Patron hero of disability

On an early Saturday in the month of November, I woke up inside my room with a lot of joy and eagerness as it was on this day that the hospital had finally given me a chance for a day leave with my mother to go outside of the hospital grounds and into the city to do whatever we wanted to do. By this time I had already changed roommates for the fifth time and the fifth one wasn't as social as the first one so it was good timing to leave the room and explore the city. My mother and I opted to go to Fremantle to visit the Hoyts cinema to watch a movie that I had long waited for, "Dr. Srange", A Marvel superhero that tells the story of an arrogant Neurosurgeon by the name of Stephen strange who became master of the mystic arts and a powerful member of the Avengers after an accident that left his hands crippled rendering him useless with his job as a neurosurgeon and soon loses his career. One day a man told him that his cure lies at a place in the Himalayas called Kamar TaJ, a place where travelers go to to to find both healing and spiritual enlightenment. 

Desperate for a full recovery, Strange heads off to the Himalayas in search of this place. Sure enough, he finds it and embarks on a spiritual journey of both self-discovery and enlightenment. Upon arriving he was greeted by Mordo, A member of the Society who was living in Kamar Taj and a disciple of The ancient one, The spiritual guru who promises Strange that he could get his hands back if he follows the teachings of the ancient one. To Strange's surprise, the ancient one was a bald woman in robes of white. She approached him and gave Strange a brief summary of the program that he is going to do with her. The teachings are somewhat contradictory to what he had learned n medical school as the teachings of the ancient one is mostly about the mind, the power of belief, suggestions, chakras, energy healing, the soul, and manipulation of reality. To a surgeon like Strange, this all sounds like superstitious pseudoscience mumbo jumbo. He quickly rejects the teachings and walked away from the ancient one. Before he could do so the ancient one hit strange with her fist and Strange's Astral body was thrown out of his physical body and he traveled across the multiverse seeing a plethora of different form of beings and places that exists in other dimensions.

After the experience, he was convinced that her teachings are true and had the potential to fix his disabilities. Over the next few weeks, and months Strange was taught how to manipulate energy from around him to move objects, create weapons out of thin air and teleport to places through opening extradimensional gateways to access other multiverses. All of these feats have been accomplished by  Strange, which made him powerful at the end of the movie and was able to defeat the antagonist, Kaecilius and Dormammu, dark entity living in the dark dimension. Despite his victory over the villains he was still paralyzed in both of his hands. Nearing the end of the Movie the ancient one told Strange that his healing lies in his choice on how he wants to heal himself, either through the standard medical treatment or using his mind to channel his beliefs into his hands and recover them by faith.

Strange eventually chose the second option and uses his mind to slowly recover the severed nerves in his hands. The movie teaches us that the mind is very powerful and has the capacity to shape who we are and the realities we perceive on a daily basis. At some point, it can even affect our physical bodies and the environment around us, surprisingly there is even a metaphysical term or this phenomenon, it's called the law of attraction, meaning we become what we believe and receive what we desire most in both our thoughts and emotions. As the great French philosopher, Renee de carte once said, "I think, therefore I am" This lesson is even taught in the Bible with Jesus's parable of words turning to flesh meaning being mindful of what we say or think as it might just happen.

Both the metaphysical and moral lesson of this superhero movie can be applied in real life for most patients with disabilities especially those with brain injuries. The movie is a reminder to all of us that the mind goes beyond the limits of the physical a that our brains are nothing more but vessels that houses our very thoughts. If we are mindful of this lesson and fully tune in into our recovery with not only positive thinking but a strong belief of recovery, then complete healing can indeed take place. Just remember the advice that I've mentioned i "Tips on stroke recovery" What we imagine or believe shapes the neurons in our brains as if we are doing what we imagine.

Another great lesson that we can derive from this movie is the transformative power of tragedy and the beauty of failure. It's not only after the accident which severed Strange's nerves that he could find the drive to search for a cure and ultimately gain something else as an addition which made him more than the average new yorker or humans like you and I. The movie is also a reminder of the importance of time and how to use it wisely. During the fight scenes, the ancient one finally dies from a falling injury. Before she died, she told Strange that she had always believed in him and that he was capable of accomplishing great things not because he was a qualified and experienced surgeon but because he believed in himself. we are also reminded in this movie that time is short it goes by fast when you least expect it, especially with a brain injury from a stroke, all those precious seconds are stolen from you and it will never be retrieved again so you have to appreciate the little things in life and make use of our time wisely as not to waste it.                                                                                   

Books to read and videos to watch

As previously discussed in my last post. I spend the majority o my free time at the hospital reading informative nonfiction books regarding neuroscience and applied neuropsychology as means of not only occupying my time to escape the boredom in my room but also to engage my brain with processing information. I would recommend all patients in the hospital to do the same and be proactive in using the grey matter in their brain. This post will be dedicated to discussing the list of books, videos, and websites for those with brain injuries.

