My Stroke: Part 1: Nightmare

August 4, 2010 is a day I’ll never forget (though, admittedly, I ask my wife almost every time I recall it, just to be sure).  It’s the day I learned I’d had a stroke. The story begins, though, on the preceding day. Tuesday, August 3.

Most of the day was like many days before it; I woke up, I showered, I got ready for work. I went to the office at the normal time — 8:00 or so in the morning — and I did many of the same things I did every day in the course of my job. I remember that i had more meetings than usual that day; not for any discernibly important reasons, but those days happen to office-drones such as myself. I remember that I had a late meeting, taking me into the time that I normally leave the office.

Near the end of that meeting, I recall a sudden sense of lightheadedness came on me; lights took on a “halo effect” and things seemed a bit hazy — just off enough that I noticed it, but not so off as to signal anything was really wrong. I attributed it to a long and mentally-strenuous day of work, and resolved to get home, take it easy, and get some food in me — surely, I thought, that would restore me to my normal self. Obviously, I was just stressed, tired, and hungry; maybe my blood sugar was off. I remember looking forward to a community barbecue in celebration of National Night Out.

Weary but recuperating, I left the office and came home, ready for the event, to relax and eat and start feeling better.  A neighbour friend of ours asked my wife if she’d like to step into her apartment for a shot; when the offer was declined, she asked me, and I happily accepted – after all, I was looking to unwind, and that’d certainly help. In retrospect, this may have helped to save my life.

I went into her kitchen. She poured each of us a shot of vodka (Smirnoff, I think, for those curious) and opened a couple cans of soda as chaser. I took the shot glass in my left hand, and promptly dropped it on the floor. Confused, addled and embarrassed, I helped clean up, and went to wash my hands as she poured a replacement. Here, I felt the first sign of something truly wrong; as I ran the faucet over my hands, I felt my right hand bump into some unknown object, and looked down – only to discover that the foreign object was my left hand. I brushed this off, too, for whatever reason, took the vodka in my right hand, and downed it with a “Cheers!”

Back outside, I ate some food and mingled. A couple of times, I remember stumbling a bit. I bumped in to a couple of things. Unbeknownst to me, while this was happening, some neighbours told my wife what they saw in my behavior, concerned I was drunk to the point of instability. She assured them I was not, and came to me, concerned. I opted to return home and lay down on the couch a bit; this is when the confusion started to come over me. I couldn’t properly process what was going on around me. When my wife came home to check on me, I could hardly maintain a conversation. The words she said held little meaning to me, and for the life of me I couldn’t convince my mouth to put voice to the words I was trying to say in response. Confusion quickly turned to fear. I couldn’t fathom what was happening, or why — and, worse yet, I couldn’t express myself to that end. I even recall very briefly wondering if I was having a stroke, but rejecting the thought out of hand. I was, after all, only 27. Those happen to old people, right?

My wife called my mom, to come and watch our just-barely-three year old son while we visited the local prompt care to see if they could tell us what was going. I struggled to buckle my seatbelt, accustomed to using a hand that now refused to comply with my wishes. We went to the clinic, waited a very short time, and then the doctor came in. We — okay, probably mostly my wife — explained the situation. He asked me to raise my arms in front of me and close my eyes, and I did so. Then he made an inexplicable demand to “move this finger”.

I opened my eyes, and his hand was touching mine, indicating a finger. I hadn’t felt a thing of it. He told us he couldn’t diagnose a stroke, but that it was possible, and told us to take me to the emergency room. We declined the offer of an ambulance, and went to the only hospital in town, and repeated the process of explaining my condition. We sat in the waiting room, surrounded by the sick and injured, for nearly two hours. I got up several times to visit the drinking fountain, and explained that I was feeling much better – after some time, I nearly suggested leaving rather than waiting it out, but we wanted some kind of answer, so, we stayed.

Eventually, a neurologist came, and brought me to a table to lie down. This moment is when it all spiralled far beyond my control, my understanding, my ability to grasp any part of what was happening to me. He asked me to push against his hand with my foot; I pushed as hard as I could, and still, he simply urged me to try. I got angry. I was trying – hell, for all I could feel, I was succeeding. It became clear that something was deeply wrong.

