It’s A Little A Lot: MS rehab at Synaptic

Day 2 of MS neuro rehab at Synaptic and my physiotherapist Jill has the best phrase. “It’s a little a lot.” As in, it’s a lot. It’s a little too much.

Turns out I love the ‘clock’ game, but my enthusiasm was a little a lot. I needed to bring it down about two notches haha.

The whole process is a little a lot.

I’m having lots of fun because Jill and Matt are great, and I like everyone at the clinic. But it’s not only physically exhausting, it’s mentally exhausting, and it’s emotionally exhausting too.

My gait issues are actually numerous. I though I just had a left foot drop and I’ve realized that it started back in 2017. That year, I badly injured my left hip. Once I recovered, I noticed that on my long walks, there was a hitch in my step after awhile. I thought I needed more recovery, maybe some physio, and didn’t think much of it. I certainly didn’t think it was an MS thing.

In October 2019, during the 75 Hard Challenge, I actually looked down after the hitch in my step became a problem on one walk. I wanted to see if I could see what was going wrong. Turns out, it wasn’t my hip at all. I had a foot drop, or an inability to dorsiflex my left foot.

Of course I was going to make an appointment to get it assessed but I had a catastrophic neurological event before I did.

I still didn’t think it was MS.

I still thought it was somehow related to my hip injury.

It seems the majority of my symptoms from last year resolved. I don’t have slurred speech anymore. I barely have a tremor on my left side except when I’m really, really tired and experiencing muscle fatigue. My balance is crap still, though.

But my walking issues….

Still the foot drop. But wait! There’s more….

Turns out, I also do this weird thing when I’m stepping with my right leg. Instead of stepping forward I kind of kick my right lower leg out to the side and around before I step onto it again. My right leg also tends to come towards mid-line instead of staying on a straight line. Jill pointed out that I tend to walk with very stiff legs. My right heel tends to move inwards, which means I end up walking like a duck as my feet turn out. As I fatigue, my left leg snaps into hyper-extension. It’s very painful and I’ve been having terrible joint pain for the better part of a year as a result.

Yesterday, I walked in the big gym but my brain forgot how to walk. I just stood there, unable to figure out how to get my legs to do their thing. It was only after they handed me a couple of walking poles that I got my brain back in gear to do the thing. I think I was fatigued. I haven’t had a brain disconnection since August when that horrid young woman accosted me in an intersection.

So that’s good, I guess?

Finding out that my gait is an utter disaster has been interesting. It makes me think that maybe I’ve been ‘MS-ey’ for years but it wasn’t until I had my catastrophic October last year that I realized. The foot drop is neurological and I’ve had that for three years. My last few years of ballroom dance, I was often corrected for my foot being turned out at the heel even though I was unaware of it.

Was injuring my hip just a coincidence? Did I injure my hip because I was having neurological issues? It’s something I might ask the neurologist about when I’m forced to see them in December after my next MRI. Maybe I have another brain lesion causing my gait issues and it’s not the brain stem one.

I already know I have multiple lesions that aren’t active anymore. There’s no way to know if one of them formed three years ago, but the neurologist can tell me if any of them could cause my walking difficulty. Knowing won’t make a bit of difference, I’m just a curious nerd.

I know it sounds weird, but I’m actually pretty excited that Jill and Matt have found so many problems with my gait. They’re all problems that can be improved and maybe all my gait issues don’t stem from a brain lesion. What if some of my walking problems are mechanical, not electrical? What if I developed a brain lesion that caused the foot drop, then over three years the foot drop led to stiffness which led to weak glutes which led to knee issues which led to compensatory gait which all became too much when my brain broke? Or maybe it’s all due to MS brain lesions. Regardless, with coaching and a lot of focus I’m able to correct each of the problems. Not all at once, and not easily, but I can execute better movement. Which means…

I think I’ll be able to really improve my walking over the next 14 weeks.