Wednesday, December 17, 2008

Rehab progress 30

Physical therapy turns out to be just plain hard work.

I don't know that I expect anything different. I have been through it all once before. But I guess the reality of it all is always a bit discouraging, especially to know that I am covering the same ground again.

Today I pedalled the bike for more than two miles in ten minutes, and I was able to run the treadmill for more than a half-mile. This is about halfway toward the mark I was setting for myself before the last stroke.

If I can sustain a pace of constant and consistent improvement in performance, I may be up to par again before the winter is over. I'm not sure I can build up enough stamina in time to get out on the snowshoes while there is still some deep snow on the skyline, but it is something to work for.

Tomorrow is another day.

10 comments:

pgk said...

Physical therapy turns out to be just plain hard work.

And yet it's good, hard work. It's good work.

But I guess the reality of it all is always a bit discouraging, especially to know that I am covering the same ground again.

Are you? By my reckoning, halfway toward the mark you set for yourself before the last stroke can't be the same place as that same goal after two strokes. By your account, this last incident nearly killed you. If that's so, pedaling the bike for more than two miles in ten minutes is quite a distance beyond where you were when you were able to pedal the bike for ten minutes before this last stroke stopped your pedaling.

I'm not sure I can build up enough stamina in time to get out on the snowshoes while there is still some deep snow on the skyline, but it is something to work for.

I'm inclined to give THE TALK back to you at this point, but I'll resist.

pgk said...

BTW, Jim, what's happening with your speech? Any improvement there?

9 of Nine said...

Hi Jim -

Dumb saying, but - "slow and steady wins the race". You know. I'm not sure if it proves true, but its the best "they" have to offer.

Here's what Dr. Warner had to say:



Hi Ruth
IIH (Idiopathic Intracranial Hypertension) is not associated with stroke. Elevated ICP (Intracranial Presure) from venous thrombosis can cause stroke, but not in the brainstem. Whether or not he has IIH, he needs a thorough evaulation for cause of stroke. This usually includes, but is not limited to carotid and vertebral artery imaging,
echocardiogram, blood work for risk such as diabetes,
hypercholesterolemia and other stroke prone conditions. I would be happy to see him at the referral of his internist, ophthalmologist or neurologist, but he might be best served by a stroke neurologist such as
Dana DeWitt, David Renner, Jenn Majersik, Kevin Call or Elaine
Skalabrin.
Judith

So see what you think. Maybe you're happy with your neuro. I'm just not settled with the idea of not knowing the reason for your strokes.

Love,

Ruth

Jim Cobabe said...

Patricia,

Your take is correct, of course -- I am just being impatient. I am really making good progress in my physical conditioning efforts. I should be, with so much time to work at it.

My speech is affected more than I would like from the last episode. I cannot speak fast enough or enunciate clearly. And I stutter while searching my mind for the right words. It is a deplorable habit, and I am trying to stop doing it. If I recite things I have rehearsed, at least mentally, I am not too bad, but in spontaneous conversation I cannot comfortably hold up my side, and I tend to break down into halting and lame stammering. It seems to get worse, the harder I try.

Frustrating...

Jim Cobabe said...

Ruth,

Thanks for the note from Dr. Warner. I will consider the options, but I note with some skepticism that other doctors have already tried all the diagnostics she suggests for determining a cause for my problems, with very little to show for it. They still insist that I must be diabetic, even though there is no clinical evidence to support the idea.

I am pretty much resigned to the fact that doctors are not going to help much more. If I have another severe stroke, the doctors may determine what is causing it all in their post mortem. I don't think they care any more otherwise. I'm not sure I do either -- at least, not if it means spending my life searcing out another doctor who can see beyond standard medical dogma.

pgk said...

It seems to get worse, the harder I try.

Then maybe trying to push through the difficulty, as if it were a snow drift in your way, is the wrong approach.

It's interesting that you achieve what you consider to be effective speech if you mentally rehearse what you mean to say.

What happens when you read aloud?

Jim Cobabe said...

Patricia,

Interestingly, recitation such as singing or reading aloud does not seem as taxing as spontaneous speech. And I don't perceive any great difficulty with cognitive process when I writing -- except a much slower rate. Apparently, some element of spontaneous speaking was somewhat impaired. I am experiencing this from the inside, as it were. It is very disconcerting to require such effort just to speak clearly. While I am delivering one sentence, so laboriously, my mind is thinking far ahead.

pgk said...

Is there a speech therapist on your support team?

Jim Cobabe said...

Patricia,

Sorry for my delay. I had a bad day yesterday.

Speech therapists have generally not made much of my speaking impediment, though it has grown worse since I was last evaluated.

My sister Mary is also a speech therapist, although I think her practice is with elementary school age kids. She said I would mostly benefit from continued practice, speaking out loud. Apparently this is what other therapists would recommend. I have been making an effort to read the recent conference talks out loud as I review them, but I have not taken time for this exercise of late. I need to get back to it.

pgk said...

I had a bad day yesterday.

Mine wasn't so great, either. Teah kept me up all Saturday night. She was fussy with discomfort. And when she wasn't carrying on, it was Pete Seeger carrying on. She's a Pete Seeger fan and we bought her a new CD, a Christmas present we gave her early. She wants to listen to it over and over and over. She wanted to listen to it all night, probably to offset her discomfort, but if you've ever listened to Pete Seeger, his singing alternates between whispering and shouting -- there's no steady volume. When I would start dropping off to sleep, he'd shout me awake: "THIS HAMMER'S GONNA BE THE DEATH OF ME, LAWD, LAWD. THIS HAMMER'S GONNA BE THE DEATH OF ME."

So no sleep, but the usual full day of duty and watchfulness. With added resentfulment for Pete Seeger's leftist disregard for his audience.

It's hard to do difficult stretches of your life well every minute of every day.

Regarding speech therapy: Working to regain your language skills is as important for the health of your brain as walking the treadmill is. Practicing speaking out loud is exactly the thing to do.

But I wonder, since you read aloud and sing all right, what will happen if you blend all three at every reasonable opportunity. Read, sing, practice speaking, read, sing, practice, repeat, etc.

It might be worth the try, just as an experiment.

Aching to go out today, into the low-lying clouds and snow mists. But I'm still sleep-starved and will refrain, as part of my general practice of not stepping outside my range of acceptable risks.

As you say, tomorrow is another day.