I was moved to a gurney, hooked to some IVs, and wheeled off towards another room. I remember having to use the restroom, and asking to do so. I was told I couldn’t, as they didn’t think I could walk; I defied them, and tried to get up. You’ll need to bear with me on this next bit, as this is the last piece of my memory from that night. I’m told I tried to get up. I’m told I managed to tear an IV from my arm, sprinkling blood on my wife, the doctor, and the gurney. I’m told I fiercely struggled as they strapped me down and took me in for CT scans. I’m told I railed, physically and vocally, as they performed the scans, nurses holding my head down as I pushed against them and the restraints I was in. I’m told. I don’t recall it, even in part.

My next memory is coming to, hooked to some absurd number of things; heart monitors, IV drips, oxygen meters. I was in an unfamiliar place. It was dark; at this point, it was early in on the morning of the 4th, and I was in a room in the neurology section of the intensive care unit. They’d had some time to look at the scans they’d managed to get, and confirmed – my brain had suffered damage indicative of a stroke — or, more precisely, some number of small “cluster” strokes followed by one larger event (this, we figure, occurred when I was laid on the initial exam table). Out in the hallway, the neurologist had broken the news to my wife, and offered the grim advice that she steel her mind and prepare for the possibility of becoming a widow that night. We reeled in shock, trying desperately to understand how this could happen, why it had happened, growing frustrated with a lack of answers to these questions – answers which would have to wait for further scans later in the day. We rested.

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My Stroke: Part 2: Waking Dream

And what will happen – will I dream?
I am too scared to close my eyes
For a second; please hold me
None can change in me these things that I believe
But I don’t know what happens now
I am too scared to close my eyes

VNV Nation – ‘Legion’

——————

You may have noticed that the previous entry in this sequence ended by saying, ‘We rested.’ It did not say, ‘We slept.’ This is deliberate. That first night in the ICU, the only thing keeping my eyes closed was unfettered exhaustion and a steady supply of IV-fed drugs; whether any of them were meant to make me sleep, I don’t know, but sufficient quantities of blood-thinning agents coupled with painkillers will do the trick well enough. I lay, half-sleeping, half-aware, listening to the droning hum of the machines monitoring my life. My wife curled up like a cat in a wicker chair far too small for any such purpose. Beeps, whirs, and the occasional drifting voice from the hospital PA lulled us in and out of fitful dreams; I think we half hoped that what was happening was the dream, and we’d wake to find ourselves curled around one another in our bed when light broke. Unfortunately, the horrid dream was the reality.

With the dawn came concerns; I was the sole breadwinner for our family. It was clear that I wouldn’t be working; for how long, I didn’t know. Around 6 or 7 am, I picked up my cell phone and found the stored entry for my boss. Voicemail. Of course. “Hey, Jason. This is Chaz. I’m, uh, in the ICU at Enloe [the name of our local hospital], so I’m, um, not gonna be able to come in today.” Somewhere in my drug-addled and still confused, fog-filled mind, it hadn’t clicked. It never occurred to me that this was going to take days, weeks, maybe months to recover from. It never crossed my mind to explain in detail, or to even mention in the message that it was my own emergency that landed me where I was.

Not long after, I got a call back; worriedly, my boss — a father of two — asked if something had happened to my son. The shock was palpable through the phone when I explained, to the best of my ability, what had actually happened. I don’t really recall the specifics of the conversation, other than that he urged me to take all the time I needed, and to focus on recovery before thinking about working again. I optimistically talked about returning as soon as I could, regardless; my family – my wife, my son – depended on that. The conversation ended with much yet unknown.

At this point, I should note that my condition, physically, was at its worst. My entire left side, shoulder to toe, was paralysed and all but numb; I remember moments of confused panic when my wife would lovingly lay a hand on mine, or pet my arm — the receptors had gone haywire, and couldn’t tell the difference between a loving caress and a stabbing pain. Anything brushing against that side sent waves of unspecified data coursing through me. The cool touch of a fresh bedsheet was like nothing I had felt before, and nothing to which I can put words. Any attempt on my part to use any left-side limb met with dull nothingness; not even the struggle of pushing a muscle that refuses to obey. Just … nothing, as if an entire half of my body was simply a flesh-wrapped sandbag somehow grafted on to my remaining functional bits.

