I recently read an article by Katie Gibbons in the Times on the role that optimism plays in women’s health, and I just love this particular quote she cites from Eric Kim, research fellow at Harvard department of social and behavioural sciences.

“ It takes a toolbox of different things to be healthy and being optimistic is one of these tools”

Life goes on...here I am  taking a selfie in Tarifa, Spain (with  my  good hand)! October 2016

Life goes on…here I am taking a selfie in Tarifa, Spain (with my good hand)! October 2016

Its almost 11 months since an artery in my brain burst, flooding the surrounding tissue with blood, destroying neurons … wreaking havoc.

I remain invested in how I experience the future, and I understand the importance of being proactive in finding support, reading and rooting out inspiration to fuel my recovery, but above of all remaining optimistic about the possibilities of neuroplasticity.

We don’t control what happens to us; we control how we respond.

Just writing this journal, describing my health struggles since my stroke, has helped me to understand possible outcomes and to remain stoic in light of the difficult situation I have found myself facing. Having an end in sight is no guarantee that I will make it, but not having an end in sight is a guarantee that I will not.

I have come to understand now, in a way that I never did prior to having a stroke, that if I am to see my grandchildren become young men, live to a ripe old age and enjoy an active retirement with my wonderful husband, I need to pay heed more than ever to what sustains and grows my brain health. I am learning how to live again but in a different way.

Anat Baniel teaches us in her program The Anat Baniel Method to celebrate every small step of progress, because small steps lead to big achievements. It’s very easy to slip into not making an effort, and there are lots of times when I don’t have the drive! Recovery from stroke takes a lot of hard work.

Since my last post (yes, yes, I am so sorry that its taken me so long to write this one), my gains in recovery seem much smaller, and then I realize that I am opening jars, turning bottle caps, chopping onions using 2 hands – in fact my left hand is becoming much more functional. Eating with a knife and fork is still an adventure though! Every so often, I catch myself, and think, hey look at that….. I just did it!

By engaging mental training more and more, improvements with my hand and arm, although minute and very slow, are occurring. I don’t find this (imagining) easy, but in doing so I am developing a greater awareness of my body and the quality of movement.

Thinking and doing are the same in the brain. In other words the same brain regions that are activated when completing a motor skill are activated when mentally rehearsing the same task.

When you mentally rehearse a movement, all but one of the brain regions that control your movements become active in the absence of movement.

After much research on the potential after effects of stroke in the thalamus, I feared that I was developing central pain. My physiatrist has now confirmed this diagnosis.

Post-stroke thalamic pain or central pain. is described well in the book The Body Has a Mind of its Own ~ Sandra Blakeslee and Matthew Blakeslee

“The pain can be moderate to excruciating, and its severity can wax and wane, but the most constant factor is an icy burning sensation like frostbite.

Half of those who suffer central pain after a stroke have damage to their thalamus, If they have damage to the right thalamus, they experience a loss of temperature sensation on the left side of their body along with intense burning pain, and vice versa. The cold sensory pathway is wiped out, and the right frontal insula is on fire.’

My haemorrhage was in the right side of the thalamus.

Pain has a very real purpose it protects you it alerts you to danger. In the case of central pain, no harmful stimulus causes the pain. Instead, injury to the sensory pathways within the brain stimulates central nerve fibres, thereby creating a response to what the brain judges to be a threatening situation. The nerves are just doing the wrong things, and responding to signals from the brain telling them that increased sensitivity is required.

Pain makes you move differently, think differently and behave differently. My pain is very real, but it is a product of my brain which is playing a very significant part. My hope is that with time and brain plasticity I will be in a better place in the future.

I am not an expert , I am just sharing  my recovery from stroke, and some of my coping strategies, in the hope that they might help others who are also struggling.

Uncertainty is where things happen. It is where the opportunities — for success, for happiness, for really living — are waiting’. ~ Martha Nussbaum

Still learning , still hanging in there

Its been a little while since my last post, I thought this would be a good time to remind you of my disclaimer. I have no qualifications – other than I had a stroke on December 26th, 2015. Everything I write is related to something I am trying in my rehabilitation, or some research or interesting thing I’ve read or heard about. I am not a professional, so if you don’t agree with something I write that’s ok folks, I encourage you to do your own research. If you have something interesting you’d like to share please do so in the comments below.

Ok so now that’s out of the way….
This neat animated gif shows the location of the thalmus where I had my brain bleed

Thalamus

By Images are generated by Life Science Databases(LSDB). [CC BY-SA 2.1 jp (http://creativecommons.org/licenses/by-sa/2.1/jp/deed.en)], via Wikimedia Commons

Our brains are designed to see patterns and make connections in order to navigate through the world.Following my stroke my body awareness was completely disrupted, my brain could not simply follow the map and make the right connections.

