Sleep and Stroke: WTF? You're Asleep Already?

"Are you asleep?"

I whisper the words, but loud enough for him to hear it. I don't get a response--not a foot twitch, not a hand movement, not a face gesture. I get nothing. He lies down and then, somehow, he is instantly asleep. Lucky him. But to this stroke survivor, not so fast. I often get up, in the middle of the night, because I can't fall asleep and don't want to lie there endlessly for more than two hours which is my limit, waiting for sleep to overtake me. 

It's unfortunate for me that I'm so active in the middle of the night. I get up and do something else, like go downstairs to my office to write, or flip through my kids' pictures--again, or listen to the night sounds of the ocean crashing against the surf. Oh, boy. I have to get up early. The vampire, aka phlebotomist, is coming at 8. *sigh* The time is now 1 AM.

First, background is needed. The National Institutes of Health say that until the 1950s, most people thought of sleep as a short, daily hibernation from our hectic lives. What we know now, over fifty years  years later, is that our brains are busy during sleep, affecting our physical and mental functioning in a slew of ways. Sleep comes in stages: 

Stage 1 is denoted by  light sleep where we drift in and out of sleep and can be awakened easily;
 
Stage 2 sleep is characterized by eye movements stopping and brain waves become slower;
 
Stage 3 happens when slow brain waves begin to appear, combined with smaller, faster waves;
 
Stage 4 is the deepest sleep when there is no eye movement or muscle activity;
Rapid Eye Movement (REM) sleep, occurring about 70 to 90 minutes after we fall asleep, is when our breathing becomes irregular and shallow, eyes move quickly, limb muscles become temporarily paralyzed, heart rate increases, and blood pressure rises.

On average, the Cleveland Clinic says a complete sleep cycle takes an average of 90 to 110 minutes.
 
As the night goes on, REM sleep increases in length while deep sleep decreases. The amount of sleep each person needs depends on age and condition. Infants usually require about 16 hours a day, teenagers about 9 hours, adults usually about 7 to 8 hours though some people need as few as 5 hours or as many as 10 hours of sleep. In the first 3 months of pregnancy, women often need several more hours of sleep than is their typical pattern. If you're sleep-deprived, the body requires you  to make it up later when you have the opportunity. You can't go without sleep for two days because sleep will catch up with you. It's a fact. Don't even argue it. You'll lose.

And most sleep studies conclude that sleep deprivation is dangerous. Sleep-deprived folks when tested perform as badly or worse than those who are intoxicated. Sleep deprivation also intensifies alcohol's effects on the body. Since drowsiness is the brain's final step before falling asleep, driving while drowsy--intoxicated or not--can lead to tragedy. Coffee, tea, or other stimulants doesn't cut it with severe sleep deprivation. The National Sleep Foundation has a rule: if you can't stop yawning and have trouble keeping your eyes focused, or if you can't remember driving over the space of three minutes, you are probably too fatigued to drive safely.

Anyway, it's the same thing one or two times every week that I can't sleep, but I'm certainly not alone. Sleep problems are usual for stroke survivors. Having a sleeping problem can be make you irritable and cantankerous, like saying "fuck" when uttering that word is uncalled for. 

Sleep problems can also increase your risk for another stroke because two-thirds of stroke survivors have sleep-disordered breathing (SDB), the most common being sleep apnea. With SDB, the side effects may increase your blood pressure and cause blood clots. Signs include, despite yawning repeatedly, the inability to fall asleep or remain asleep throughout the night which, in turn, causes excessive sleepiness, attention problems, depression, irritability, and headaches during the day. SDB is a vicious cycle of events.

Treatments are tricky. Aside from sleeping on your stomach (some people say that helps with the snoring), the most successful treatment is Continuous Positive Airway Pressure (CPAP), which is a compact machine no larger than a few reams of paper, blowing heated, humidified air through a short tube to a mask which fits tightly around your nose and mouth to prevent humid air from leaking out. Albeit not good for curly air that might to turn to frizzy hair, it might help. The National Stroke Association said sleep studies using CPAP revealed that better thinking abilities and having higher energy levels were the result.