Between the brain injury, the constant drug-dose, and the whirl of activity, the events to follow swirl around; inconsistent, sporadic memories of panic and relief, of heart-wrenching fear and hopeful desire. I know I was moved, cords, IV drips, and all, from my bed to a gurney, and wheeled to an ambulance that took me across the street to the imaging facility; here, I got to experience my first MRI. Unlike the prior CT scans, I remember this. I was warned that the machine, from inside where I would be, could be incredibly loud; it was, but I much more distinctly remember that it was ice-cold inside. Shivering uncontrollably, I did my best to hold still at their request. I think they pulled me out to add some blankets to help with that. After the scans, I was returned to my room in the ICU.

My mom and sister visited; this stands out to me — and them — for some interesting reasons. You see, I’m typically a reserved kind of person; I have a strong, constant inner monologue, but I tend to keep my thoughts and, more specifically, my emotions to myself. Pumped full of no small number of things, though, and still in a half-shock state overall, the filter was most certainly off. I rambled endlessly, smiling and joking and choking back a welling weep-session all at once. I remember my mom remarking to the nurses that it was the most talkative she’d ever seen me. We had a laugh about that, too, and the nurses were very surprised by my open and, perhaps, off-colour humor about the entire affair. That remained a constant through my entire recovery process, a steady supply of gallows-jokes and oddly-worded commentary. I think it was a hallmark of my road back to whatever normalcy I was going to regain.

The results from the MRI showed, at least in a physical sense, the cause of my stroke. My right carotid artery had dissected, forming a blood clot over the time between when I initially felt the lightheadedness in the office before and when I’d been laid down on the exam table. Laying down had given it the opportunity it needed to travel upward, into my brain, causing what’s known as an ischemic stroke, spreading damage throughout the right side of my brain. I took pictures of the scan results with my phone.

All told, I spent three days in the ICU. It’s a blur, as I’ve mentioned; I know my family members visited more, and my wife never left my side.  The ward nurses were even kind enough to look the other way and allow a brief but greatly appreciated rule-breaking visit from my son — kids aren’t typically allowed inside the ICU rooms, for relatively clear and logical reasons. I was taken for more MRIs at one point. I struggled through meals, each one bringing waves of nausea like I couldn’t believe. I don’t remember if, or how many times, I failed to keep it down. Anti-nausea medications were added to my existing retinue of drips, pills, and shots. Blood was drawn several times a day, monitoring the coagulation factors, looking for identifiable risks, searching for more answers about how an otherwise-healthy 27 year old male had come to be rendered half-mobile and swinging in and out of coherence. Nights were especially difficult, as laying in bed was my only activity in the day, and my limited mobility left few options to tire me. Fitfully, I weaved between moments of calm sleep and panicked sobbing. My hope dwindled with every passing hour, and, while I did all I could to imagine recovering, the crashing reality that I might never regain function in my left side splintered my emotions. I wondered — mostly, but not always, to myself —  if the Chaz of before all this was gone for good. I wondered if my mind would start to fade from me, and I would cease to be myself in a fundamental way.

Eventually, I was told I’d be moving to a normal room, outside of the ICU. Days of monitoring and constant vigilance had played out their role, and the doctors and neurologists were confident that I had stabilized enough to allow me to relocate. A room with less menacing-sounding monitors. A room with a window to the outside. A room where non-family visitors could enter. Ecstatic, I prepared for that as best I could; we spent the third night in a row crammed into the confines of the intensive unit, my wife still spending her night-times curled up in the small chair in the corner.

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My Stroke: Part 3: Seeking Normalcy

And I know I can’t explain 
The commotion in my brain 
Like a terrifying reality 
Deconstructed but inadequately 

Bad Religion – ‘To Another Abyss’

——————

The most memorable thing about my being moved to a normal room was the ‘lift team’. A lift team is the means by which patients in a hospital, unable to move themselves in any meaningful way, are moved from one place to another. Typically, this involves two large, muscle-bound folks who are trained in proper transfer technique and work in tandem to support one another in the process of moving an effectively dead-weight human from a bed to a gurney, wheelchair, or other person-moving device. My lift team was anything but typical.

