The Last Word

This is the final posting in the NeuroBilly blog. I am merging it with the ScrapbookBilly blog because neuro therapy has become part of my everyday life, so to single it out no longer seems sensible.

I want to finish by outlining two aspects of therapy I have come to use and trust. First is EASY REPETITION, and second is BODY AWARENESS.

From the outset, repetition is a mainstay of neurorehabilitation: sit-to-stand, GRASP, both drill the message home. Do it, do it again, do it forwards, do it backwards, don't stop, stopping is for cowards. Now let's try that one more time. It's relentless. And it works.

Taking the repetition regimes home when you leave hospital puts you in a spot. Many carry on, with various exercises tailored to their own needs. But to make it stick for the long term, you need to find a routine you can live with. Many soon get bored because, hey, it's, like, a bit repetitive...

My own method is to work out what works for me. Shoelaces were impossible to begin with, got to be frustrating after about 2 years, then settled somewhere between irritating and annoying. But I never once thought of giving up on them, selling out and stepping into slip-ons. Now, after five years, they are still a nuisance, but an easily tolerated nuisance. The same is true for washing my hair in the shower. At first it was dangerous, now it is a 'bilateral 'pleasure.

So the trick for me was to find fun, or at least a curious interest in the things I knew I'd need to do for the rest of my life. That way I will not only continue the repetition but find enjoyment from doing it. I have become really quite good at emptying the washing machine with my left hand.

Body Awareness for me came mainly from the repetitive exercises I do in the gym: discovering that a session on the recumbent bike to strengthen my legs was also a chance to poke my shoulder blades into the back of the seat. This exercises your subscapular muscles, I'm told..

Once discovered, these moments of comfortable compatibility with therapy, when doing beneficial exercises doesn't actually seem like exercising at all, can take some getting used to. Walking with a tight core, pelvis sticking out front, can feel self-consciously strange. The word 'mincing' springs to mind.

But once you know how to spot the signs, the invitation to better understand your body and its movement can be genuinely revealing. Not long ago I was getting some balance therapy at London's National Hospital for Neurology and Neurosurgery (NHNN). I did something called 'Tandem Walking', which involves walking heel-to-toe in a straight line. It was tough for me, until I tried it at home, whereupon I started to cheat by using my walking stick lightly to stop me tippling over. I confessed this at my next therapy session and Hannah, the physio, staightaway drilled me in 'Tandem Walking With A Stick'. This, I now understand, will one day result in 'Tandem Walking Without A Stick', but for the time being I am enjoying my 'Tandem Walking'. One cheeky young member of our family calls it my 'Supermodel Catwalk'. I transferred the routine to the treadmill in the gym and a once-boring exercise machine is now my personal dancefloor.

So it is goodbye to Neuro Billy and welcome Scrapbook Billy, where my neuro activities will sit side by side with everything else I do: writing a diary, drawing and painting, travel, teaching, and anything else that comes along. I see this moment as some sort of progress, which I suppose is how it's meant to be.

Headway: Ski Therapy

My instinct was to say no when invited to go on a skiing trip to Hemel Hempstead. It is now five years since my stroke and I have long since accepted that activities that depend on good balance are out of my league.

The trip was with Headway East London, where I've been a member for around four years. Yes, I declined, but then had second thoughts. First, I didn't like the idea of ruling out any activity that I might still be able to enjoy. Second, I had never been skiing and this was probably the best opportunity to break my duck safely, since I would be surrounded by experts who could save me if I got into trouble.

So it was off to Hemel Hempstead Snow Centre, to be kitted out in all the gear and released on to, in my case, a slope so slight that hardly warranted the name. It might have been but a marginal incline of around 0.05° but it did its best to keep me at the bottom. Eventually, by adopting a gentle swaying motion to transfer my weight, I was able slowly to step sideways with my stronger right leg the haul my weaker left leg after it. It didn't look pretty, but it got me about 3m upslope, from where I could then begin my elegant descent.

