As February drew to a close, my life started to feel monotonous. I was going to the gym a few days per week. We were getting a lot more snow. I was no longer in therapy. My days were broken up between lifting weights, taking Mary outside, and writing for my blog. I was motivated, but I was also feeling kind of empty. Even my writing started to feel uninspired. So I had to get myself on a schedule that would help me to organize my mornings. That would help me to mentally focus.
I had communicated with assisted living to start having my stretches done daily by staff. I asked them to do this in the morning, so I could be ready to go out for the day. The staff brings me my morning medications at 7:00am, and although that would have been an ideal time for stretches, I was advised that the staff had to dress and feed other clients between 7:00 and 10:00. So the time they could get around to me wouldn’t conflict with my scheduled rides, I asked if they could help me with my range of motion exercises at 6:30.
Having a dog meant that I would have to let her out even earlier. Otherwise I ran the risk of her having an accident while waiting to go out after my range of motion treatment. This entailed me committing to getting out of bed at 6:00 each morning.
The first day I tried this, I was very tired. I dragged myself out of bed, dressed, and put on the shoes with shoe buttons so I wouldn’t need help tying them. I went downstairs so security could zip my parka. Mary peed immediately, then I went back up to my apartment so the assisted living worker could come in to do my range of motion stretches.
No one had stretched my shoulder aggressively in years, so I wasn’t prepared for what it would feel like. It was painful. Even with the amount of exercise I was doing every week, I still didn’t realize how tight my shoulder was. Each time he raised my arm above my head, I wanted to cry and tell him to stop. But I knew if I endured the pain, it would subside a little more each day. The goal was to recover as much muscle function as possible, so I knew I would have to go through a little pain each day, just as I had the first year after my stroke. There had been a time when I could barely use my left arm, but perseverance had gotten me to the point where I could lift weights again.
When he was finished, I had him attach electrodes to my forearm, so I could perform e-stim on my fingers for 30 minutes. After I was done with e-stim, I was still a little sleepy. So I decided to take a nap for an hour. After the nap, I took a shower. The shower was the thing that finally helped me to completely wake up. As I got dressed, I decided to type up a daily schedule in Microsoft Word. In the future, I wouldn’t have to plan out anything before 1:00pm again. As long as I was half-awake, I could sleepwalk through my tasks until I was on the bus to the gym.
I wanted to supplement tthe passive range of motion stretching with active movement. I was already doing a modest amount of exercise on this region of my body. Now I resolved to target it more intensely. I began by devising a more traditional training split. I would go to the gym a minimum of four days per week. Two days would be spent at Planet Fitness; two days at L. A. Fitness. The two days at Planet Fitness would focus more heavily on building leg strength. The two days at L. A. Fitness would feature upper body movements. There would, however, be some carryover. At L. A. Fitness, I would also use the treadmill and perform one leg exercise per session. At Planet Fitness, I would do at least one exercise that would stretch my shoulder. This way, each body part I was trying to rehabilitate got some attention most days of the week.
My two consecutive weeks of going to the gym four days in a row had increased my endurance, so I was able to rest for shorter intervals between sets and perform more sets. Thanks to this, I started doing four different exercises on my upper body days. While these exercises were meant to target the back and chest, they also had the effect of adding greater flexibility to my arm and shoulder, since you are using those body parts whenever you pull or row.
I usually performed lat pulldowns, lat rows, and chest flies during every upper body session. However I felt like even these exercises were only providing passive exercise. They allowed my shoulder to be manipulated more easily. And while that was good, I wasn’t actively using the shoulder. Before the stroke, I had been able to shoulder press 80-lb dumbbells. I hated not being able to even bring my hand to my ear. If I ever wanted to be able to raise my left arm above my head again, I knew learning to lift weights using my shoulder again would be crucial to my progress.
When I examined the issue more closely, the problem was not that I couldn’t raise my shoulder. I could bring my shoulder to a position where I could at least begin lifting; I just couldn’t rotate it so my palm was facing forward. This had seemed like a hopeless situation for years. Then it occurred to me how much my triceps used to burn after a good shoulder workout. If I could get my arm into the correct position for shoulder presses, I could probably regain strength in my arms too, thereby regaining rotational capability.