A variety of medications prescribed in the rehabilitation process can change the quantity, quality, and pattern of sleep. Medications prescribed for sleep may interact with sleep processes by increasing or decreasing the amount of time spent in sleep. The intake of medication and its timing can also influence sleep quality in a negative way and should be monitored carefully. 

Inherent factors to the hospital or rehabilitation environment may, in themselves, contribute to produce sleep disturbances in some patients, like co-habitation with other patients, pain, anxiety, noise, lights, and the strict schedules for a routinized day. Then when the stay comes to an end, patients must integrate their lifestyle to accommodate the home environments. Any factor alone isn't a walk in the park, by no means. 

When the patient returns home, resuming sleep patterns may not happen if these conditions are present:
* Consuming big meals late at night
* Ingesting alcohol, caffeine, and nicotine in irregular patterns
* Performing extreme exercise  
* Maintaining obesity which is linked to sleep disordered breathing
* Taking naps within three hours of bedtime
* Incurring emotional upheaval 

An average of 30% of stroke survivors have “circadian disturbances” or sleep-wake cycle disorders (SWDs) where your sleep regimen is no longer set by day or night. But in my mind, no matter what acronym one calls it, many stroke survivors are left with, in conjunction with other sleep disorders, the big "i"--insomnia, the inability to fall asleep. An insomniac is usually defined by the following criteria: 
* Dissatisfaction with sleep quantity or quality
* Difficulty initiating and/or maintaining sleep
* Recurring sleep difficulties at least 3 nights a week
*Significant impairment in social, inter-personal, or other areas of daytime interactions

Insomnia is considered chronic when it has lasted for more than 6 months. Mine had lasted for 4-1/2 years.

Sleep is still in the partial mystery category. While researchers and doctors know something about sleep, like the regulation of the body's temperature, the conservation of energy, and immunity to disease, they don't know everything. 

When it comes to rehabilitation, pioneers in sleep disorders, Canadian researchers Marie-Christine Ouellet and Simon Beaulieu-Bonneau, said even though problems with sleep are often regarded as minor problems, the lack of sleep is developing into a serious problem. It can retard rehabilitation and make a difference for patients in their outcomes. With the efforts involved in rehabilitation, it is important to deem sleep disorders as possible roadblocks to the entire rehabilitation process. 

Indeed, it was a roadblock for me. I don't think I was in a state of mind to receive therapy as soon as I did. So should there be time allowed before the stroke patient is ready for therapy, or should therapy start right away even though the patient's not ready to receive it? I don't know the answer. Nobody does. And hospitals don't have the money for psychologists to pave the way for therapy.

It's 2:30 AM now as I write this post. Sleep is the furthest thing from my mind.

How to Change Your Own Mind, Literally

"You can't be too skinny or too rich," said my old college buddy back in the 60s. But now you know the truth. Skinniness sometimes is related to anorexia or bulimia. And you've heard stories about the deaths of lottery winners who blew their money on drugs or died from being poisoned. My friend got it wrong. She should have said, "You can't be too brainy."
 

The brain controls everything, like our emotional outbursts to pain, our nervous eating, our ability to pee regularly, our resistance to confront people, our neurotic tastes. But what was thought prior to the 1970s--that the brain was fixed and couldn't be changed after early childhood--was wrong. The brain can process new experiences, like having a stroke, by creating neural pathways to accommodate them. Welcome to neuroplasticity, the game changer.

There are four key truths about neuroplasticity:

Neuroplasticity is ongoing throughout life and involves brain cells and neurons.
 
Neuroplasticity can happen for two distinct reasons--as a result of learning, experience, and memory or as a result of brain damage.
 
Neuroplasticity can vary by age, and while plasticity occurs throughout life, certain types of changes are more predominant.
 
Neuroplasticity and environment, both together, play an essential role in the process.

In the first few years of life, the brain is growing rapidly. The average adult brain grows slower because as we process new experiences, some connections are strengthened while others are merely replaced by the process known as synaptic pruning. By developing new connections and pruning less important ones, or synapses we don't need at all, the brain is able to change either size or shape, and maybe both.

