My OT and I: how occupational therapists achieve the impossibleNovember 10, 2015
Just a few weeks after farmer Robin Foord lost his leg in an accident with a combine harvester, he was sitting in a wheelchair in the hospital garden with his occupational therapist staring at a mountain in the distance. The Sugar Loaf, a pointy peak near Abergavenny in the Brecon Beacons national park in Wales, had been a favourite hike for Foord and his wife before the accident.
He turned to his OT, Eve Parkinson, and asked whether he’d ever make it up there again. “Eve said I would within two years. I replied, ‘You wouldn’t lie to me, would you, Eve?’ and she said, ‘No I wouldn’t, you’ll be up there again I’m sure.’”
Eighteen months after the accident, Parkinson joined Foord, his family and friends on the hike. Not only was Foord hiking and raising money for his local artificial limb and appliance service, he was also back working on his farm, using an adapted quad bike to get around.
Parkinson says: “Walking up the Sugar Loaf with him was amazing. At the top he made a little speech and said thank you to me, because without the vision and the goal he wouldn’t have been able to do it. He’d done it. It’s really important to have a goal, not just in the short term but in the long term.”
But Foord’s story could have taken a different route if it hadn’t been for tough love from Parkinson at Nevill Hall hospital, where he was treated. With Foord having lost his entire leg, including his hip, even getting him out of bed and sitting in his wheelchair was excruciating.
Parkinson says: “He was lucky that he survived. He had been out in the fields on his own and was trapped for many hours. He could have bled out.”
When Parkinson first visited Foord he was still coming to terms with his condition. He says: “She said, ‘Which way are you going, Robin? Backwards or forwards? Because if it’s backwards I’m not particularly interested in helping you.’ Just like that. It really shook me up because I was feeling a bit sorry for myself at the time.”
Although Parkinson doesn’t recall being quite that harsh, the conversation had an effect. Foord says: “It was the motivation I needed to get me going. She played a tremendous part in my recovery. I didn’t know what to expect about what my life would be like and everyone was telling me different things. Some of the hospital staff were a little negative and were telling me what I would no longer be able to do. Eve was different.”
Getting outside was crucial for Foord’s recovery. Parkinson says: “As soon as he felt able to sit in the wheelchair for 20 minutes, we went outside. For the next few weeks, we did all the therapy outside whatever the weather. It was bloody freezing at times.”
She learnt a lot from Foord’s case, and has thought about him when treating others. She says: “Everyone is motivated by something. You just have to find out what means so much to them that they will get there. It’s not just about the therapeutic goals, and if you can find out what matters, you can line the therapy up with that.”
It’s a similar story for Brian Toomey, a jockey who was given a 3% chance of survival after the horse he was racing, Solway Dandy, took a fall in a handicap hurdle at Perth in July 2013. As paramedics rushed to help him, he died for seven seconds before being revived. Doctors in Dundee carried out emergency brain surgery and he was in a coma but nobody expected him to survive, let alone get back on a horse.
However, after 157 days Toomy was able to leave hospital and received treatment from Susannah Giles, then a new OT for Neural Pathways, which provides rehabilitation for people with complex neurological needs.
To go from a coma back to racing was a slog, especially as Toomy was battling memory loss as well as physical problems. He credits Giles and others who helped him along the way with his recovery. He says: “I hadn’t a clue what occupational therapists did before the accident. I was going through a hard time. I didn’t really realise how much it was helping me.”
Keeping his goal in mind was crucial. “Being a jockey is my passion, it was my goal to get back. That really helped me, because it was all I wanted to do. I knew I had to be near enough 100% to enable me to even apply and try and get back, so that’s what I did.”
Giles laughs when she hears Brian says he couldn’t have done it without her. “That’s absolutely amazing, but I think the surgeons played a big part too,” she says. “But yes, Brian had quite a low mood at the time and Rachel and I from Neural Pathways did a lot of work on structure and routine. We wanted to engage him in activities that prevented him from losing that drive to get back into work.”
It wasn’t long before Toomey got back on a horse, and he made his racing comeback in July. “It had never been done before,” he says. “I’ve been told it’s apparently the biggest professional sporting comeback in the world because I actually died for seven seconds.”
Giles is proud when she talks about Toomy’s return to his passion. “That’s what’s so amazing about this story. We didn’t know if it would ever happen but my main aim when working with him was to prevent him from losing his motivation to achieve his goals. And he didn’t.”