Her name was Toni. She was a shorter girl — not much taller than my wife, if at all — and had a slender frame. The other lift team personnel on hand were busy with an emergency patient who’d been airlifted in moments prior, and so, Toni was operating alone in moving me from the ICU. At first glance, I’d never have thought she’d be able to effectively and safely haul my half-limp form from the bed. She expressed some concern to this end, as well (being used to having a partner and all), but was determined to have a go at it nonetheless. With what I’m sure was no small effort despite the apparent ease, she quickly had me out of bed and sat into a wheelchair; I was wheeled down the hallway to an elevator, swimming in her apologies for the sweat she left on me in the process, which I repeatedly dismissed as unnecessary — after all, this was the small, thin superwoman who’d just singlehandedly done the work of two people and was doing so to expedite my egress from the ICU.

When we got to the new room, she (once again alone) lifted me up into the larger and marginally more comfortable bed of the hospital proper. Here’s where we learned perhaps the most amazing part of her feat in moving me: not long before, she’d been on the other end of this process after a hip and knee replacement. To this day, I’m really not sure whether it was strength or sheer will with which she’d managed to get me from Point A to Point B, but she did so impressively well regardless of mitigating circumstance. I had some time to settle in to new surroundings, but it wasn’t long before the never-ending stream of nurses drilled back into me that I was still in no shape to consider myself truly recovering. Again, the phlebotomist came and took what I was sure was far too much blood, and the IVs continued their incessant numbing of my would-be pain.

We had more visitors during this time, too. Friends, family, coworkers all coming to express their concerns and, I think, try to fathom the reality; I imagine that it’s a different experience entirely to hear that someone you know has been struck half-lame and bedridden, and seeing it with your own eyes as they lie mostly still in front of you. I tried to keep up my spirits, continuing the jokes (many, now, far on the side of inappropriate, as tends to be with my close friends), smiling as best I could. I got flowers, a bottle of wine, a book of crosswords. I also remember that, at a time in that first day, my loving wife managed to requisition the necessary materials to conduct a sponge bath; I had, after all, been laying in my own accumulated sweat for several days, and, any stench notwithstanding, I was beginning to develop red, irritating rashes from it all. Readers, you have not known true devotion until your significant other has washed you, laying in a bed, incapable of doing the deed yourself. I cannot express enough how wonderful it felt to have this done, and to have someone willing to do it.

Nights, though, remained difficult, sometimes insufferable. When I would drift off to sleep, I’d bolt awake in half-panic, the daze of intermittent consciousness forcing me to remember time and again that half of me was simply not working. My wife would lull me back to sleep, where the process would slowly repeat until morning, when the bustle of visitors, nurses, et cetera would keep me from any such thoughts. My second day in this room, I got my first taste of physical therapy; it was a simple act of sitting up, at the edge of my bed. I used my good arm to hold myself as steady as I could, and a vigilant hand kept near the other side to ensure I didn’t tumble to the floor. I sat up for about five minutes, then I was laid back down in bed to recover from the strain; strange as it may sound, it was quite a physically demanding task.

The second night, I’ll never forget. I told my wife to go home, be with our son, and sleep in our own apartment. My mom took on the task of staying with me in her stead (damned if they were going to leave me alone with my thoughts and beeping machinery). I remember a horrid, uncomfortable sensation of needing to urinate, despite the fact that I was, at this point, fitted with a catheter and, by all accounts, achieving the task at a normal rate. I was hot, uncomfortable, and riddled with the early onset of would-be bedsores. Around two in the morning, the panic and fear set in like it never had before. My poor mother did her best to console me, but the rising emotional storm made that an impossible task. Eventually, I had her find my phone and dial my wife. She talked to me, soothed me, and my nerves finally began to settle enough that after some time, we hung up, and I slept.

The third day, I met with the speech therapist; while my speaking didn’t seem to require any direct attention, they were concerned about my cognitive ability; they spoke with me, gave me some simple abstract thinking puzzles, and, satisfied, left me to more physical therapy. This time, with the help of a lift team (a proper one), I was moved to a chair. Propped up a bit with pillows, I sat up for a few hours, seeing visitors and generally relishing the fact that I wasn’t confined to a bed, even if it was a brief reprieve. I think I was let to sit for longer than they’d planned, but I was far from the only patient in the hospital and I was in no real rush to return to my “home” atop the sheets and pillows and antimicrobial mattress.