The human brain is made up of around 100 billion neurons. Early research was comfortable in the fact that neurogenesis, or the creation of brand-new neurons, was over after birth. Before the 1970s, most researchers believed that the brain and nerves could not regenerate themselves to replace damaged ones. Most stroke patients and individuals with brain trauma were convinced that brain damage from accidents or disease was there to stay. Areas of the brain that were dedicated to control the movement of arms and legs, for example, were expected to stay just that way from trauma following brain injury. The brain was not capable of relearning lost functions, most researchers said, because the brain was deplete of plasticity.

In the 1970s, in experiments with rats, researchers found a region of the

animals' brain--the hippocampus--where new nerve cells were miraculously generated. The hippocampus region is where memories of new things and places are established, and the scientists found two cavities in the hippocampus where the new cells were generated. These cells, called stem cells, traveled to different parts of the brain and took on the functions of that specific area of the brain.

So neurologists a few years later were excited and actively worked with

human patients who had brain injuries, and they were enacting experiments in animal models to determine whether the brain could be re-mapped following injury. Neurologists along with researchers knew what part of the brain controlled the activity of various body parts. A major part of this effort was determining what types of physical therapies were suitable in retraining those parts. Neuroplasticity was indeed coming to the forefront and was seen in animal experiments where a number of physiological changes were observed--changes in the size and shape of brain regions, increases in the molecules that assist and  transmit signals through the brain, and the generation of new neurons.

Michael Merzenich is a neuroscientist who is known for being a frontrunner in the field of neuroplasticity. For over thirty years, he has made some remarkable finds. For example, in a post-doctoral experiment in the 70s, he cut the peripheral nerve of monkeys' brains and sewed the ends together again. The result was that those brains was nearly normal, prompting Merzenich to conclude, "If the brain map could normalize its structure in response to abnormal input, the prevailing view that we are born with a hardwired system had to be wrong. The brain had to be plastic."

Today, it is documented that the brain possesses the capacity to redo neural pathways, regenerate new connections and, in some instances, create new neurons. NICHD-funded researchers have concluded that the brain is receptive to neuroplasticity. The magnetic resonance imaging (MRI) can also tell where the  neuroplastic events occur. In a recent stroke patients' study, the MRI detected where neurons sprung new connections that extend into the area surrounding the affected site.

So the question is, if disabled or not, what can YOU do about enacting neuroplasticity on your own brain, i.e. be more brainy?

1. Plenty of studies have linked meditation and yoga to changes in the density of gray matter or cortical thickness. In 2000, Sara Lazar from Harvard , and Richard Davidson, a neuroscientist at the University of Wisconsin, teamed up with the Dalai Lama on what results would be incurred on the brain. The results suggested changes in different levels of activity associated with such qualities as anxiety, depression, attention, fear, anger, and the capability of the body to heal itself. (Yes, there are modified meditation exercises for the disabled. Call around).

2. In another study, mice who were coerced to run on treadmills showed signs of molecular changes in many portions of their brains when viewed under a microscope, while mice who had the comfortable wheel-runner had changes in only one area. Chauying J. Jen, a professor of physiology and an author of the study, said, "Our results support the notion that different forms of exercise induce neuroplasticity changes in different brain regions." (So when it comes to humans at the gym, sometimes pain IS gain).

3. Hyperbaric oxygen therapy, or HBOT, is an simple treatment with catastrophic results. Patients inhale oxygen while inside a mildly pressurized chamber. The oxygen dissolves  into the blood, plasma,  and tissues. HBOT enables oxygen to go into areas with restricted blood-flow caused by injury or disease, thus stimulating the body’s natural healing process. Oxygen is a basic part of our physiology. Among other things, we require oxygen to heal from injuries and illness. During a normal day, the average adult inhales approximately six pounds of oxygen, of which about 2 pounds are automatically dissolved into the blood. While inside the chamber, patients inhale oxygen in its purest form at ten times the normal rate. (Some people said it's phenomemenal, even for stroke survivors. Start with the Washington Hyperbaric Therapy Center, (425) 644-7999, to learn more). 