This is when the déjà vu descended. As I slid gently down that meagre slope, crouched forward as instructed, the overwhelming, uncontrollable urge to stand erect got the better of me. In doing this the skis do what they are supposed to do and pull the rug from under your feet. You tipple backwards, saved only by a last-ditch, desperate forward-wheeling of your arms to propel yourself back to a balanced position.

The experience took me back to the early stages of stroke recovery when I was learning the classic 'sit-to-stand'. In this case, the irresistible motion is forward rather than backward. As you attempt to stand from a sitting position, you feel yourself pitching dangerously forward, straight into a nosedive to the floor. Only a slow, purposeful rebuilding of your body confidence over time allows you to throw your weight forward and flex your legs to a standing position. At that moment on the ski slope in Hemel Hempstead, I could not imagine any time in the future when I had would have the confidence to hold my position without fear.

But because I know what I know from past experience, skiing IS something I might one day be capable of. The real question is whether I want to.

Diary: Bridges in a Group 2

Different strokes

Lemon Polenta cake, Scottish shortbreads and Malteser chocolate bunnies: I could get used to hanging out with stroke survivors, says Billy Mann

I’m only half joking. This outbreak of gluttony came at the start of the final session in a PhD study by Ella Clark at UCLH into testing Bridges Self Management for stroke survivors in a group setting. We were all stuffing our faces and grinning madly.

Bridges is a project pioneered by Prof Fiona Jones at St George’s hospital in Tooting, London. The mission is to help stroke survivors build their own step programmes to meet long-term goals set by themselves. These goals vary in the widest sense, but the Bridges approach seeks to find a series of baby steps by which big gains can become part of everyday life. It’s a method that will work for some but not always for others.

Motivation is a key player in progressive recovery and these four-week trials were part of a study to see if fellow group members (6-8) could play a role in the process by offering mutual support. In the three trials I helped facilitate, the goals of the group members varied depending on the individual, any support they might or might not have, and in the ways their stroke had impacted on their lives. In the second group I joined, one member wanted to try to regain some of the problem-solving skills he had lost. He mentioned crossword puzzles and arithmetic in particular. Another member defined as a goal writing and signing a Thankyou card for her daughter and her husband.

It is always fascinating to watch small-group dynamics unfold. You instinctively reach for the reality-TV stereotypes and make snap judgements about personalities, only to be confounded in the next session by behaviour in total opposition to your initial prejudice. Baddies become goodies and that bossy boots turns into a pussycat. The relationships between individual characters are thrown into relief and you sometimes end up siding with the person you thought at first you would dislike the most.

Group members respond in different ways to different types of stimuli. One identified her goal as getting back to cooking and entertaining. The stroke had left her unable to plan, organise and implement a dinner party for friends. Fatigue wiped her out and the mere thought of it built in her mind to become an impossible task.

By just talking about food, the group learned of some of her favourite dishes and the special ways she prepared them. All of this took place in the context of a natural conversation, so when it was proposed that she might cook a cake for the group, a competitive twinkle appeared in her eye. She wanted to show us she could do it. And she did. The lemon polenta cake mentioned in the opening paragraph is the proof. The zing of the lemon was a sensory delight.

But her determination didn’t stop there. She had also completed and fed friends with specialty dishes of lamb and salt beef. She was obviously on a roll. If we were giving out marks, she passed with distinction.

A recurring issue among members in all the groups I was involved with was whether the post-stroke difficulties they now face and experience were related directly to the stroke, or whether they were part of natural ageing. Forgetfulness was the chief example. This was especially the case among some of the older group members.

Balancing time with health needs emerged as a another challenge. Take on too much and it might end up costing you in terms of stress and fatigue. Take on too little and it seems like you are treading water, stuck in a rut, but all the time feeling you should be more dynamic, making more progress, just doing things.

One member talked about withdrawing from what was once his very active participation on neighbourhood committees and working groups. He had taken several steps back and, by rationing his time more selectively, was able to focus on and tackle a specialist academic mentoring role, which had proved far more personally rewarding and much better suited to the skills he had built over many years.

