The swallow lady

She carried a notebook and pen, and a bag that contained saltine crackers, some applesauce, and a box of juice. The Swallow Lady. “Are you ready for the tests?” she asked.

“Yes,” I said, ready to show her I could swallow.

She leaned over the bed and placed her fingers gently on my throat. “Try swallowing for me.”

What could be easier? But my mouth was dry and my throat constricted. I couldn’t swallow. The harder I tried, the more my throat tightened up.

“Relax,” she said. “Try moistening your mouth.”

I managed to work up some saliva. Then my chin pushed forward, my neck stretched, and I swallowed.

“Good,” she said. “Everything 
appears to be working.” She scribbled in her notebook, then passed a cracker to my good hand. “Now try eating this, but do it slowly, in little pieces.”

Immediately, I took a good-sized bite. The cracker stuck to the roof of my mouth. I couldn’t chew and only managed to spit it out.

“Nibble,” she said. “Tiny bits.”

I felt like a fool. How could I not swallow? But I did as she suggested, taking a tiny bite of the cracker, and then swallowed.

“Good. Now try this. Sip slowly.” She poured a small amount of juice into a paper cup, and I drank it, forcing myself to concentrate on each stage of swallowing.

it’s unsettling to have your children see you so vulnerable.

The therapist smiled. “You’ve done well. You’ve passed the test. For the first few weeks, your food will be minced or pureed. You must eat and drink slowly and carefully. This is only one of many things you’re going to have to relearn how to do.”

Relearn. That word would become a mantra of my therapist community. Restoring what has been damaged is a very complicated process

Rehab and relearn

My first night in the rehab ward was terrifying. Alone with my thoughts, I no longer felt like I belonged to the human race. My brain kept taking tours into my distant past. I drifted in and out of sleep, and through the night, I wept.

Yet memories, I was convinced, were the one touchstone I shared with my old self. They worked like a metaphor to help establish my new claim on “being.” A part of my brain was damaged, but other parts seemed to be working overtime to compensate for what I had lost.

Thankfully, Pat would not let me feel sorry for myself. Nor was the staff tolerant of any quitting. As I traveled through the halls in my wheelchair in the weeks to come, I heard a chorus of voices raised in a song of healing. Rarely did I hear anger or annoyance escape anyone’s lips but my own.

That first day of rehab, I had an appointment in the gym. “Do you know the way?” one of the nurses asked. I realized they expected me to wheel myself to the gym. Good luck, I thought. I couldn’t begin to go in a straight line. My right arm hung lifeless in my lap, and when I pulled with my left hand, I did doughnuts, spinning in circles.

“Drag your left foot along the ground as you push,” a nurse advised. When I tried, I made it a few yards before I veered right and smashed into the wall. “Perseverance,” she called to me.

I repeated the lurching motion, once again smashing into the wall, then continued down the hall, swerving to my right, almost colliding with an elderly woman. Then, to my surprise, I bolted in a straight line toward the gym.

The next few weeks were a grueling process of relearning and repeating the simplest movements: swallowing, standing, stretching.

To regain movement on my damaged side, I practiced “mirror therapy.” The goal is to fool the brain. A mirror was placed on a table by my right shoulder, my right arm behind the mirror. Then with my good hand I performed several simple exercises, staring in the mirror as hard as I could.

There is nothing smooth about stroke recovery, but there’s also no limit.

I drummed my fingers, formed a fist, flexed the fingers of my left hand. I did this slowly so my brain could take in the movement, pausing and then repeating, for about a half hour.

What I saw, of course, was the reverse image. I thought I was looking at my right hand doing the movements, not my left hand. My brain was being fooled. Or was it? I wasn’t sure. But I was determined to embrace this little deception. I think these exercises helped forge new pathways between the hemispheres of my brain.