4. Lumosity.com says it targets core cognitive processes that underlie performance in many different areas, and these processes include attention, flexibilty, memory, and focus. You can subscribe to Lumosity and play 5 games at a time to build up your endurance or, if money's an issue, you can play some games for free. It has a Brain Profile Index where you can compare scores over a period of time. (Lumosity, which was a gift from my son, is a staple for me now).

But sometimes, nothing helps but patience and hope. I've got both of them... literally.

ALERT: Why You Didn't Read My Last Post About The Handicapped: You're Scared to Tempt Fate

This post is a short one and I'm going to be shouting at you. I wrote my most recent post, "The Handicapped in America: The ADA Has Your Back" (http://stroketales.blogspot.com/2013_08_12_archive.html) in my blog "The Tales of a Stroke Patient," about the Americans with Disability Act (ADA). I also have a dashboard, as the administrator of the site, that tells me how many hits I got. I haven't had such low numbers ever. (I put "ALERT" in the title to get your attention. Did I succeed? Maybe).

Of course, there's a reason for almost everything unless you're spiritual, and then I have to correct myself and say, there's a reason for everything. And there's a reason for why many of you didn't read the  post.You're afraid to read anything handicapped-related because you don't want to tempt fate. 

A lot of people believe in fate. There's a good chance you're one of them. Fate is defined in Webster's as "the will or principle or determining cause by which things in general are believed to come to be as they are or events to happen as they do." To tempt fate is to push the odds in fate's favor, to make fate go the wrong way--or the right way--depending on what's at stake. Handicapped anything is bad news.

"The Antidote," which I read twice, is a book whose mission is to poke holes in positive thinking. Anybody who's handicapped and thinks that's a good thing lives in a delusional world if they truly believe it or have the ability to move forward. I don't have either. I worked for an international law firm and the job was taken away from me because I had a stroke. HOW IS THAT A GOOD THING?

Anyway, please read my post "The Handicapped in America: The ADA Has Your Back." I said in my book, with low cholesterol, low blood pressure, no diabetes or obesity, following a healthy diet, if I could have a stroke, ANYBODY could have a stroke. Did I upset you? Good. Maybe now you'll pay attention to handicapped anything, like strokes, the largest long-term disability group. Get tested for your clotting levels. You don't want to have a stroke. Or another one!

Right now, I'm wearing high socks in the heat of summer to protect my skin from the perpetual brace, I'll eat no chocolate after Coumadin, a blood thinner, because that could affect my clotting levels, I'll drink no alcohol when everybody else is imbibing, yada, yada, yada.  

Maybe now....

The Handicapped in America: The ADA Has Your Back

My mother-in-law used to always have a lawsuit going on. But, alas, they were frivolous suits, mostly slips and falls in the market, on someone else's sidewalk, or falls in the street, all when barriers were in her way, where she just bruised herself almost every time. And she wasn't handicapped. She was clumsy. In all that time, around 30 years, I thought about when would be the next time for her, and I didn't give one thought, not a single one, to handicapped people who really had to be worried about barriers.

I am now handicapped from the stroke, but the government protects you--sort of. The Americans with Disabilities Act (ADA) was signed into law July 26, 1990 by George H. W. Bush, so don't say Bush was a bad president. Oh. My bad. That was his son.
 

Anyway, the ADA was later amended with changes on January 1, 2009. The ADA is really a civil rights law that prohibits, in most cases, discrimination based on disability. Disability, as defined by the ADA, is "a physical or mental impairment that substantially limits a major life activity." Excluded are those with vision impairment, fixable by lenses, and drug users because those conditions can be repaired. (Are you listening, drug users? There's hope for you yet, but not through the ADA).

Look at some of the lawsuits filed recently in the past and the winners from them:

Barden v. The City of Sacramento
The City of Sacramento failed to bring its sidewalks into compliance with the ADA. Certain factors were resolved in Federal Court. One issue, whether sidewalks were covered by the ADA, was appealed to the 9th Circuit Court of Appeals  of Appeals, which ruled that sidewalks were a "program" under ADA and must be made accessible to persons with disabilities. The ruling was later appealed to the U.S. Supreme Court, which refused to hear the case, letting stand the ruling of the 9th Circuit Court.
Winner: Barden

