9.12.08

She blinded me...with SCIENCE!

Ms. A's aunt had a stroke last Friday. She's in her sixties and has Alzheimer's (don't know how far along) so this was rather devastating. She's a very sweet little lady, likes mumbling jokes to herself and apparently like's flipping Ms. A the bird.

Ms. A and her mom drove out to see her and see what they could do, if anything, to help. (A side trip to a haunted state hospital in a place called Yorktown will have to be told by Ms. A later. Look for it in her new book, Ah, Fuck I'm Crazy.) When they got there, she was in and out of sleep and remembering who was there. Very average affects of the stroke were evident such as slurred speech, and the loss of movement in her right arm and leg. She wasn't eating much.

It was sad for Ms. A and her mom, as it would be for anyone.

So they went out again the next day and I'd mentioned to Ms. A that it was good that it was a left brain stroke, those tend to recover quicker and easier than right brain strokes. I don't know why, I can't remember - something about the right emotional/egocentric brain prohibiting awareness of what it considers a lost limb. I also knew that most recovery from a stroke comes in the first few days if not hours. While she was there we shared text messages because voice service was spotty. She asked if there was anything they could to help her, any therapy they could suggest to the doctors.

Maybe I should stop and say why she kept asking me questions. Over the summer a coworker had lent me two books. Both were about neuroplasticity (the ability of the brain to change the way its mapped) and while both focused on different aspects of the cause of remapping or the attempted behavioral therapy that could be applied, both were solid on the premise that the mind does have a measure of control over the physical landscape of the brain. Volition can cause change in the pathways of your brain, concentration and applied will can cause new pathways to be formed even around damaged areas. It also isn't the age of the person that limits this malleability. Rote and the right methods can enable anyone to overcome a trauma - if you can learn something new, you are altering your cortical mapping.

I know, blah blah blah. So after she asked if there was anything they could do on their own, I suggested something I remembered about the use of mirrors. I have to say now that it wasn't even a stroke patient I'd read about, but an amputee. The Phantoms in the Brain book had studies where patients with phantom limb would have severe pain from a clenched fist in their non-existent hand. Being unable to send a motor relay to that hand, the sensory receptors were constantly firing saying the fist was clenched. They still don't know why it happens; areas around the "closed off" part of the brain trying to exert control, nerve endings damaged in the trauma stuck in a state of pain, etc. But an experimental procedure was to take a mirror and situate it in front of the patient and then ask them to move both arms. The trick is the person sees their good arm move and its reflection looks like the other arm. The brain understands it's sending a signal to the arm, the eyes confirm that and thus the brain thinks there's a working arm. What this did was to allow the patient to clench his fist and then release it and the phantom painful clench disappeared. (It came back after a while, but successive sessions allowed him to control the pain and eventually it was gone.)

So, I suggested finding a mirror and putting in front of her and tell her to move both arms. She'll see "both" arms move, the brain is tricked into thinking that arm moves and is able to re-map that area accordingly. The biggest issue you run into with trying to recover motion from a stroke is the patient's understanding of their body image. If they logically think they have no control over their arm, it takes a monstrous amount of will to overcome that. The brain is a stubborn bastard.

However, I think what they did in the hospital room was backwards from what I had envisioned. (The danger of 140 character physical therapy.) I had thought if you put the mirror so the person saw their good arm and its reflection, that if you said to lift both arms and you see both arms move, that's where the trickery comes from. However, they blocked off her good arm and made two bad arms. Then placed objects in front of her and told her to grab them. She tried to use her left arm and they kept holding it down, but seeing the reflection of her left arm and the comprehension that THAT arm should work, she was able to start moving her right arm. By the time they left, she could slide pennies around on the table tray, pick them up, point her toes, move her feet, flap her wings and flip Ms. A off.

She said it gave her hope that she'd get back to how she was. She was so excited and worked up that the nurse came in to check her heart monitor, thinking she was either having problems or the battery on the machine was going out. When she saw what was going on, she said to limit it to just a few minutes at a time so she can rest.

It made me feel good that I'd read these books. I enjoyed them so much but have had to sheepishly cast down my eyes and shuffle my feet while getting blank stares from people . I might as well be saying I like the feel of pudding on my skin but only when someone reads Russian poetry to me in the dark. It's weird and nerdy but dammit I like learning and how often does this happen where you read something for fun and it ends up helping someone.

While I was reading them, a coworker was telling me about her husband and his dyslexia and I'd suggested looking up some behavioral therapy. There have been cases where they take children with the disorder and slow down every day speech. Dyslexia isn't your brain's inability to see correctly, it's a hearing problem. At some point during infancy, when your brain is sorting new sights and sounds, if there's any hearing problem (early ear infections for example) there could be a problem in hearing what speech sounds like. Sounds come in packets, let's say 2-3ms long. It's how you learn to talk, you hear a sound and repeat it. When you get the hang of it, it's a solid pathway and you don't have to think so hard about it. When there's damage to this pathway, shorter sounds are lost. If your brain can only handle sounds greater than 5ms, you lose shorter sounds such as quick consonants. Since you can't hear the sounds, you don't have a frame of reference when that sound is applied to a visual symbol; letters. The word may be C-A-T, but all you hear is "at." Your brain does its best (being the stubborn bastard it is) to fill in the gap with like-sounding letters or even create its own.

They've been able to successfully treat this (I think something bug-fuck crazy like 90% of the time) by playing slowed recordings. The pitch is the same, but the recording has been stretched so patients finally can hear the sounds they may not have heard before. Pairing these new sounds with their corresponding symbols, helps the brain remap and inside of a couple months, the dyslexia is diminished if not cured. Isn't that freakin' awesome? Come on! After all you've heard about medical advances with surgeries and drugs and lengthy psychoanalytical therapies, isn't it great to know how simple some of these treatments are? Who knows how long Ms. A's aunt could have gone without being able to regain her hand. It could have recovered on its own, or she could have sat with a useless arm for the rest of her life. I think it's great we were able to help her.

I'm not letting this go to my head. I was glad to help, but I realize I'm just a messenger. I didn't do the treatment. I didn't go to medical school and become a neurophysiologist. I didn't write the books. I'm also not condoning applying everything you read to your own problems, especially if they are possibly life-threatening. I still feel bad that her heart rate and blood pressure went up - adding a coronary to the list would have been a tragedy. But what I do recommend, and none too highly, is to read. There's a brilliant world out there in which people are discovering new things every minute. Every once in a while you should put down the mysteries or romance or fantasy novels and read something scientific just to mix it up. A closed mind is an empty one.

Besides, you'll never know if what you learn could help make someone's life better.

Cheers.

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