Saturday, February 28, 2009

The Purpose of the Ride

One of the outcomes of stroke is that various systems in the brain have been damaged. For some people, like me, the biggest area of damage is in the motor planning area of the brain which has affected my left side motor movement and proprioceptive balance. For some it is primarily cognitive, for some it is vision, for some it is motor language and for some it is a combination. The type of sytem damage that occurs is all dependent upon where the brain damage has occurred. One of the clearest concepts in the rehab process is that to create repair to these systems requires them to be stressed and challenged in order for the brain and the body to adapt and for re-wiring too occur.

Initially I lost even my awareness I had a left side of my body. I remeber early days in the hospital telling my sister that I had lost my soup at lunch time. No that's not like losing your cookies, I thought someone had taken it. In actuality it had just disappeared from my vision on the left side. Turning my head a little and voila it wasn't gone afterall. My peripheral vision is now back in acceptible norms.

From a walking perspective, I have spent many hours leaning to my left trying to re-orient my body to know where vertical was. That required leaning against a wall and having a pole beside me for support so I could challenge that balance system safely.

In order to safely challenge some of my motor planning and movement, there is some equipment that would help myself and others to safely push back those barriers to improvement. By attempting this bike ride I am asking for your support to raise money in order to acquire the equipment to help people help themselves. This is specialized exercise equipment that is either adapted or has additional safety features. I spent lots of time on a regular treadmill, however, I also ended up on the exercise room floor a couple of times when I tripped. You see being able to use only one hand, changing settings becomes challenging because you have to let go with your only support in order to do that. One of the pieces of equipment I want the centre to have is a treadmill with a safety sling and overhead frame. With that you can practice getting faster with the safety of knowing you won't crash off the back of the treadmill.

The exercise bike was great for me to get my left hamstring activated and starting to work. However, because of my poor balance, it had to be a seated or recumbent bike. Right after I was discharged fron the hospital I had no ability to lift my foot into the air. Hence it was constantly falling off the bike pedals. What I discovered was using my cycling shoes and clipless pedals I taught my left leg how to cycle again by having my good leg pull it though the cycle with the clips. The challenge is to find a way to have universal size bike shoes. Pyro plates, a product out of the US will allow us to modify recumbent exercise bikes for various size running shoes that can strap on a rigid plate with embedded cycling cleat. The result will be mulit-size cycling shoes that will match each individual running shoe. Having this equipment will enable people to challenge themselves towards improvement. It is hard work but it can be done.

Tuesday, February 24, 2009

The Route

Danelle Laidlaw, operator of TourBC has graciously allowed me to piggyback her tour in order to undertake this fund raising event. The tour consits of 7 days of riding covering 850 kilometres. The tour is fully supported with meals and snacks included. The communities we will go through include Ainsworth Hot Springs, Nakusp, Revelstoke, Golden, Radium, Kimberley as well as starting and finishing in Creston. One of the highlights will be going through Rogers Pass. There will be over 100 riders on the trip of varying abilities using recumbents, tandems and regular road bikes. For more information on the tour see and you can follow the route. I have completed 6 previous tours with Danelle, however, this will be the first one following my stroke.

Saturday, February 21, 2009

My hospital rehab

One of the first things that my physio worked on was getting me to be able to sit up on my own on the edge of a bed. Literally that took weeks before I could sit upright without assistance and without toppling over. Your trunk balance was needed before you could sit in a wheel chair. The next thing they worked on was getting me into a standing frame so that I could get weight onto my legs. The next task was working upon my standing balance so I could actually stand without holding onto anything. I will always remember the look on Margaret's face when she came into the hospital to visit and I stood up on my own. What an accomplishment after 2 months in bed. By standing on my own, I was able to start transferring to a wheel chair without assistance. Another celebration, until I fell in the lounge trying to get back in my chair from the couch. My break had come off.

