Monday, September 17, 2012


Balance has been on my mind a lot recently.

On an immediate and obvious level, my balance is very poor these days. Walking now is quite like walking while drunk off my ass; I stagger and weave and bump into things, especially if I'm not concentrating or I'm doing something extraordinary like talking. As an added bonus, I bruise easily, too (thanks, Aspirin!), so my upper arms are particularly beautiful. 

I can't tell why my balance is so poor (apart from the blindingly obvious because you have brain damage resulting from a stroke, dumbass). I maintain that my sense of balance is still good, that I know when I'm going over, but that it is muscular weakness on my right side and my brain still expecting dead bits to control my right side that fails to prevent the fall from happening. This is an optimistic view: it suggests that as I strengthen my right side and keep doing coordinated movement with it, my brain will gradually learn to use not-dead bits to control muscles that keep me upright, and maintaining balance will become less of a conscious activity.

This view might be wrong, and the neuroscience facts I learned 20-30 years ago would say that it is wrong. It's possible that I will always require conscious mental intervention to stay physically upright. Video game controls tend to give the lie to that thesis, though, if you've ever played a game obsessively enough.

Somewhere between the two is the possibility that it will take too long for an adult brain to sustain the level of intent attention that making balance automatic requires. In this view, I will reach a point where my walking is good enough for my brain to be satisfied, and it won't improve further. The trick to avoiding this seems to be to keep my mind dissatisfied and hope that it influences the brain to continue adapting. Same deal with my eyes: if ever I get too used to the double vision, the neurologists end up being right, and my vision stops improving.

All of which plays into another issue of balance: how much time do I spend on recover versus how much time do I spend just accomplishing the task at hand. I can stagger quickly, or walk more correctly slowly. This affects almost everything: when I use my right hand (for example typing this), am I doing so correctly or quickly? Correct doesn't become quick without time and effort, especially at 41. 

The intention tremor in my right arm and hand makes this choice even more pronounced: clearly, it's worth taking time to lift a glass or write with a fountain pen, concentrating on not having the tremor. Sometimes, though I'm just thirsty, or I just need to get a phone number down quickly and don't have a computer right there. That's when I have to compensate for the tremor, and hope that I'm not reinforcing it.

Furthermore, I think about work-life balance quite a lot. I am lucky to have the opportunity to focus on recovery, but soon I'll be looking for work (or student loans and work), and I wonder how I will ever have time to keep up the exercise I'm doing and sustain a paying job. Long before I had the stroke, I thought that American (and British) working practices were insane, and I think so even more now. Whatever work I do in the future must allow me enough time to return to full function.

Finally, I wonder about the balance to be struck between being disabled, and looking disabled. The facial palsy is a strange help here, as is the occlusion in one lens: I look as if I am disabled in the head somehow. That seems to be picked up on more than my walking stick, where although I look increasingly muscular and buff (huzzah!) I am actually more impaired by the physical than visual (probably; it's hard to quantify). The net result is that sometimes I do need help, but not necessarily where and when an observer might think. I'm new to the term and concept of invisible disability, and honestly never thought I'd be looking at it from this side. But then I never thought I was going to be disabled at all, more fool me!