But in stepping back he also stepped forward to wrest control of low-key domestic aspects of his life from his children, who had intervened to ensure his comfort. He was calling the shots now and, bit by bit, nurturing a newfound self-reliance.

Towards the end of the final session, one of the group asked Ella if she had a title for the published study that would emerge from these eight group trials. Not yet was her answer, so cheekily I asked the group what might be the key words that would help Ella come up with a successful title.

Earlier in the session that day I had tried to summarise the essence of the past four weeks. In my notebook, I had written “the power/potential of peer support”. Looking at this now I am horrified by its inadequacy. In collecting the thoughts of the other group members, the word that won the day was “sharing”.

Throughout the final session, many of the group had identified in their own ways the importance of sharing. One member spoke of how rare it was for her to share her stroke experience with people who could readily empathise. She said she no longer “felt so alone”. Another talked about how positivity breeds positivity and that the group sessions had somehow almost magically instigated an outbreak of optimism.

Sharing is one of the enduring themes of the early 21st century, much of it enabled by the world wide web. Touch that SHARE button on your digital device and look at the ever-growing number of platforms across which you can connect with others: Facebook, Twitter, Instagram, LinkedIn…


Yet, yet, yet… sharing a traumatic experience with relative strangers is not easily done. The group found that doing it in person, face-to-face, with all the risk any kind of human encounter throws up, was overwhelmingly positive. One group member used the word “transformative” and, when pressed, explained how, as bad as having a stroke is, in some respects it offers an opportunity for renewal, a chance to become a new person. Another talked about life after stroke as an exercise in planting seeds. These, for me, were both fitting remarks to herald the onset of Spring and to end what had for me been a fascinating experience.

See the lemon polenta cake recipe

Headway: OT Students' Society, LSBU

Meet the ones who do

Billy Mann joins the fun-loving gang of OT students at London Southbank University for their annual conference

I was invited recently by Headway East London, where I am a member, to talk to students at London Southbank University (LSBU) about Occupational Therapy. OT is a thriving department at LSBU, so much so that the OT Students Society holds an annual event in which they all get together to discuss the current issues facing their chosen profession and invite guest speakers to contribute. That's where I came in. Headway East London has a longstanding buddy relationship with the university and conducts training seminars at which students get to talk directly with people who have experienced brain injury.

For my own comfort, I always try to make my contributions to these events simple. I am no expert in brain injury, and neither do I have ambitions to be so. I just tell the story of my stroke and the aftermath in the hope that it fuels questions, which I try to answer as best as I can. I enjoy the process most when I can persuade an expert to join in just in case I panic and start fluffing my lines. My partner at this gig was Headway East London Clinical Lead Amanda D'Souza, who also kindly projected some pictures on to a screen while I ran through my jibber-jabber.

I got some good questions from the LSBU students. They asked me how OTs had contributed to my recovery. They asked about the classic OT-physio tag-team partnership that prevails. I said in my case it worked best as a threesome, OT-physio-patientclientserviceuserorwhatever, where we all fed off each other to advance the therapy. This, I said, could only have happened if we trusted one another. Happily, we did.

The title of this event was The Power of Occupation, its subtitle "maintaining professional identity in the face of change". I detected from this and from some of the questions that all was not happy in the land of OT, that they were feeling neglected and undervalued as professionals.

This was not exactly a shock to me, but from the impressive display of organisation and attendance I was seeing today, I was surprised the LSBU students were struggling for status and recognition. It seemed to me like they were at the top of their game, and embracing it all with relish. Four years earlier, when I was in the neuro-rehab unit at the National Hospital for Neurology and Neurosurgery (NHNN) in Queen Square, London, my OT had told me that Occupational Therapy was misunderstood and its therapists unsure of their identity within the nhs. OT is a broad church, covering a large area from behavioural OT to hardline neuro. I mused to the LSBU students that one day new names for jobs might need to be invented. I don't think this offered them any comfort, and nor did my pronouncement that after a conversation one day with Headway East London OT Natasha Lockyer, I had come to define OT as a subspecies of Anthropology or Ethnography. I saw it as "the science of how we do things".

