Part 4: Electric!

The two major problems with my left leg were my ankle and my hamstring. Both were completely non-responsive to my massive effort to move or tense them. As one might expect, trying to walk safely without fear of falling is linked intricately to the functioning of your ankle and hamstring. So that’s what we worked on. Many of the exercises focused on trying to ‘trick’ the muscle into remembering. The brain was there, the muscle was there, both were working, but they weren’t communicating; the messages were getting blocked along the way. We weren’t looking to hamstring curl 50kg, we were simply looking for the tiniest contraction (twitch) of the muscle. Once that one tiny contraction was achieved, it was just a question of doing it over and over again, eventually strengthening it to (perhaps) what it once was. Phillip was doing a lot of research and reading into electrical stimulation of muscles in rehabilitation, and he asked if we could try it (some people ‘don’t like current’). I was happy to.

The way we would use it was to attach the electrodes to the muscle with Phillip at the controls. We would count down and then try to time the electrical stimulation of the muscle with the stimulation coming from my brain, so that it seemed as though the messages from my brain were getting through to the muscle. Eventually we managed to get a contraction (very much a twitch) out of the hamstring without the use of the electrodes -that was the message getting through to the muscle. After that the hamstring got stronger relatively quickly. Soon Phillip was pushing down on my foot while I tried with all my might to do a hamstring curl, a massive departure from trying to initiate the tiniest of contractions.

The ankle was an entirely different matter, not co-operating at all. The problem with having a non-functioning ankle is that when you walk your toes drag because there is no dorsi-flexion. As a result, you have to walk in such a way that you bring your leg and foot ‘around’ instead of ‘through’ in doing a walking motion. If you’re wondering what dorsi-flexion is, it is when, if you are standing or sitting with both feet flat on the floor, you try to lift your foot off the ground as far as you can without your heels leaving the floor. That motion is very important for walking/running.

My ankle was not playing the game at all. This was highly significant to me because I still dearly wanted to run and participate in sport again. Without a (working) ankle this would probably be impossible. Phillip put together an ingenious little device that might give me a chance. Using the electrical stimulation device, he modified it so that a pressure sensor was placed underneath my foot in my shoe. Every time I lifted the foot to take a step the sensor would activate electrodes that were on my ankle in strategic positions. The ankle would then move in a ‘dorsi-active’ manner, and I would not drag my toes. So with this contraption attached to me I could achieve dorsi-flexion while walking. Not exactly the most convenient thing to have a battery powered electrode attached to your foot semi-permanently. Nevertheless, the device did have the effect of simulating a walking motion, and thereby perhaps reminding my ankle how it used to feel. One day I discovered that I could move my big toe. When I told Phillip this he almost jumped through the roof. He was happy to the point of laughter, whereas I thought that it was not such a big deal. He did however say that this meant that my ankle would ‘come back’. Of course, this was good news for me.

Phillip and I would practice stair climbing as well, albeit only one at a time. We started with the small stairs outside the ward reception, then graduated to using higher boxes in the therapy room.

Phil was (is) a really good guy and always seemed to be thinking about my case as he always had new ideas and thoughts about what we could try.

Klare Hein was my OT (Occupational Therapist). She was also pretty cool, a pretty woman about my age. The first thing she taught me to do was to get dressed. She told me that you always first dress/undress the affected side (the weak side), that way you are using you strong side in the best way. Hey, don’t laugh, getting dressed with one arm and one leg is a difficult task. The next port of call was to try to remember how to tie shoe laces, after the first day I could manage, even though my left hand was still quite spastic. We did a lot of physical stuff like throwing and catching a ball with my left arm. We also did mental tasks like puzzles and games that might incorporate my left side in some way as well as my mind. OTs generally try to make sure that you can do ‘normal’ everyday things like brush your teeth, dress yourself, etc. Klare did that no problem, she wasn’t particularly entertaining, but she did the job. Whereas Phillip’s passion and love for his job really shone through, I don’t think Klare had the same fire burning inside her. Not to say she was a bad therapist, though.

My speech therapist Danielle was brain crushingly irritating, although she was just trying to do her job. My speech had come back really fast after the strokes, I did not think that there was anything wrong with my speech, yet I needed this therapy. The most entertaining thing about my time with her was the fact that she had eloped and fell pregnant in the last few months. She wasn’t showing yet so it must have been quite recent. I always hoped she forgot about me. She always sat on chairs in the way that kids do; like when they sit on their own foot. One day she fell off onto the floor, it was pretty funny, sadly most of the others who witnessed it were either too brain-damaged or on too much medication to laugh. Shame, not a bad person, but that’s how it goes.

As I mentioned before, I was initially in the section of the centre for those with neck injuries. In a way I fitted in well because my injury seemed like it could easily be similar. Eventually they moved me to the ‘brain-injury' section. Now this was something to behold. Packed to the rim with loonies of every description. While I was here I started to realise that I was actually very lucky in that I was not more severely disabled than I was. I shared a room with the joy of joys, an Indian guy by the name of Shaun Johnson. Now, I hate to stereotype people, but hell, ‘Shaun Johnson’ is hardly a name you’d find on an Indian ballot paper. He was a seriously miserable bastard. Didn’t really complain much to the staff, but was always muttering something about ‘have you EVER had such a shit day in your life??’. He did have quite a story though. He was in a car accident and apparently had been declared dead on the scene. He wasn’t though, and lay in a coma for 3 months before waking up. He had spent the last 6 months or so at Riverfield.

There was a lady who came in who seemed seriously cooked, and she was, you could tell be the massive scar arcing across her shaven head. I couldn’t help but laugh sometimes. She would constantly ramble on not making any sense at all. At first I thought that she was perhaps just chatting away to herself in her home language, but after I asked one of the others he told me that she was just muttering nonsense in an array of sometimes indistinguishable languages. During exercises she would do completely random things like crack her knuckles and try to co-opt others into joining her (with the nurses scrambling to prevent this). Of course I felt sorry for her, but funny is funny.

Another lady there, Mrs White I felt really sorry for. She was very old and in bad shape. Her ankles and calves had swollen to the point that they didn’t look like they belonged to a human being anymore, and she was only ‘with us’ about half of the time. She would also do and say the most random things. During exercises one day she started begging and pleading profusely to be given….. ‘just one (gesturing with her finger) teaspoon, pleeeaaaaase’. Once given the spoon she was confused as to why she was given this thing. I felt really bad for her, she was on her way out. Her husband who also looked quite old used to visit her often, they would just sit quietly on one side of the room talking. My heart broke everyday for them.

The person I felt most sorry for was this young (20-25) guy from Mozambique. His name was Manguelle and he had been electrocuted while at work. He was severely, severely brain damaged. He could not really walk around without crashing into things or falling over, he was mostly tied with a sheet into his wheelchair. He always wore a nappy. He did not appear to have proper control over any of his limbs or his body, although they did seem functional at least. It was impossible to communicate with him and he barely understood instructions or greetings. At mealtimes he would have to be fed, and eventually his mouth held shut so that he did not spit out food. If left to his own devices he would simply make a massive mess through attempting to get the food into his mouth. For him I was so, so sorry. No-one came to visit him, no one ever asked about him, he was completely alone in a world which his damaged mind could no longer understand or make sense of.