I’m looking back on a year of very low activity on this blog. I never thought I’d slow down this much. There are three primary reasons for it. I can share two of them, one today and another tomorrow or Tuesday. The first one has to do with what it’s like recovering from a long-term injury. There’s more to it than most people realize.
Recovering from a long-term injury
It’s been eleven weeks since my fourth foot surgery for a complicated tendon problem. I’m approaching four years since the injury and the first surgery. I’m in physical therapy now to re-strengthen my lower limbs. On most days it’s about an hour of home therapy, but if I’m having scheduled PT at the hospital it takes about two and a half hours out of my day. Everyone is predicting this will last a year.
That’s not the worst disruption, though. I’ve just thought of a way to explain it.
This is my story, but it’s many other disabled persons’ story, too. I’m sure it’s the same for many stroke patients, only (I’m sure) much more so. If you’ve got a friend or family member with a long-term disability or injury, I’m writing this for them as much as for myself. I suggest you ask them to read this, and then ask if it helps them describe any of what they’re going through. The physical aspects are challenging in ways that are easy to see. To every long-term disability, however, there’s a hidden challenge that others may not easily understand. I’m hoping this will help.
I’ll start with an analogy. This will communicate best if you’ve ever helped anyone learn to drive.
It was fascinating to me, when I was helping my son and daughter learn to drive, just how much mental energy they spent on operating the vehicle: how much to turn the wheel, when to hit the brakes in order to stop on time, how hard to push the pedals, and so on. They had almost no capacity left to notice things like traffic lights changing or cars merging onto the expressway. I had to serve as their eyes for them; they literally didn’t have mental space left over see the things a driver needs to see to drive safely.
They could navigate to familiar places but they could never have followed a map to someplace new. Their minds were fully occupied with making the car move forward without hitting anything, and that was all they could do. For experienced drivers, of course, none of that involves any mental effort whatsoever. When was the last time you actually thought about how fast to accelerate out of a turn?
Similarly, when’s the last time you had to think about how to take a step? I don’t mean taking a step on rough or uneven ground, but just walking across your living room. During this phase of my recovery, I spend at least some mental energy on every step I take.
I had developed habits, you see, of sometimes walking flat-footed on the left foot, and sometimes pushing off sideways, so as not to irritate the injured part of the foot. My balance-control muscles are badly out of shape, so for stability I tend to walk with my feet spread further apart than they should be. None of that is healthy walking technique. I’ll never correct it unless I concentrate on it. Meanwhile, though, there’s that balance thing going on. I really do start to lose my balance sometimes.
My foot tires easily, which calls for further energy devoted to decision-making, as I ‘ll explain in a moment. By “tires easily,” I mean for example that this morning I got as far as making the coffee and feeding the cat before my foot delivered its first complaint of fatigue. That was the best it had done since the last surgery. Even a short-lived experience of normalcy like that, while pleasant, was distracting. I couldn’t help noticing and thinking about it.
Pain is tiring in itself, and pain is present with nearly every step I take. Sometimes it’s a debilitating ache that goes all the way up into the hip. Sometimes overuse doesn’t lead to pain, though. Sometimes with little warning and without any standard sensation of pain or tiredness, my ankle simply decides not to hold me up. I’ve only fallen the floor once from that happening, and it was when I was already leaning forward to look get a shoe out of my closet; still, it’s a disconcerting and debilitating feeling to know that my foot might just decide not to do its job of holding me up on the next step.
So as I said, that leads to further decisions: Do I use crutches? The answer is often yes, if I’m going further than just across the room. But what if I need to carry something? Do I use a backpack? Most of the time I do, but it’s not much help if I want to take a coffee cup along. I have to pause to get my car keys out of my pocket. A phone call will stop me dead in my tracks.
Mostly, though, I have to think about every step I take. To be standing upright isn’t just a physical challenge for me. It’s a matter of expending constant extra mental energy on ordinary activity. I used to walk a mile every afternoon. It was usually my most productive “think” time of the day. Now if I’m walking, if I’m thinking about anything other than walking, then by necessity I’m thinking about two things at once. Either that, or else I’m walking in those bad habits I mentioned above. It’s tiring to work that way.
Last night I had a great night’s rest, nine full hours. Today I had nothing urgent to do, and I got about a 90-minute nap. I feel fairly rested for the first time in weeks. I think now you might understand better why I would feel that way.
That’s part of what’s been slowing me down: I don’t have as much energy to think and write as I’d like to have. I keep thinking I’m going to get this blog active again. I do think that day is coming. There’s more going on, though—much better news than this, mostly, though with a bittersweet side to it as well. I’ll be back with it in a day or two.