Forgetting to be neglectful

I’ve been trying to use my left hand more and seeing as how I can’t open my fingers on command, turn my wrist, or create any real form of manipulation of objects with my hand due to a lack of direct communication between my brain and near the entire left side of my body, it’s been really frustrating.  Yeah.  I’m not going crazy…yet, but I am losing patience little by little; and by little I so-so-small-150x150mean:
I’m trying my best.  There’s a few problems and most of them are my fault.  It’s been over three years since my stroke and only within the last year (or less) have I actually been taking the idea of a decent recovery seriously.  I’m not making any sort of dream for myself that I will one day jog down a street, but what I’m not doing is building a higher platform than is necessary to fall from.  The higher you are when you fall, the harder it hurts and the more damage it causes but I’m also not trying to let my frustration get to me.  It’s not that difficult to remember where I was in March of 2011 and compare it to my current position so I know there is reason to allow in a teeny, tiny peep of hope, I just have to be mindful of where it rests.

   I think back to my first therapists since they were most concerned about me developing bad habits and focused on educating me on what was happening with my body than any therapists since. I am trying to remember the hints and tips they gave me so I can work at home on my deficits before returning to therapy.  I have a routine I follow every day I can list it out right quick.  It’s about a 40 minute – an hour-long work out:

  • Hamstring stretches: 30 second holds, 3 times
  • Toe lifts: 3×10 (3 sets of 10)
  • Arm lifts: 15 (laying down on back and straightening out arm, lifting up and back, then back down at side)
  • chair_lift
    Knee extensions

    Knee extensions – in a chair: 3×10

  • Heel lifts: 3×10
  • Squats: 3×25
  • Marching: 3×10
  • Modified Bulgarian squat (if Kasper is available): 5
  • Bridges/hip lifts: 3×15
  • Modified push up (if Kasper is available): 10
  • Hip flexion/abduction with Thera-Band: 25 for each leg, each of 4
    Hip flexion/abduction
    Hip flexion/abduction

    directions

  • Bicep curls without weights: 3×10
  • Tricep flexion without weight: 3×10

The thing to remember, I’ve learned, is that goals are kind of pointless.  The reason I say this is because I’m a sort of optimistically,  pessimistic realist.  I’m pessimistic because I don’t think I can improve much more; an optimist because I’m trying in hopes that I’m wrong and can actually meet more gains in my future; and realistic about the fact that not everything included in the old “anything is possible” saying is actually possible. My goals are super small and I am constantly reminding myself that there is no need to rush any of this.  As long as I keep moving, keep doing what I’m doing I will not sink.  I may eventually plateau but flat lining is better than sinking altogether.
People with my type of deficit, (hemiparesis/hemiplegia), are physically weak and unbalanced.  I watch my son, who is also hemiparetic, and when he teeters I imagine that is what I look like when I get that brief I’m falling over! moment that makes me inhale sharply and sometimes yelp.  We cannot rush. We must take our time and like any ‘normal’ person trying to build muscle, it doesn’t happen with one trip to the gym.  It takes dedication, mental pats on the back and constant reminders that this is a process…it can be taxing on the mind but it’s worth it.

   When your brain is injured in a way that affects you physically, there is the chance that you won’t recover in a week or two.  A lot of people seem to recover quickly, I noticed, but if the bleed is too close to the parts of the brain that controls motor function, it becomes much more difficult and you end up like me three years later trying to figure out if this is the end of the road.  It’s amazing to hear of people who woke up completely paralyzed and slowly gain use back one day at a time and within weeks or months they are near 100% functionality.  It’s amazing how quickly the brain can heal itself.
When your brain doesn’t heal ‘fast enough’ and you find yourself with all of this equipment now in your daily life, your body begins to break down immediately.  Muscles weaken incredibly fast and it’s something you feel you can literally watch melt away from you.  I sat and watched it, I did nothing about it for almost three years.  Now I’m trying to reverse the process. I don’t think it’s too late and that’s why I’m trying to recall the advice of my former therapists.
The most important thing to think about when trying to create your own home therapy type situation is that you can’t build on muscle when the muscle is weak. Strengthening is super important. With a deficit caused by brain injury, the recovery will begin closest to the head and reach the portions of the body farthest from the trunk last.  There is no point in setting a goal to work your fingers when your shoulder has limited ROM (range of motion).  If your shoulder is weak, so is your elbow; if your elbow is weak, so is your wrist and fingers.  I’m not working on function because of this.  So I set small goals to increase in intervals.  Most of my home regimen is developed by the advice of therapists and guided techs.  I’m afraid of my insurance capping me too soon so when my insurance (medicare) said it was time for a new prescription, I decided not to continue in a facility but at home until I gained enough strength to require new training or move into function of my fingers and possibly toes where I would need direct assistance with a therapist.
A year ago I could not control my arm. It got stuck everywhere, in everything and occasionally managed to clear entire countertops.  With a few exceptions, I can manage to keep my arm somewhat down and to my side now.  I’ve started to walk around outside without my cane.  I can go to the car without it and can walk a few feet away from the grocery cart without assistance and these are actually huge accomplishments.  I wish I had video but I do not.   What is more amazing to me is my arm than my leg.
If you look at my listed workout you would think my leg is my primary focus but it is not.  It is key to my recovery and essential to my achieving further progress with regaining function to my left side but my arm, my hand and my fingers are my ultimate goal.  My ultimate goal is something I prefer to keep shuttered.  It’s kind of like…the imagesrose in Beauty and the Beast. It represents a goal, an event in time marked to take place in hopes of success…or ultimate failure so it’s kept hidden in the dark.  I know it exists, this goal, I know I want to reach it; but first, I have to meet these smaller checkpoints to ensure that I can meet that goal at its highest standard.
I have to build strength and improve my balance.  I worked primarily on my balance and while at it did some random arm stretches while breaking.  For instance, while sitting after doing knee extensions, I’d do the bicep curls. After doing the hip flexion and abduction stretches, I’d sit and do my tricep flexion.  I was slowly building up strength in my left arm while breaking from my leg.  Increasing ROM on my shoulder little by little and doing so in a way that seemed to be by accident.
So now I have an odd predicament.  I have more control over my left arm.  I am able to direct my tight fist to turn on the water faucets and flip switches on and off.  This is huge! But what’s the predicament, kt? I am suffering from a mild form of left side neglect.  I’m so used to not using my arm for things that I forget to do the few things I have learned to do!  If I could remember then I would be building control over this limb in the same manner as I have been with strengthening it – seemingly by accident. Also, the more I do these things, like with the stretches and exercises, I will become less stressed about fulfilling a purpose and the tone in my limbs will decrease, allowing me more flexibility to earn more gains. Ugh. This is a post I didn’t mean to make so long.  I have to go make dinner… to be continued I suppose…

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