I had started my talk by telling the students that earlier in the day I had bumped into a neighbour, a head teacher at a special needs school, and told her that later I would be talking to OT students. "Ohh, I love OTs," she said, "and they make the best managers ever." This was a positive start and I'd tried to find a catchy soundbite to finish my talk, but as the endpoint neared, "Everyday OT is the key" started to sound flimsy, so I told them how my wife uses OT to get me to do chores. When she wants me to do things like set the dining table or empty the washing machine, she finishes her request with "It's good OT". I have a feeling she could be right about that.

Diary: Stroke World Café

Take a talk on the wild side

An initiative to put good communication at the heart of stroke treatment got off to a lively start. Billy Mann reports

Tess Baird is an unstoppable force. In November 2016 she gathered together a few colleagues and contacts in a small room in London's Mile End Hospital to explain her bonkers idea. She wanted clinicians and service users to get to understand and communicate with one another in more meaningful and effective ways. The subject in focus was stroke care, which is how I got the call, being a stroke survivor. She reckoned this new groundbreaking bond between patient and practitioner could be found using something called a World Café. I posted a report of that meeting shortly after it took place.

Grand ideas often get lost in what is sometimes called Development Hell, so I turned up to that first meeting, made whatever kind of contribution I could and went home expecting the idea to fizzle out. It didn't. Emails were exchanged and the spark generated at the first meeting was oxygenated into a comfy campfire, around which a whole bunch of people (plus one newborn child, Leo) sat early in the new year to thrash out some ideas for how quality communication might flourish on the stroke ward. This event quickly got its own hashtag, #trustworldcafe.

Seven round tables in the Garden Room at St Luke's Community Centre, London EC1, each hosting five or six people, fired up and the room quickly took on the buzz of the marketplace, the sound of chatter and earnest declarations bouncing off the walls. Hot beverages were taken and posh cake digested. And to think some people were pretending to 'be at work'.

The event swung around four questions. The first asked us to talk in pairs about a time we "totally trusted someone". What was the experience, what did it feel like? I got chatting with someone who told me how they had 'bonded' with their partner over an intense dislike of dating. As described to me this was a proper meeting of minds and outlook that was recognised instantly by both parties. They saw it as an 'opportunity' and both were 'relieved' to have found a sympathetic ear and a glad eye. It was heartwarming stuff.

We then moved the topic from the personal to the professional and asked what made trusting relationships function in the workplace. The answers we arrived at jointly sounded like statements of the bleeding obvious, but put under intense scrutiny started to carry more weight. All the time we were jotting words and phrases on to a paper tablecloth. Lines such as "say what you do and do what you say" and "deliver on promises" put some flesh on to the bones of everyday exchanges that involve trust, and which without trust would collapse. Relying on others is how our lives function.

From working in pairs we moved to working the table, exploring within the group the mechanics of trust and how that might be nurtured. I learned of one stroke survivor's desire to ride a horse again, having grown up around horses in Romania. By now an artist had been earwigging at each table and was busy creating a 'live graphic' of our thoughts. It was worth stopping just to watch as she gave visual birth to all our ideas.

The questions continued. We moved tables, went into huddles, struggled to find answers, but didn't give up. There was still plenty of cake left. At one table I put forward the idea that every 'hard', factual question a patient is asked by a clinician should be offset with a 'soft' question that gently explores the patient's life outside hospital. Cat or dog? was the example I used in a round-the-table demonstration (our table: three dogs, one cat and an awkward "cat and dog"). Questions about football, hobbies, telly, films, etc, can provide the therapist with valuable 'clues' that might open a window of opportunity on how best to advance treatment. There was some concern as to how what is essentially small-talk can be parlayed into 'productivity', the looming presence of a cash-conscious clipboarding nhs manager being the sticking point. I'm not sure my attempt to liken this kind of information-gathering to 'detective work' found any buyers.

