More about Conducting "Enable Me"

I know that my role in the "Enable Me" project is personal trainer / exercise lady.  However, I have been switching hats a lot lately -- mid session and discreetly taking my personal trainer hat off and slipping my conductor hat back on, barely stopping to notice how comfortable it feels, but noticing the change in my tone, the way sets and repetitions of exercises give way to rhythmically intended tasks, the subtle stylistic changes in the way the session is delivered.  The people I work with in this project are in their eighties -- if they notice the hat change they don't react though they certainly respond.  Whether what I am doing would look and sound normal in a CE group but seem a bit odd in the gym is irrelevant to these people for whom the concept of a personal trainer is as foreign as that of a conductor.

Don't get me wrong -- I am passionate about how valuable exercise is for people of all ages and abilities and firmly believe that exercise helps people stay strong and healthy and can actually intervene with what is often presumed to be an inevitable part of the ageing process.  But there are times when what is needed and what is more appropriate in a given moment or over a few weeks of working with a particular person is Conductive Education -- the learning, the structured approach to problem solving, the way of breaking complex movements into manageable segments, practicing them, and stringing them back together as fluent, purposeful movement, the use of speech and rhythm and intention and motivation as facilitation -- in other words the unique tricks specific to the conductive trade.

Mr LH's file says that he has had a frozen shoulder, has had a few falls, and has mild cognitive decline.  In reality Mr LH's movement and cognition is characteristic of something in the Parkinson's plus family of conditions -- I of course wouldn't try to guess or diagnose, that is certainly not my role, but I am pleased that the case manager and physiotherapist accept my experience based hunch that there is something neuro-motoric going on and have written a letter that Mr LH can take to his GP recommending further investigation.  I am even more pleased that Mr LH has spontaneously started rhythmically saying tasks and counting with me (it is often hard for me to get people to count and say tasks in individual sessions, especially if they have not experienced the power of rhythmical intention in a CE group); I am even more pleased that when he counts he can walk and swing his arms and get up from a chair and coordinate complex movements.  I hope -- as I often do about my 'hunches' -- that I am wrong and that there is no neuro-motor disorder creeping in.  Without my training and experience as a conductor I would have no entry point for working with Mr LH -- I wouldn't know where to start.

Mr GL had a major stroke 15 years ago -- at the time he was fit and healthy and his stroke baffled his medical team and shocked Mr GL and his family.  The 'Enable Me' case manager wasn't sure if this was something a personal trainer should be involved in and called to chat with me about how frail Mr GL was and about his increased risk of falls.  I reminded her that I had many years of experience working with people after strokes in my previous life as a conductor.  Today Mr GL and I had our first session -- within minutes it felt like we had been working together for years.  I knew right away which tasks would work and what tricks to start him with, where to put my hands, where to push him, what it must have felt like for him to have his posture and symmetry and weight bearing corrected after 16 years.  I saw his eyes light up when he conquered a task that moments ago had seemed impossible -- a few moments and a little conductive magic make a big difference when those moments are spent practicing and learning to apply nifty little CE tricks.

There have been a lot of people in the 'Enable Me' program that have been deemed too frail for personal training and who have instead received physiotherapy only instead of a combined approach -- there are a lot of people in the 'Enable Me' program that I would have been able to help if I had been given the chance to work with them.  I got the contract with the 'Enable Me' program because of my work as a Conductor -- somebody whom I used to work with at the local cerebral palsy centre referred me and people involved with the program saw me working at the gym with people in wheelchairs.  But I am contracted as a personal trainer, and what I bring to the table as a conductor is not fully understood or recognized, and therefore opportunities to help people as a conductor have been missed.  At this point I do not believe that Conductive Education will even get a mention when the reports about the 'Enable Me' project are written up.  I hope I can correct this but I am just not certain it will happen.   I wish that when the contract was negotiated I had had the guts to stand up for Conductive Education instead of just being glad for the opportunity to take part.