One day, after a few weeks, Nicole was sitting opposite me when she jumped to her feet and shouted that my damaged hand had mimicked the movement of my good hand. At first, I didn’t believe her, but then I lifted my paralyzed arm and, much to my amazement, flung it in a circle, hitting the mirror. I let out a whoop. I had movement in my arm for the first time since the day of the stroke

Going home

The week before Christmas, five weeks after my stroke, the rehab doctor came to see me one morning. By then, I was able to stand on my own. I had started to climb the stairs in the gym, hanging on to the railing. I could pedal the stationary bike for 15 minutes. And I was now able to transfer myself to the toilet without assistance.

Sure, I sometimes became morose, but I had taken a vow: to remain positive and happy. And recover.

The doctor said to me, “Would you like to go home for Christmas? Then if things work out, you’d return in the New Year as an outpatient for three months.”

I was both elated and a bit scared. “Who’ll take care of me?” I asked.

“Pat. Your wife? You do remember her, don’t you?” he said, and then he smiled. “We think you’re ready. Pat’s keen to give the idea a go. We’ll supply all your medications and requisitions for the aids you need—wheelchair, walker, anything to make your home more comfortable.”OK, I thought, being home was a good choice. As the doctor turned to leave, he smiled and said, “Merry Christmas.”

I spent most of Christmas Day sleeping. Nicole arrived the next day with her partner, Iain, and their daughter, Flora. As soon as my grand*daughter saw me, she frowned. What happened to Poppa? She was intrigued by my wheelchair. And fearful.

“They’re my legs,” I told her, “until Poppa gets better.”

The sorrow I felt choked me, and 
if my lips had parted, the whole neighborhood would have sworn they’d heard a lone wolf cry in the wilderness. As they were leaving the next morning, Flora said, “Poppa, please get better.”

A year would pass before she felt confident enough to approach me and wrap her arms around my legs. By then I was walking with a cane.

Meanwhile, my weeks of outpatient therapy were monotonous, but the benefits were immeasurable. I pedaled a stationary bike, climbed steps, and did leg lifts, squats, and arm pulls. I was finally able to pronounce a word without confusing the vowels and consonants.

My emotional control was still 
fragile. I would weep when I saw scenes of poverty on TV. The silliest jokes could give me unstoppable giggles.

The author and his wife, Pat, who nursed him through his recovery
Courtesy Peggy New

The author and his wife, Pat, who nursed him through his recovery

I’ve learned that there is nothing smooth or predictable about stroke recovery, but there’s also no limit. The old notion that there is a finite window in which to achieve rehabilitation is simply false. So, like most stroke survivors, 
I expect full recovery. It’s unlikely I’ll return to being the person I once was, physically, mentally, or spiritually. I have both lost and gained things that define who I am as a person. But with the advances in treatment and therapy, I believe I can continue to repair and rebuild, and find a place for myself in my reconfigured world where I feel both valuable and valued.

24 Secrets Pain Doctors Won’t Tell You

Meds are available, but…



istock/kupicoo

Sure, they can give you some meds to dampen the pain. But the best doctors will talk to you about the cause of your pain, whether it’s your lack of activity, your stress level, a condition like arthritis, your mattress

10 Secret Reasons for Your Back Pain



Alyssa Jung




Prone to back pain? Experts share common but surprising reasons for back pain and ways to make your back stop hurting.




You’re stressed out“Emotional outlook is a big predictor of back pain,” says Todd Sinett, a New York City-based chiropractor and author of 3 Weeks To A Better Back. Mental distress manifests itself physiologically, says Sinett. “If you’re uptight for a long period of time, that muscle tension can lead to aches and spasms,” he says. Common areas for stress-triggered back pain include the neck and shoulder region and lower back. Try relaxation techniques like deep breathing (inhale slowly for a count of four, hold the breath for a count of four, exhale for a count of four), a walk, or yoga. Don’t miss these everyday habits that are seriously damaging your spine.

