Monday, April 30, 2012

I'm sick at the moment with a chest bug. This is a pain, because it means I can do less, which hampers my recovery, and I feel crappy. It also illuminates for me something I have grown to suspect about stroke in general, or maybe just my stroke in particular.

A lot of people, from sufferers of stroke, to stroke doctors, nurses and physios have warned of the great tiredness that can come with stroke. Now, there's no doubt that in the first months of my recovery I tired very easily; anyone who came to Mt. Sinai and found me asleep in the middle of the day can attest to that. But I don't think that tiredness itself is symptomatic of the post-stroke experience.

Instead, I think that we sufferers of stroke are told that we'll get tired, we experience that overwhelming tiredness in the early days of recovery, and we then practice being tired. Our brains learn that being tired is an acceptable way to be, and it's pretty cool, because other people take care of stuff while we're snoozing. Being tired as a symptom of stroke is, in this case, pretty awesome, because most of the time "he had a stroke" is an adequate STFU to any question.

I'm left wondering, though, what's the biological cause of the tiredness? I mean, sure, when we're first recovering our brains take frequent times out to create new pathways, but six months later? Why would I be extra tired? The short answer is, "I'm not," but maybe that's peculiar to me, and there really is some reason why everyone else gets tired and sleeps more.

What I have found is that stroke is a sort of magnifier, but again that's not quite right. My response to emotional stimuli, for example, seems magnified, even in as trivial a case as really enjoying The Avengers movie. But that's more to do with the fact that my physical response is less muted, so my emotional response feels disproportionate for an adult. I'm actually pretty content with saying "adult with brain damage here" and enjoying a lot more bang for my exorbitant movie buck. Or at least, I shan't be working overly hard to recover from that particular change; I'm content adapting to it.

Ultimately, my experience is that I have little to no reserves. When I get tired, that's it, I'm done. This makes sense when you accept that I lost a few c.c.s of highly optimized motor control brain matter, and now the rest of my brain is having to pick up the slack. Unfamiliar parts of my brain are working to learn how to interpret signals and send meaningful responses to the bits of me that have been walking, seeing with binocular vision and being a face for forty odd years. My brain is still at it, it hasn't even finished just figuring that stuff out yet, let alone started to optimize it so that there's some left over capacity for me to draw on.

If this seems incomprehensible or far-fetched, let me put it to you that I now have a visceral understanding of why a child who's just become a toddler will rocket around, then keel over and fall asleep. Just the act of walking right as well as getting where I want to go can be exhausting. Or it was, it's getting easier with every passing day, because I'm working hard at the exercise I do.

Which brings me back to being sick, which is annoying because, although it's exactly the same as when you get sick, it seems to affect me more, because unlike you, I don't have anything to draw on in reserve. Of course you could just as easily have depleted your reserves burning the candle at both ends, but for me it means that I shan't get up tomorrow morning to go see the Queen toddle around Sherborne and I'll be asleep in about 20 minutes' time.