Four year anniversary post stroke

Last month, September, in 2020, I got slightly distracted, from my accustomed way of life, by a doctor entering a hospital room to inform me that I had six TIAs and a stroke. It was a multi-focal, bilateral cerebellar stroke. Two hemispheres of my cerebellum got damaged, more damage on the left, but some on the right. At that point, I couldn’t walk nor understand my relation to physical space but I was still breathing and coherent, so I guess there was nothing else for it but to unravel myself from this bewildering state.

Everyday, these days, I awake and I say to myself, 'Right, I have twenty-four hours," and that is the sum of my life until the next twenty-four hours. The symptoms are milder but not any easier. The idea of kicking back and relaxing is a luxury to me. I have moments of reprieve, and that’s what I seek. Delicious moments where I feel as if I hadn’t any troubles at all. These occur at odd times, mainly in the morning when my brain hasn’t properly started communicating with my central nervous system. Other times, it’s after a few beers or when completely immersed in company. It’s a strange and uncomfortable existence, peppered with thoughts of further complications or a plateau of a dysfunctional last leg of my life’s journey.

When symptoms are acute, it’s a bit like how I imagine bungee jumping is, I don’t want to backtrack and let fear stop me from stepping forward, but it is still exhausting. In theory, everyday movement should be rehabilitating my symptoms, and still I’m creeping along with progress, but I suspect certain psychological obstructions may impede this process a little. The cerebellum is a complex and under-studied part of the brain, and I suspect there is little understanding of the effects of Schmahmann’s syndrome from the perspective of a stroke survivor. I imagine my cerebellum like a city, what got blitzed? There were six transient attacks, maybe striking some major infrastructure, disabling it but in that moment, putting offline other integral networks. The two strokes, left and right; the left disrupting transport facilities and observational units, and the right hitting libraries and assemblies. What a mess. What a clean up.

The ongoing complication, with it all, is that four years ago, I was a younger, fitter fellow and subsequently have aged, no doubt with deterioration associated with aging, other bodily erosion, and the weakened state of my corporeal being. Not to mention the challenge to my mental state, which has defended its sanity like the Black Knight from Monty Python and The Holy Grail, “'Tis but a scratch.” - “A scratch? Your arm’s off.” - “No, it isn’t.” - “Well, what’s that then?” - “I’ve had worse.”.

So, what are my residual symptoms? Well, residual from stroke is ongoing visual/spatial confusion. I can be walking and depth of field narrows which means I slow down but then the field of vision increases, causing me to stumble slightly. The nystagmus can be quite intense at times, so much so I can almost feel it in my eyes. I believe I have vertical and horizontal nystagmus and, as far as I know, there is no cure or rehabilitation for it. Dyspnoea is still oppressive at times, even with controlled breathing techniques to put my mind at rest that I am not slowly suffocating. Brain has its energy easily zapped by cognitive activities, particularly following information and absorbing it. Working memory can still be a little undependable but other memory functions have actually improved and exceeded functionality prior to stroke. I have a strange dichotomy between target fixation and low levels of concentration. Mind seems to be able to interpret and react very quickly on its own terms, but is slow in responding to stimulus. Tinnitus and auditory overload still persist. Have days when nothing soothes.

That wraps up four years with my five year personal review of symptoms coming up next year in 2025. I don’t look to recover completely, but would rather just pootle along the passing years, trying to be productive and sensory, until it’s my time to exit stage left.

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Future thoughts? I don’t know, I haven’t had them yet. :grin:

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@Rups thanks for sharing your journey & your thoughts.

I think this is a good way of putting it. I think i’d say something similar with some of my symptoms. But maybe we’ve just got better at managing them.

Is the reference to 5 years the point at which you say I’m going to move on from the constant looking for improvements & go ahead & live your life as best abd as full as you can as your are?

Hope all the other things you are dealing with are going ok too.

Best wishes

Ann

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Hello Rups,

always enjoy reading your posts, though I don’t check this forum as much as I used to. I’m just wondering if you have experimented with saccadic eye movements? I have, and the object of the training was to “access the brain through the eyes”, with a view to alter the brain, or fine tune it, as if reverse-engineering the eye-brain connection. I believe it helped me, but I did this training about a year ago on my own… initially following Arjan Kuipers at bran.rehab.

The cerebellum is one of the main components of our reptilian brain, and thus contains many secret / backup pathways to all sorts of systems that are replicated by our main higher brain functions. Through this mechanism, I believe many abilities lost after our stroke may be recuperated. (& I appreciate you cannot quite count on this backup system the way I can).

Anyway, thank you for your valuable testament four years post stroke.
Best wishes, ciao, Roland

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Thank you for the feedback, Simon. Yes, so sorry I missed the zoom, but the sun was out, and I spent 7 hours on my patio recharging my beloved mitochondria! It’s my number 1 therapy by a mile. Catch you next time. Ciao, Roland

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Well, people discuss with me the future, my future and the future of other things. I fail to take it in, mostly. The problem is, between me writing this and at some point leaving this chair to go and do something else, is often future enough. I don’t mean to sound glib, but my life in the longer term just feels mountainous, and I struggle to be able to take it all in. This may be at odds with my weakened impulse control, and if there is something projected in time, my brain yearns to attend to it now while it feels it can, so I avoid such thoughts.

I always had the five year review plan from the very beginning. It’s not based on any science, just from a conversation I had with another stroke survivor early on, and he told me that it was counterproductive to assume recovery was imminent (I called it recovery too, in those days). So, I wanted a marker that I could use as a measuring stick for the next subsequent years, and five years just seemed sensible.

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Shwmae Ann, no, the five year marker is a means to look back on progress and use it as a measuring stick for future improvements. It’s just a timeline because I like the idea of having a set period which can be used for reflection, and contemplation for the proceeding years to come.