Your heels are too high



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Your fashionable shoe collection might be bothering your back. “High heels throw off your center of gravity,” says William Suggs, a certified personal trainer and licensed sports nutritionist in New York City. Heels make you lean forward to walk, put extra pressure on the feet, and cause you to not fully extend the calf. This puts more strain and stress on the lower back, which can cause pain, he says. “If you must wear heels for work, invest in a nice pair of walking shoes for the commute and change at the office,” says Suggs. This is what you need to do if you wake up with morning back pain

Your diet is “dirty”

A 2014 study in the Asian Spine Journal found that about 31 percent of women and 25 percent of men who suffered from back pain also had gastrointestinal complaints, such as abdominal pain or food intolerance. The link between nutrition and back pain is all about inflammation; foods high in fat and sugar trigger inflammation throughout the body, including the lower back. When Sinett’s father injured his back, he saw an improvement in back pain symptoms when he cut back on sugar and caffeine. Aim for “clean” whole foods instead of processed ones whenever possible. “Always have a protein like lean meat or beans, a good whole grain like brown rice, and vegetables,” Suggs says. Here are exercises that could relieve back pain.

Your pants are too tight

Skinny jeans could be doing a number on your back. Dr. Kenneth Hansraj, MD, chief of spine surgery at New York Spine Surgery & Rehabilitation Medicine told Shape.com that too-tight outfits constrict the body, which limits your range of motion and can strain your back, neck, and shoulders. The biggest fashion culprits? Skinny jeans and pencil skirts. For clothes that are snug but not skintight, look for fabrics with a bit of stretch to them. Make sure you can easily slip a finger under the waistband.

You sit on your duff all day

“Inactivity is one of the most detrimental things you can do to your body,” says Suggs. “Your muscles get used to being in that seated position, so they tighten up.” To combat sitting-induced muscle stiffness and tightness, stretch your lower posterior muscles (Achilles, calves, hamstrings, and glutes) when you wake up. “When those start to tighten then your lower back starts to feel the brunt of the pain,” says Suggs. He also suggests a quick stretch midday and before bed. “It’s also a good idea to get up and walk around a few times throughout the day, and to make sure your back is supported and not slouched when you are seated, says Suggs. Check out the reasons why your back pain could actually be a warning sign of sciatica.

You still smoke

A recent Northwestern University study found that smokers are three times more likely than nonsmokers to develop chronic back pain. “[Smoking] affects the way the brain responds to back pain and seems to make individuals less resilient to an episode of pain,” the researchers said in a news release. Smokers who quit their nicotine habit during the study period experienced a decrease in chronic pain. Previous studies found that smoking may damage tissue in the lower back by slowing down circulation, which reduces the flow of nutrients to back muscles.

You’ve been skipping ab workouts

A strong core could combat an achy back. “If your abs are weak, your lower back has to work harder, which can lead to back pain,” says Suggs. Try plank, superman, or bird dog exercises, which engage your erector spinae, the muscle that keeps your spine erect and helps maintain correct posture, he says. Pay attention to your midsection throughout the day. “Your core should never be relaxed, whether you’re sitting or walking; that’s when you put yourself at risk for developing pain,” says Suggs

You’re dehydrated

The bones of your spine have discs between them, each partly made up of a jelly-like substance that is 90 percent water. Your body needs a steady stream of fluid coming in to help keep that cushioning intact, according to the Cleveland Clinic Center for Spine Health. When your body lacks hydration, those discs become flatter and less cushiony, which can lead to pain. A good way to know if you’re drinking enough to water is to look in the toilet. Your urine should be clear or light yellow; if it’s dark yellow, grab some H20.

Your hips are uneven

Many people have no idea that their hips are uneven, which means one side of your pelvis is slightly higher than the other, says Suggs. The imbalance can cause lower back pain in your day-to-day life, and often becomes especially apparent while you work out. “It affects how your body responds to certain moves and will be different for everyone,” he says. For example, if your left hip is higher and you do a lunge on the left side, you may feel that hip muscle pull tighter. If you notice persistent back pain during a workout, Suggs suggests seeing your doctor before trying to cure yourself. “Your doctor can evaluate your whole body and detect potential imbalances,” he says. These are the signs of back pain that may be more damaging to your health than you think.

You have a urinary tract infection

Pain in the lower and upper back or sharp pains in the flank (side) can be a sign that a urinary tract infection has spread to the kidneys. If you’ve noticed other classic UTI symptoms like increased urge to urinate or pain during urination, see a doctor immediately for treatment.

