Urban Trek

A big walk begins at my doorstep. The first stop .. a stone passageway that runs around back of the high school stadium. It’s not only a short-cut ..it has rails that are the same height as the bar in a dance studio. Perfect for stretching my piriformis and softening my ride. On Figueroa Street someone honks and gives me a thumbs-up. I wave but have no idea who it is. I narrow it down by women who know I’m recovering and have a bright smile. Pat springs to mind. I pass by Andrea’s place but I know she’s at work. Must remind myself to send her an IM. At Wells Fargo they have table and chairs and bottled water. Good place for a pit-stop. I tank-up ..begin writing this screed and plan my next move. The men’s room at the court house. I’m sitting in the mural room chatting with a girl and her parents from LA . They’re on a college tour ..Mount St. Marys ..Occidental ..UCSB. Her preference ..University of Utah. I gather she wants a little more distance between her and her parents. I return by way of the high school ..stretch and sit in the stands. A tune fills my head ..recovery is going well .. feels like downtown is getting closer and closer.

Flexibility

I’m doing physical therapy exercises for flexibility. Stretching. They include yoga postures. I maintain correct posture by imagining a cord tied to my spine and pulling it through my navel. A visual Andrea my OT gave me. Today I realize I’m doing one for strength and not flexibility ..and I’m doing it wrong. It’s a bridging exercise meant for the abs and gluts. I decide to keep it but do it right. Instead of reps ..I maintain a posture. I also found that doing sway-and-arch back postures relieve my back of the tension that builds while doing yoga for the abs. Tomorrow I’ll do physical therapy exercises for strength and balance. Right now I’m eating lunch and preparing to water the great outdoors ..possibly do a walk-about locally.

Unlocking paralysis

Monday August 6, 2012 Rehab: One thing I saw when I first entered rehab was a video about ‘learned paralysis’. It was a lecture by VS Ramachandran that I found on the Internet [ link ]. Although my paralysis wasn’t learned in the sense he talks about ..it made me realize how much of a stroke is information-based. Transmission from the motor areas of my brain had been interrupted. Rehab was going to depend on me finding pathways around this. I needed to re-establish contact with the left side of my body. To me this meant flooding my brain with information. Tuning-in to internal (proprioceptive / kinesthetic) as well as external sources (visual / tactile). So, even though my paralysis wasn’t ‘learned’ ..I was going to have to re-learn and re-juvenate neural-pathways to unlock it. Gaining a better sense of ‘somatic awareness’ was the first step.

Somatic awareness

Psychologists say that yoga and breathing exercises improve ‘somatic awareness’ ..and that somatic awareness replaces anticipation and rumination. I have a tendency to look forward and backwards a lot. They say it can be a source of anxiety and depression. Somatic awareness helps me better sense when my mind wanders from the here and now [ link ].

Declining memory

I don’t think I’m losing my memory. No ..it’s more like I’m blurring the lines that separate memories. I’m connecting people and events that never occurred together in the first place. For instance, the other night I was watching the movie ‘Time Travelers Wife’ ..and Jen came to mind, the person who originally recommended it. That’s OK. However later on I was thinking about someone else, Andrea ..and suddenly I’m sensing the presence of ‘Time Traveler’s Wife’ as though she were the one who recommended it. In fact we never talked about it. It took me a moment to realize that the only connection between her and the film is that she works at the same place as Jen, which is really no connection at all. I wonder if there’s a word for this type of condition. Hyper connectivity ..? Perforated boundaries ..? The older I get ..the more loosely organized memory becomes. Am I losing memories ..? No ..it’s more like I’m losing my mind.

Gaming

Day 61:  I have broken the habit of turning off lights whenever I leave the room. Maybe it’s more of a compulsion ..I don’t know. I’m not being wasteful ..I just don’t want to end up in a dark place. My head doesn’t handle it well and usually drops the rest of me on the floor. Without visual it doesn’t know my position in space and it’s like ..everyone for themselves. Anyway, I credit computer games with helping me break this habit. They’ve help me think strategically and move forward carefully .. knowing I can’t move backward in time.

The ride

Day 60:  I finish my physical therapy and walk over to the high school football stadium. It feels like I’m detached from my body and viewing it through the narrow lens of a camcorder. What’s in front of me is in focus while the periphery fades away. I’m hoping my peripheral vision will pick up anything there that requires attention. I walk around the track that I used to run. I use the rails to stretch my piriformis muscle, which loosens my pelvis and gives me a smoother ride. I sit on the steps and watch a soccer game that’s already in progress. Feels comforting. Like I’m in the hands of some benevolent neighborhood spirit or something.

progressive relaxation

Day 60: Feels like I go through the day experiencing long periods of tension followed by short periods of relaxation. They seem to follow whatever comes up or the type of activity I’m doing ..like receiving news of a project deadline or working through a computer problem. I think progressive relaxation [ link ] works by forcing me to spend at least 20 minutes or so repeating this ‘tense and release’ cycle quickly and deliberately. It seems to put tension and relaxation more under my control .. extend the period of time I get to spend in relaxation and, who knows ..maybe even help me learn to relax at will.