So what did I learn at the #trustworldcafe? Too many things to list here, so please check the Twitter feeds for details. But if I had to pick one it would be at the beginning of the session when, by way of a warm-up, Tess gave us a list of questions to ask each other. The last of these was something like, "What is the craziest outcome you can imagine springing from this #trustworldcafe?" To illustrate, Tess told us her answer. It was that news of this event's runaway success reaches a rich publisher, who invites Tess to write a book about it, earning her £4million. Her newfound wealth somehow puts her in contact with George Clooney, who promptly ditches his existing wife and marries Tess. And everyone lives happily ever after. Such is the power of the hashtag.

Diary: A Better Conversation

Stroke World Café

The first patient-clinician interview is the chance to start a beautiful partnership, says Billy Mann

Health professionals fret far more than you might ever imagine about how they interact with patients. Many even struggle with the word patient. Other terms for the person being treated are ‘client’ and ‘service user’. They temptation to reach for the word ‘customer’ is never far away.

Hold that thought while I tell you about a group I attended recently to work through the foundations of what will hopefully turn into a World Café around the subject of stroke. Briefly, the idea is to build the notion of a ‘conversation’ into the clinician/patient meeting point. Those present at the meeting, brought together by Tess Baird from Barts Health, all came from the health professions or from academia. Plus me, with my A-level in Geology and a diploma in stroke survival.

So it goes without saying that my input was purely anecdotal. I told them all how, during stroke rehab, I stupidly urged an OT to coach me in getting in and out of the bath, only then to get stuck in the bath, robbed, as the stroke had left me, of the upper-body strength to lift myself into a bath-exiting position. I told other hilarious stroke stories, too, and watched as they all glazed over, but my one serious point concerned what I called the ‘partnership’ a patient needs to form with the health professionals charged with their care.

I decided early in the exploration of my post-stroke world to ‘get people onside’. OK, confession, my wife told me to do it, in fairly blunt and unambiguous terms. But it worked, or at least it did for me. I talked in a friendly way to all professionals. I listened to their gripes. I learned that my physio was studying for a masters degree. I gossiped for Britain and passed on advice for vegetarians travelling in Italy. All of this seemed to bind our common purpose in a more meaningful and, yes, fun way. My wife now refers to me as a 'people person'.

I continued this crazy experiment once I had been discharged from hospital. First on the list for my newfound charm offensive was my GP. I learned about his family, about his specialist areas of medicine and tried to get him to bitch about bureaucracy and the tedium of top-down meddling in the nhs. He didn't crack, maintaining a steely resolve throughout. No confidential or compromising disclosures took place, but the very act of talking made, and continues to make, a difference to how we ‘work together’.

Others in the group made serious points, too. Physiotherapist Volkmar Müller talked about the everyday realities of the physio’s job and how ‘had nice a chat with X’ would not be considered by his line manager as a suitable entry on that day's list of ‘work completed’. Stefan Cantore, a seasoned egghead in organisational behaviour at Southampton University, fleshed out the World Café philosophy and its potential. He also helpfully (for me) clarified the difference between conversation and dialogue.

The small room in Mile End hospital fizzed with the desire to find practical routes towards better communication, but one theme emerged persistently: TRUST. Build trust. Professionals to trust patients; patients to trust professionals. It’s a two-way thing and demands active participation and a big old willingness to give it a go. And this is where we come back to THE CONVERSATION.

Just for a laugh, I decided to do a quick search of synonyms for the word ‘conversation’. Top prizes go to: tête-à-tête, heart-to-heart, breaking bread, head-to-head, shoot the breeze, natter, confab, chit-chat, rabbit. In my head it's already starting to sound like two lines in a rap song, but whatever you want to call it, just get on with doing it, and at some point in the future maybe we will be able to state with confidence that to Talk The Talk and to Walk The Walk are exactly the same thing.