List of neuroscience books to read:

• The brain's way of healing:  Written by Norman Doidge, a Canadian Neuropsychiatrist. This book is a collection of real-life cases of people that have overcome some of their mental and physical disabilities through a rigorous form of self-training and therapies that are both conventional and non-conventional. The chapter starts off with a man by the name of John pepper who regained his lost movements from Parkinson's disease with a form of conscious movement that he developed by always being conscious of where limbs are in space. Other cases include the application of the Feldenkrais method that was developed by an Israeli engineer and physicist, Moshe Feldenkrais which promotes reconnection between the brain and body to improve movement and overall mental wellbeing. 
• The brain that changes itself: Written by Norman Doidge as well, this book is similar to the one mentioned above but focusing more on the biological mechanism of how certain therapies work and how certain neurological illnesses affect the body. This book may be a little it more complicated to understand as a lot of scientific jargons will be used to describe the cases that are mentioned in this book. Best to read this book slowly and take down some notes on scientific terms and concepts that are hard to comprehend, so you can research them later to better understand
• The body keeps the score: A comprehensive guide written by Bessel Van der Kolk on how trauma is stored in both the brain and body and how one can make use of their biology to turn off its negative effects and to maintain and develop a healthy mental state afterward. Some cases that are mentioned in this book also describes the treatments that are applied to resolve the issues. Some treatments that are mentioned include the following: Neurofeedback, EMDR therapy, Yoga and acting.

List TED talks on Neuroscience to watch:

• You can grow new brain cells, here's how: An informative TED talk delivered by neuroscientist Sandrine Thurette on the biological mechanism of Neurogenesis, the brain's natural ability to grow new cells. The talks also discuss the importance of maintaining a healthy lifestyle and diet which all play a contributive role in fostering cell growth. Link: 
• The brain changing benefits of exercise: This talk discusses the healing capabilities and benefits of physical exercise on the brain as well as how exercise plays a role in determining the quality of recovery after a brain injury.
• One more reason to get a good night's sleep: A talk that discusses the important role of sleep in memory consolidation and recovery.
• Power foods for the brain: Discussing the role of diet in shaping our brains ad how they function with a comparative example of how bad diet leads to the development of certain brain diseases such as Alzheimer's.
• The brain may be able to repair itself: A Swiss neurosurgeon delivers a talk on some methods to improve a patient's well being and overall function after surgery or trauma to the brain. The methods mentioned include deep brain stimulation and implantation of cultured stem cell.  

Lst of brain training sites:

• Jetpunk: A quiz website on general knowledge and logical reasoning
• Lumosity: A brain training website that is specially designed to test the brain's neuroplastic capability in terms of memory, planning, and reaction.
• Sudoku: A number games website that tests your reasoning with arranging numbers.                                                  

     

Day four

The fourth day at the hospital follows the same routine schedule that was already designed by my group of therapists. The only difference with this particular day was that I woke up without my roommate on the other side of the room. Turns out, Roy had been transferred to a different section of the ward as he was making significant improvements and was already prepared to be discharged. Without a roommate to chat, my time inside my room would most definitely be mundane, thankfully my new roommate came in a few minutes later and took the place where Roy was sleeping. Reese was a typical Aussie millennial, still looking young in his early twenties. I assume he had been admitted to the hospital for some ridiculous cause as most Aussie blokes within their twenties are prone to doing dangerous acts of stupidity that ends up giving them self injury. My predictions were true, Reese had a brain injury from bashing his head against a rock after somersaulting drunk on a fence.

Though his case of being admitted to the hospice was undoubtfully stupid. Such cases don't surprise me as there are plenty of young millennials with substantially low grey matter in their brains to even think with common sense to decide on things which they should or should not be doing within the confines of reality. Reese wasn't that much of a talker as he would spend the majority of his time gazing the television. Because of this lack of a social presence, I diverted my attention into looking at educational youtube videos particularly TED videos concerning Neuroscience and Neuropsychology. I would open one of these videos and try to focus in to obtain the key points of all the presentations. Surprisingly they were all very informative regarding the brain and how an injury affects it both mentally and physically and metally. If any of you are stroke patients of a ruptured AVM that is still an inpatient in the hospital then I highly recommend looking at TED videos as a productive way of enjoying your free time when you're not doing therapies or engaging in a meaningful conversation with your roommate.

Another highly productive activity as an alternative to watching TED videos is reading books whether they are fiction or non-fiction. I will list some of my favorite TED videos and books to read in my next entry to make things easier for you to choose the book you would like to read or the videos on TED you would like to watch. If you do end up watching or reading some of the things that I will suggest in my next post, be sure to take down notes to make things easier for you to understand.

