Someone here asked me what remapping my arm entailed. Here’s the passage from my book. It’s written in the rough… but you may get the gist. I suspect I have not been as clear as I would like to… the significance of this procedure may not be obvious… anyway, here goes :
Remapping and reinstating mobility
Six months after my stroke, I am left perplexed at why many a limb is left in a lethargic state to wither away until it is too late to remap control to new, undamaged, parts of the brain. In my case, I was extremely lucky to know my Chinese doctor, Kangnian, who had firm knowledge and experience on how to perform this magical “old-school” procedure to reinstate full mobility and movement to my arm, hand, and fingers. In China it was his job to reinstate movement in patients. The process of remapping and establishing feeling, sensation, touch and eventually proprioception would then follow on naturally, because movement and use of the upper limb had been achieved. The procedure was done in about three weeks, with hourly sessions twice a week. Most sessions were closer to 45 minutes in length. Ten days after the stroke were allowed to pass before we started the remapping. This is to allow BDNF to do its thing, and for things to stabilize after the stroke. The activation and rehabilitation of my arm, hand and fingers was done by issuing clear, concise commands. The first task was to issue orders for the arm to right itself, so I could see it in front of me. Remember my arm, hand and fingers were totally paralysed, and no amount of casual effort sufficed to move any part of my upper limb. Kangnian would issue a command for me to move my arm, and I would obey the order with all my might. Kangnian would always have the next step in mind, and would consolidate each new stage in acquiring mobility before the next session. The repertoire of movement was built, from one movement, to two, to several, to many. The beginning was hardest and slowest. Practise on my own in between sessions was important. After raising my forearm was established, the next stage could be raising and lowering my arm in the manner of chicken wings. Every step had to be taken extremely slowly. Remember, there was no connection between brain and arm so it was a question of mind over matter. Every movement required maximum concentration and will-power. The next step might have been rotating my hand from supination to pronation and vice-versa. Gradually we worked on components of the arm which were smaller and smaller. One main objective was to establish precision in controlling the first three fingers (including the thumb) since these components work in tandem to manipulate objects. The first three fingers combined take up a relatively large area of the brain. Again, all these stages were established, one movement at a time, with commands issued verbally, out aloud for the brain to digest and process, along with a single movement, back and forth. Each stage of development was tried and tested, and consolidated before being resumed next session. The Concentration on my gaze, my focus of thought, and determination was essential. It was team work, for my belief and trust in Kangnian’s guidance had to be total, and without question. He was after all proceeding exactly at the pace I could manage, going back if anything were still uncertain or a bit shaky.
My stroke-side arm movements were all recovered and re-established. No one type of movement was omitted. The functions of my upper limb were completely remapped to redundant, healthy parts of my brain, and there was no way to unlearn the procedure. The new part of the brain that took control of my arm would now be established and hard-wired into my system. The new pathways that had been established with this remapping technique would now reinforce themselves and grow in confidence each time I moved my arm, hand, or fingers. I realised that I had participated in a rare technique that might possibly, someday, become standard practice. A movie scene, again from Tarantino’s “Kill Bill” comes to mind, when Bill realises Uma Thurman has been taught a secret and deadly martial arts procedure. “Pai Mei taught you the five-point palm exploding heart technique?!” The story of Pai-Mei, like Kangnian’s remapping, is now something of a lost art.