New balance

Day 59: My vestibular system is shot [ link ]. Since it’s a major component of balance I’ve come to rely on vision and proprioception to know my position in space, which is what enables me to walk upright like a human being. However, I don’t receive the best signals from my legs and feet, which are a big part of proprioception. So that leaves vision. I’ve come to rely on my eyes. But my eyes come back to haunt me. So I’m learning that the best way to navigate mother earth is by keeping my eyes directed forward and not shifting them from side to side. I need to trust peripheral vision for that. It actually does a better job. Focused attention augments visual features. Too much attention to what’s on the periphery lowers the threshold for warning signals. For instance, bright shiny objects, like passing cars, signal motion ..but not necessarily the motion of the cars. It can trick me into thinking that I’m the one in motion and I’m moving in the wrong direction. It can also trigger alarm as though they’re coming at me. Best left to peripheral vision to correctly screen for these things ..keeping my eyes focused on what’s in front of me.

Rule-driven

       ..whereabouts unknown

 “Perpetual devotion to what we call business is only sustained by perpetual neglect of many other things.” ~ Robert Louis Stevenson

Day 56:  I think my new obsession with counting carbs is making my taste buds dull. I’m wondering what other things my senses are missing. The sign that says: no pain no gain has definitely taken a toll on my flexibility. I feel about as stiff as a board. In my search for common ground I think I’ve been missing subtle differences. Now I don’t know but I’ve been told knowledge is knowledge of differences. Or is that the language of separation ..(?) Lately I feel like a commodity that requires a ton of self-promotion. And this what’s-in-it-for-me attitude is robbing me of what’s-in-the-moment. Dr Thompson says he doesn’t know too many people with good mental health who don’t also have good presence-of-mind. Even Ecclesiastes says “..what the eye beholds is better than what the mind foresees.” Makes me wonder if I haven’t veered off-course somewhere.

Neuróticos Anónimos

“I can’t seem to face up to the facts / I'm tense and nervous and I / Can’t relax / I can’t sleep ‘cause my head’s on fire / Don’t touch me I’m a real live wire.”

Day 48:  Hi, I’m B. and I’m neurotic. I get uncontrollably weepy during movie scenes. Especially when someone is experiencing some kind of adversity ..as well as when they’re overcoming adversity. Watching ‘Hunger Games’ was a real roller coaster ride. I get angry when I read the paper. I quarrel with authorities, my father, and other family members ..even when they’re not around. I feel like my tolerance for frustration is slipping into dangerous territory, which frightens me because I’m obsessive about my mental health and take frequent sanity-checks. When it checks out OK I’m afraid I may be rationalizing something away. Like, is so much media distraction good ..? Beats tranquilizers. But when does it start to do just the opposite ..? I go around and around a lot. I’m irritated by people who show-off during casual conversation. I’m irritated by myself for showing off during casual conversation, which tells me what I dislike about others is most often myself.

The Jabberwock

“Beware the Jabberwock, my son!

   The jaws that bite, the claws that catch!

Beware the Jubjub bird, and shun

   The frumious Bandersnatch!”

Day 19:  Whenever I’m practicing progressive relaxation or sitting meditation ..an image of the Jabberwock comes to mind. I frequently remind myself to unclench my jaw and loosen my grip. Noticing change and allowing things to pass without grasping, biting or otherwise judging them as they go. Principles of Vipassana meditation I picked up at a workshop many years ago [link].

Willingness to yield

Occupational therapy:

“Jen, is it really necessary for me to take a behind-the-wheel test for the  6-week   follow-up ..?”
“Well, it is optional but it’ll help make a better case to present the    DMV ..”

     This is where I cut her off to explain ‘the agreement’

“Dr Bryson said she was going to wait for the 6-week follow-up before deciding whether she even needs to notify the DMV ..”
“Well, any doctor can notify the DMV anytime ..”
“Yeah, but we agreed ..”
“Let me explain how it works ..”
“Wait, first let me explain the agreement ..”
“I think I need to tell you how it works first ..” 

I sense things getting a little edgy and now I forget who actually went first but I blame myself for not being more ‘yielding’. Jen has no idea about a verbal agreement I made as an inpatient, which is an exception to the way it works. But if I'd given her a chance to explain how it works, I’d have understood hat it’s totally up to the whim of the doctor and nothing I could say was really going to matter much. Not even the agreement. It’s out of our hands and that’s good enough for me ..yielding soul I aspire to be.