The next time I went to Planet Fitness, I used the Smith machine to perform squats. Before starting, I set it up to perform shoulder presses. I knew my left shoulder would be extremely tight and might just be along for the ride for several months. But even if I couldn’t gain much strength from the exercise, I could continue to loosen up the joint. I pushed up on the bar. It was even more difficult than I’d anticipated. I pushed harder. Now I could feel my left arm quivering as it strained from effort. It was all I could do to get the bar above my head, but I pushed for nine more reps. Then I managed to do three more sets of ten. I wasn’t able to do that much on my first day, but I would attempt shoulder press every day I went to Planet Fitness and reassess in three months.
I had recently committed to walking on the treadmill every time I went to the gym. I wanted to start walking for five minutes per day; to expand that to ten minutes per session after a couple of weeks; then ultimately to be walking for a mile by the end of the year. By the time I was at a mile, not only would any amount of walking I needed to do be easy, but I planned to be transitioning away from using a cane altogether.
When I started on the treadmill, I had a couple of body mechanics issues that made it difficult to walk for more than a few minutes. I couldn’t lift my leg very high and I couldn’t extend my left arm. Because I needed to pick my foot up off the ground to move it forward, I had developed the habit of kicking it out to the side to compensate. Although this would achieve the desired goal of advancing my leg, it made for a very unstable stride. The weightlifting was meant to address this by building brute strength. The treadmill would force me to constantly coordinate all of the muscle groups, leading to a more natural stride. I quickly improved, but I would get tired after five minutes and have to stop.
After I had been trying to work at this for a week, it occurred to me that I wasn’t brining my leg up high enough on a consistent basis. I was already working my quads, glutes, and hamstrings. By a process of elimination, I surmised that I needed to strengthen my hip flexors. They had shown me how to do this in physical therapy. I would lie on my back on a raised surface with my legs extended over the edge, so my feet could rest on the floor. Then I would lift my knee as high as I could.
I began by doing ten reps at a time and worked my way up to twenty. After I was able to do this much on the edge of my bed, I began doing it in a seated position. This way, I could exercise my hip while I was watching television or sitting next to Mary on a couch. It only took a couple of days of working my hips before I could see the difference on the treadmill. Because my foot didn’t drag nearly as often, I was able to keep walking for ten minutes. I felt thrilled. I wanted to do more, but I decided to get off the treadmill and go lift weights.
For the next week, I committed to ten minutes on the treadmill. That was so easy that I pushed myself to fifteen. At this point, the only thing stopping me from walking longer was the tone in my left arm. Because the arm was still severely constricted, I couldn’t hold the machine handle and continue to walk normally. Although I was tempted to just use my right arm and walk for a mile or two, it was important to keep using both arms. It would align my gait, keep my fingers engaged, gradually straighten my arm, and help me when I was doing things like pushing carts and carrying boxes.
I paid rent for March a month in advance so I would be able to buy things I needed for the year. My ILS worker and I went down to a department store to pick up jogging pants, jeans, and a belt. The last two times I had shopped at this store, I had required a wheelchair. Although I would be walking this time, I was concerned at how slow I would be and how exhausted the trip might leave me. I also was wary of incontinence. It had been months since I’d had anything resembling a restroom emergency, but I still worried about how difficult controlling myself had been right after the stroke.
My ILS worker dropped me off in front of the store and went to park the car. I made it inside quickly and noticed how easy it was to walk back to the men’s department. We found all three items in my size and made our way to a fitting room. I already knew the jogging pants would fit, so it was only necessary to try on the belt and jeans These were easier to pull on and fasten than I had anticipated. Not only did I not end up having to use the restroom, but after I put my clothes back on, I still had an hour to spare.
It was still morning when we drove home. Moving around was becoming easier every week. This was going to be the first year when trying to live life would not be physically taxing.