Eventually, though, I was moved back, and the routine of half-edible food, pills, shots, and blood draws continued. It occurs to me that I haven’t mentioned the food until now. Typical of a hospital, it was all technically edible but often bland and not particularly interesting. I didn’t know it at the time, but there were also some foods I couldn’t have, or could only have in small quantities; this, I’ll leave for later exploration, as it was something I learned great detail of later. I remember that nearly every breakfast, more than any other meal, made me nauseous; the scrambled eggs, in their many forms, were particularly good at this, leading to a string of experimental attempts to find a medication to soothe it, and a similar number of changes to my painkiller buffet in search of some combination of things that would help me keep my food down. For whatever reason, lunch and dinner didn’t produce this effect quite so much, and some were even relatively palatable.

At this point, doctors began to talk to me about my eventual chance to leave the hospital — not for home, but for a live-in physical rehabilitation facility run by the hospital, where I would continue my road to recovery for some indeterminate timeframe expected to be anywhere from three weeks to three months. The uncomfortable reality continued to settle itself in my mind as I tried to reconcile my insatiable work ethic with my utter inability to do anything like work. I was still to be kept in the hospital for a few more days, regardless; there were still more tests to run, more scans to collect, and other such business to tend to. Keeping exhaustion and the relentless scraping of depression at bay as best I could, I soldiered on for the last days of what had become my routine existence. My left side remained unresponsive and aggravatingly numb.

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My Stroke: Part 4: Marginal Freedom

Even though I know it’s
Only chemical
These peaks and valleys are
Beginning to take their toll
Try to convince myself that
All it takes is time
But the most derisive voice
I hear is mine

Assemblage 23 – ‘Cocoon’

——————

The last few days in the hospital went by much as the preceding days had; visitors, doctors, nurses — the constant parade of people tending to me, whether physically or emotionally continued throughout. I’ve forgotten to mention that during this time, while I first had the room to myself, another patient was moved in to the other side, hidden by the curtain separating each room into two spaces. His transfer was at request, as his prior roommate had been a very loudly negative and was constantly complaining with a string of expletives; he seemed more than content to have me as a replacement, as I was consistently pleasant and what the staff called an ‘ideal patient’. We conversed a few times through the divider, and I learned that his stay was brief, the result of some particularly troublesome kidney stones (if I recall right); his condition being rather more painful than mine, neither of us envied the other’s position. I mention him now because he plays a part in one of the more frightening parts of my preparation for release from the hospital.

If you’re a squeamish sort, or have an aversion to certain biological necessities of living things, you may want to skip this paragraph. You see, one of the more common and well-documented side-effects of many high-potency painkillers is a stopping up of one’s internals; while a catheter relieved one portion of this, the other side of the coin had been in a sort of stasis since my admittance, and there was no way that I was to be allowed to leave to the hospital until that situation resolved. To that end, a sit-down commode was brought in and set up beside my bed, and I was administered a few assisting medications to free up the blockage. A nurse or lift team (I don’t recall) helped me on to the seat, and then, after confirming my preference, I was left to some privacy to “do my business”. I remember that I was trying to adjust my position on the seat when, very suddenly, my balance swerved wildly out from under me, and I found myself, plastic commode and all, crashing to the cold tile floor. My neighbour, hearing the commotion, immediately asked if I was alright and activated his call button, also yelling out to the hallway that my wife had stepped out to. I’m told she bolted off, found the nearest nurse, and grabbed their shirt, telling them what had happened; they rushed in, gave me a quick once-over, helped me with some pillows and the like, then called for a lift team; I had to stay there, on the floor, until they could arrive to haul me up; I’m not sure how long I was there, but I actually recall that (biological panic-response notwithstanding) it actually didn’t bother me much, as I was, if nothing else, no longer captive to my bed. Eventually, I was lifted up, put back on the seat, and — this time with supervision — able to complete the task at hand. In retrospect, I’m extremely grateful that the fall preceded this, rather than following it.

They did some quick physical examinations, ran vitals (blood pressure, temperature, etc) and fitted me with a shiny new yellow bracelet reading “Fall Risk” after determining that, all things considered, I’d managed not to hurt myself in any way needing attention. That ordeal done with, I was told that the next day would likely be my relocation date, and I’d be moved to the rehab facility. The remaining time in the hospital proper passed without incident, and I soon found myself being moved to an ambulance, driven across town, and introduced to my new home-away-from-home. Here, unlike before, I was to be trusted with some measure of self-reliance and, perhaps best of all, some modicum of mobility.