Class action suit v. Expedia.com and Hotel.com 
Customers with disabilities could not book hotel rooms, through their websites, without substantial  efforts that persons without disabilities were not required to perform.
Winner: Class action
 
Bates on behalf of Deaf/Hard of Hearing v. UPS
UPS failed to address communication barriers and to guarantee equal conditions and opportunities for deaf employees; Deaf employees were mostly excluded from workplace information, denied opportunities for promotion, and in harm's way due to 
unsafe conditions due to lack of accommodations by UPS
Winner: Bates on behalf of Deaf/Hard of Hearing
 
National Federation of the Blind v. Target Corporation
Target Corp. was sued because their web designers failed to design its website to enable persons with low or no vision to use it.
Winner: National Federation of the Blind
 
Michigan Paralyzed Veterans of America v. The University of Michigan 
Michigan Stadium violated the Americans with Disabilities Act in its $226-million renovation by failing to add enough seats for disabled fans or accommodate the needs for disabled restrooms, concessions and parking. In addition, the distribution of the accessible seating was at issue, with nearly all the seats being provided in the end-zone areas. The settlement required the stadium to add 329 wheelchair seats throughout the stadium by 2010, and an additional 135 accessible seats in clubhouses to go along with the existing 88 wheelchair seats.
Winner: Michigan Paralyzed Veterans of America
 
Spector v. Norwegian Cruise Line Ltd. 
The defendant argued that as a vessel flying the flag of a foreign nation was exempt from the requirements of the ADA. This argument was accepted by a federal court in Florida and, subsequently, the Fifth Circuit Court of Appeals. However, the U.S. Supreme Cout reversed the ruling of the lower courts on the basis that Norwegian Cruise Lines was a business headquartered in the United States whose clients were predominantly Americans and, more importantly, operated out of port facilities throughout the United States.
Winner: Spector
 
Access Now v. Southwest Airlines 
The District Court decided that the website of Southwest Airlines was not in violation of the Americans with Disability Act because the ADA is concerned with items with a physical existence and thus cannot be applied to cyberspace. But Judge Patricia A. Seitz found that the "virtual ticket counter" of the website was a virtual construct, and hence not a "public place of accommodation."
Winner: Access Now


Don't think the court is up to its neck with ADA lawsuits. The ADA had yielded a unusually miniscule number of lawsuits on employment issues--only about 1,200 across America in the first seven years of the statute. But as with all statutes, once people know them and what they include, many disabled people file worthless actions, thus, every ruling does not benefit the handicapped. For example, an qualified job applicant or employee with a disability can claim employment discrimination under the ADA, but job applicants must meet all the necessary requirements of the job with or without reasonable accommodation. Small businesses with fewer than 15 employees are not covered by the ADA.

The ADA covers individuals with psychiatric and neurological impairments that mostly limit essential life activities because individuals with such impairments have traditionally been subjected to ongoing employment discrimination, not because they are unable to successfully perform job duties, but because of fears and stereotypes associated with such impairments. Psychiatric impairments involve social, biological,or psychological dysfunction. Neurological impairments are conditions or diseases involving the nervous system, like the brain, spinal cord, and nerve centers.

The ADA, at the heart of it, is all common sense. For example, with the ADA excluding people with interim physical problems, it also excludes people with short-term mental health problems, too. The law recognizes that modifying existing structures is more expensive than making new construction accessible. The law only requires that public accommodations, like restaurants, stores, banks, and hotels, remove barriers in existing facilities when it is readily achievable. 

Inexpensive, easy steps that can be taken to help the disabled include, for instance, a ramp to cover five steps, a bathroom grab bar to help with balance, special hinges to widen a doorway, a paper towel dispenser that's low enough to reach, and an accessible parking space.

The ADA requires all government programs to be accessible, not all government buildings. The ADA only insists that clear communication not exclude people with disabilities, like providing them with written materials instead of watching a PowerPoint that they can't easily see or hear. But the law does not require any measure that would cause extreme financial or administrative difficulty to the employers. Remember in the beginning when I said "sort of"? That judgement, right there, is arbitrary. In other words, how much difficulty is too much?

