted his wheelchair in and out of our rental car on our last visit; sweating in the blistering sun. This time the placard was no longer essential. This time, he could walk.
I watched Patrick walk onto the side walk, into the building, down the hallway and towards the elevator. The cafeteria smelled the same. The air felt just as crisp and cold as before. The front desk was in the same place. The grand piano was still positioned in the lobby. The sensations were so familiar, that time seemed suddenly suspended. I flashed back to pushing the wheelchair; the burning sensations in my legs, the grind, and the exhaustion.
“We’ve come so far,” I thought. “Everything is the same, except for us.”
It’s been 18 months since Patrick and I came to Miami, Florida for our first experience with Brucker Biofeedback Therapy. I’d seen a you-tube video, featuring a woman who’d suffered a TBI, which rendered her paralyzed on one side. She was wheelchair-bound. After receiving the therapy, she claimed to have gained sizable results in re-training her brain to control her body, and was able to leave the wheelchair. I was immediately intrigued. A few calls were made to see if Patrick would be a good candidate. A month later, we arrived and began our journey with biofeedback therapy.
“Biofeedback” is a broad term which refers to a treatment technique, in which people are trained to improve their health by using signals from their own bodies. In a very basic sense, if you’ve ever stepped on a scale, or taken your own temperature, you’d dabbled in the field of biofeedback. We all use devices to measure an internal status of the body, which then “feed back” information that we can implement to foster better health (I.E, lay down if we have a fever, lose weight if we find we’ve gained too many pounds).
On a clinical scale, doctors use Biofeedback as a form of alternative medicine to help their patients. Psychologists use it to help tense and anxious clients learn to relax. Specialists in many different fields use biofeedback to help patients cope with pain. Lastly, physical and occupational therapists use biofeedback to help stroke, spinal cord and TBI patients to regain movement in paralyzed muscles. It is the latter form of treatment from which the “Brucker Method” derives its purposeful use.
Brucker Biofeedback was created by Dr. Bernard Brucker to help individuals with paralysis due to disease or injury, that affects the brain or spinal cord. Technicians help patients retrain their brains to use muscles and inactive nerves, improving muscle function, as well to increase awareness of their proprioception (body in space). Using electrodes, which are placed on isolated muscle groups, the patient is asked to “fire” the muscle, and the brain/body connection is measured and displayed on a graph for the patient to see. The graph provides feedback for how well they are controlling and/or isolating the muscle group, and records the strength of the connection, which allows them to challenge themselves and ultimately make progress. The beauty of this type of therapy, is that even if the muscle doesn’t move at all, a connection will still show up on the graph if present. This is particularly useful in patients like Patrick, who because of hemiparesis, can appear to have no brain/body connection to the naked eye of a therapist or loved one.
Patrick had received almost no therapy in the first 9 months of his recovery. Expectations from doctors were very low. His motor control was greatly impaired by his TBI, and when we arrived at Brucker, he was unable to walk, and had very minimal use of his left side. However, as we walked into the halls of Brucker on our first day, we were greeted by an enthusiasm that was, as I like to call it, “an injection of hope to the heart.” There was a tangible energy to the place; faces bright and smiling, encouraging words abounding, and an everything-is-possible attitude from the therapists and doctors.
There is a tendency I think with our TBI loved ones, to want to treat them with kid gloves. Brucker takes a “gloves off” approach and really pushes their patients. Patrick’s first session was sort of like biofeedback boot-camp for him! It was so intense! I worried at first that it was too much for him! However, it soon became obvious that the intensity of the therapy, was a product of the confidence that the therapists had in his abilities. That confidence quickly became Patrick’s confidence as well. In other words, they didn’t treat him like he was made of glass. And for all of us, it shifted the dynamic from thinking of Patrick as broken or fragile, to simply a human being who was very much in need of a brain work-out.