I was first wheeled via gurney to my new room — a much larger and more comfortable space, if still outfitted in ‘hospital chic’ décor-wise. I was transferred to my new bed, which was, like the room, larger than my prior confines; before long, a string of staff members came through, asking questions for paperwork purposes, explaining some of the routines of the place, and, perhaps best of all, delivering my new means of transportation — a black, cushion-seated wheelchair. I laid in bed there for a bit before being moved to the chair, and given a tour of the areas of the facility that I’d be calling home for the next … some length of time.

There were all the typical things you’d expect from such a place. A nurse-station hub in the center, a cafeteria, a large physical-therapy gym; I was shown a courtyard, where patients could be outside while still within the confines of the facility, a pool for water therapy, and several offices and the like. I was shown a large whiteboard with a system for showing, by surname and room number, which therapies each patient was expected to attend each day; I was told I’d be having six 30- to 45-minute therapies every day (my introductory day not included). This included two sessions each of physical, occupational, and speech/cognition therapy every weekday, scheduled around structure mealtimes (8am breakfast, noon lunch, 6pm dinner) with plenty of space, typically, for resting between; physical therapy was conducted primarily in the gym area, with speech/cognition and occupational sessions taking place either in office rooms, patient rooms, or, from time to time (and as would become more common later) in the gym or attached kitchen and mock bathroom.

These rooms, too, were double-patient spaces, but I was alone in my room; they offered the second bed to my wife, who could use it for as long as no other patient needing it was brought to the facility. I was, for clear reasons, among the youngest of the inpatient folks, surrounded mostly by elderly persons who’d had similar conditions to mine, falls leading to bone breakage, or any of a number of other disabling injuries or medical procedures. I was introduced to my physical and occupational therapy team — patients were assigned to duos that would work together in the recovery process, facilitating easy communication between them along the way so that each could know the progress being made on the other’s side of the journey. My overseers and taskmistresses over the course of my stay were Lisa, in charge of physical therapy (PT, as I’ll likely refer to it henceforth), who would focus mostly on gross motor skills such as using the wheelchair, standing, walking, and the like;  Stephanie, the occupational therapist (OT) whose focus was in fine motor skills and everyday skills such as brushing my teeth, shaving, and dressing myself; I also met Carrie, my speech and cognition therapist, who would work with me on any roadblocks in my communication and critical thinking skills.

This first day, I was allowed to familiarize myself with the place, and given relatively free reign in doing so; my wife and I toured the halls after the initial go-through, getting our bearings and taking it all in. I should mention that, in all of this, I was expected to be the primary driving force behind my own recuperation; while the schedule board would tell me what slots I had for any therapy sessions, attendance and participation was, ultimately, my own responsibility, and I could decline at any time, though, obviously, for a recovery to happen, I was strongly encouraged to keep to the schedule. There were also plenty of on-call nurses and staff to help with other things; transfers between bed and chair, using the restroom (which was private to the room I was staying in), delivering medications, and all the trappings of a life inside of a medical complex. In the next instalment, I’ll get into more detail of these and my initial forays into various therapy sessions. For now, I’ll note that — while it was still hospital food — I had the best dinner put before me in a while, and then, I in my bed and my wife in the adjacent one, we had what I think was our best nights’ sleep since the beginning of this long and difficult journey.

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My Stroke: Part 5: Learning Again for the First Time

Work it harder, make it better
Move it faster, makes us stronger
More than ever, hour after hour
Work is never over

Daft Punk – ‘Harder Better Faster Stronger’

——————  

 My first morning waking up in the new room was a bit jarring; not only had I become accustomed to the hospital’s confining space, but I found there was more to adapt to than I’d anticipated when I was woken at 6am for blood draws. This, I’d soon find, would become a part of my daily routine, but the initial go-through was anything but expected. I settled back to sleep afterwards, and soon, it was time to wake for breakfast. A nurse came to help me transfer from my bed to my chair, and we headed down to the cafeteria after stopping by the whiteboard to examine the day’s therapy schedule; fortunately enough, the board was essentially unavoidable en route from my room.