While people have the right to file lawsuits, not all suits are winners for the handicapped. On its website, http://www.eeoc.gov, the U.S. Equal Employment Opportunity Commission (EEOC) is responsible for 

"enforcing federal laws that make it illegal to discriminate against a job applicant or an employee because of the person's race, color, religion, sex (including pregnancy), national origin, age (40 or older), disability or genetic information. It is also illegal to discriminate against a person because the person complained about discrimination, filed a charge of discrimination, or participated in an employment discrimination investigation or lawsuit." But Human Resources departments everywhere don't abide by that ruling. If they want to get you for filing a discrimination suit, they'll figure out a way.

The EEOC has authority to dismiss the complaint. Trivial complaints do not make it through the system. EEOC investigators are taught to scrutinize whether one person or a party, like class action suits, has an actual ADA disability. Go to https://egov.eeoc.gov/eas/ if you think a charge should be filed.

So there you have it, everything I know about the ADA. Hmmm. It's too late to file a complaint against my former manager, J, and her boss, stupid D, for making cracks about my lack of hearing when I asked them to repeat themselves. Actually, it was D's fault. My hearing went south because the work environment in which I was located initially, with observable roaches and vermin, affected my ability to hear clearly.

"You don't hear anyway," was doltish J's remark.  D used to roll his eyes and twitch his jaw if the remark had to be uttered again.

I didn't know about the EEOC back then, but I surely wish I had.

"The Tales of a Stroke Patient"....YES!

“The Tales of a Stroke Patient” is making its way into the limelight.

I am a stroke survivor, and I’ve written a book that tells of my expedition. If a stroke could happen to  me, with low cholesterol, low blood pressure, no diabetes or obesity, it could happen to ANYBODY!

If you’re a stroke survivor, caregiver, have stroke in your genes, an avid reader of memoirs, or just curious if a stroke could happen to you, please read my book that will educate and inspire to make stroke awareness so much bigger than it currently is. 

Warning: Not intended for the faint of heart or politically correct crowd.

Click the link to buy it:

from the publisher, http://bookstore.xlibris.com/Products/SKU-0115053049/The-Tales-of-a-Stroke-Patient.aspx,

or for Amazon’s Kindle, http://www.amazon.com/The-Tales-Stroke-Patient-ebook/dp/B009J9QC64/ref=sr_1_1?ie=UTF8&qid=1373898600&sr=8-1&keywords=tales+stroke+patient

or for Barnes & Noble’s Nook, http://www.barnesandnoble.com/w/the-tales-of-a-stroke-patient-joyce-hoffman/1113052852?ean=9781479712496.

Don’t have a credit card? Message me by email--hcwriter@gmail.com--or Facebook to see how you can get a copy!

The 5 W’s and the H of Getting Up and Moving Your Ass

I was playing a game with myself. I recalled a famous personality of the past to test my memory. The topic of the day was who died from blood clots that went to the heart or brain or lungs. There were many.

David, David, what-his-name. Of course, I got it after a while. I was thinking about David Bloom, the weekend anchor of the Today show.

Although David is dead now--he died at 39 years old, I read that his heart and thoughts belonged to his family. In David’s final communication with his wife, Melanie, he wrote on April 5, 2003, "When the moment comes in my life when you are talking about my last days, I am determined that you and others will say 'he was devoted to his wife and children, he was admired, he gave every ounce of his being for those whom he cared most about… not himself, but God and his family.'

He continued, "My legs have been cramping up, and I really have to stretch them out tonight."
 
A day later, on April 6, Bloom died from a pulmonary embolism caused by a condition called deep-vein thrombosis (DVT). DVTs can occur when people have certain risk factors like clotting disorders and restricted mobility, like when Bloom was broadcasting from Iraq in the Army tank in which he was traveling.

(I’m going to tie this in soon. Wait a minute, will ya?)

In journalism class, decades ago, we were taught about the 5 W’s and the H: Where, Who, Why, What, When, and How.

“Always include them in the top one or two graphs [paragraphs] at the beginning of an article,” the professor said. 

The professor was right on, but journalism has gotten more creative since then and some journalists start off with an intriguing statement or question like “It was all about the water” or “Two plus equals four, right?” 

