Standing Ready

I moved from Select Specialty Hospital to Methodist Rehabilitation Center the first weekend of July. I had never transferred to or from a car before, and I wasn’t prepared for how difficult the process would be with a weak leg. Moving from the wheelchair to the car was not an issue, since the car seat sat lower than the wheelchair seat. However, when I tried to get out of the car, my left leg would not cooperate. First, I couldn’t lift it to get out of the passenger’s seat properly. Then after I did maneuver it free, it was too weak to stand on. It buckled several times under my weight. Finally, a couple of the hospital workers took pity on me, and came over to help. One held the wheelchair steady; the other guided me safely into it. I would’ve fallen had I not had someone else to support my weight. I couldn’t imagine why my left leg refused to work the way it always had.
When we got into the building, I was wheeled to the elevator and up to room 505, where my mom and sister were waiting I couldn’t figure out how I was going to get into the hospital bed. But then a bored looking woman in the doorway piloted an overhead lift over to me. The staff strapped me into the apparatus. It lifted me into the air and over to the bed, where it gently deposited me. I was unstrapped and undressed.
Eventually my family all left. Since it was Friday, there weren’t many staff members who had to run tests or come by for any reason. Instead, I lay there in solitude. I was unable to get out of bed, and the room seemed so large. I became aware of just how little I could do. I was frightened that I might never be able to get out of bed and take care of myself again. I lay there wanting to cry.

The following day I had intake evaluations. I would see a physical, occupational, and speech therapist. They would test my body’s abilities and figure out where to begin my various rehabilitation programs. The first person to come was the physical therapist. She asked me to move my leg in various ways. I couldn’t. So she began moving it for me, just to elicit responses. Each time, the muscles would fire of their own accord. Then she would exclaim, “I thought you couldn’t move that!” She reminded me of an aggressive PE teacher. All of the muscle movement, and the fact that I had never lost sensation on my left side, gave me reassurance that I would walk again.
The next person to evaluate me was the occupational therapist. It was her job to work with my left arm. I don’t really remember how this went. But since my arm was still sensitive, I don’t think that we could do much. I’m sure that I was frustrated, yet slightly optimistic.
Finally I had to go to the cafeteria to meet with speech therapist. We did a lot of cognitive testing. She asked me things like the day, time, and several other random facts. Finally she asked me to write my name. I still had horrible double vision and my control in my right hand was not fully recovered. I knew I couldn’t write my name legibly, but I was worried that she might think I was stupid. So, I reasoned that, if I wrote it in Korean instead of English, it would be almost exclusively straight lines and right angles. I scratched out “마이클”,’ hoping that she might understand that it was my name in some language, and that I hadn’t simply lost too many brain cells.
It quickly became apparent to me, and later to those who had known me before the stroke, that only my physical body had been impaired. I couldn’t walk, speak clearly, or use my left arm, but my sense of humor, cognition, and memories were unchanged. I liken it to people who contract ALS or Parkinson’s Disease. They have fully functioning brains that are merely trapped inside of compromised bodies. There is little more frustrating than mentally knowing exactly what you want to say, but being physically incapable of expressing yourself. It seems that it would often be less frustrating to simply not have the vocabulary in the first place.

The next day was Sunday. Around noon They informed me that it was shower time. So I was strapped into the overhead lift hanging, moved across the room, and deposited in a shower chair. This was a chair with a large opening where the seat should be. I was then wheeled into the bathroom and stripped naked. It’s difficult for me to describe the humiliation I felt at this point. The staff did not belittle me, and they maintained complete professionalism. It was just the feeling of knowing that I was no longer in control of my body. The CNA turned the shower head on. Warm water began raining over my body. She began soaping me down all over. It felt so wonderful that I forgot how uncomfortable and cold the room had felt heretofore.
Monday my routine began in earnest. Around 6:00 am, a lab technician would arrive to draw my blood. Then around 7:30, someone came in to help me get ready. She dressed me, then used the lift to transfer me from the bed to a wheelchair. She wheeled me over to the sink, and helped me to wash my face, brush my teeth, and put on deodorant.
After that, she wheeled me down the hall, until we came to the cafeteria. Instantly I had the same anxiety as when walking into a junior high school cafeteria for the first time: my heart rate quickened and my knees buckled. Luckily, I was in the chair so people couldn’t see my nervous gait. These patients weren’t menacing, but I was used to years of weightlifting. That had brought with it a natural confidence. Without being able bodied, I was stripped of this self assurance, and I felt like an undersized thirteen-year-old again. I had them park me between two fellow patients, and quietly ate my breakfast. After half on hour or so, various therapists began filing in to collect their patients. A young, red haired guy called my name, and when I answered, he wheeled me out the door and across the hall.

