May 22, 2017

Surgery is Contraindicated

Since knee surgery my standing balance is worse.  I have repeatedly stumbled backwards because I cannot feel when I am leaning too far behind vertical.  Losing my balance was the first symptom of my two brainstem strokes.
My strokes were caused by narrowing of the vertebral artery that supplies blood to the pons.  The pons in the brainstem is the bridge to the cerebellum which controls balance.

There is a chance that bending my neck back to put a breathing tube down my throat during surgery put a kink in the vertebral artery in my neck.  If a 15 minute meniscal repair surgery impaired my balance, I do not want to see what happens after a longer knee replacement surgery.   

Bottom-Line: I am serious about the exercises I got from my latest PT.

May 13, 2017

Rolling Discharge While I am Still in Therapy

When I am in therapy I do a rolling discharge.  I never wait until I am discharged to start doing exercises at home because there are often problems transferring exercises to a new environment.

The 1st challenge is modifying how I exercise at home because I do not have the right equipment.  For example, my PT had me lie on my stomach on an 8 foot wide mat table and bend my knee.    I need strong knee flexors to stop the joint-damaging SNAP my knee makes when I straighten it to swing my leg forward to take a step.  However, my single bed at home is narrow.  I tried lying on my back close to one edge, rolling onto my stomach which moves me to the other edge, and carefully inching my way back to the center by pushing with my elbows.  This was scary and stressful for my hemiplegic arm.
My soft bed also does not provide a firm surface to push off of.  I tried folding a yoga mat to create a firmer surface under my belly, but it was a nightmare to position with one hand.

The 2nd challenge is establishing a consistent routine that saves me from muscle atrophy after I  worked so hard in therapy.  A reliable memory aid helps me follow through on my good intentions.  I reach under the bed covers to remove the ball that keeps the covers off my hyper-sensitive big toe.  Instead of rolling the ball into its corner, now I roll it towards my leg brace.  After I don my brace the ball reminds me to go to the bathroom, stand while I hold onto the grab bar next to my bathtub, and bend my knee.  I can do 8 repetitions before my weak hamstrings poop out.

Bottom-Line:  Figuring out how to do exercises at home can take creativity and persistence.  Starting this process before therapy ends means I can ask my therapist for suggestions.

May 5, 2017

Mini Exercise

Pain did not end after knee surgery so I asked for PT.  My PT discovered my knee problem was caused by weak muscles that do not keep my joints in good alignment.  However, I cannot be trusted to do boring, time-consuming exercises that never end because my weakness will never fully go away.  In the 13 years since my stroke I learned I will do 3 to 5 repetitions every day  IF I use an object as a memory aid.  The stranger the memory aid the better it is at catching my attention.  I call doing a few reps every day forever a mini-exercise.

When I told my PT about mini-exercises she looked skeptical.  She is in her thirties so she can recover strength and flexibility if she stops and then starts exercising.  She does not know how
mind-numbing exercise is when it must be done every day until she dies.  Here is one of the
mini-exercises I added to my daily routine because I do not want knee replacement surgery.

My PT had me do lunges to strengthen my knee.  My knee wobbled left or right (red arrow) as it bent because my hip muscles are weak.  After 1 or 2 reps my knee stays lined up with my foot (green arrow) because hip muscles work together to keep my knee in the midline.  I chose the toilet to prompt me to do a few lunges.  On his TV show Dr. Oz showed how much water sprays out of a toilet when it is flushed so I got in the habit of lowering the lid before I flush.  I have to wait for 10 seconds so I thought I may as well do lunges.