20211014 : two broken systems

This has no medical basis.

I feel/ think, based on the progress of my rehab, that my stroke did 2 kinds of damages to me. Physically speaking, the consequences have been several...

The stroke happened in my brain stem.

The brain stem is the main connector between the brain and the rest of the body (through the spine mainly). Like a conduit.

The brain stem is also considered the most ancient part of the brain, so nothing "human" is managed by it. But it controls very vital automatic functions - like hear beat, blood pressure, breathing, body temperature, swallowing, sleep cycles, coughing, amongst many other things we do automatically and naturally.

So actually, the stroke left me with all human abilities, and many of the animal abilities stripped off. 😂

It's anti-evolutionary if you think of it like that...

Some things - like heart beat, blood pressure, etc have been ok - although struggled in the ICU initially

Many other things -like breath control, swallowing, coughing, body temperature etc, - the brain stem having the controlling microchip, is burnt to various extents and not functioning - either fully or to various degrees of disabilities.

The brain stem, being small but managing so much and being the conduit, has a very high density of neurons compared to rest of the brain.

Given the pace of recovery and strengthening of various functions - I imagine the neuroplastic magic is harder and takes longer.

So, my broad assessment, given the assumptions above - and observations, are like this:

Cognition, thinking, logic, etc. : Basically all evolved functions. They are all done by the frontal lobes. Doesn't have to leave the head for materialising, so is all ok .

Motor functions: most of the motor functions and voluntary movements of the muscles - are also controll by the outer parts of the brain. So it should work, but it isn't. So I can only assume that the conduit is fried. Very slowly recovering.so, I can assume most movements will come back - albeit, much weaker, slower and will take a very long time.

The "intention" is there. The "knowledge" on how to do it is also there. But the messages don't go through. So "action" doesn't happen. ( "Iccha", "jnana" and "kriya" - all three are needed)

Breath control: this is managed by the stem. But I am still breathing. Very shallow and no voluntary control. Over time, I think it will get stronger as the muscles around the lungs wake up. But control - don't know.

Speech: the function of speech is also controlled by the outer areas in the cortex. Like all things, "where" is known but "how" is anybody's guess. So, my theory is this:

The "knowledge" (what and how) of speech is there.

The lips, cheeks, tongue have to move correctly to make the right speech. These don't work effectively. But they are muscles. Same issue as above. It should come back, slowly.

Finally - the actual sound/ voice, for it to come, the vocal folds need to work. These are soft muscle tissues also. So, as above - I am hopeful.

("Para", "Pashyanti" and "Vaikhari" if my memory is right)

Swallowing/ gag function: this is the concerning bit. While it is all throat muscles, the complex operation is orchestrated by the brain stem. So, I don't know about it and whether it will repair.

Cough: while the lung muscles are involved, A good portion of the actual work is done by the diaphragm. This was the first thing my neuro said will be impacted by where my stroke happened. Although I am far from cough/ voluntary control, it must have gotten better as i suffered from unbearable hiccups earlier - which has gotten better over time.

Body temperature: Again controlled by the brain stem. I still can't make out temperatures. Folks around will be regularly complaining of heat or cold and I will be unable to make out. 

My body also behaves weirdly - suddenly the extremities get very cold. Sometimes, the forehead will be hot, but the measurement in the armpit will be normal, etc.

I have mentioned many times seeing my body temperature indicates nothing. Still it is taken 3 times a day religiously 🙂.

Anyway, I don't know about this one as well - where it will end up.

Hearing: I am deaf in my right ear. The ear or hearing apparatus is fine. The transducer is fine. Interpretation of the signals happens in the auditory cortex. Close, but not the brain stem. Unfortunately though, the main pathway of the auditory nerve is through the brain stem. Same wiring problem. I was stone deaf in the first 2 years. Now, I can hear some gibberish sounds once in a while - nothing intelligible. But, moving in the right direction I guess.

Taste/ Smell: same problem as above. Very diminished currently. But moving in the right direction.

Memory/ emotions: the seat is not the stem, but sits just above attached to the stem. So, some areas might have got affected. I don't know. All I know is that some memories got affected and my emotions are still all over the place. Don't know if it'll get better...

Varius organs: i don't know what all organs the brain stem controls. Eg, it is responsible for digestion. I don't know if it means just stomach or all organs and process involved. But as long as stuff is going in and coming out, it must be managing - in whatever capacity.

Sight: the eyes are the spoilt brats. They have a direct line to the brain and don't have to detour to the stem. So, thanks to the small mercy, I am able to still see from my right eye. Otherwise I would be completely blind as my left eye was anyway rotting - even before the stroke.

Which brings the question. Everyone knows that the brain has 2 hemispheres and they control opposite sides of the body. I have not seen any of my reports, but I think it must be the right side only as the nerve clusters interchange only after the brain stem.

The stroke must have done significant damage. Everything on the right side was/ is affected. Not just the limbs, pretty much everything. Eg, my tongue - its easier to move to the left and only recently I have been able to move right. I still can't lift right lip. Cant hear on right, etc. I won't be surprised if it's the same story with nostrils and taste buds.

It's absolutely strange to have a part of the body immobile. I can see the hand. I can feel it externally - if someone or something touched it. But I can't feel it internally. It's a very weird feeling that I can't put in words...

The neuro physiotherapy - for me, is more for the brain rehab than any affected part. Have to somehow convince the brain to recognise the affected part than building strength in the function. 

My physiotherapist makes me do some movements. For eg, he has been holding my arm down and asking me to lift my shoulder. I manage very mildly for 2-3 times. But he will continue for 20 counts, by lifting the arm itself trying to cheat the brain to think it is doing it itself. But since I know this, I am guessing the trick won't work. So I close my eyes, so I can't see him doing it, so I truly can't say how many I do and how many he does for me. It's a trick to trick the trick - so that the brain can't know the trick.

So, in general, I can continue the rewiring of the conduit. But where the chip is blown, I can only hope there is a replacement. I feel like I am equally affected by the pandemic induced global supply chain crisis - resulting in shortage of processing chips. 😂

Anyway, that's my assessment - having to think of something to keep my mind engaged.

Could be all fiction... But makes for a good story nonetheless...🙂

PS: sorry for the lengthy note. Started out with a small thought. Mind couldn't help itself after...😂