Headway: Olympic swimming

You might have sat comfortably during the 2012 Olympics and gazed at the pictures on your telly of the Zaha Hadid-designed London Aquatics Centre and wondered whether it was as impressive in real life as it was as seen through the lens of a TV camera. Let me answer that question. Yes. Yes. Yes.

And it’s not just a stunner on the outside. Despite the modifications that took place before its 2014 opening to the public, the huge interior is a dream just to walk around, even before your nose catches a whiff of chlorine. The views of the 50m tournament race pool and 25m diving pool recall instantly memories of the moments that took your breath away during those glory days in the summer of 2012 (was this when Michael Phelps officially became ‘the greatest swimmer that ever lived?). The overall effect is somehow magic, and even the signs to the changing rooms start to look full of grace, visual harmony and touched by the hand of triumph.

Now, here we were, a willing contingent from Headway East London, itching to see if getting wet could do anything for brain injury.

My own post-injury experience in the shallow end is meaningful - to me at least. Shortly after discharge from hospital following a hemorrhagic stroke, I was assigned to a therapy team from London's Homerton hospital. A physio and OT visited me at home and devised various exercises and routines that might aid my recovery. On one such visit we went for a swim in my local pool. The OT was at first concerned how I would manage getting in and out of the pool. Her worry was short-lived as I pre-empted any practical what-have-you by simply throwing myself in.

Hitting the water and being bathed instantly in its warm, forgiving embrace was a moment of sensuality words cannot do justice to. Four months of deprivation in a hospital bed might well be the psychologist's explanation, but ‘bliss’ is as close as I can get to describe the sublime feeling.

I'd like to say that in that single moment swimming became an essential post-stroke exercise for me. That would be a lie. But what I did find on our group visit to the Aquatics Centre, in between some infantile splashing of my fellow Headway members, was a new way to use a swimming pool. Some of the yoga and tai-chi routines that Headway Therapy Team offers regularly to its members are given a whole new dimension when tried in a pool. The soft resistance of the water slows the movements and provides weight support for those with balance problems. Falling over in a swimming pool is no biggie. It's fun, actually.

So, expect to see me in swimming pools more often from now on. The legacy of London 2012 is alive and kicking, despite all those doomy predictions. It was shortly after attending events at the Games that the stroke hit, leaving me for dead. I can’t be sure, but I like think that the courage, determination and sheer strength of will I saw in the athletes helped things turn out differently for me, so if anyone ever tells you those Games were a waste of money, tie a brick to their foot and throw them in the deep end.

Diary: Bridges Symposium

Symposium isn’t a word that trips off the tongue. It sounds impossibly proper, serious and really quite grand. When asked by Bridges Self Management to help out at their 7th Annual Symposium at St George's hospital in London I felt out of my depth just reading the email. In an attempt to at least look like I was somehow in the loop, I looked up ‘symposium’ in the dictionary. It is a compound word that dates back to ancient Greece and translates roughly as a ‘drinking party’. A symposium was a bunch of mates getting together for the sole purpose of getting drunk and talking endlessly. That’s more like it. What could possibly go wrong?

What went wrong is that I forgot to mention several key points. Drink had nothing to do with it, and neither was the panic that struck when I arrived in the designated conference room in St George’s at the sight of three, yes THREE screens from which our presentation was to be projected. The main purpose of my involvement was to supply a repeat performance from a 2015 conference in which physiotherapist and Bridges trainer Katie Campion interviews me about how I coped after discharge from hospital following a heamorrhagic stroke. We talk about goal setting and I seize the opportunity to make plentiful reference to football and the team I support, Liverpool.

In outward appearance, our presentation resembles the work of a second-rate comedy duo. We feed each other lines, but they are not always the right ones. I’m always aware of undermining Katie’s proper professional status with my bad jokes, and sometimes the result is confusion. So, in the part where we talk about my understanding of the word 'goal’, I had intended to shoot a line about the importance in football of coaches and captains. I missed the shot. And in the part where I answered questions about devising small steps to big goals, I should have mentioned the importance of visualisation. Again, I fluffed it and the chance went begging.