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Shwmae Roland, yes, I practised many forms of exercises that relate to saccadic eye movements, of various kinds, over two years, but unfortunately nystagmus is untreatable, and sadly impedes rehabilitation, as when occurring there is no saccadic eye control. The issues I face are a combination of light change, space change, head movement and eye control. The challenge is that all these elements are constantly in flux.

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I see, Rups. Well, totally unrelated, but have you ever “experimented” with your vagus nerve? I thought perhaps you have looked into this? I certainly think this is a very good lecture on it:

I have recently finished a book “Our Polyvagal World” by Porges, and I have learned even more about this subject through my studies on Qigong. I just posit this subject on the off-chance it might be of help,

best wishes, Roland

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I have indeed come across reference to the vagus nerve, many years ago, as a late teenager, in fact, when I was involved in theatre and dance, and some of our tutors referred to stimulating it through the warm-ups we would do. I haven’t experimented as such with it, but have used common techniques that Pradip mentions, and still do practice some of them, particularly for anxiety.

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I feel I may be expressing my relationship with the future too obliquely. It really is just a case of not having any longer term plans then switching the lights off and preparing for bed. There are vague ideas of what I ought to do tomorrow, but because I don’t know how my symptoms are going to behave tomorrow, I tend to not set those plans into my mind until I can address them at the time. As for long term plans, do I want to re-apply for a PhD? Do I want to invest in my own house? Do I want to drive again? Do I want a career? Well, those thoughts are mere musings and I can’t commit to them because my condition is so mercurial that it doesn’t allow for me to have any confidence in projected events. I can be fine in the morning, by late afternoon I can barely function, then just before putting myself to bed, because the evening has been so disabling, I can feel ready to take on the world.

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Interesting Rups,

…and through my study of Qigong (certainly it goes way beyond Western medicine in terms of sensing our own body) I “take control” of my Yin organs / or certainly feel them ; Lungs, heart, kidneys, liver, spleen. Yet 80% of the vagus nerve is afferent, meaning there’s only 20% of it working from brain to organ. I thought this would be a wonderful topic to explore for you and one that could potentially put you back in control to a degree. I know it doesn’t help you hack the vestibular system; but that too is hackable, according to some accounts.

Nice chatting, ciao, Roland

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Thanks for sharing. Much of what you describe I also have 2 and a half years later. I hoped by now residual symptoms might have eased - setting expectations that perhaps they wont’ any time soon is perhaps more realistic and easier to deal with. Que Sera, Sera.

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What is your academic speciality, Rups?

I do know about the vagus nerve. I always wondered why when I would feel relaxed when I sneezed. I always thought if I sneezed in social anxiety situations, I would do just fine.

How have you been overall, friend? Thinking of you.

Take good care of yourself.

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You better stop climbing fences, or you’ll be in jail. :grimacing:

What are you going to become? The UK’s serial fence climber? :open_mouth:

If you keep doing Qigong, you’ll be flying over them…

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Aye, Matthew,

I’m going to become ‘normal’ if I continue like this.
No chance of a record today ; I’m totally grounded with the bad nerve today. I was up in the night in crisis with cramps and nerve pains. Courtesy of a chiropractor who pressed hard on my aching piriformis, yesterday. The good news is that I was 4 hours in the sun today, though it’s pretty feeble by this time of year, here in the UK. I have embarked on a high dose Vitamin D program, which I hope will see me through the winter when it kicks in.

How are you? and what are you up to? Are your eyes all good, now?
Sending good vibes your way. May the Qi be with you !!

Roland,
Stroke Improvement Group

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My eyes are fine, Roland. They have been for quite some time. Thank you for asking me about them. Nice that somebody shows concern.

Sorry that you’re not having such a good time right now. Hey, every day can’t be a bowl full of sunshine. At least you’re climbing fences all over the UK.

You need a trip to the south of France to get more sunshine.

May the Qi be with you, as well.

By the way, you going to set another record soon?

Take good care.

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Academic speciality, good question, I started with media studies, majoring in cinema, but soon took to hypertext and online spaces, MOOS and MUDS, and was lucky enough to have a lecturer who was the first person in the world to VLOG, before influencers and others were more “watched”. :laughing: Beyond that, I launched into post grad film and television, and eventually swerved into further post grad studies in writing. Back to the source, so to speak. I tend to sneeze if consuming any sweet that contains peppermint. It seems to tickle my olfactory network, like catnip for cats. Overall, I have been sort of okay … I passed a gentleman the other day, on the street, and I said the obligatory Welsh greeting of, ‘all right?’ He glanced at me briefly and replied in a stone-cold voice, ‘I’m alive’. I guess, I am satisfactorily existing, neither with felicity or misery, just passing time. I hope you are well.

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I would have thought you were a world literature expert.

Many of us get in states where we are “just existing.”

I do qigong, which helps me at times to transcend some very negative states of mind.

I get through the days of grief. Second-year grief is worse than the first year in some ways. Oh well…not much you can do about. All I know is that everything is impermanent, and that everything is in a constant state of change. We can only hope for better days.

The only guarantees in life are that things will change and that you will die. LOL. I know — sounds great!

I wish you peace and happiness.

Take care.

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I’m not one for needing a purpose in life. In fact, I think less of a purpose since having been struck. The purpose that makes the most sense to me is having a symbiotic relationship with other living organisms and modest hedonism; eating, sleeping, laughing, burping, dreaming, farting, reading, writing … I think I echo Eric Idle when he sang, “You come from nothing … You’re going back to nothing … What have you lost? Nothing!” I do Qigong too, but I’ve switched it out for gentle daily stretches, mainly because I want to listen to a few audiobooks, and stretching is easier to do while following a narrative.

Rups

Of the stroke improvement team.

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