Friday, August 16, 2013


On Tuesday, my roommate left for Gen Con, where he'll be showing off his excellent new game, Torchbearer, and hanging out with a load of people I would love to see. I'm a little jealous, but quite glad I am not there because right now I can live without the punishing schedule and lack of a gym. 

I have been exercising more again, after gaining a bunch of weight when depressed earlier this year, and fighting to remind myself that "good enough" is no such thing when it comes to my recovery. It gets easier to accept compromise and not recovery, so I have to actively remind myself first, that I want to recover physically as much as humanly possible, and second that such a recovery only happens if I take exercise. 

To build up my overall endurance, I swim laps of a pool that is miraculously on my block, but is a bit skeevy. Fellow New Yorkers will know how unusual it is to have a pool right there, so the skeeve is a minor hindrance. I go to the pool on weekdays, typically, and to the gym on the weekends. Since swimming in a straight line requires concentration, my vision is poor and the pool has enough chemicals in to be murky, those are the times I can go and hope for fewest other people to collide with.

Anyway, on the Tuesday, I was primed and ready to go to the pool, when Thor set off, and a naughty thought popped into my brain: I could stay at home, not go the pool, and nobody would ever know! Never mind that this is not true, because I log all my exercise on Fitocracy, and that it makes no appreciable difference to Thor whether I swim or not, there was the delicious temptation to get away with something.

It didn't matter that I would, in the long run, suffer for not going, nor that after the first half dozen or so lengths I settle into a pleasant rhythm; the opportunity to pull a fast one was almost irresistible. Almost, but not quite: I told my brain to go screw itself and went to the pool. 

Unfortunately, my brain had a few tricks lurking in the grey matter. When I got to the pool, I discovered that I had left my fancy new swimming watch behind. I went and got it. Back home, I was again tempted to be all huffy about being jerked around by my brain and just not go, but I quashed the temptation, and set off again. 

I got about two steps out of my front door, before realizing that my brain had made one last desperate attempt to skive off: I had left my walking stick behind. Happily this all had the reverse of the desired effect: I was more determined than ever to go swimming, and I did. 

My brain has had the last laugh, though. This morning, I took my time getting up, and faffed around on the Internet, until my brain gleefully remembered that I have an acupuncture appointment today. There's not enough time to go swimming and to make it to happy fun needle time. Bugger.  

Tuesday, August 13, 2013

Taking Fatigue In My Stride

Last week, I worked quite hard: I swam on the five weekdays, for a total of a hair under 10km, and then went to the gym at the weekend. I went to acupuncture twice, and managed a few social engagements as well. After each bout of exercise, I felt 'good' tired; my muscles felt like they had done some work, but not sore. I might be a bit achy the next day, but I hadn't overstressed anything.

I have to watch my overall level of tiredness as well as, though. If I do too much on one day, then I'm often much less effective the next day, sometimes to the point of being a total spud.

Having to watch my fatigue is often counterintuitive, because I'm gauging neurological tiredness, and we've evolved to be better judges of muscular states. Pumping a bunch more adrenaline out is not going to help me escape the hungry lion, if it's my brain that is not going; my legs are still going to flail about.

The problem with taking too much rest is figuring out how much is 'too much'. If I don't stress my system just the right amount, then it will take longer to recover. I am already comfortable with the notion that it will take years of work to get better, but if I can shave months off that time, I want to.

So, yesterday, on Monday, I had to decide whether to go swimming or not. It was a crappy rainy morning, which definitely influenced my mood, but rain often makes the pool less busy. Muscularly, I was a little sore, but I expected that after working out my upper body on Sunday. However, I felt tired yesterday morning, and decided not to go, full of misgiving that I was just being lazy and self-indulgent. I spent much of the day feeling itchy to go swimming, but tired enough to take a short nap.

It was the right call. I'm sore today from the Tui Na massage I had yesterday, but I just swam two and a half kilometers, and I feel 'good' tired again. Sore, but ready to go again tomorrow. It wasn't the first time I've had to make that call, it wasn't even the first time I made the right call, and it won't be the last. I'll be making those calls for years to come. I just hope that I get a little better at balancing efficient recovery with living a real life.

Friday, August 9, 2013

Teardrops Keep Falling

A single tear rolls down my still-slack cheek, and falls from my poorly shaven jaw. I wipe away the telltale track swiftly; it wouldn't do to be seen to weep in public.

Am I mourning the loss of mobility, of vision, of ability? Do I constantly cry inside at my infirmity, these single tears the only expression of a strangled emotion kept buried? Perhaps I lament the boy I was, the man I have been, and the shadow of humanity I have become, is that what these tears represent?

No. Both my eyes tear normally, but my left eyelids don't close fully yet, and so the natural lubricant of the eye—tears—accumulates on the left and sometimes rolls down my cheek. I make sure my left eye is moist enough, but other than that, these drops are a minor inconvenience at worst. That is all.

I may have regrets, but I am far from unhappy. Sure, there's a lot of hard work ahead, compounded, no doubt, by hideous bureaucracy, but life is working hard, and anyone who tells you otherwise is deluded or lying. 