It wasn't all bad, though. Katie did manage to grab victory from the jaws of defeat while we were on the topic of my early goals when still in hospital. In this section I typically talk about the desire to complete bathroom activities independently. I then move on to describing my attempts at the 'transfer’. This will be familiar to stroke nurses worldwide and involves getting a patient to move themselves safely from wheelchair to bed, and vice versa. At the time I was desperate to master this manoeuvre because being able to snoop around and then return to bed for a snooze was, for me, the very essence of being alive.

Maybe I was a bit too desperate because my early attempts involved hurling myself from a sitting position on the bed in the general direction of the wheelchair seat. The reverse process was not much prettier and, as I outlined this technique to the rapt symposium audience, Katie quite sensibly interjected, “Wasn’t all that hurling a bit risky?” This remark opened a can of worms on the subject of risk, and to what extent patients should be entitled, encouraged even, to explore the everyday fringes of jeopardy. It is a big, important subject, and relevant not only for stroke patients but for anyone living with a long-term condition. Is not the freedom to make mistakes a universal human entitlement? Discuss. Needless to say, we barely scratched the surfaces of it, but I am glad the subject of risk had put in an appearance as Katie and I tumbled our way innocently towards some kind of conclusion to our presentation.

So, as I sat down afterwards, the word PHEW shot to mind. I had barely paid any attention to the symposium’s previous speakers. All I can remember is that two experts from Lewisham CCG, Damian and Angelika, proposed what seemed to me a perfectly valid practical distinction between self-care and self-management, illustrated using a projected Venn-style diagram that looked like a hard-boiled egg. I was pleased to note that the yolk was not centred but irritatingly offset, just like mine are when I make boiled eggs. Another pair, Heide and Tino, ran a video of a lovely chatty couple who were calling for a bit more joined-up thinking from practitioners and clinicians in regard to service users.

Lisa Kidd, a leading goal-scorer for nursing and Scotland, followed our presentation, and made some telling points about how things actually happen on the ward. I am often guilty of gushing praise at the doctors, nurses and therapists who have all contributed to my stroke recovery, to which they most commonly reply, “Thank you, but I was just doing my job”. My response is always the same: “I know, but you choose the way you do your job, so please accept my thanks for that.” I was extremely grateful in this respect to be able to forge good communication with all those involved in my progress after stroke. It is an experience and a lesson I hope I will never forget.

Headway: 300 Club Results

Once more, with feeling

A project to test the theory that 300 repetitions results in improved performance has come to an end. And the results are in. By Billy Mann

The Occupational Therapy project at Headway East London I posted about a while back has now finished. To recap, Club 300 as we cheekily called it, brought together four members of Headway East London, each of whom wanted to gain some improvement in the execution of an everyday task. Two members wanted to improve their handwriting, another wanted to cut up food on a plate more confidently, and I tasked myself with the mission impossible of walking without a stick while holding a cup of water in my weaker left hand.

If you want detailed information on the results of this exercise, the OT in charge was Natasha Lockyer. I cannot discuss how others performed, but to finish the analysis, the tests we performed at the start were repeated at the end and the change recorded. At the start, I had walked a given distance (not sure what it was) holding a cup in my left hand filled to near the top with water in 46 seconds, and I spilled around 10ml in the process. At the end, I walked the same distance in 18 seconds and spilled no water. Get me, eh? Top of the world, Ma.

In my daily executions of these 300 steps, I determined to make the task more difficult as my performance improved. This, I am afraid to say, has fallen by the wayside in favour of basking in the success of spilling no water. Still, I do continue to perform the routine every day (or thereabouts) and continue to notice a difference. I shall report on my progress as and when something of interest happens, and I will ask Natasha if a re-run of the test in, say, 6 months is possible. Only then will I be able to declare Club 300 a giant leap for mankind.