But I was a creature of habit when it came to journalism and I mostly started with the 5 W’s and the H, which made me think of sitting in one position as Bloom was, at length vs. standing.

Where: This information comes from one of the best in the world, the Mayo Clinic.  

Who: A group of researchers studied the problem of sitting too long.

Why: They discovered that sitting too long could cause health problems.

What: Sitting too long in one spot in excess of 2 hours could lead to high blood sugar, blood pressure and cholesterol, and/or an excess of fat around the stomach.

When: The research was done in June 2012.

How: Sitting too much could increase the risk for cardiovascular diseases and cancer.

The organized paragraph would go something like this:

Researchers at the Mayo Clinic discovered in June 2012 that sitting too long could cause health problems like a spike in blood sugar, high blood pressure, increased cholesterol, and an abundance of belly fat leading to cardiovascular disease and cancer.

Stroke survivors, if they can stand at all, should stand more. But most survivors, at least the ones I know, seek out the comfort of a chair or sofa.
 

That’s why I’m going to the gym three times a week—to get off my a** and do something. 


As a writer, I  do a lot of sitting. But I know I should be standing more. So at most every two hours, I go for a break. I don’t mean a potty break because that would involve sitting, too, for women all the time and men half the time. I mean, men don’t have to sit to pee, but women…. You get my drift.

What I meant was, I stand sometimes to take a lengthy phone call. Or I go for a walk, up to the corner and back. Sometimes I stand to watch television if I’m sitting on the sofa too long. If you’re working, get the powers to be to buy a standing desk, or improvise with a high counter.

Bloom needed to stand more and stretch his legs. Maybe he didn't know about DVTs. Even if he did, he didn't think he could die from it. This situation reinforces my mantra, "You never know what's around the corner." Plus, the Army was on a mission. So was Bloom. Rest in peace, David Bloom.

An Accident Waiting to Happen, aka The Dangerous Treadmill Throws Me for a Loop

2009 was a rotten year for me, and brutish Mike Tyson as well. That was the year I had my stroke. That was also the year Mike Tyson's 4-year-old daughter, Exodus, died from a treadmill cord wrapped around her neck, strangulation style. (Her mother was busy, cleaning in the next room because they couldn't afford a housekeeper. All of Tyson's money now belongs to the IRS, but I digress). The point that Laura Cox made in '09, as a medical writer for ABC news, who informed us of Exodus' death, was that exercise equipment is dangerous.

Take treadmills, for example. Treadmills are risky pieces of equipment. Health club owners have an obligation to inspect their machines and tell members who use them if the treadmill is not in condition to work properly. Typical injuries connected to defective treadmills include back problems, spinal cord injuries, fractured bones, torn ligament and knee injuries, electric shock, facial fractures and lacerations, and traumatic brain damage. If placed too close to a wall or other equipment, a treadmill user may become trapped and the moving treadmill belt can access exposed skin which, in some cases, can require expensive skin grafts and rehabilitation. The problem with the treadmills has gotten so dire, there's attorneys out there who only represent treadmill injuries.

The U.S. Consumer Product Safety Commission (CPSC) documents cases, like the 86-year-old woman in Chicago who sued a health club after a treadmill malfunction threw her from the machine and then severed her right foot. How about this one? A 2-year-old boy was brought to the emergency, and he received treatment for a friction burn to his right hand after he got it stuck in a moving home treadmill. His mother, who had been running on the treadmill at the time of the accident, pulled the safety strap, but not in time to prevent the injury. The treadmill in question had safety instructions underneath the machine and were not visible to her.

West Bend Mutual Insurance Company says that adult injuries are "typically caused by deficient knowledge of the functions of the particular machine. From heart monitors to programmable routines, treadmills have become increasingly complex, and several advanced features can make operation overwhelming. When televisions, headphones, and magazines are added to the equation, it’s shocking more accidents don’t occur. Distractions, complexity, and exertion combine to set the stage for a potentially devastating trip and fall exposure." So true.
 

Here's where I come in. It was yet another day at the gym which, as a stroke survivor, was questionable anyway. But I always have someone nearby while I'm working out on the safe machines. This is my current regimen: The elliptical (safe), the inclined plates for stretching my hamstrings (safe), the treadmill (not so much), and the leg press machine (not safe at all). All my exercises are for the legs because I can't lift my hand independently. I hired a trainer at the gym, whom I liked, but he quit after two weeks of training me, and I got a new one to replace him.

