When Is Enough Exercise Enough?

[This post is to all chronically-ill people, their caregivers (or personal assistants as I call them), their family, people who suspect a chronically disease eventually because it runs in the family, and that equals a lot of folks.]

I came across this statistic: By 2030, as many as 11 million people could be living with stroke as more people live longer. Yikes. Research time.  

The title from Flint Rehab: More Is Better… Except When It’s Not, caught my eye. 

Flint Rehab says, "While repetition [of exercise] is important, too much exercise can start to hinder your progress. [Uh huh.] You need a good amount of rest and sleep in order to successfully recover."  

Something, but still nothing that answers my question specifically.  

And it got me thinking, because most times for me, it's never enough. Then when I hurt badly, aka when enough is more than enough, I turned to guilt because for several days, I rested my weary bones. One step forward, one step back, kind of thing. No progress at times. None at all.

When I achieved rest, and dreaded naps, it messed up my sleep, aka circadian rythyms. Then I couldn't go to bed before 3am. That's 3am on a good night. Now, I don't take any naps. And yes, I am tired, but it's a trade-off. I want to have good results with my exercise instead of giving in to my fatigue.

Now, I set the alarm on my cell for 15 minutes no later that 1pm. The power nap routine! That's just enough rest to re-fire my engine and sleep, aka nap, or not fall asleep. With my  eyes closed, it's still rest.

But I digress. This post is not about circadian rhythms, let alone mine. It's about exercise, specifically, "Am I doing enough exercise and how do I know when I reach that point of, it's enough?"

The Stroke Foundation across the other pond, aka Australia, says the repetition is the main focus on improvement. 

"Regular activity will help you to continue your recovery. Exercise improves your fitness, your general health, and reduces your risk of having another stroke." 

That means not when you feel like doing it but doing it every day. But nothing in that article addresses "when is enough exercise enough." I plowed on.

Then I came across this: Exercise is a valuable yet underused component for post-stroke care, according to an American Heart Association/American Stroke Association scientific statement. [Hmm. Now we're getting somewhere.]

"There is strong evidence that physical activity and exercise after stroke can improve cardiovascular fitness, walking ability, and upper arm strength," said Sandra A. Billinger, P.T., Ph.D., lead author and a physical therapist at the University of Kansas Medical Center in Kansas City, KS.

[Read more, I said.] 

"Yet, too few healthcare professionals prescribe exercise as a form of therapy for stroke. There is a big gap in America once stroke patients are discharged from rehabilitation and the transition to community exercise programs when they go home. Many are left on their own. [I was.] We don't have a system in place to help stroke patients feel comfortable with exercise.

And here it was:

"The general recommendation," says Billinger, "is that survivors exercise at least three days a week for 20 to 60 minutes, but that depends on their individual functional capacity. For many stroke survivors, multiple 10- to 15- minute bouts of moderate-intensity exercise may be better tolerated.

Aah. Hard data. At last. I was striving to do the exercise every day. It was too much, the good doctor implied. Every day. Core strengthening, 15 reps, 3 sets, the same with marching and leg stretches and Thera-band leg pulls and lifting my legs outward and behind me while holding on to the countertop, one leg at a time, and walking the halls for 500 feet, and weights, left hand only. 

Now I alternate with walking the halls and weights, and the other stuff aforementioned. I just started last week but no pain. I feel the good hurt. Life is good at the moment. I have the feeling that I found the key.

But Stroke is an ongoing mystery to find the other keys. Always a key. 

10 Things You Probably Didn't Know About Brain Bleeds

It's quiz time! 

If a hemorrhagic stroke could happen to me, with both low cholesterol and blood pressure, no diabetes, and a non-smoker, it could happen to anyone. Or is it an aneurysm? Now I know! And even more.

Here's 10 questions about brain bleeds. Write down your answers and compare them with the real answers below. Let me know how you did. 100%? In your dreams! (But maybe). Good luck.