Jen
Therapist Extraordinaire

sisters of mercy

O the sisters of mercy they are not departed or gone. They were waiting for me when I thought that I just can't go on. And they brought me their comfort and later they brought me this song. O I hope you run into them you who've been traveling so long.

                                                                                              

Rehab

Physical therapy - Jill:  I need to score ‘22’ points on a scale of 1 – 30 in order to be  officially ‘discharged’ from the walker. That means I have to be able to walk a straight line while maneuvering around obstacles, changing my pace ..then do it again backwards. Today I scored ‘13’. For me this would be a killer even under the best conditions

 

My physical therapist, Jill, holds a doctorate degree specializing in the neuro-vestibular system. This means she deals with the part of the brain that gives me a sense of my orientation in space. It’s one of three components of balance. She informs me my vestibular system is shot

 

I remember a female instructor at Santa Cruz who wore a camcorder on her head while walking around school one day. Afterward, she showed us the film. It looked nothing like what we ordinarily see. It was a bumpy and jarring ride. 

 

“That’s because we have a vestibular-ocular reflex (VOR) that keeps our eyes steady while our head bounces around. ” Jill explains “..without it, the world looks like it did on the film ..it’s called ‘osillopic’ or bouncy vision.” I’d say that pretty much captures the essence of my walking expeditions.

Day ten

Wednesday August 15 ~ Speech Therapy:  My speech therapist has got me playing games-for-the-brain on the computer. ..detecting birds that momentarily appear in the forest while keeping my eyes on the trail. Learning to use my peripheral vision while staying focused on what’s ahead. Although this may not seem like it involves verbal skills ..Holly is dealing with my attention and tracking abilities, which are involved with conversation. These exercises also contribute to my physical therapy. Noah (PT) encourages me to trust my peripheral vision more. He prescribes ‘smooth pursuit’ exercises and recommends I avoid making ‘fast tracking’ movements that diminish my eyesight and throw me off-balance.

Day nine

Monday August 13 ~ speech therapy:My speech therapist isn’t just dealing with my speech. That’d be too narrow-focused. She’s also dealing with the mental skills that underlie speech. Skills I need to translate concepts into spoken words as well as words back into concepts. We get past the slurry speech issue and begin working on verbal memory, which I know didn’t work all that well to begin with. We take turns conjuring-up words for items in the food department (lexical retrieval) ..and repeat the growing list of items back to each other as we go (verbal short term memory). We play a game like charades to see how fast we can explain words before the other gets it (semantic processing). It’s fun working with Holly.

Day eight

Friday August 10, 2012   Speech therapy  I have a Speech Therapist who leaves me speechless. She’s drop-dead gorgeous. So I'm like ..how’s this gonna work ..? Brilliantly it turns out. Seems my slack larynx isn’t hitting all the ‘fricatives’ it needs. In my rush to say something pertinent, I’m speaking gibberish. She offers me a simple remedy. Slow down and breathe. Sequence words before sending them out for production. Allow my vocal cords to concentrate on delivery and not word selection. I guess I used to rely on the sound coming out of my mouth to make that determination. Worked OK till the delay at fricatives made me trip over my words. In order to avoid that ..I’m doing an end-run around the troublesome sound, which causes me to slur my words. She cleared that up nicely. Even though I walk like a drunken sailor .. I no longer talk like one

Day seven

Thursday August 9, 2012   Andrea, my Occupational Therapist, wakes me at 7:00 am every morning to take stock of my ‘preparation skills’. This morning I surprise her ..I’m already awake and, with my headphones blasting ..I’m rocking out to the Jerry Garcia Band on YouTube. A clever way to practice my PT training from the day before (with that interactive bastard metronome) ..following the beat with my head, hands and feet. Another attempt at neuro-muscular recruitment. Andrea (aka as Dr Dreaus) is a Renaissance woman. A former Olympic-class swimmer ..she’s in her early 20’s and into the Dead. She understands my references to subversive culture and Indie music. She renews my interest in music by Phish. So, the next morning at 7:00 am ..I’m rocking out to a Phish concert on YouTube.

Day Six

Wednesday August 8, 2012 ~ The Interactive Metronome:   I used to be confident that I could tap my feet or clap my hands to the beat ..until a computer that measures accuracy to the nearest millisecond said otherwise. Visual feedback tells me that if I wait until I hear the beat ..I’m already too late. When I try and anticipate the beat I’m way too early. If I wait until it feels right I’m much more accurate. The trick is relying on my hands and feet to follow the rhythm without me interfering. I need to tap-in to my native abilities at responding  to external cues. Kind of like the way I used to surf or ski. Rhythm is a necessary part of walking upright ..and waking upright is a peculiarly human characteristic. How pathetic. I think I’m discovering what it’s like to be human again.