Extra Mural Program keeps me mobile one foot at a time

  

Photo: BNI Archives

        Since 2007, after my husband passed away, I’ve had an ongoing relationship with New Brunswick’s Extra Mural Program aka EMP, often called ‘a hospital without walls’. 

A physiotherapist visited me a few months after the death of my husband to determine what my ongoing ‘home alone’ needs would be in order that I would be safe within the parameters of living and aging with spastic diplegic cerebral palsy. At that time, it was decided that I would benefit from a walker. Choosing one with four wheels, I have found it to be a huge assist to my daily ambulation. Moving around inside and outside my home had always been relatively easy as I pay close attention to surroundings. Housework was undertaken in blocks, based on related tasks, room by room with no going back and forth with no rushing. Staying focused ensured I stayed safe and well and reduced the potential for falling injuries. 

In my 67 years of living with CP, I’ve fallen only a few times and without injury. Luck ran out when,  in the early 80s, I tripped over my black cat, Mr. Basil, dislocating my dominant elbow, landing me in the hospital for a month unable to use crutches or propel a wheelchair. I stayed at the then Northern Carleton Hospital during that period, after which there was weekly therapy for 9 months at the Stan Cassidy Center to regain range of motion.

Fast forward to current time where a  falling injury, given my advanced age, could do me major harm or very possibly do me in with regard to independent living. Thus the value of EMP interventions.

How many seniors have sustained serious falls in the home that required surgical intervention followed by at-home care with visiting clinicians from Extra Mural?  Where would they be without that intervention? A huge debt of gratitude is owed to the men and women of EMP who go above and beyond to restore New Brunswickers in need of their services to a level of independence in daily living that most of us enjoy with ease. To not do our part and follow through with daily program designed by the care team insults their role as providers of health care with their time and attention to us. If you’re guilty of doing that, just stop it. If you’ve been given a list of exercises to do a few times a day, DO them!

As a child, growing into cerebral palsy, I was exercised 4 times a day for 12 years and had no choice in the matter; those pushes and pulls hurt. They hurt a lot. I can honestly say, in retrospect, were they not done and had I not been blessed with parents committed to my daily care, I’d not still be uprightly mobile today. That is the truth.

Today, I’m fortunate to have access to a fine therapist who works with me to keep my legs in good form so I may continue getting around in my home. We’re currently challenged by the recovery process after the TIA and my brain is being retrained, revisiting many of the exercises that were done to me as a very small child. They’re tweaking muscle memory to get me back to more efficient stepping and heel-toeing.

For many  years, the Extra Mural Program specialists have visited homes across the province, working with patients coping with a range of situations, whether related to aging or focused on recovery after surgery or some other medical intervention. Their goal is to work with  the individual so that greater mobility and confidence is restored so that independent living may continue. Staying in the home safely and well is the goal and those availing themselves of the services of  the EMP have a duty to ‘get with the program’. As I’ve said before, clinicians are like Santa - they know when a patient has or has not done daily exercises. It’s patently unfair to them and to folks on wait lists if those currently utilizing their services aren’t going to be compliant.  I do my part with stretching and ankle-foot rotations and heel cord strengthening standing with my walker. The therapist does the heavy lifting and I tell him at every visit that I appreciate his involvement in keeping me forward moving — one floppy foot at a time.

Carla MacInnis Rockwell is a freelance writer and disability rights advocate living outside Fredericton, NB with Miss Lexie, a rambunctious Maltese and Mr. Malcolm, the boisterous Havanese. She can be reached via email at Carla MacInnis Rockwell

Vitamins are critical to good health

Transient Ischemic Attack (TIA) erroneously called a mini-stroke, is often a precursor to a full-on stroke. It’s more appropriate to call it a ‘warning stroke’. 

After my own experience with a TIA, what I call a bump on the brain, the 2nd in my 67 years, I decided to immediately go into action to regain as much as I could; it’s imperative that I be able to walk with crutches again as I rely on the walking as another way to stay toned. Wheeling around when I’m in the city gets me where I need to go quickly, but I spent years learning how to walk and I’d hate not to be able to efficiently do it again. Tenacity propels me forward.

For years, I’ve been taking a range of vitamins and minerals, a morning round and a bedtime round. Notable among them are magnesium, C, D, Zinc and B Complex. I had taken a course of B12 years ago to treat implications of carpal tunnel syndrome. At diagnosis of CTS, surgery was recommended but I couldn’t risk anything at all going wrong with my hand, so I opted out. The B12 aka methylcobalamin wasn’t going to hurt. As it turned out, it resolved the issue totally and I’ve not had another episode of CTS.

When I learned B12 was indicated to heal the brain after stroke or TIA, I decided I’d just go ahead and take as directed. I informed my doctor of the plan. Living with CP among other issues affecting mobility and general health, it was critical that the residual effects of the TIA be banished from my body as soon as possible.

All B vitamins are crucial for overall brain health, but vitamin B12 may be the most important. That’s because it may help improve general cognitive and motor function, and possibly help prevent a second stroke, doing this by repairing and protecting the health of neurons, the basic cells of the brain. This has enormous implications for stroke recovery. Vitamin B12 can help patients regenerate neurons and improve neural communications, allowing survivors to improve various stroke side effects, such as impaired movement.

I took B12 for a week following the TIA and found that it has helped. I will continue to take it throughout my life with an every other month for 7 days schedule. As an infant, my brain was insulted by cerebral palsy; the TIA was my senior citizen warning. Nutrition and supplementing will hold me in good stead and it is my hope that I won’t have to join those in the ‘I take 10 doctor drugs a day’ group. Far too often script meds are contraindicated and some actually compete with each other, not always in a good way. So far, I’m a single script drug user. I hope I am able to maintain that status for many years to come.

In addition to boosting overall brain function, vitamin B12 also promotes axonal growth after a brain injury. Axons are the part of a neuron that connects it to other neurons, where the electrical impulses that a neuron sends travel.

Without axons it would be impossible for any of the billions of neurons in the brain to communicate with each other. After a stroke, many of these axons are destroyed when blood flow is cut off, leading to loss of function. With CP, it’s very often an infection that causes the deficits to brain development. My late father, a doctor, felt that it was, indeed, an infection within weeks of birth that set the stage for my  own diagnosis of CP when I was just over a year old old.

Since I’ve had brain building and repairing vitamins and minerals on board for decades, I am confident that my brain will be sufficiently protected from future insult. In the meantime, my goal is to work on getting back in step so that I may do the occasional walk-about outside with my crutches. Walking in the house is going well and I’m back to doing all those kitcheny things I enjoy so much. I continue to focus on foods that will contribute to brain health. I’m all about the fish, and my home made yogurt, of course. 

As with all things, consult with your physician before undertaking any protocol you read about. What might work for one person may not be appropriate for you.

Carla MacInnis Rockwell is a freelance writer and disability rights advocate living outside Fredericton, NB with Miss Lexie, a rambunctious Maltese and Mr. Malcolm, the boisterous Havanese. She can be reached via email at Carla MacInnis Rockwell