A follow-up

So, I did a little treadmill run today after lunch and felt pretty great. My heartrate stayed normal! I did not want to die after a few minutes! Did a version of C25K week 5 part 2, with two 8-minute runs. Yay.

Then I came home, had an early dinner (roast trout and broccoli, easy to prepare quickly and cholesterol approved) and went to an improv class.

I had this idea a couple of days ago. I am really struggling with losing my words, especially when speaking. How do I get that back? How do I work that muscle? So I looked up improv classes, and discovered that Bad Dog Theatre has improv drop-ins every Saturday and Monday. The closest sessions were booked out, but I put myself on the waitlist and got a spot today.

Of course, as soon as I got on the bus there, I started getting a headache, and wished I had brought my new meds (there’s a daily med, and two “rescue” meds to take when you feel something starting). I don’t know if this headache was due to stress, overexertion, the fact that the last dose of the last med was wearing off, or what. But I kept my water bottle handy to keep hydrated and selectively opted out of things like spinning or bowing low. (I really appreciated that they started the session by inviting us to share accessibility needs.) And I got through it! A little nausea by the end, but it was okay. It was great to be in a room full of beginners, none of whom really knew what to expect, so I didn’t feel like “the slow one” or like I was holding anyone back. I did feel like I was getting into the swing of things like “thinking” and “speaking” by the end, and the great thing about improv is that it’s fundamentally supportive, you’re working to build a scene together, and no one is wrong. One of the exercises was even about the value of patience, waiting for your moment, waiting to have someone’s attention, and making sure that you’re connecting and they’ve understood what you’re conveying.

I feel like this could be helpful for me and wish I had thought of it sooner. Maybe there’s a two-day bootcamp I could try? That would at least work as a make-it-or-break-it type of thing? 

So wrecked.

Feeling some kind of a way but maybe it’s just because I’ve been feeling off all week. 

Part of it is stomach upset from the junk food lunch we had on the weekend. 

Part of it is the looming six-month anniversary of my tumble, coincidentally also my birthday. 

I thought I would be better by now. 

Last fall, six months was the longest I thought it could take. At the beginning of this year, 31 March was one of the dates on my LTD letter and I sort of mentally noted it as “will be better by then.” 

Now those dates are coming soon and filling me with anxiety. 

Part of me is frantically thinking, “What else can I try?” I still haven’t called the osteopath my friend recommended (I’m honestly unsure what osteopaths even do). I had the idea the other day of seeing a speech-language pathologist since it seems to be speech where my cognitive difficulties really overwhelm me. I had the idea this morning to try Improv classes to “work those muscles.” Why didn’t I think of that months ago? (Answer: I wasn’t capable of thinking months ago.)

I am typing all this from the waiting room of my doctor’s office, to follow up on some bloodwork results, anx probably get another lab req.

And wondering: 

Do I tread extra carefully now so I don’t mess up my progress as I approach the finish line?

Or do I go hard, to guarantee that I will be either 100% better or 100% obviously not when 31 March rolls around?

So this is why I feel like crap

Update from the exam room, my blood pressure is low even for me! No wonder I was feeling pooped climbing stairs on my way here from the gym. 

Is it me, or…

So I started a new migraine medication this week, propranolol.

Previously, I had been taking amitriptyline for migraine prevention, with mixed results (maybe it would have been worse without? But I did have that nasty incident that drove me to ER). A friend suggested I ask my doctor about Qulipta. My insurance wouldn’t approve Qulipta until I “failed” two other medications. So amitriptyline was one, and propranolol will be two—or maybe it will just work and I can stay on it?

Here’s the thing with propranolol—the side effects include lowering heartrate and blood pressure. For most people, that’s a win. As someone with low blood pressure normally, it makes me a lil nervous. I already have issues with feeling lightheaded if I stand up too quickly, and now we’re doubling down on that? Hmmm…

My first treadmill run the day after starting it went really well. It was the first day of week 5 of Couch to 5k, which feels like a bit of a jump from week 4 (week 5 feels like a bit of a jump every day). I was pleased at how manageable it seemed, and noted also that my peak heartrate wasn’t as high as it had gotten two days prior when I was finishing up week 4. Meds, maybe? 

Today, though, I just felt off. My skin felt prickly? Or almost pins-and-needles but not quite? I repeated day 1 (5 minute jog, 3 minute walk, 5 minute jog, 3 minute walk, 5 minute jog) instead of progressing to day 2 (8 minute jog, 5 minute walk, 8 minute jog) because 5 minutes of jogging felt like I was really pushing it. Afterwards, my skin was super blotchy—really flushed in some areas (face, chest), really pale in others (neck). 

Blotchy!