Now going back to the current situation in my room. Without a very social roommate to talk to, I rarely spend much time in my room. I spend most of it on my therapies. uring this day in my speech therapy, I asked my speech pathologist Alicia if there was some sort of social group Where I could talk with other patients and improve my speech at the same time. Turns out there was something called Dysarthria group every Wednesday. Patients who would like to join and chat with other stroke affected individuals are free to come and join them. n this group patients are able to talk just about anything as long as it's not controversial such as political or religious discussions.

After having registered for this group with Alicia, I went to the kitchen to get some alone time for myself. This room has the only large screen telivision, where visitors can relax while they are visiting their sick relatives. I turned on the Television and there it was a Promo for the new upcoming Marvel movie, Dr. Strange. I had to see this film as I am a devout Marvel fan and an admirer of Stan Lee, the creator of Marvel comics. After watching this trailer, I walked to the main reception of the nurse's station and asked if I could get a day leave from the hospital to watch the movie at the cinema. They gladly approve my request and gave me the time to leave the hospital the next day to watch it. however, I have to take my meds with me and I had to be accompanied by my mother while I'm outside as part of the conditions for da leave and I had to be back before six or the doors will close shut for me.                                                                                 

Eating after brain injury

Food is the nourishment that the body needs to sustain its biological function, primarily keeping us alive. However, all of the body's function comes to a near stop after a stroke or any other form of brain injury. Patients are to be reminded that both brain and body are inherently interconnected. One does not work without the other. If you are suffering from a hemorrhage in the brain or a clot, it's most likely that you will end up with damage in one of your brain's hemispheres. These damages will have a profound impact on certain functions such as our cognition, mobility, spatial awareness and so on. The damage will also likely to affect how we eat and drink, especially if the subcortical cortex suffers damage as well. Therefore the first steps of recovery should solely focus on relearning how to eat and drink.

Actions such as eating drinking may look simple on the outside but its biological mechanism often fails or slows down after a brain injury. The esophagus will contract slower causing food or liquid to get stuck or move too fast, which could result in choking or asphyxiation. Most hospitals would attach a feeding tube through the nostrils, directly connected to the stomach to feed us without the need of putting it in our mouths to chew. Other methods include a PEG (Percutaneous Endoscopic Gastronomy)  tube directly attached to the stomach via an external incision, this the most common form of eating for most patients. It's safe and direct, however despite having a tube attached to you to help you eat. Patients should not be dependent on them, it is recommended that brain injury survivors take the chance of trying to consume normal food. In doing so they are readjusting their bodies natural function of eating and swallowing food after the injury.

Another important reminder for patients is that readjusting to normal food may take a long time as the body after the initial injury to the brain may reduce the contraction movements of the esophagus, making swallowing difficult. Thus patients should at least try to eat something a bit solid for a start but not too hard on the texture. Most speech pathologists would use a sponge cake to retrain a patient to eat since they have a soft texture and easy to swallow. Once you've accomplished eating something with a soft texture, you can proceed with eating something harder that may take a bit more chewing before swallowing. These can be crackers or cereal grains. When chewing these things, patients should try to chew on the side with weakness or paralysis to strengthen their jaw muscles. This will also help improve pronunciation and prevent slurring during talking.

Patients must always remember to stay upright as possible when eating or drinking a this prevents choking or food going down the wrong way and would help digestion become easier. straight posture is also needed when taking as it helps air travel easily into the larynx and voicebox that we need to produce our voices. Being aware of posture most of the time is essentially the key to regaining a normal gastrointestinal system for a speedy recovery. Besides being mindful on how to eat or drink, we should be mindful a well by what we put in our mouths. Most hospitals would assign nutritionist to oversee the type and amount of food we consume during our stay in hospitals but it's very rare that the nutritionist plays a role in maintaining our diet. A lot of times hospitals end up serving us with unhealthy stuff such as fries or sizzled sausages. At times these things will be substituted by liquid supplements in the form of antibiotics probiotics which cause constipation. If possible they should be substituted with something healthier for the digestive system such as fruit and vegetable juice that will easily be absorbed by the intestines and easily disposed of as excrements once it has gone out of our rectums. Another reason for changing to such diet instead o following the catered meals in hospitals that are randomly prepared by the catering crew is simply because of certain food containing BDNF ( Brain Derived Neurotropic Factor), these are naturally occurring chemicals in the brain that helps speed up neurogenesis to produce new neurons.     

When being fed alternative supplements like antibiotics, doctor and nurses will most likely feed it through the peg tube as a means of easy access. Using the tube fo feeding should be done with good maintenance. Once food has gone down the tube, nurse or doctors should flush it with water to prevent any leftovers from getting stuck. Failure to do so would cause the leftovers to clog up the peg tub and it would become unusable for further use. the stuck leftovers may even become breeding grounds for bacteria that could cause infection when this happens it is necessary to get the peg tub removed and replaced with a new one. When replacing the tube, it should be conducted with an endoscope to firstly remove the inner seal that will release the outer tube with ease.