1. Is a hemorrhagic stroke the same thing as an aneurysm?

a. Yes, they're the same

b. No, but a hemorrhagic stroke is one of the most usual kinds of a ruptured aneurysm

c. No, but a ruptured aneurysm is one of the most usual  kinds of a hemorrhagic stroke


2. A cerebral aneurysm is

a. a thin or weak spot that can occur on a blood vessel of the brain

b. random with no known cause

c. a thick spot that can occur on a vein in the brain


3. A hemorrhage stroke

a. is not emergent and which requires immediate bed rest at home

b. is a medical emergency that requires immediate treatment

c. is a medical emergency that always requires an operation


4. A hemorrhagic stroke

a. is more common in women than men

b. is more common in men than women

c. splits 50-50 among genders


5. Symptoms of a hemorrhagic stroke usually occur 

a. when the person is awake

b. when the person is asleep

c. both a and b


6. Most brain aneurysms

a. don't rupture

b. don't create health problems or cause symptoms

c. both a and b


7. Although aneurysms can appear anywhere in the brain, they are most common in arteries

a. at the top of the brain

b. at the base of the brain

c. anywhere in the brain

8. Go to the hospital immediately if

a. you have a mild headache

b. you have the worst headache ever

c. if you have insurance

9. Among the first blood tests in the event of an ruptured aneurysm is to determine

a. your ability to clot

b. your stress level

c. your cholesterol 

10. Usually, hospitalization is followed by a period of living in a rehabilitation center, where additional intensive stroke therapy may be provided

a. to assist the patient with financial responsibilities

b. to help the patient recover as much physical and speaking function as possible

c. to make the patient aware of all the negatives

Answers: 1. c , 2. a, 3. b, 4. a, 5. a, 6. c (a brain aneurysm that doesn't rupture is often detected during tests for other conditions), 7. b, 8, b (whether you have health insurance or not, the hospital has to treat you, but you may wind up with a huge bill if you don't have health insurance), 9. a, 10. b

Acupuncture--It Isn't For The Faint Of Heart, aka Needles In My Body? You've Got To Be Kidding!

I have, at times, a painful lower back and, since we're enumerating, a restless leg and arthritis in the hip, as a result of the stroke, the latter from bad posture I constantly (except when I'm not) try to correct. I tried everything around the house--heat packs, cold packs--and wasted a lot of money on Lidocaine-based, over-the-counter products from the pharmacy. But three weeks ago, I had an epiphany, truth be told, from desperation. Acupuncture! There are many places in Portland that offer it. But first, a little background.

Acupuncture, in a broad context, is a process in which skilled practitioners insert fine, thin needles through the skin in an effort to eliminate or lessen pain in the lower back, neck, and osteoarthritic knee, headache, migraine, dental pain, and nausea, for example.  The downside is substantial if a practitioner uses non-sterile needles which can cause infections, punctured and collapsed organs, and injury to the central nervous system, but in the hands of an experienced practitioner, (and if you're desperate enough), in my opinion, it's worth a try.

With the help of herbs, diet, and massage, acupuncture flourished in China and slowly spread around the world but was disdained by Western medicine. Yet today, even in China, there is confusion and mystery over just how acupuncture works.

From the NIH (National Institutes of Health), comes the bottom line: "Results from a number of studies suggest that acupuncture may help ease types of pain that are often chronic such as low-back pain, neck pain, and osteoarthritis/knee pain. It also may help reduce the frequency of tension headaches and prevent migraine headaches. Therefore, acupuncture appears to be a reasonable option for people with chronic pain to consider. However, clinical practice guidelines are inconsistent in recommendations about acupuncture.

"The effects of acupuncture on the brain and body and how best to measure them are only beginning to be understood. Current evidence suggests that many factors—like expectation and belief—that are unrelated to acupuncture needling may play important roles in the beneficial effects of acupuncture on pain."This from one site: Check acupuncturist's credentials. Most states require a license, certification, or registration to practice acupuncture; however, education and training standards and requirements for obtaining these vary from state to state. 

