The Stroke, part 5: fatigue
Today I went out with my brother – only the second time I’d left hospital grounds since the stroke. We had to visit the bank, scare up some paperwork, visit my parents, and grab a bite of lunch. It was nearly five hours out, and although my brother did most of the heavy lifting, when I returned to Pine Valley Care Center I was exhausted and I told everyone so who would listen. (Looking back, that could have been a mistake. What if I had a chance to go out again?)
If I lay here
If I just lay here
Would you lie with me and just forget the world?
– Snow Patrol, Chasing Cars
But OK. It was a good day. But I’ve been taught, ever since I was able to get out of bed, to be careful to avoid fatigue. When a brotha gets tired – one who’s recovering from any medical condition or surgery – that’s when mistakes are most likely to happen.
Flashback: 02.21.2012 – In therapy, I don’t just learn to exercise. I learn how to keep an eye on myself, how to understand what I can and can’t do. In that sense, I get stronger in my head as well as in my body. I didn’t fully appreciate that at first: for the first few days of therapy, I couldn’t do much, so I guess I looked at it as a failed exercise. I was first set up to take a few steps along parallel bars, and I totally couldn’t do it. One therapist would lead me along holding a gait belt, and another followed me with a wheelchair. I not only ran out of gas after a step or two, but I landed in the chair with a plop. And we know how therapists are about plops.
The thing is, despite the plop, I found the therapists were encouraged by every little thing. They have notebooks, and they take extensive notes. With really small handwriting. They knew how little strength I had when I started, so when I could do something they’d say “that’s something you couldn’t do before.” But they were really watching me also for signs of fatigue, because someone fatigued may fall harder than with a plop. They also knew that if I could do more today than yesterday, I might want to keep going, and see how far I could go.
There’s a condition called clonus – it’s found commonly in guys like me who are recovering from strokes. It’s a kind of spastic stretching and flexing of muscles, and in my case it turns up in the right ankle. The therapists noticed that it often happened when I was becoming fatigued, so it became a sign that I should take a break. And they wanted me to learn that sign so I would know not to overwork myself, and sit down if I needed to.
Flash forward: today – after a few hours out with my brother, I saw clonus in my right ankle; I was starting to have trouble landing my right foot properly as I walked; and even though I wasn’t sweating, panting or wheezing, I knew I was running out of gas. And I sat. No plop. A win for therapy!
If I can recognize when I’m tiring, then I can pace myself. I can always work myself hard, and make myself tired, but because I know the warning signs, I can make myself not overwork. I can make myself not do anything stupid, make myself not get hurt, make myself not fall down, make myself not set my recovery back by who-knows-how-long.
Forgive me if I just lay here. Or is it lie here? …and just forget the world.
End part five. I’ve received a great deal of encouragement for using my blog this way. But this is service – something I can do for the world.