Some things are just hard to explain. Even to the people who know you the best. When a physical trauma happens, it affects you in so many ways and usually you are never the same. The more severe the trauma and the physical loss, the more emotional changes usually occur. The outsider looking in can't understand it. They think it is just a back surgery, a mastectomy, a knee that won't bend anymore, or a mini stroke, but what they forget is it belongs to you and now you have to figure out how to live with a different set of circumstances.

Hold on families, spouses, friends and loved ones, this is often where things get tricky. You may think that Aunt Susie was lucky and all she had to have was a breast lumpectomy. We think she should be grateful that's all she needed, but to her there is a loss and now actual grieving must take place in order to heal.

Grief is a funny thing; it will sneak up on you when you are often involved in other things. Other times you will think you are done with it and it will run you over like a Mack truck. Some times it overtakes you in the night when your defenses are down at three am and you suddenly feel like you are experiencing the trauma all over again. Grief takes time. Grief takes skills and most of us don't have them naturally. Grief is something that we all try to avoid. It's painful and it never leaves you the same. It requires you to "do something" and often we feel we are just too tired to do it.

There are natural stages of grief and what we see in physical therapy is that no one ever really does them the same. Whether it is the person to whom the loss occurred, their spouse or their children, everyone must deal with them as they come tumbling down around them. So often this is why the divorce rate skyrockets and families begin arguing and fighting when physical traumas and health issues occur.

The pain of grief can often be just too much and people lose their way. The person who has brushed up against death's door is just no longer the same, and the spouse is just not sure who they are anymore. There was a reason marriage vowels said "in sickness and in health," they knew that the sickness part could destroy families, draining them emotionally and financially.

For many years the Kubler-Ross theory was the standard for grieving. Her theory attempted to compile a list of what we would need to do when loss occurred. Her theory included five steps: denial, anger, bargaining, depression and acceptance. The problem was it really didn't work that way and often research indicated that many people had already accepted the loss they just weren't sure how to deal with the loss and the new set of challenges they were suddenly faced with.

Now the American Psychological Association has recognized that grieving is a very individual and personal activity and that no one can really say how it should be done. Grieving is still a process and sometimes we need a counselor or a friend to talk to as we travel this road. You need to know you are not alone in your loss and you should know others have had the same feelings of loss whether because the death of someone you love, the loss of a physical function or the loss of your dominate arm. There is a new set of ideas for mourning: Accept your feelings, talk about your feelings of loss (sometimes there is sadness, frustration, confusion about the future and exhaustion), take care of yourself by eating good, getting rest and exercising daily, reach out to others that have experienced the same type of loss, and celebrate the new. It doesn't mean you forget the lost loved one or the lost physical ability, you simply are committing to a new life within a new set of circumstances. Everyday you will have to choose it. Never give up on your health, the people you love and your finances. You can do it, I know you can.

Sheree DiBiase, PT, and her staff can be reached at Lake City Physical Therapy CDA (208) 667-1988 and in the Spokane valley at (509) 891-2623.