The room we entered next was the therapy gym. In it was a mock staircase, several raised mats, various pieces of gym equipment, tables, and all sorts of different activity stations. I was in awe of the room, but I was excited about what kind of recovery was going to take place there. Telling me that he was my physical therapist, the young man introduced me to his helper. However, I was still too bewildered to remember names. They wheeled me over to a set of parallel bars. They positioned me between the bars then the therapist wrapped a gait belt around my waist, so he could support my weight. He then asked me to stand.

I shifted my weight, pushed through my heels, and rocked forward using my right forearm. I felt the overwhelming weight of my body. So much of it felt inert, lifeless. I grunted and strained for several seconds. Then mercifully, the therapist told me to sit back and rest. I sat back for about thirty seconds, then I tried again. Slowly, I rose to my feet. I was shaky and weak. My left leg felt like it would explode from pain. It took me several seconds, but finally, I was standing again. My chest was heaving and I realized that I was sweating profusely. I told the therapist, “I need to sit down.” He then held the gait belt with both hands, and I quickly collapsed back in the chair.
I could feel the back of the chair against my ribs. My lungs were burning. The helper mopped the sweat from my face, head, and neck with a cool towel. I looked around the gym then out window. I could see a water tower, and a construction that must have been erecting a building somewhere to the northeast of us. It made me wonder how much I would have to go through to remake my body into a functional mass of flesh. The muscles would only be rebuilt if I could wake up the slumbering nerves.

After working with the physical therapist, I saw the occupational therapist. It was her job to get my left arm to function again. She strapped my forearm onto a board with wheels on the bottom. Then asked me to push the device forward. I couldn’t. And it was disheartening. Next, she placed electrodes on my arm – one pair along my forearm and another pair on the triceps. This was known as the e-stim. When she was switched it on, she told me to let her know when I could feel it activating the neurons in my. I alerted her when I felt my arm move. She then told me that she was about increase the voltage.
She turned the dial a little more. Slowly I started to feel my arm move.
“Let me know when you start you feel it sting.”
“I think it needs to go higher.”
“Okay. Tell me when to stop.”
As she increased the voltage, I watched my wrist move. My fingers didn’t open, nor did my triceps fire. However, I had never used this sort of device before, and I didn’t know what to expect. I hadn’t seen any part of my arm work in a month. At least it was something.
During the month that I’d been awake again, my entire left arm had been unbelievably sensitive. It still hurt badly, but I noticed that the pain was slightly less severe with e-stim. I guessed that, for some reason, if I kept allowing current to go through it, maybe it would hurt less. So I I allowed her to keep doing activities with e-stim, no matter how painful. The few seconds of relief were worth the agony I had to endure in order to put my arm into position for any exercise. It was going to hurt regardless of whether it was moving or not, so I figured that I might as well engage in the activities that might make it hurt less.

When we were finished with a few exercises, my second hour ended. A transportation specialist came in to wheel me out of the gym. We went up in an elevator and arrived next at the Respiratory Therapy Department. I was parked in front of a specialist. He asked me to breathe into a tube and exhale until I could breathe no longer. I was asked to repeat this test several times and in different variations. I felt an increasing resistance that made it harder and harder to breathe. He was establishing a baseline of my lung function so they would know which breathing exercises I would be able to perform.
I assumed that they were addressing my chronic problem with asthma. For years I had had a serious affliction with the disease. While I had always enjoyed playing sports, the running aspect had been a big challenge. Whether it was time on a track or treadmill, or the mile run that coaches expected you to complete before practice, my lungs would burn. In fact, my breath capacity had been below 70 percent for years. Running was such torment that I really only got my cardiovascular exercise by the actual scrimmaging.
That was probably what had kept me from having a stroke in Minneapolis years earlier. After I returned to Mississippi, I found that the economy simply didn’t lend itself to people having the type of disposable income it would take to support the multiplicity of adult sports leagues I was used to. And even if the economic situation had been different, the population was much smaller. There are more people in the Twin Cities metropolitan area than there are in the entire state of Mississippi. As a result, there is a critical mass of people in a smaller geographical area to support various types of enthusiast groups. Without readily available cardio outlets, I was reduced to weightlifting for exercise. So while I was in good muscular shape, I wasn’t helping my blood pressure in the least.

In retrospect, I wasn’t able to eat yet. I was still being fed through a feeding tube. Each time I could smell food on the breath of other people, I was insanely jealous. The therapist might have started the day by coming directly to my room, instead of my going to the cafeteria. I don’t remember. But since I’m telling you all of this from memory, I would rather do so with the fuzziness and inconsistencies that exist in my head. A completely reliable record of the facts would obviously be advantageous in some ways, but it would in no way communicate what it feels like to suffer through a near fatal brain injury. I wish to relate what it actually feels like to experience a stroke.

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