Seeing is believing!

Sometime ago I met a very engaging, cheerful young lady three years after her stroke enrolled in one of the FES trials. We walked with her through her journey thus far. Being a swimmer and a marathon runner prior to her stroke put her in an advantegous position as she was a quick learner who worked very hard and knew the importance of regular exercise. As our instructor Mr. B pointed out she was someone they would have to ask to stop pushing herself so hard and slow down. She doesn't even live in this city but comes down for her therapy sessions four times every week. She was happy with her progress. When she related that she had developed an aphasia along with her weakness, I was amazed because she was speaking so normally! I have always known that a lot depends upon how much patients want to get better but since I hadn't seen many patients outside the acute inpatient setting, it was heartening to see reamarkable recovery and a testimony to will power. She had 5 implanted electrodes in the muscles of her rigth leg which weren't being used presently. I saw her work her way to almost normal components of gait with the help of FES. Having experienced the unpleasant sensations of FES, I was amazed to see how she was using it so effortlessly and beautifully! She would break into an easy smile with a compliment from Mr.B about how well she was doing and knew exactly when she wasn't doing a good job. I liked the way she was tuned in providing herself feedback! No wonder she was doing so well!
She told us about her brother who was in medical school and wanted to become a neurologist as well. As we parted ways, she wished me luck. I couldn't help but thank her for teaching us so much in just a couple of hours!

Shocking move!

Functional Electrical Stimulation (FES) is a technology which can make weak muscles move by stimulating them via electrodes which could either be implanted or be placed on the surface. A little box is used to supply current and change its amplitude and frequency. It's the power of electricity at work for you and I was very excited to experience this technology first hand, quite literally!
My heart skipped a few beats when I saw our instructor's fingers move after she let 3 ma of current run through a few muscles of her right hand. Now it was my turn. I was a little apprehensive and very excited. I had been told that the current might feel funny, almost like parasthesias and even painful. One set of tiny surface electrodes and I was ready to experience electricity! I began feeling parasthesias with a very small strength of current and before long my fingers were moving; moving at their own will. I felt pain in a few tiny muscles of my hands and we decreased the signal intensity.
Then I wondered, I was experiencing this pain for such a short duration. People with stroke or SCI who undergo therapy have to go through these unpleasant feelings repeatedly and work with it to regain functional motility of their upper or lower extremities. Of course, there are many who will have some impairment of sensation and perhaps can tolerate higher intensities of current by virtue of their impairment but it still seemed like one had to be strong to endure and prevail.
My mom says this often, "There's no gain without pain”. I wondered about how much pain is enough; how much endurance will get you to where you want to be; how much patience one must have... I wondered about that amazing Creator who planned these moves and about the power-house our neurons were a part of. Every little synapse, every molecule of neurotransmitters at work every single moment of our lives; making us think; making us move; making us fall in love; making us do things we thought we were incapable of; making us feel pain; making us the people we are; is part of the incredible magic of nature and the Creator! We are trying to replicate nature and restore function in the way it was created. I like the idea but wish it was less painful and that we were using this technology more widely.