During the early stages of rehabilitation I followed the hospital protocols and worked to regain the movement that I had lost.

I simply didn’t have a plan, much less much of an understanding of the enormity of what lay ahead for me. Now I’ve reached 7 months post- stroke I can safely say that this path is not quite as easy and straightforward as I conceived it would be. Along the way I have also incorporated treatments that are maybe a bit less predictable.

The gains I initially experienced daily have slowed down, nevertheless its still important to celebrate those gains.

Since my last post I am working hard on correcting a lifetime of slouching, it was bound to catch up with me eventually!

I am learning to love just hanging out on my yoga bolster,( its a great chest opener ), and when doing so, concentrating on my breathing. This activity is really helping my shoulder, and my range of movement.

As I sit typing this, I am drawing my shoulder blades down, (not forward) tucking my chin, Hah!. It sure is difficult but slowly it is beginning to become a little more instinctive.

Today I learned about Lumo Lift Lumo Lift is a small lightweight wearable digital posture tracker that helps you train and maintain great posture . I have just ordered one, so I will be sure to let y’all know how useful this little gadget is once I receive it.

I have a growing frustration with my sense of touch, or lack thereof, (in my left hand). When reaching into a pocket I am unable to distinguish or even sense objects.

Our brains seamlessly integrate the tactile, sensory cues from our fingers with hand movements to perceive the different objects. The neural coding that underlies touch is very challenging. I had hoped that in gaining more movement in my hand and arm, that touch would follow, but it’s very very slow.

I have started using Electrical stimulation ( e stim). E-stim can be used for everything from providing a stretch to spastic muscles to regaining sensation on the “bad” side. It is an easy “do-it yourself tool” for recovery.

Drum roll…..

Today I picked up a dime with my left hand ( first time)!

Drugs can help or hurt recovery, but no drug can replace the hard work needed to rewire the brain, rather it can provide a temporary respite necessary to do the hard work necessary to rewire the brain. The nerve sensation in my hand , arm and face have become so much more intense, and much as I didn’t want to, I have started taking a pain relief drug. Its a trade off, so far the overall effect has been pretty good at reducing the nerve pain, but today I am experiencing a side effect of dizziness and finding it hard to focus.

There are no rules that guide you through the process of deciding when a set course of recovery action works. I have found that adding new things keeps it interesting, but also when something doesn’t work or provide a benefit then I have no problem dropping it… so that was my logic in trying the drugs!

Loosing knots, and flossing my nerves

This week I’ve been exploring the symptoms of nerve entrapment. In the early days, after I first had my stroke, I experienced a lot of problems sleeping. First of all I put it down to the hospital bed…. A side sleeper I just couldn’t find a comfortable position and often found myself waking in pain lying on my left arm , with my neck in a wrenched position. I blamed the bed… too small Goldilocks…. But guess what ? The problems continued when I returned home to my lovely king sized bed.

Trapezius muscle

Trapezius muscle connecting the upper extremity to the vertebral column;

One day I experienced a painful knot in my Trapezius muscle… and now on reflection, I am beginning to understand that this may have been a precursor of some of the symptoms I am now experiencing.

There are three major nerves that run from your neck all the way to your fingers: ulnar, median, and radial. The ulnar nerve runs along the inside of your arm and ends in your pinky and ring fingers. Entrapment of the nerve, is when the nerve gets trapped at a location, then when you move your arm the very taught nerve gets pulled and results in pain.

Ulnar Nerve

Front of right upper extremity, showing surface markings for bones, arteries, and nerves.
Bartleby.com: Gray’s Anatomy, Plate 1235

What’s a bit tricky in recognizing that my pain, and some of my symptoms , could be a nerve entrapment issue, is that the symptoms of tingling fingers and sensory loss as a result of stroke are also a symptom of nerve entrapment. Nerve entrapment generally causes referred pain, meaning the site of the issue can cause pain in another area much like the shoulder pain I have had.

By the by, did you know my maiden name was Holmes? I just have to keep digging….. It drives my hubby crazy because I have theories about a lot of things. This nerve thing though….. it so makes sense at the moment.

So this is where my headspace has been this week. I have been working on loosing knots, and flossing my nerves!
Coincidently there is every indication that my research will pay off, the tingling in my fingers is starting to ease.

There are several nerve flossing videos on YouTube, here’s one that I’ve been incorporating to my rehab.

* I want to caution anyone reading my account, that I am no medical expert, I am writing this as a personal account of how stroke has affected me, and it’s my journey of recovery.