So, I thought maybe I should look up the side effects (up till now, I’ve only known what the doc and pharmacist told me). Here we go…

From Migraine Again:

Propranolol is a beta-blocker medication developed in the 1960s to treat chest pain and high blood pressure… By blocking adrenaline, propranolol slows your heart rate, lowers your blood pressure, and reduces the dilation of peripheral blood vessels (is that where the blotchiness came from?)… Propranolol may also reduce stimulation of the trigeminal nerves in the head, which contributes to the migraine process… Common potential side effects of propranolol include:

• Dizziness or lightheadedness
• Drowsiness
• Fatigue
• Nausea (hmm, my tummy has been off lately)
• Exercise intolerance (ah, maybe that’s it)

Some readers reported intolerable side effects:

“I tried it, but it made me feel spaced out, I couldn’t concentrate, and my brain was always fuzzy—I’d rather have a migraine!”—GW (I am definitely spaced out, but I was already kinda spaced out, so…) 

“It did nothing to prevent migraine and gave me horrendous, vivid nightmares. I would not recommend it.”—MLA (not nightmares, but I have had difficulty sleeping and some vivid dreams!)

I was worried about having a “hangover” effect after last night’s struggles, but not doing too badly today (although I did almost start crying for no apparent reason on the way home from the gym). So maybe it’s helping with the anxiety too, which it is also supposed to do?

Guess just have to wait and see; often side effects go away as the body gets used to things.  

Run Towards the Danger

So I finally finished the book Run Towards the Danger this morning and it has me thinking all kinds of things, but more importantly, feeling hopeful.

I’ve been going to the gym pretty steadily for the past week and a half, doing the sub-symptom threshold cardio and trying to keep my heartrate between 80 and 90 (around 50% MHR for me). My heartrate usually tends to be on the high side, I work on regulating it through slowing down, breathing exercises, etc. (I’ve found gazing at the potted plants helps). It’s pretty boring, but I do my best.

I will also admit I have slacked off on the shoulder physio, because doing that consistently for a couple of days will give me a day of headache, so I have to rest to recover.

In the book, the expert Sarah Polley sees insists, just like the title, she needs to “Run towards the danger.” Do the stuff that makes her brain hurt. And when the symptoms come, instead of resting, exercising (she has a routine of fast-paced vestibular exercises to do).

I sadly do not have thousands of dollars to go to Pittsburgh to visit this clinic, but I want to try my own little experiment. In a low-risk way (not in a way where I risk falling and hitting my head again).

Amping up my cardio (while staying on the stationary bike, no chance of falling). And doing cardio when I feel symptoms coming on, and also talking myself through my symptoms.

One thing that happens to me when I’m experiencing cognitive stress or visual stress is that I feel a wave of heat wash over me. I’ve taken that as a signal to stop what I’m doing—finish my session with my SAD therapy lamp for example. Today I felt that rush of heat on the bike at the gym, but instead of stopping or slowing down, I just said, “This is a normal response,” and kept going. It went away.

After getting home, when I sat down to write this, I felt a headache starting. Instead of, “Oh no, a headache,” I said, “That’s just my brain fixing itself,” and the pain dissipated. Placebo effect? Maybe? Probably? Who cares, I don’t have a headache.

One of the things she mentions in the book is she started saying yes to all of the social events she had been avoiding. Man, I would very much like to get back to socialising. But I want to be mindful about how I do all this stuff, and not just knock myself out and set myself up for regression. I do have a number of things planned for January—things I planned before my accident, mostly, and a few I planned figuring, “Surely, I’ll be better by then”—so my goal for now is not to plan more, but to not need to cancel anything. 

Part of me wants to set a crazy goal, like running a marathon this fall (literally running towards to the danger). I don’t know about that. But maybe. We talked about getting a team going to fundraise for the theatre I’m on the board of, so maybe?? Is that nuts? 

I guess the first step is to see how I do tomorrow.

For now, I’m going to try going to the grocery store—an overstimulating place I’ve avoided—since my kid is here with me to support if I need it. Tomorrow he goes back to university, and I am intending to take the train with him. Last time I did a day trip to Waterloo, it knocked me out and I needed to rest a few days to recover. What if this time, instead of resting to recover, I stick to my cardio routine? We shall see…

Cardio for concussion

This morning I had an exercise counselling session with a physiotherapist at the Toronto Concussion Clinic. The plan is “sub-symptom cardiovascular exercise training protocol.” Basically, try to maintain a consistent heartrate—starting at 50% of maximum heartrate (MHR)—for 20 minutes, without getting concussion symptoms. Warm up beforehand to get to that heartrate, maintain for 20 minutes, then cool down. My target heartrate at this point is 80-90.

I went for a little walk to the library today to print out the session notes (I have soooo many notes… I did finally buy a binder so I can organize them, but it feels like so much work), which is a walk I have done approximately one million times. Usually takes 13-15 minutes sauntering, depending on whether you have luck with the traffic light.

Today, it took me 21 minutes, and my heartrate was all over the place:

Heartrate 69-111?!

Hrmph.

It may well be that the watch I stopped wearing because it gave me a rash is not accurate (I have a new, hopefully better heartrate monitor on order). But it definitely felt like my heart was racing. And around the 14-minute mark, I was getting headaches and nausea. Do not like.

