Jessica Cox: The World at My Feet

A Blog by Jessica Cox


Physical Therapy Is Vital to Us All

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Today something happened to me that has not happened in a long time—I lost my balance and fell flat on my face. My husband heard my scream and was bewildered to see me on the floor. Fortunately, I did a "face plant" onto the living room carpet, and only suffered carpet burns. I cannot remember the last time this happened. I use my right foot to accomplish so many tasks, I’m normally perfectly poised balancing on one foot.

In part, I owe my balancing skills to the physical therapy I did as a little girl. Because my mom was a nurse, she realized that as a toddler I would need some training to help me transition from scooting around on floor, which I did instead of crawling, to walking upright. Learning to walk was difficult for me because I didn’t have arms to grab on to furniture and walls the way toddlers do. I also couldn’t catch myself if I fell.  

Physical therapy helped me develop the specific muscles I needed to balance and eventually to walk. Thirty years later, I’m still reaping the benefits of that physical therapy, and I know I was lucky to have it during those critical years of development.

As you may already know, rehabilitation is at the core of Handicap International’s work in 57 countries. Whether helping victims of war with disabling injuries to learn how to walk again, teaching children with cerebral palsy how to feed themselves, or ensuring a person with diabetes stays active to avoid the disease’s disabling consequences, Handicap International gives the people it supports the chance to live fuller, more independent lives. While other organizations save lives through emergency medical care, you might say that Handicap International gives people the bodily means and hope to stay alive.

It’s unfortunate that in both the world of international development and the U.S. healthcare system, rehabilitation is often viewed as something of a luxury, rather than a necessity. Funding for rehabilitation falls well short of the need. That’s scary, considering that 15 percent of the world’s population lives with some kind of disability. Plus, as more and more people are living past their 70s, chances are that many of us will eventually develop physical impairments as a result of conditions like stroke or osteoporosis. We will need rehabilitation to recover.

I know how vital physical therapy can be for people as they age. My mother has been living with brain cancer since 2009, and had grown weaker from radiation and chemotherapy when in 2010 she suffered a huge setback: a stroke. The stroke mainly affected mom’s walking ability. (Strokes can cause other impairments such as speech loss, changes in vision, or memory difficulties).

Physical therapy was key for her recovery. Since we started taking her to rehab she’s slowly regained a lot of her mobility and strength. Her biggest goal is to walk without an assistive walking frame.

Unfortunately, last year, my mother’s insurance stopped covering her physical therapy because she had reached her maximum allowance. It’s maddening that her insurance provider can limit something so critical to her quality of life. My mother has Medicare, which caps annual payments for physical therapy. Members of Congress, who determine the budget for Medicare, acknowledge that the physical therapy cap is harmful but the Senate failed to repeal the cap when it came to vote in April 2015.

The road to mobility and independence through rehabilitation literally takes one small, slow step at a time, but progress through rehab is well documented. I have seen the benefits with my own eyes. Before her insurance coverage ended, my mom was close to giving up her walker and progressing to a cane. We hoped she would soon not need rehab at all. Today, with her rehab cut short, she feels like all her progress had been erased. We worry that her mobility will slowly deteriorate and she may lose her independence completely, having to rely on other people for her basic needs, such as going to the bathroom. She will likely develop further, potentially costly health problems as a result of being unable to move.

We did some research and were able to find a personal trainer with a background in physical therapy at a local gym who charges us a fraction of the physical therapy center rates. We once again reached out to her insurance providers to ask if her personal training sessions could be covered. As expected, they said no: they’ll cover some therapy, but they will not cover the full treatment that my mom, and so many other people like her need to thrive in the long term.

My mom continues to fight for her independence every day. I will continue to help her. I hope that in some small way, by my sharing this story, more people will call on policy makers to ensure that rehabilitation becomes an integral part of health care systems. If you're a U.S. citizen, you can send a message to your members of Congress about the Medicare physical therapy cap through the American Physical Therapy Association website.  Handicap International is taking this one step further, working with 18 other rehabilitation organizations to call for the international community to include rehabilitation in all global health programs.

In the case of my fall, well, I’m not sure I need a tune up just yet. But I may need to call on the power of physical therapy in the future, and I think everyone should have the ability to do the same.

Watch this ABC News story to see how Handicap International is using physical therapy to help seriously injured Nepal earthquake survivors learn how to walk again.

Jessica Cox

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