Over and over and over again I hear people relate the advice they have been given by well meaning professionals -- 'you have CP / MS / PD / stroke / old age / whatever, there is nothing that can be done, accept it'.  That is just not how we think in Conductive Education -- because I am a conductor I have a place to start and a unique bag of tricks and conductive magic, but more importantly I have a conductive attitude that makes me believe that there is always something that can be done, something that can be learned,  that it is worth trying, so I do start, and start again, and try something new if one thing doesn't work.  I'd like to think that I am the same when I am wearing my personal training hat -- and I know that if I am it is because that conductive attitude is so much a part of me now, or because no matter what role I'm in, I'm always wearing my conductor hat.

http://195.122.253.112/public/mp3/Beatles/14%20Let%20It%20Be/The%20Beatles%20-%20Let%20It%20Be%20-%2010%20The%20Long%20And%20Winding%20Road.mp3

Saying goodbye to MrsVB

One of my long standing pet peeves about telling people what I do for a living is the sigh, head shake, and smile that come before the standard stereotypical comment about how "wonderful/patient/special/angelic I must be" to do "such hard work" that "they would never be able to do", but "how rewarding it must be". The comment is always well intentioned, and the moment is never right for a rant and a rave about seeing the person instead of the disability, and my awkward response is almost always something equally standard about being lucky enough to find value in my work or to do work that I love.

I wish that more often there were moments when I could gush exuberantly about the amazing people I work with and amazing little things that these people say and do; to explain that I never have to look far for everyday heroes and inspiration and simple pleasures and joy. I wish that the moment was appropriate to talk about the genuine relationships and friendships that I have developed with participants and clients over years, based on mutual trust and respect, based on shared experiences of battles won and lost and overcome and worked through over hours, weeks, years of working closely together. Shhhhh -- I know -- I'm supposed to be all professional and objective, to keep a professional distance -- don't tell anyone, but I often find myself really caring about, really loving the people that I am lucky enough to work with. In fact, even the ones that drive me bonkers have this amazingly special place in my heart.

One of the big challenges for me personally with the Enable Me project is that the clients are in the program for only 9 weeks -- in other words the relationships have a pre-determined end date. My other clients and participants drift in and out or fade away, and often stay in touch by email or facebook when they aren't actually seeing me, but the Enable Me bunch are literally discharged from the program. We have a running joke at my gym that when a training relationship ends it feels a bit like breaking up -- with the Enable Me project it feels like I'm breaking up with people every few weeks.

Mrs VB is in her mid 80s and for 2 months we worked hard to find ways for her to use exercise to manage her back and sciatic nerve pain while learning strategies to move and function with as little pain or aggravation of pain as possible. It was very hard work for both of us -- learning to manage inoperable and untreatable chronic severe pain can never be anything else. There was tears, exhaustion, frustration -- much more often than moments of joy or relief. While we worked she told me stories of her late husband and of her life, her passions, her hobbies which included volunteering at a museum and genealogy. She lent me her Leonard Cohen box set when she noticed me noticing it.

On the day of her last session (her 'discharge'), Mrs VB invited me to stay for coffee and a chat. Though I didn't really have time, I stayed back, and looked at wedding and antique photos. I stayed because I recognized that the gesture wasn't about saying thank you, but about acknowledging the end of the relationship, and more importantly acknowledging that something 'magic' had happened in the exchange that had meant something to us both, that wasn't tied up in whether or not the goal of pain management had been achieved, but in the gruelling experience of working on it together. I knew that if I didn't stay, I wouldn't have honoured the fact that we hadn't just worked together, but that she had let me in, had exposed so much of her fear and her pain to me. I wasn't done; I really wanted to be able to keep working with her -- I felt that if only I had a bit more time I might be able to find something that worked, or worked a bit better. I left feeling sad about the end of the relationship, and sadder that I had not been able to help her, and that I was leaving her with the same pain that I found her with.

I have just had an email from the case manager saying that in the post intervention interview Mrs VB reported feeling more positive and in control of her life, and that even though the pain was still there she had more things she could do that provided her with some relief, and that trying to remember and do the exercises distracted her from the pain for a few minutes. And she said that she didn't feel as alone in the whole thing, and that she was going out with her daughter and volunteering more often even when she was in a lot of pain, because she knew that having a laugh was better than sitting at home in pain.