Anyway, after the elliptical for 15 minutes and the inclined plates for 2, which I accomplished by myself because I safely could, I motioned to the trainer for what was supposed to be a 30-minute session including the treadmill, the leg press machine, and some body exercises he thought would be helpful. He was there in an instant because most trainers are usually bored at the gym with nothing to do unless they train somebody. I mean, my trainer was on a 6-hour shift and how long could he occupy himself by doing show-offs things like sit-ups and weight stuff.

I approached the treadmill, with the trainer right next to me, and got onto it by stepping up and transferring my hand from the cane to the side bar. The trainer took the cane off the treadmill pressed the appropriate buttons and I was off at 0.5 miles an hour. Then a few seconds later, I stopped the machine.

I said, "My safety strap isn't on. The last trainer said my safety strap has to be on in order to shut off the treadmill immediately in case I'm in trouble," quoting the last trainer exactly.

"But I've got you," he replied. "And anyway, that safety strap doesn't work sometimes. It pulls away from the treadmill. I've got you," he repeated again. Then he turned the treadmill on again.

I was going for about three minutes with my one hand holding onto the side bar, when I decided the front bar might be better. So I moved my left hand right under the treadmill's console. After thirty seconds, I realized the side bar was more comfortable, and when I moved my hand back again to the side bar, with the "I've got you" trainer right along side of me, something happened.

My feet did a turn around in which they were now facing the wall behind me. The treadmill was still running. And worst of all, I cracked my head on the cross bar. I began to cry. In that defining moment, I wasn't a jock anymore.

"Stop the treadmill," I screamed. "It's still going."

Everybody in the gym came running. Somebody, maybe the trainer, turned off the treadmill after about 15 seconds.

"You should have told me what you were going to do before you did it. It's the first time that I worked with you," remarked the trainer, as if the accident was my fault.

"Gwyneth," who brought me to the gym, showed up at the very moment. She said, "If I was there when it happened, the trainer would lose his [censored] when he made that remark." Gwyneth is a hard ass.

The trainer dragged a chair over to me and asked me to sit in it. He gave me a cup of water and I gave him the worst news.

"Every time I have a fall," I said between sobs, "I need to go to the hospital to have a CT scan, to make sure I'm not bleeding internally. My head is starting to swell up."

The trainer  looked like he was going to throw up. And the owner asked me if I required an ambulance. All I wanted to do was to leave there ASAP, worrying that my brain would burst yet another blood vessel.

I got up from the chair and sat of the bench near the elevator while Gwyneth made a call to the hospital, indicating I was coming soon.

The 10-minute ride to the hospital passed quickly, and I didn't have to wait long before I saw a triage nurse. She took my blood pressure and my temperature and said, "We are kind of crowded so you'll have to wait for the doctor in the hallway. In a gurney, of course." Gwyneth was brought a chair at my request. 

Another nurse came by to check my vitals--again--and a doctor agreed that the CT scan was the best way to tell if there was any internal bleeding. After the CT scan, I returned to the hallway and Gwyneth, and within a half hour, the doctor came over to my gurney and said that there was no bleeding and that my discharge papers would be coming momentarily.

Two hours and I was out. But some questions remain: There are three treadmills at the gym. Why did he have me on the treadmill with a defective strap? Why wasn't the owner told of the defective strap? And why wasn't the trainer's first instinct to turn off the treadmill? I'll never know the answers, and I don't care. Bottom line: the trainer failed. But I'm going back to the gym where I'll use the elliptical and the inclined plates. And the treadmill? Not yet. Not even with a safety strap that works. It's too soon.
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After-the-incident note: The owner of the gym, who wasn't told the treadmill safety strap pulled away at times, told me after the fact, even if it did, the treadmill would stop running anyway. Why didn't the trainer know that? And was he not listening to the owner if she said the safety strap stops the treadmill if it pulls out of its socket? Maybe the owner didn't tell the trainer. 

I got lucky.