For comparison, here’s something I posted (not here, but an online discussion about fitness) a year and a bit ago:

Yesterday I checked my heartrate barely a minute after I got off my bike. I rode to work, 15 minutes averaging about 13mph, fastest was 22mph. According to one of the articles, cycling over 10mph is “vigorous activity.” Going by the how does it feel—breathing, perspiration, but can hold conversation—it would be “moderate activity.” I felt like my heart was pumping, so I went straight to the machine in the drugstore, and it said BP 105/60, pulse 73, which according to the charts is not even “low intensity” for a 75-year-old.

I’m like an entirely different person now.

Tomorrow I’m seeing Angus; I will bring my notes from the TCC physio to see if he has any tips/thoughts as the longterm keeper of my shoulder. They also gave me some coordination and asymmetrical bilateral exercises, which involve arms (because I have forgotten how to swing my arms like a normal person when I walk).

It’s so frustrating to feel like I’m getting worse instead of better. I feel like I’m regressing and I want to be progressing. It’s depressing as hell and I’m just exhausted and crying all the time. Do not like. 

Wow, that really knocked me off the rails.

My headache appointment with the concussion clinic today really set me off for some reason.

I suspect part of it is because I am still so wiped from yesterday—waiting for the streetcar that was super late, waiting at the fracture clinic, waiting for a bus that never came and eventually having to walk home carrying stuff—so I was starting at a low ebb. 

There was also frustration at realising I might be making my headaches worse by taking too much Tylenol—I was following with the orthopaedic surgeon at the fracture clinic said, but apparently the amount I had been taking is not good for more than maybe a week, and could be making my headaches worse. So, no more over-the-counter pain relief, unless I really, really need it, which is kind of daunting considering I’m starting physio tomorrow.

But the real kicker for me was when the doc started talking about other ways to keep headaches at bay, to allow me to sleep and rest and heal. There are some off-label medications, which mainly sounded like they would not be good for me. For example, there’s a high-blood-pressure med that can be a prophylactic for headaches—considering my blood pressure is already low (dropped down to 87/49 this summer), that would be terrible for me. Likewise a medication for treating tachycardia. My pulse doesn’t need to get any lower!

Then they mentioned Botox injections for headache. Just thinking about getting a needle to the face took me right back to the ER department and the horrible mean cruel Dr. Firdouse laughing at my pain. Just thinking about it now, I’m fighting back tears. I need to go through my emails and finish filing my complaint about that guy, but it’s just one more chore on the daunting to-do list and just thinking about the pushback and doubt and denial I’ll have to face makes it feel like an impossible task.

Anyway, after my appointment I had headaches and nausea and tears and I couldn’t face going back to work. Which means I need to log in tonight or tomorrow to finish stuff. Ugh ugh ugh.

One thing after another!

Be warned this is kinda gross. The yucky pics are at the bottom of this post; if you don’t want to see them, don’t scroll all the way.

After my fall I got a fitness watch so I could track my heartrate and know when to take a break before things got too far. I am including this pic mainly so one of the gross pics doesn’t end up being the thumbnail for this post.

Mainly putting this pic here as a buffer

The watch was suggested by my concussion pal. Current wisdom says that rather than avoiding everything completely when you have concussion, it’s better to do a little bit, rest a little bit. But take that rest break before you are really feeling that you need it (i.e., before you get symptoms, like headache and nausea in my case).

It’s pretty basic, but does the job. Or, did the job. It was wild to see my heartrate spike to 132 as I slowly shuffled around the grocery store, occasionally needing to lean against the shelving when I lost my balance. It was set to warn me if my heartrate went above 100 or below 50 (I got warned for both of those!) For the first two weeks, it regularly warned me that my resting heartrate (50) was too low, and now it’s happier with me because my resting heartrate is more normal (60). My sleep is crappy and irregular, but no surprise there.

It was also “fun” to count my steps. I’ve never been a pedometer person, but it was instructive to see my daily average of 600 steps climb to 1,200 steps. Just 9,000 more and I’ll be an average sedentary person!

Anyway I’ve been wearing it for three weeks now, taking if off to bathe. 

As my shoulder gets a little better, I can do more with my left hand as long as it isn’t weightbearing (I’ll post about exercises and physio later). One thing I’ve done is go back to two-handed typing. I can only do it for a little while though, and then I start to feel sore. Today I figured out why.

(This is where it gets yucky!)

My skin is rubbing off under the watch strap. I swear it was not like this two days ago! But now I am rubbed raw.

For the time being, my fitness watch has been replaced by ointment and bandages. Photos of my wounds below, so I can find them if I need to show them to one of the docs. I can’t figure out a way to “spoiler” them, so consider yourself warned and stop reading now if you don’t want to see! No more heartrate tracking for me, I guess. It just seems to be one thing after another these days and I am tired of it. 

So that’s why it’s so tender

I had a different worse gross extra problem last week that I don’t even want to talk about.