 I did and found this:

Although a license does not guarantee quality of care, it does indicate, Dr. Lu in my case, that the clinician is up to standard in the use of acupuncture. Some conventional medical practitioners—including physicians and dentists—practice acupuncture. But I couldn't find one. Ergo, Mercy and Wisdom Clinic. 

Mercy and Wisdom is weird both in the waiting room and the acupuncture rooms, the former having very low seats that I struggled to get out of and the latter, simply put, old fashioned with its high examining bed and it archaic case for supplies. But other than that, Dr. Lu knows her stuff. 

When I first met her, she explained how Chinese medicine was different than the Western kind, in engaging detail. It was all about having blockage where you shouldn't. And then the needles came out. It hurt at first, but Dr. Lu reassured me that the needles were placed where they were needed because if they went in to easily, that means they weren't addressing the blockage. The hurt went away in less than 5 minutes.

The needles, and 20 more, stayed in for an hour, and they were placed in something she called channels. She said my arm which has been dead for nine years could move, too. Dr. Lu suggested I'd walk for exercise. So I did, up and down the hall. My assistant, Joyce (I call her Joyce 2), came with me each time, and she was a key factor in my relaxation. Dr. Lu said I have to go a month to notice results with my sore lower back, my restless foot, and arthritis in the hip. She told me to avoid the night shade vegetables and fruits for arthritis: eggplant, tomatoes, peppers, and potatoes.

I stopped taking the Oxycodone after the 2nd visit. Maybe there is something about pain and acupuncture after all. I'll write and let you know when I take a significant step. 

My Sons, My Sons and the Makeshift Playroom

I have two sons. 

It was in the late 90s when a childless friend asked me during a hectic, weekday lunch, out of the blueish of blue, "Do you think I missed anything by not having kids?"

I answered him directly, "You love to travel. You went to places I didn't know exist. Travel with kids isn't always a possibility." 

But to myself, I silently shouted, "Hell, yes!" 

When my boys were young--one 7 and the other 2--I built them a playroom in our dingy basement with exposed pipes and a low ceiling, albeit high enough for them. Earl, my handyman, bought fluorescent lights and hangers that suspended them (that made the ceiling a teensy-bit lower). 

He bought a used television (he knew a guy) from which they would play video games. He installed a solid shelf for the television because boys will be boys. (If you don't know what that means, ask someone with two or more sons). 

He installed a heater/air conditioner unit because my thought process was it will be a 12-month to do. (And it was). He paneled part of it (my idea) and painted the rest (his idea) a soft yellow. And last, he installed a rug bought as a remnant but covered the whole floor because he made it fit. (The rug had 5 seams and Earl was good at math).

When it was finished, I brought the kids downstairs to see the outcome. It might have been put together cheaply, but it was the "playroom" and they loved it. 

Soon after, I built a 4x6 train set with fast-moving trains and railroad crossings and tiny people waiting on the platform in the playroom. Even though the planks of wood were wobbly (upper arm strength isn't my forte), it satisfied my sons.

I catered parties down in the playroom. Birthday parties, half-birthday parties, graduation parties starting with preschool. And more parties just for the sake of parties, many of them sleepovers. 

And then one by one, they left for college and stayed there after graduation in two respective different cities, both 6 hours from the house. That playroom existed as a monument to great, great times. 

It was followed by my bouts of depression and I asked the biggest question over and over again: Is that all there is? Sullen moods went on for a bunch of years until the youngest one graduated from college. And then a miracle happened a few years later. 

Both boys invited me, in the same year, as a guest visitor to see what they did for work. The older son, a Senior Programmer, showed me his workspace and explained in detail what he did to make things work and do what they did. My younger son, a Systems Administrator, showed me his workspace and what he did for networks, the lines of communication, to exist.

It was then I stopped thinking of them as children and moved on. 

My two sons were making a contribution and were self-sufficient. Isn't that what every parent wants? 

My stroke happened shortly after, and I knew, in all that despair, that my sons were going to be fine. Every time I thought that way, it led me to smile.