Tuesday, August 6, 2013

Taking Advantage of the Stupid Brain–an Exercise Hack

A lot of recovery focuses on how amazing the brain is, how it is astoundingly good at picking up the slack left by damage, and how resilient it is. To be this way, the brain itself has to be stupid and lazy, at least when it comes to self-aware animals like us. If we're cunning, though we can use some of that stupidity and laziness to our advantage.

The brain is evolutionarily geared to prefer activity that takes least effort for greatest reward. Throughout our lives, it tries to make our actions, in particular, as efficient as possible. Not only do we use less energy that way, but we end up using fewer neurons for things that we do repeatedly, and have more brain left over for complex, abstract thought. If you have ever got to work but don't remember the coffee you drank on the way, you've felt this.

This process can be seen in children when they go through adolescence and prune an amazing number of neural pathways to leave optimal paths, and the clumsy duckling becomes an elegant swan. It's what is really going on when we talk about "muscle memory"—when a complex sequence of physical actions is neurally optimized as an atomic unit that, once initiated, completes without conscious intervention.

It's impossible to decide consciously which path is going to be optimized, and which is going to be discarded; repetition tends to be the key, at least for physical activity. How do we determine, though, what habits of mind we can form?

Although the impetus to exercise was clear to me, a year ago, it's not so clear now, not so immediate. Put another way, the small incremental gains I get in function are proportionately less significant, so I appear to be getting less reward for more effort. Put yet another way, it's gotten harder to go to the gym and pool.

So I tried a hack on my brain, to see if I could make going to the gym (and pool) easier. I've already made the going as efficient (and energetically cheap) as possible, so the idea was to front-load the reward. Typically the benefits of exercise that we can sense, and the brain can operate on, come too late for us to associate the action of going to exercise with the reward of having exercised. The hack was simple: any time I thought about the action of going to exercise, I would then say to myself, with a mental tone of glee, "ooh, goodie! I'm going swimming tomorrow!"

That was it. I didn't have to mean it, and I frequently didn't, I just had to think (or say) it, no matter how artificial. That was the totality of my experiment.

It worked.

I was far more likely to actually go to the pool or gym, after I had thought "yippee! gym tomorrow! and legs, I love legs!" (I don't), the night before. I'm hoping that in two or three years' time, I won't have to say my silly fake mantra, because my brain will have associated the benefits of the exercise with the (short and painless) drudgery of getting to the exercise. Until then, "Yay! Skeevy pool tomorrow!"

Thursday, August 1, 2013

Fraudulent Brain Damage? No Such Thing.

When I was in England at the end of May, I went back to the ASPIRE group as the alum guest speaker. It was the day after I had flown in, but I didn't let the travel affect me, because I think the group is really good, does important work with people who've had strokes, and they gave me a chance to run my mouth, which is always welcome.

Before I started talking, though, one of the group's members, a woman about my age escorted by her mother, said that she felt "a bit of a fraud" attending the group. She had had her stroke quite recently (like many in the group) and had not been hit very badly: she suffered some left-side weakness, and that was it. The worst thing for her was that she got tired knitting, and could only wield the needles for short periods. Compared to the people in wheelchairs, she was fine and dandy, she thought.

Soon after I joined Fitocracy (and started the "stroke recovery" group there), I found a group for "people with disabilities" and even though I did not consider myself disabled, I joined it. Almost at once, I posted to the group that I felt like "a bit of a fraud" joining the group because I expected to recover. As if, somehow, the possibility that I might one day recover disqualified me. I was going to the gym regularly, after all. 

Over a year later, I don't have that problem any more. It is going to take me years to get better, and there are some things (vision, balance) that may never truly recover. In the meanwhile I am disabled. I am not making shit up. I am not a fraud. I worry that I say I can't work, but I write this blog, don't I? I make funny on the Internet, don't I? I can play games and read comics can't I?

Then I remember that it takes hours to write blog posts, and far longer than it once did, to read the context to make the funny. I recall that I read comics because I have to read and even novels are damnably hard work. When I play video games, there are whole classes of games I can't play, when I play tabletop games, I can't run them weekly, and I can barely sustainable length of a normal session. 

So, although I joke that I am a welfare queen, I am profoundly glad that the social safety net has not failed me, at least. Both because it will be several years before I take out what I put in, but more because it should not fail anyone. That's part of what it means to live in a civil society: we help each other out. Put baldly, it also makes economic sense to afford me the recovery time to become a productive member of society again. Maybe not everyone is fiscally worth it, but that's the cost of coming down from the trees and deciding to band together to build a society, instead of just flinging poo at each other. 

In the end, I told the knitter that she should not feel any kind of fraud: she had brain damage and it was affecting her life. Knitting was symptomatic, but useful as a metric: she should use it to measure how long she can now knit, each day, and celebrate as that time gets longer, gradually or in spurts. She may not be as badly affected as many who get brain damage from a stoke or otherwise, but it's a mistake to trivialize your own damaged brain; if you are to recover, you must be honest with yourself.

It is hard to be comfortable with the idea that I am damaged, perhaps permanently, and still sustain optimism that I will recover. It's harder still not to consider myself diminished, when in some respects I clearly am: trivially I couldn't run to save my life from zombies. One thing I am sure I am not, though, is a fraud.