Not rehab, reconditioning

The last six months of hospital stays, bleeds, transfusions, infections and heart stuff has left me pretty scrawny and deconditioned – my enormous abs, legs and biceps are but dim shadows of their former selves.

But over the last few weeks, I have turned the corner.

My infection is under control (with horse-size doses of Clindamycin, a yucky-tasting but effective antibiotic. My bleeding and other mysterious blood disappearances have at last come to an end (mostly because I stopped taking the blood thinner Ticagrelor, which was poison to me). My AF is under control, with fairly large doses of Amiodarone. The almost-blockage in my right coronary artery won’t be stented or otherwise operated on (to remove the calcium lump I have patiently built up over years on dialysis). I am taking aspirin daily as a moderately effective blood thinner and maybe that will be enough. So far this has proved to be the case.

So there’s no need to be skinny anymore. At last, I can walk further than around the bed. This morning Julie and I walked about 3km (1.8m) around our block. It was no speed record, but I have been walking regularly now and as long as I don’t try to run up hills, I feel pretty pleased with myself.

legsBut Julie, being Julie, doesn’t think that this is enough, so I went to my local doctor, got a referral to a rehabilitation centre and made an appointment.

Julie and I went along a couple of days ago. The first step is to be assessed by a doctor, who then nominates a plan for reconditioning (yes that’s what its called) over the next 10 weeks. I imagined the assessment would take 5-10 minutes and I’d be outta there. But no, it took 1.5 hours and was the most thorough (and humbling) I’ve had.

It began in a friendly way, with the usual questions confirming who I was, where I lived, why I was there, my medical history of how my body came to be in such a sorry state. Then a little family history: illnesses and causes of death in the family, etc. All to be expected.

What was not expected was a detailed physical and mental assessment. First the physical: sit, stand without help, checking the level of movement of arms and legs, timing me to get out of the chair, go to the wall and touch it, then return and sit in the chair. Of course, I moved faster than I have for weeks to make a good show of it, but all the doctor said was: 8 seconds, that’s ok. I thought it was pretty slick. But there was more to come.

First, he gave me a pencil and a printed sheet: join the dots in the right order, redraw that cube and others. OK. Now I’m going to say 5 words. You repeat them after me. I’ll say them again and you repeat them again.  Then a little later, I’ll ask you to repeat the words. They were face, velvet, church, daisy, red.

1-IQ testHe then asked me to count backwards from 100 by 7s. Now, this is not something I do on a regular basis, but off I went subtracting and concentrating until I got to 65, when (thankfully) he stopped me.  It was a slow and stumbling performance. (I later asked my 40-year old son to do it, and he raced through the numbers without thinking – his kids do these backward counts all the time, instead of the old times tables we learned at school, and he picked it up from testing them. Not me.

Still recovering from putting in such a poor performance, he asked me to list as many words beginning with f that were not proper nouns (beginning with a capital F). I began like a racehorse, listing the fa’s (fat far fantasy, etc – even fart), then fe’s (feeble fear fellow, etc), the fi’s (fin finance fickle, etc,) then fo’s (fox fondle forest, etc). then fu’s (future fun full, etc. I left a couple of the more disreputable f-words out. I realised later that I left a lot of fr words, like frank frenzied friar, and even good old from.

But of course, that’s all very well when you are in the car leaving the car park. (The French have an expression for it: esprit d’escalier – spirit of stairs, or wit of the staircase: witty responses thought of only too late, on the way home.  Just like me.

Sitting in the back of my mind all through these tests was: do I remember the five words?  When will he ask, because I need a moment to think. Of course, the tests went relentlessly on for another 10 minutes. Then he asked: what are the five words?

1-memorygameMy mind immediately provided the first two: face and velvet, then nothing. He looked at me, I looked at him, then I looked at Julie (who smiled and looked away – thanks Julie!). Then he said I’ll give you two hints and if you still can’t remember, I’ll give you a multiple choice. I got two more with hints and the last with multiple choice. What I also got was a strong dose of humility.

But there was more to come.

In his very next sentence, he said he not only specialised in rehab/reconditioning, but also in Alzheimer’s disease. My immediate reaction was: SO? It was unspoken and followed (also silently) by When does this session end?? Let me out! I came for rehab, not embarrassment.

Fortunately, it ended shortly after. We were taken to the physiotherapy area and I was booked in the start next week.

I must admit I was a little peeved when we left (i’m a sensitive kind of guy), but Julie thought it was hilarious. After a while (and after testing a few friends) I have mellowed. Either we are all lining up for dementia or those results, under those conditions, for people who need “reconditioning”, are pretty normal.

Anyway, that’s what I reckon.

Ask me again in 10 weeks.

Keeping brain-fit on dialysis using iPhone brain games

I have posted a little about keeping your body fit on the BigD before, but nothing about exercising our most important organ, the brain.  I have just read a life-changing book: The Brain That Changes Itself, by Norman Doidge.  I very much enjoy reading about the brain, how it works, what affects its performance, what motivates us, how and why we choose.

But this book took me to a new level.  Doidge explains through real-world examples and studies, how our brains are continuously changing, no matter what our age.  It begins by showing how people who have lost parts of their brain through stroke or trauma can with training, have other parts of their brain take over the lost roles. (more…)

Keeping your brain sharp on Dialysis – Part 4

4.    Substances that help

Apart from the prescribed substances that support the usual bones and organs when you are on the BigD, there are a couple of others aimed at the brain that I’d like to mention.

First a lightweight

My mother was 82 when she passed away, and her brain was a sharp as a needle.  When I was about 10, she told me about a new product she had heard about that was “Good for your brain”: Nutritional Lecithin Meal.  I think it came with the same door-to-door salesman that sold Rawleigh’s products, or maybe the Tupperware people sold it under the counter, but it was a permanent feature of her every breakfast. (more…)

Keeping your brain sharp on Dialysis – Part 3

3. Get lots of Mental Exercise

If regular dialysis is a prerequisite, and regular exercise is a key contributor to keeping your brain sharp, then constant mental exercise is the main event.  Much research has shown that like every other part of your body, you’ve got to use it or you will lose it.  And I’m not talking about doing more of what you do now (though by all means stay at work and absorb the stimulation, do crosswords and Sodukos, jigsaws  and puzzles – it all helps to hold off the decay). (more…)

Keeping your brain sharp on Dialysis – Part 2

2. Get Regular Physical Exercise

I have always done some kind of exercise, and for the last ten years, I have exercised regularly at least three times per week. I began this routine after a longish stay in hospital, when I felt especially dull, unmotivated and weary.  So I decided to get up half an hour early of a morning and walk or run.  It was difficult to begin with, especially in cool weather.  But I found that the secret not only of rapid recovery, but to feeling good: bright, alert and optimistic, is simple, physical exercise. (more…)

Keeping your brain sharp on Dialysis – Part 1

One of the (many) fears I had about going onto the Big D was that I would become a dullard (or perhaps a greater dullard; all things are relative).  Back in 1995, my Doctor John Dawborn warned me that after kidney failure, I would have extra toxins on my bloodstream, reduced oxygen levels to the brain and a more sedentary lifestyle (due to feeling less well), all of which could slow me down mentally, so that I may not be able to finish The Age newspaper’s crossword. (more…)