At breakfast, my second unpleasant surprise of the morning was also served. No longer attached to the IVs I’d had in the hospital, I now required a retinue of pills with my first meal, including a blood-thinning medication which came in a large-needled syringe requiring injection into my mid-torso. The pain of such an injection aside, it also left a radiating soreness from the injection point, feeling not unlike a stiff bruise about four inches from the needle-point and lasting for several hours. This, too, would become a part of my daily routine for some length of time. I finished breakfast and set off to therapy.

From here, I’ll admit that the specific sequence of which therapies occurred in which order is lost to me, but I’ll recount as best I can what I worked on that day. I know I met with Carrie, the speech therapist, in my room; she had me do some simple lateral-thinking puzzles. Perhaps to my advantage, such were the realm of family fun in my childhood, and many of those presented early on proved familiar to me. Satisfied – or, perhaps, impressed – with my answers, she left for the day. I think, after this, I napped; this, too, would become routine for me, though it hadn’t ever been something I was accustomed to. Between mental and physical efforts beyond what the hospital had put me through – and, in honesty, the still-continuous flow of high-powered painkillers (one every four hours, roughly) – kept me tired throughout much of the day.

My first session of occupational therapy introduced me to something I’d come to be familiar with, as well, in the form of electro-stimulation therapy. My left wrist and arm were strapped in to a device with contact points against the skin; pulses through these points would essentially force the muscles beneath them to contract until the pulse ceased. For the first time in a week or more, I saw my hand move. The fingers would fan outward from their tightly-clinched position as I felt a tingle through the numbness still present, then tighten back up as the tingle subsided. I watched this, fascinated, unable to control the movement yet equally unable to resist it. This went on for, I believe, some fifteen minutes; the purpose, as was explained as it went on, was twofold. Firstly, the stimulation driving movement would help my brain’s neural paths reroute, finding methods to go around the non-functioning areas to allow me to regain movement. Secondly, the forced movement of the muscles would help to break up the hypertonia present — essentially, aside from lack of mental impulses directing the movements, my muscles tightened to extremes, becoming stone-hard and practically immobile even if the brain’s signals managed to reach them.

Early physical therapy, I recall less distinctly. I believe it centered on being laid on a large, raised mat, where I was assisted in rolling to one side or the other, and my affected leg was stretched and massaged by Lisa, my therapist, in order to evoke much of the same tone-breaking as was the focus of my other therapy. I know that the small movements seemed nearly impossible yet simultaneously insignificant; I know that I was left exhausted after what seemed objectively to be a minuscule amount of work — though, of course, through great effort.

On this first full day of rehabilitation, my wife also retrieved something for me that I’d missed much in my time at the hospital — my work-provided laptop; while I had no intention of attempting to work, per se, the cut-off from my normal supply of internet was, in its own way, maddening, and I longed for my social-media outlets and access to the freely-flowing information of the world wide web. Unfortunately, having the laptop present proved futile — while my room had plentiful outlets and a perfectly functional wireless connection, I’d entirely forgotten the password required to unlock the thing, either through the trials of the prior week or the damage to my mind.

Defeated through many attempts to access my own computer, exhausted from a day of physical and mental labor, and drained by the sheer magnitude of adapting to new routines, I was introduced that night to the last uncomfortable new-routine piece when it was, at last, time for bed. A large, padded support boot and pair of blue, tube-connected “sequentials” were brought in to me; the first was a simple enough device, looking not unlike a snow-boot due to the thick, synthetic-wool lining, with a prop-support on one side. This was designed to hold my leg in a proper, upright position through the night, preventing the natural inclination to turn in towards one side, and help prevent the worsening of muscle tone in my leg. The second are a bit more difficult to describe; they were large, bright blue Velcro-on cuffs that surrounded my calves and ankles, connected to a machine at the end of my bed which, through a sequence of tubes, pumped air into the cuffs, applying a squeezing pressure to my legs which would hold for a few moments, release, and repeat this endlessly through the night. The purpose of these is to stimulate movement in the legs, affecting the flow of blood to prevent the formation of clots. On the first night, while unusual and uncomfortable, they bothered me only slightly, and I, without significant difficulty, slept soundly again.

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