Another celebration was being allowed to go downstairs on my own in my wheelchair to get a cup of coffee. Freedom. Not without comedic complication. You try wheeling a wheelchair in a straight line using only one hand and a cup of coffee between your legs. Fire doors were also a real challenge. I had to get close to the door, push the bar hard with my one good hand, then try and wheel my chair through the opening as the door rapidly closed. Coming home from weekends, I also had a clothes bag in my lap.

Finally came using the bars where I was able to work on bending and straightening my legs and that magical moment when I got to try lifting my feet to actually move forward. I didn't get just forward though, they made me do backwards and sideways as well.

The next big step was taking away the bars and using a quad cane. A regular cane with four feet rather than one. What a sense of independence. I loved walking the halls just to be moving. God help the person that moved one of the hallway chairs on the rehab floor which was the rest stop locations.

The next big step was when Leslie took Carl and I outside to work on the sidewalk and hillside. We had to wait for each other sitting in our wheelchairs like blind beggars with our shades on. Coming in from outside, the best part was getting to walk up the 5 flights of stairs to get back to the rehab floor. What an accomplishment. After 3 months and one day, Iwas released from the hospital to continue my rehab at home.

Friday, February 13, 2009

The Power of Supportive Positive People

It truly amazed me how many people showed up when my family needed help. The North Shore running and triathlon communities have some very special people. The hospital staff were also great. When they first found I was sick, there was a meals on wheels set-up to help my wife keep all of the balls in the air. Running the house, making meals and visiting me in the hpospital for three months was a tremendous feat. The tri-club really helped out. Another angel on our team was Denise Morbey who is a physio in West Vancouver. She would come and visit me and helped me retain range of motion in my left arm and leg until they started to work on their own. Talk about service, straight to my hospital bed. One of those people who can never really thank enough. When I first started coming home from the hospital on weekends, I had members of the NS Tri Club carry me up and down the stairs of my house in my wheelchair so I could be at home. These people have been incredibly encouraging throughout my rehab and seeing their accomplishments as triathletes and runners has kept me motivated to continue pushing for improvement.

It took me almost 16 months to realize that it was unlikely I would fully recover. What kept me going during that time was focusing on total recovery. In July of 2008 I began to realize that I could no longer rely on total recovery and I had to start facing what activities I was no longer able to do. Jennifer Allen, the Social Worker at the lions Gate Out-Patient Rehab Program helped me to see that although I could no longer do things the way that I used to, it didn't mean they couldn't be done. She helped me to realize that I couldn't cycle anymore on a typical upright road bike, however, a recumbent trike was quite possible. That is the attitude I try to continue to maintain. Now I look at how I have to modify things in order to participate rather than what I can't do. My friends continue to help me by inviting me along on their activities.

This melding of my old attitude of try anything once, with the need to find new ways to participate has been the turning point in the emotional part of my rehab. This is also what has led me to be a volunteer Co-ordinator for the Young Stroke Survivor's Group with the North Shore Stroke Recovery Centre. Hopefully I can draw other stroke survivors along with my new attitude.

How it happened

I had been hydrating for the Vancouver First Half Marathon to be run on Feb 11, 2007. At about 3:00 in the morning on Feb 10th I woke up needing to go to the bathroom, however, when I tried to rollover to get out of bed I discovered I couldn't move anything on the left side of my body. I was unable to sit up and I couldn't move either my left arm or leg. I woke my wife up who called the ambulance. At the time I remember feeling very analytical about it. This paralysis seemed very strange, I wondered if I had eaten something that was off. Initially I didn't have a headache, however, after being awake for a few minutes the headache started and I started having trouble breathing. As it turns out the stroke affected the motor planning area so although I initially had some vision issues and slurring of words, the primary deficits were and continue to be motor function on my left side.

Ultimately I spent three months in the hospital with seven weeks in and out of the critical care unit in neurology and 5 weeks on the rehab floor. It was 2 months in the hospital before I was allowed to transfer from bed to wheelchair by myself. I was discharged using a quad cane and told to get a wheelchair. Well, once I started using a cane going back to a wheelchair seemed to be a step backwards. I haven't used one since.