5 Clear Signs Your Mystery Back Pain Is Actually Arthritis



Alison Martin




A backache that won’t quit may not just be from shoveling, lifting too-heavy weights, or wearing too-high heels. These telltale signs suggest it could be osteoarthritis, or arthritis of the spine


You wake up to pain

If your back hurts when you first get out of the bed in the morning, the pain may caused by the inflammation characteristic of arthritis. (By the way, here’s what to do if you wake up with back pain.) “When there’s inflammation, it’s not the arthritic changes that bother you, it’s the nerve,” says Mark Mickhael, MD, of the Illinois Bone & Joint Institute. Pain can also be caused by a herniated disc, as it pushes out and hits the nerves in your spinal cord. Herniated discs are common with degenerative disc disease, which often accompanies osteoarthritis, or arthritis of the spine. (Learn about the miracle cure that soothes osteoarthritis while sitting down.) Look out for back pain that lasts for roughly 30 minutes in the morning and then goes away. “With arthritis, the pain tends to get better during the day, but then in the evening it feels a little worse,” says Prakash Jayabalan, MD, of the Rehabilitation Institute of Chicago. Evening pain may not be from arthritis, however, but rather from the stress of daily activities such as sitting at work. Find out how to recover from a day of sitting.

Other body parts hurt, too
When arthritis of the spine advances, wear and tear on the vertebrae can cause a pinching or compressing of the spinal cord and nerves. Since the nerves running down your back connect to different areas of your body, you could end up feeling pain, numbness, tingling, or weakness in your hips, butt, legs, and feet. (Scarily enough, this form of osteoarthritis has doubled in the past 50 years.) “Those nerves go down the muscles of your legs, so that can cause weakness,” Dr. Jayabalan adds.

Your spine feels extra stiff

“Even if you’re not in pain, you may feel stiff in the morning,” Dr. Jayabalan says. In most cases, this stiffness will wear off as you start walking around, but the pain may return at night as the joints are stressed from the day. Bending over and arching your back may be particularly painful, and the pain can migrate—one day affecting a shoulder and the next day affecting your neck, and so on

The pain keeps getting worse

Everyone experiences pain differently, and there’s no right or wrong time to see a doctor. “Some patients come in because of a very new pain,” Dr. Jayabalan says, “and others come after months or even years of suffering a twinge here and a twinge there.” (Learn what you should and shouldn’t do before a doctor appointment.) Dr. Mikhael recommends seeing a doctor if the pain comes and goes for more than four to six weeks. (Find out how to manage chronic pain without medication.) Most pulled muscles and other minor injuries heal over that period of time, so if the pain persists and especially if it gets worse, schedule an appointment. Don’t miss these everyday movements that are wrecking your joints

The pain disrupts your z’s

Back pain that keeps you up at night is a vicious cycle: Pain can worsen if you don’t get enough sleep, but if your pain is already keeping you up at night, there’s no way for it to subside. “If the pain is so significant that it’s impacting your sleep and quality of life, then I would say it’s time to see a physician,” Dr. Jayabalan says. Still tossing and turning?

50 Things Nutritionists Never Eat—So You Shouldn’t Either



Lindsay Tigar




Want to know what the experts avoid? Here’s the list of foods, processed goods, ingredients, and chemicals that nutritionists won’t put on their plates.

Artificial sweeteners



Daniel-S-Edwards/Shutterstock

A grande iced coffee with skim milk and two Splendas, please? Think again—and hold the sweet stuff. “I do not think there is sufficient evidence to prove that most artificial sweeteners are safe for consumers, so I prefer to stay away from them and indulge in the real thing [sugar] occasionally and mindfully. Plus, there’s a plethora of research that shows how consuming diet beverages may counter-intuitively lead to weight gain, which can increase your risk of chronic diseases like diabetes and heart disease,” registered dietitian and nutritionist, Chelsey Amer says. This is what could happen to your body when you stop eating
artificial sweeteners