Wednesday, February 20, 2013

The Words to Say It

A little more than a year after stroke, my therapies were winding down. I needed to try something new, maybe a class. Several family members and friends suggested seated Tai Chi or yoga classes. I tried to be enthusiastic.

People assumed that I would be more comfortable in a chair. It was hard for me to move, right? But when I finally went to the gentle, i.e. seated, yoga class, I knew it was the wrong thing. I stopped going.

At that point in my recovery, there were still so many thoughts that I couldn’t articulate because of my aphasia. But there were other thoughts I couldn’t say because my vocabulary, even pre-stroke, didn’t include many neurological terms. I was lucky that I had heard the word aphasia before the stroke, thanks to writer Oliver Sacks. But the word proprioception--and the concept--were still new to me. After the stroke, it took me a long time to figure out that the general feeling of loss on my right side was different than say, the numbness I had felt from local anesthesia at the dentist’s office. In fact, I’m still mulling over the difference between lack of sensation and lack of proprioception.

So I couldn't explain that it felt precarious to do exercises in a chair, especially the flimsy chairs at the yoga class. Not because of balance issues, really, but because I didn’t know where the right side of the chair--or my body--was.

About a year ago, I found a great yoga teacher. She comes to my house about once a month. Most of the standing poses are beyond me, although sometimes my teacher cajoles me into trying a standing pose with the kitchen table to stabilize me. But usually, we work on the living room floor. When I need to stand up, I do have enough strength to haul myself up with mostly with my left leg, or  using the couch as a prop.

But I like being on the floor. There aren't any edges.

13 comments:

  1. Grace, how I appreciate your proprioception issues! Indeed, at the inception of my stroke, I had NO feeling on the right side of my body. Picture drawing a line vertically and meticulously down the middle on my body. A quarter of an inch on the left side felt normal. A quarter of an inch on the right side felt nothing. Not just unfeeling, but absent. When riding in a wheelchair I was constantly cautious of bumping or stabbing my right side into anything solid. I had no sense of where my right side was in space except by inference from awareness of my left side. NOTE: after reading your excellent post, I noticed that simple Google searches for "proprioception" and related terms such as "proprioception testing", "proprioception exercises", and "proprioception training" provide links to a number of interesting & likely helpful sites.

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    1. Thanks, Billy. I did Google it, but it was a while ago. I should try it again.

      Yoga seems to help a lot with general body awareness for me.

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  2. I think my proprioception is probably pretty OK (I still don't quite get what it is, but not having had a stroke, I ASSUME it's OK). That said, I too, much prefer the floor in yoga. Not only is it without edges, it hurts far less when I do a nose-dive and subsequent face-plant from a seated posture than from way, far away.

    Today my yoga teacher said that for every minute we spend upside-down, we add another day to our lives. While I'm not sure that's true, I think I'll pretend it is. It sounds nice. Keep up the yoga!

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    1. I'll settle for adding another minute. I don't think any handstands are in my future.

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  3. Proprioception is one type of sensation (e.g. light touch, hot/cold, etc.). Proprioception comes from receptors in the joints, muscles, and tendons that tell us where our body parts are in space and how fast they are moving. My hand always moves better when my OT gives it resistance which intensifies the input to these receptors.

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  4. Hi Grace,
    Lack of proprioception is very common for stroke survivors. I am most familiar with lack of proprioception in the leg, where stroke survivors are unable to discern where the limb is in space. But with a lot of gait training, we have seen stroke survivors regain some proprioception by walking with a proper step over and over again. Keep working hard!
    Brian Glaister
    CEO
    www.cadencebiomedical.com

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  5. Grace: Oliver Sacks, off hiking in the Alps alone one fine day, had a very bad fall. He was found and taken to hospital. His proprioception was severely impaired on one leg. He wrote a book about his experiences as a neurologist, and now, patient. It is called, "A Leg to Stand On." Listen to it or read it as you like, but don't miss it.

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    1. I think I have to buy a boxed set of his books (if it exists)! Finished "The Mind's Eye" a few weeks ago.

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  6. My proprioception is pretty good now. But it was truly bizarre, right after my my stroke, to realize that if I closed my eyes, I had no idea where my left arm was in space. Between the lack of sensation and proprioception, I'd sometimes fall asleep lying on top of my left arm. But over time it got better. Hang in there!

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  7. I am glad to hear you have a great yoga instructor. I found the biggest improvements in my balance were related to starting adapted Tai Chi classes and doing aquatic therapy. I had never done either so both were new to me. I can understand how going back to an old activity like yoga for you could have been extra frustrating.

    The tai chi instructor (a physiotherapist) is great because everyone has their needs met. You can sit/ stand what ever you need in a given moment and she challenges us just to the right amount.

    The water exercise is like your floor. You can't fall over and hit yourself. It is so freeing that you canget on with concentrating on relearning to balance.

    My left side awareness has improved a lot but I still find myself letting my left arm dangle and doing everything one handed. My arm is working not bad and I still don't even think to use it!

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  8. Hi Grace. I recently started reading your blog and am really enjoying it. I appreciate the time and effort you put into it in order to get information out to other stroke survivors. After my stroke, I had proprioception issues along with left neglect. Both are much better now. But while it lasted, the left neglect was severe. To the point that I would not acknowledge anyone on my left side and ignore faucet and appliance controls that were on the left. My stroke was 18 months ago and those issues have resolved themselves thankfully. I hope you experience the same healing as time goes on.

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  9. Best wishes as you continue to recover. I am 5 years post stroke which was a complication of brain surgery. I have improved tremendously by learning how to bake again. We can all learn from each other. Check out my Blog at:

    www.bakestoke.com

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    1. I really enjoyed looking at your blog! Thank you.

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