Retraining the brain

We have started studying the nervous system in Anatomy which I have been told is the hardest part in the class. But we don't need a class to tell us that it is amazing what the brain can do. I've seen it over and over again as I watch therapists interact with patients with some type of brain injury. A few weeks ago, Theresa asked if I'd help her with one of her new rehab patients who was recovering from a stroke that had strongly affected his left side.

"Sam" (I don't remember his real name) loved to talk and as soon as we got into his room he started talking. As Theresa and I went to get some things we needed she told me that the challenge would be to actually get some therapy in with him. "I'm going to learn a lot from him but my job is to give him therapy so he gets better, not just listen to his stories." One story Theresa asked him to tell me was about how the day after the stroke he had thought someone had placed the arm of a cadaver in his bed. Evidently it took his daughter some time to convince him that the unknown arm was his. He just couldn't move it or feel it.

As we helped Sam sit at the edge of the bed, wash a bit and get dressed it was obvious that he wasn't sitting up straight. His body was leaning toward the left. The funny thing is that it didn't feel that way at all to him. His brain was telling him he was sitting up straight. Theresa had me sit right next to him on his right side and his task was to get his shoulder to touch mine. Only then was he really sitting up straight. It was hard work and took great concentration but he could do it. But he couldn't wash his face and sit up straight at the same time. In fact he would have fallen over if Theresa hadn't caught him.

The last thing we did that morning was to get him into a wheelchair. Standing up was a challenge (as would be expected if you can't feel one of your legs) and a nurse came in to help with the transfer. Theresa gave me another pointer after she left. "I would have tried to get him to work on some things rather than doing it so fast but you don't mess with rehab nurses." Before we left I asked Sam if he felt like he was sitting up straight (which he was). He thought he was to the right of center. The tricks the brain will play on us. The wonderful thing is that the brain can rewire itself to compensate for lots of injuries or damage and eventually it figured out where the center was and Sam's sensations were much closer to reality.