Chapter 7: A different kind of bear?

Over the last 18 months or so, my physical condition has deteriorated.

Walking has become increasingly difficult – when my brain is tired, my legs feel like they belong to someone else and I have difficulty controlling them. When my brain is particularly fatigued, my legs feel like they are “full up” with fluid, with a tingling sensation that makes me want to rub my feet together. The power that I am able to generate when cycling has diminished – particularly in my right leg – though my leg strength seems to have stayed about the same (I am able to squat the same weight). 

My right side has always felt different and indeed behaved differently to my left since my accident – for example, the muscles and tendons in my right leg tighten up when my brain gets overloaded, regardless of whether I am doing any physical activity – but the changes that have happened more recently were deemed significant enough that I was referred to a Neurologist around 9 months ago.

After an initial diagnosis of nerve damage to my right side at the Ambulatory Clinic – relatively common apparently following a high impact trauma – I paid a visit to a Neurologist, who sent me for a full-spine MRI scan to check that there was nothing else going on.

By the time the results came back a few weeks ago, I had convinced myself that my issue was something to do with my brain injury – the effects are magnified when my brain gets tired – rather than purely physiological. Lo and behold, the scan showed nothing untoward – good news – which seems to leave hemiparesis (albeit minor) as the most likely cause.

Hemiparesis is a weakness down one side of the body – in my case, the right – that can occur when a specific part of the brain is injured. The more I read up about it, the more it becomes obvious to me that this is the issue. In addition to a lack of power in my right leg, I have always had a weakness in my right pectoral and abdominals, plus the right side of my face changes in shape and sags a bit when my brain is overloaded – all of which are common symptoms of hemiparesis.

To this point, I had believed (or perhaps wanted to believe?) that these symptoms were not connected and that I could make them gradually dissipate through physical training. To give you an idea of my “determination” (bloody-mindedness?) to do so, the day after getting out of hospital, I walked up and down the stairs for 20 minutes and I was back on the indoor trainer within a month.

The last visit to the Neurologist has been a bit of a reality check for me. On the one hand, the realisation that the issues with my right side are linked to my brain injury – so can’t simply be trained away – has been a knock-back. Making use of my physical capabilities has been a source of relief during my recovery and so I had hoped to find a way through these difficulties. In some respects, though, it has also been a release. Knowing that things are not going to change reduces the frustration that I experience by continuing to work away at something that never seems to bear the results I am looking for. It seems that I have found myself another, different kind of bear – one that affects me physically rather than cognitively – but that by riding smarter not harder, I can perhaps learn to live with this one too.

So, going forwards, I will be resetting my expectations of where I can get to physically. In the back of my mind, I had hoped to gradually build up my physical strength and stamina so that I could take on some kind of epic cycling challenge – I suppose because this would have represented getting back to being my old self in some small way at least. To this end, over the last 8 months I have ridden over 3,000 kilometres on the bike – though never further than 28 km in a single ride, due to the issues with my right side. I had tried various different approaches to increasing the distance I covered each week – from a single short ride every day to multiple short trips in a day, with at least 1 rest day in between – but I would always end up reaching the point where my right leg would give out, no matter how hard I tried to make it work like it used to.

As it turns out, this is a known feature of hemiparesis – “Pusher Syndrome” – where, due to a lack of response from the hemiparetic (weakened) side of the body, the individual tries to push harder with that side in an attempt to overcome the weakness – though ultimately making the situation worse. Anyone else noticing a trend here yet?

If nothing else, this at least explains why my physical condition has deteriorated over time. Over the first 18 months or so of my recovery, I rode around 6,000 km on the indoor trainer with no apparent problems – it wasn’t until I tried to get out on the road that I started experiencing any issues. I now realise that I had shifted my position on the indoor trainer to compensate for the weakness in my right side – not something that you can do out on the road due to the need to maintain your balance!

Armed with this knowledge, I have now reluctantly decided to give up on my dreams of becoming the next cycling superstar – and I was so close before my accident (not!). I’m not sure that I am yet ready to give up on the bike completely – I still enjoy riding and the cognitive benefits that it provides – but I am going to stop expecting things to change and try to appreciate more the fact that my right leg is still good enough to allow me to potter over to the shops a couple of times a week.

After more than 2,000 miles, it’s time to take the hint …

After all, it’s not about what you can’t do, it’s what you can …