And I can't even remember what exercises I left her with. But I can remember the green coffee beans that were too hard for her to grind so we drank instant, the wedding dress that she made herself, the pictures of her grandmother as a baby, and the Leonard Cohen dvds.

"I did my best, it wasn't much
I couldn't feel, so I tried to touch
I've told the truth, I didn't come to fool you
And even though it all went wrong
I'll stand before the Lord of Song
With nothing on my tongue but Hallelujah"
                                         Leonard Cohen

Conducting "Enable Me"

The Phys. Ed. Studio is the name of the personal training studio that AR, my partner in crime (as well as in business and in life) and I plan to open when the time is right.  It will house a fully accessible studio suitable for training people with disabilities and their able-bodied counterparts and a purpose built Conductive Education classroom.  Until we are actually able to open the doors to the studio it will exist in our dreams and goals, and here in cyberspace in the form of a blog about our passion, life lessons, and work.  Until then we both work as personal trainers out in the community at large and in local gyms.

Over the past several months my personal trainer alter ego has had the chance to work as the personal trainer / conductor on an amazing pilot project run by Community Care Northern Beaches called Enable Me.  This is a government funded research project looking at whether pro-active, preventative allied health and exercise can help elderly people remain living independently in their homes for longer, improve their function and confidence on activities of daily living, and can impact their overall health and wellbeing.  Self motivated senior citizens who meet the specified criteria receive 9 weeks of personally tailored, fully funded therapy and exercise in their home.  Interviews carried out by a case manager before each person starts and after they have finished the program provide detailed information from the individual client's perspective on their progress towards self identified goals and most importantly on their sense of well being and quality of life in order to ascertain whether the intervention has been effective.

Normally I am very reluctant to participate in research projects, and when I have done so it was under duress.    However, this project appeals to me for a number of reasons.  For one, it is not seeking to determine the efficacy of Conductive Education.  Also, it comes from service providers recognizing a population trend and trying to pro-actively address a gap in service provision.  And most importantly to me,  I was invited into the project as a personal trainer because of the combined skill sets I have as a conductor and  personal trainer.  So far, it has been amazing.  I have been given a licence to work conductively with a 'non-motor disabled population'.  With every participant in every interaction I have to pick, choose, and combine both professional disciplines -- adapting exercises to make them suitable to this population, teaching functional mobility and specific task solutions, finding the why and the how so that the what is worth doing.

And I get to hang out with these awesome people in their 70's, 80's, and even 90's -- I don't know, maybe it is because I'm so far from home, or because my grandparents aren't around anymore, or because I'm an old soul but I love the eccentricities, the words of wisdom and words of a completely different nature, the stories of days gone by.  I hope when I'm in my 80's I can bear the idea of some personal trainer with dumbbells and  exercise tubing showing up at my door a few times a week for exercise.  My time is appreciated and I am rewarded in so many ways.  I am grateful that I am one of the lucky few people in the world who gets to make a living doing something that I love and that every day something happens at work that thrills or inspires me.

My words of wisdom today come from Mrs.BP.  Last week, while walking through her retirement village, I was treated to a running commentary on everybody who passed by.  We were taking the scenic back route so as not to pass by the reception lounge where a farewell was being held for a retiring manager.  As Mrs.BP explained, she was lots of things, but definitely not a hypocrite, and she didn't like this manager and had expressed this to other people, so absolutely would not be going to the farewell for nibblies and farewell drinks.  I asked why she didn't like this manager -- and Mrs.BP said that it was because at the age of 86 she only had time for people who made her happy, not people who made her upset.  She went on to say that some people were so draining with their complaints and their 'poor-little old-me-itis', while others were so uplifting and always had a pleasantry to exchange, and that in fact she could tell by the look on someone's face and the way they were standing whether it was was in fact a good idea at all to stop and chat or to just pass by and nod.


"Man is fond of counting his troubles, but he does not count his joys.  If he counted them up as he ought to, he would see that every lot has enough happiness provided for it."
                                                                                                                   ~Fyodor Dostoevsky