Right away, our therapist Maria shook up our world by asking us to change the routines by which we’d become so accustomed. We’d found through the therapy, that though his hand wasn’t moving much, he had a VERY strong brain/arm/hand connection. However, the brain needed to reform the neural pathways to strengthen the connection and increase the movement. This was only possible through repetition. He had barely any gross motor function in his hand, and could not lift his arm above his chest, but Maria still encouraged him to use his left side for EVERYTHING in our hotel. She explained to me that only by using it, would it return. Nobody had ever told me that before, but with her assuring me, I promised her we would be diligent. Likewise, when it came to standing and transferring, she gave us a new routine which would encourage him to do much more of the work. We worked hard at it, day in and day out in between the therapies. (Poor Patrick had never been more frustrated by what to him, seemed like an impossible task: using a nonfunctional hand for functional tasks). Everything took longer because everything was even more challenging than before.
There was fighting.
Screaming and yelling.
It was certainly no vacation.
But the results were fantastic and for us, quick to come. Within just two weeks, Patrick’s hand and arm were coming back to life. On a magical night in our hotel, I watched him pick up a cookie like a little kid for the first time, and bring it to his mouth with his left hand. A week later, he flushed the toilet with his left hand. Little bit by bit, the changes came. And with every session, the biofeedback taught him more and more how to control his body.
Before coming to Brucker, I had naively expected the therapists to get Patrick up and walking the first day! What I didn’t realize was that walking properly was an impossible task at that point, because his glutes, abs, quads, hamstrings, and back were all too weak to support him. So they began isolating those muscles and building a foundation. Some days they would hook up concentric muscle groups (like bi-ceps and triceps) and using color coded lines on a graph, teach him how to flex his bicep while relaxing his tricep, and vice versa. Without biofeedback, it would be hard for a therapist to know exactly what muscle is firing in a therapy session, or whether other muscles are overcompensating or not. Biofeedback takes out all the guess work, making it amazingly efficient in re-training the body. It was fascinating to watch, and I learned so much about how the body works, which only made me a better seudo-therapist to Patrick at home.
Patrick learned how to push up out of the wheelchair on his own. He learned how to extend his wrist, individual fingers, open and close his hand, and more. He also learned how to shift his weight from left to right when standing, and how to trust his impaired leg. At the time of our first visit, he still had severe Clonus and spasticity in his leg. He could not put his ankle all the way down, but they worked at it anyway. He made such progress, that we decided to stay an entire month! And towards the end, they even had him gait-training.
Though the physical changes were amazing, they weren’t the only ones I saw occur in Patrick. The therapy increased his awareness, his affect was less clouded, and it improved his focus and attention as well. He also began to be much more verbal during our stay; speaking quicker and much more often!
When we returned home to NJ in September of 2014, Patrick was able to press himself up out of the wheelchair on his own. And while his left arm was still greatly impaired, it had improved 200% from where we were when we went for therapy. He still needed a ton of reminding to use it, but the connection had been made. Shortly after, we finally got him into outpatient therapy 2-3 times a week. At a year post, his new therapists also had very low expectations of further recovery. But after seeing what had transpired at Brucker, I was 100% convinced that we were only beginning.
For the next year and a half, we pushed as hard as we could with whatever tools were available to us. And as many of you know, well, the rest is history. Brucker Biofeedback was a catalyst for us; a jumping off point. And we wouldn’t be where we are today without it.
It was 9 a.m as we exited the elevators, turned left and walked towards the lobby of Brucker Biofeedback for our first day back. Half way down the hallway, Maria appeared, waving her arms with excitement. Patrick picked up his speed with his walker, as the two met in the middle.
“Patrick! LOOK at you! You’re practically running!”
He smiled instantly. “I’m so glad to be here.”
Maria embraced him in her white lab coat, and then with her face full of pride and shock, she turned to me.
“Hey, who is this guy? Look at him!! No wheelchair! No helmet!”
Patrick’s smile widened.
“I can push you around now, eh?” she said, shoving him playfully.
Patrick smiled even harder and laughed.
That little dialogue between them, explains the magic of Brucker Biofeedback in the best way possible.
I smiled right along with them.