Back at the start of 2015, I attended a stroke rehabilitation clinic at the National Hospital for Neurology and Neurosurgery to improve the function of my left arm. Part of the treatment involved restricting the use of my dominant right arm. In the downtime between serious physio and occupational therapy sessions I started writing a blog, using only my badly affected left hand to type the entries. This was the start of Neuro Billy, a blog that continued for 25 posts over three and a half years. It covered all the therapies and research projects I took part in, plus my own darkly comic observations of all things neurological. As my rehabilitation gained momentum and my ability to live with my brain injury improved, the need to record my activities declined. In short, the neuro aspects of my life are now just part of my everyday life. This is why I have now incorporated the blog I started back then, Neuro Billy, into this blog.
What prompted me to do this was a research project I took part in last week at NHNN into fatigue after stroke. This, I was told, is not fatigue as we generally understand it. I does not refer to physical tiredness or a lack of stamina. This is fatigue as diminishing attention. It refers to how the brain deal with a new stimulus by standing to attention. It remains standing to attention so long as the stimulus is novel and performs at the top of its game, alert and ready to respond. If, however, the stimulus becomes repetitive, the brain with shift into a kind of cruise control and act according to a fixed pattern it believes to be the right one. In many people who have suffered a stroke, this mechanism no longer works and EVERY experience is detected as being novel. The brain is thus dealing with every new stimulus as if it were the first time it has experienced it. This is what can, in the end, lead to wipeout in strokies. Their brains stand to attention ALL THE TIME, and that's a bit knackering.
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