Sunday, March 11, 2012

March Update

It's five months to the day since I had my first strokes, including the big old brain stem bleed, so it's time for a round-up.

I'm down to 85kg / 187.5lb. and 32" waits pants (trousers!), I go to the gym and swim five times a week, on top of doing 45-60 minutes of physio and other exercise first thing in the morning. The effects are clearly showing (I peaked somewhere north of 230lb.), but the paunch and muffin-top will be the last to go. I'm in no rush, since I'm able to do a little bit more of somethingpretty much ever day. So, in general terms I'm fitter and healthier than I've been for a while, especially since my blood pressure is medicated under control, futzing with Windows not withstanding.

My walking has improved. I can get around more confidently without my stick, but still need it, especially when tired. I still lean to the right involuntarily, and have yet to get whatever musculature is lacking there to get a grip. It's quite likely to be a neurological problem, which just means it will take effort and time. Although I have plenty of both, it is frustrating in the extreme to be toppling to the right and both not know why and not be able to fix it. I concentrate as much as possible on what I can affect, which is mostly my general health and fitness. Fitocracy has been a boon there.

I believe the diplopia is resolving, but it's taking so long it remains hard to tell for sure. It's easy to doubt what I think I'm seeing. My guess is that the maculae will get lined up first, so I have binocular vision at the focal point, and then the eyes will work on twisting so they have the same horizon, and my hope is that somewhere in there, the oscillopsia will go away. Hope springs eternal.

In real terms my ability to stay upright has improved, thanks to persistence with exercise, but I still don't think my actual balance has changed in months. I still fall over if I lose concentration or turn around too quickly, or just stand up forgetting that I had a stroke. Most recently, and rather embarrassingly, I fell in the hospital gym, scratching my elbow on a mirror. It was stupid, and really only partly my fault, and my pride (what little is left of it) was the most injured part of me, but it served to keep any hint of hubris at bay. I've retained much of my dexterity, though lacking the equilibrium to back it up sucks.

Since proprioception is such a large part of my working balance, low light doesn't actually make me less steady, although of course some other part of my brain thinks it should. I've recently got myself a pair of "VIVO Barefoot" shoes (I think sold as Vibrams in the US), which are designed for runners to have the proprioception of being barefoot, with thin, puncture-proof soles. I love them so much that I can't imagine wearing any other kind of shoe. It amazes me that there's no research study into using barefoot-style shoes for post-stroke (and other brain injury) balance. 

Since I'm in the mood, some fun statistics about haemorrhagic and other strokes:

• Survival rate for haemorrhagic stroke is 26.7% within a period of five years. [1997-2003 study] (Well, that sucks.)
• Survival rate for haemorrhagic stroke is 60.5% within a period of five years if you're 41-50 years old, though. [Same study.] (That sucks less.)
• 10 percent of stroke sufferers recover almost completely. (I'm aiming for this end of the bell curve)
• 10 percent of stroke sufferers require care in a nursing home or other long-term care facility. (Yeah, no thanks.)
• 15 percent die shortly after the stroke. (Dodged that one.)

• 14 percent of people who have a stroke or TIA will have another within a year. (I'll pass, thanks.)
• About 25 percent of stroke sufferers will have another within five years. (No, really, I'll pass.)
• People with uncontrolled high blood pressure are seven times more likely to have a stroke than people with controlled high blood pressure. (Ah. Good to know. Bit late.)
• Statin use before a haemorrhagic stroke improves short- and long-term survival rate. (Well, I'm taking some now.)
Statistics are, of course, for suckers. The best any of us can do is look at our major risk factors and eliminate them. My naturally high (and at the time unnaturally elevated) blood pressure is under control. I don't smoke, drink very little, and don't have diabetes mellitus. My weight is heading in the right direction (and you had better believe it's going to stay there), and I am going to stay fit. Beyond that, worrying about having another stroke is only going to make me more likely to have one... so why worry?
I still think 'victim' is preposterous, since no malicious agent victimized me, 'survivor' is entirely redundant, since I'm evidently not a corpse, so I've settled on 'sufferer.' Although any pain is related to exercise, typically, and hardly unpleasant, the experience has not been without anguish.