I arrived home, from what was supposed to have been a relaxing holiday, completely exhausted and totally wiped out emotionally. Exhausted from the physicality of travelling, the altitude and doing more physically than I had been since the last of my strokes. Emotionally I was finding it hard to deal with other issues. I was still struggling with the after effects of my meeting with the Consultant (See Post: Consultant’s Outpatient Appointment) where I was told that I had had numerous strokes added to which I had to assimilate finding additional levels of deficiencies.
A week after arriving home I had my next visit from my Stroke Nurse (RP). She was not surprised that I had had a hard time on holiday and indeed she had counselled against my going at all. RP stressed, yet again, that it was not possible to develop new deficiencies. No matter what I said she was adamant. Sensing that I would get nowhere we agreed to simply accept the situation and look at what my options were, which is when RP told me that there was no way that I would meet the requirements for Community or even Hospital Physiotherapy, for two reasons: my relatively minor symptoms and budgetary constraints. But RP did introduce the concept of GP Referral.
Under this programme I would be given 20 seasons at my local public gymnasium. Well, not given, I would have to pay £33, which obviously equated to £1.50 each, which was a major saving on the over £6.00 a session for the general user. We filled out the paperwork and RP took it with her to have my GP sign.
A week or so later there was a message on the house phone from a young woman NC who is an Instructor at my local Leisure Centre. Returning the call we arranged date for my acclimatisation session a week later. The concept of having an instructional session was interesting; I have been into many many gyms in my life and I didn’t really need telling how to workout.
Arriving at the Leisure Centre at the appointed time, 15:00 on Thursday the 9th of April, I was told that I would now be meeting with another Instructor (ZH), who is the GP Referral Instructor. ZH took me to a side room where we talked about my condition and what I was looking for from exercise as well as explaining the GP Referral scheme and filling in some paperwork.
Together ZH and I decided that I was not looking to build muscle or even to lose weight so the range of equipment and activity was to be a mixture of cardiovascular work, free weight and resistance machines. After further in depth discussion it was agreed that what I was looking for from my time in the gym was a way of working on my right side without pushing it too hard and with many repetition in order to help my brain could find and get used to different pathways but without allowing my left side to grow weaker by ill use.
Finally ZH took a range of measurements.
Weight - 17 st.93.9 cm (108 Kg)
Height - 5ft 9in (1.75 m)
Waist - 37in (93.9 cm)
Body Mass Index - 35
Body Fat Percentage - 32.3%
Blood Pressure - 163 / 93 (Which ZH confirmed as being higher than she would want. Thanks for that earth shattering piece of news)
Heart Beat - 72
Having set my bench marks we moved into the Gym where ZH checked that I knew how to use each piece of equipment.
ZH watched as I worked my way through each peace of equipment. My deficiencies showed themselves the moment we reached the resistance machines where my right side struggled to move the weights, especially as I to the end of the second repetition and entered the third, and my left had to work harder to cover. When we moved on to the free weights both the Front Raise and Lateral Raise showed up my the right side showed definite signs of muscle retardation and spasm which meant that the arm was slightly restricted in its movement, specifically that it could not raise to the same level as the left and that it could not hold a weight for as long and began shaking at an earlier stage.
The package of exercise that ZH developed was as follows
Cycle Machine
Warmup - 15 mins @ level 6
Resistance Machines
Back Extension - 60 lbs @ 2:5 ratio
Chest Press - 40 lbs @ 2:5 ratio
Leg Curl - 30 lbs @ 2:5 ratio
Leg Extension - 30 lbs @ 2:5 ratio
Treadmill - Walk
15 mins @ level 1 and speed 6
Free Weights
Front Raise - 3 X 15 repetitions @ 3 Kg
Lateral Raise - 3 X 15 repetitions @ 3 Kg
Bicep Curl - 3 X 15 repetition @ 4 Kg
Rowing Machine
1000 m @ level 10 resistance
Cycle Machine
Cool Gown - 2 mins @ each level from level 6 down to 0
The whole regime took between an hour and 15 mins and an hour and a half. I was warned by ZH not to do two things. One, to push my right side too much and secondly, not to let my heartbeat get too high. She said that what I was aiming for was resting heartbeat plus 50%.
Normally ZH ran GP Referral groups on a couple of days a week, where people with similar conditions worked together. We agreed that as I was beginning to go back to work I might find it difficult to attend these groups. In view of my being used to gym work it might easier if I was to find two days a week that I could manage under ZH’s supervision, of course
I cannot say it was easy but nor was dealing with these new found deficiencies. To begin with I found that I was tired after going to the gym, which would last into the evening but as the weeks passed I could see that my stamina increasing. This was evident in two ways. The time that I needed to rest between repetitions and different exercises began to reduce and the tiring effect of the exercise got less.
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