Mahes Visvalingam
Post-retirement postingsPlease note that this site is under construction.
Some Experiences with Natural Medicine
and related observations
Muscle spasm and flaccidity following brain damage : Case Study 1
Case Studies
My notes on:
Neuromuscular system (optional background reading - being drafted)
Muscle Energy Techniques (counterpressure and isometric stretching - being drafted)
Case study : my father
IntroductionAlthough these pages on stroke rehabilitation focus on the use of counterpressure, I believe that the therapy is much more effective when the minds of the therapist and the patient are emotionally charged and focused through some sort of ritual. Blood relationships and religious beliefs help but they are not essential for concentrating our minds. Unfortunately, many of us suffer from mental blocks of various kinds. I myself come from a non-traditional but a proud and inhibited family and have always found it easier to express my negative rather than positive emotions. So, I found it difficult to help my father in his hour of need and his recovery of the use of his left side was mainly due to several (co)incidental factors. Although psychic elements made us psychologically receptive, my father's recovery of motor function was by no means a miracle. We had to work hard at it and, while it may not always work, the case study of MM shows that therapy based on counterpressure can sometimes work.
The circumstances
I do not wish to obliterate the psychic, psychological and emotional dimensions from this case study since I believe that they played an important part in healing. Such accounts may seem soppy to those, who wish to view reality through only the spectacles of science.
After a series of mini strokes, my father had a major stroke in his 90s. Owing to work commitments, including supervision of research students at critical stages, I was only able to visit him in Aug/Sep 1996 when he was aged 93. By then he was very frail and feeble, bed-ridden and fed though a nasal tube. He was the only resident in a specklessly clean, private care home run by a still bubbly retired nurse, who offered me a warm welcome, a room, full board and sincere friendship. Guna Selvadurai is an exceptional person who cared for my father with compassion and who took great delight in hosting a party in his honour for a very large number of people at her home.
I arrived at her residence before the other overseas visitors. I wept after I first saw my papa - a once proud and independent man reduced to a helpless bed-ridden state. He had lost control of his left limbs. The left arms and hand were limp and flaccid. In contrast, muscles in his left leg, were contracted and the sartorious muscle in particular was as hard as bone. His left foot was tied with a soft cloth rope to the bottom of the bed in a vain attempt to keep the leg straight. He turned his head, which was facing the wall, to look at me hesitantly with his dimmed eyes with a gaze which said it all. I was choking and he gave me a hint of a nod in acknowledgement. I made some silly enquiries while struggling to hold back my tears. He whispered a few words with hardly a voice.
The eczema which he had on his feet had flared up. Strangely, on the stroke-ridden left side of his body his skin was smooth and glossy. But, the still functioning right limbs were covered with scabby, oozing eczema, which he found unbearably itchy. The treatment of the eczema is outside the scope of this page, which focuses on how he regained use of his flaccid muscles through therapy based on counterpressure. But, my reading of alternative therapies made me think that this showed that he still had some vital force left in him; for eczema can be a symptom of healing, and not a disease in itself.
I knew that this 8-week period would be the last time I would see him alive. I would have to share this time with other members of our large family who were due to return from various parts of the world for his party. I was not a special child - not the eldest boy/girl nor the youngest - but my parents had made sacrifices to give me an education and a good start in life. It was now his time of need and we had to find appropriate ways of showing our appreciation and love for him. This was going to be difficult since we as a family were inhibited and not given to outward show of affections. I had tried to hug him when he was aged 90 to say good bye when I was about to leave for the UK. He was taken aback, pushed me away and scuttled back into his room. My unexpected show of affection became an embarrassment to him and to a lounge full of people who had gathered to wish me good bye. That was the first and last time I tried to get close, although I have spent many hours massaging him. So, physical show did not seem appropriate. Equally, he was not really in a fit state for a lot of talk - he used to proclaim proudly that he was "a man of few words" and that "action speaks louder than words". So, I had to find some other way of relating to him during our last 8-week good bye.
My agenda
I use various divination systems and the reading for my father (using Derek Walters, 1982 Fortune Telling by Mah Jongg, The Aquarian Press) stated the following amongst other things :
I would be involved with an incident which will have lasting importance.
In the depths of winter, a few warming rays of sunlight are eagerly awaited. This seemed to sum up my father's condition.
Even the worst problems can be solved.
People usually have rich untapped vents of resources which can now be called upon.
Although the situation may not be what is immediately wanted, out of the morass will emerge something of greater value.
Be prepared against loss. A sister, who visited people in hospices, said that death was already upon him when she first saw him on her return. She was right - he died in November 1996.
I was therefore convinced that my father and I had a mission - but did not know what it was.
My initial attitude and actions
The Tamil text Thirukural states "annaium pithavum munnari deivam"; i.e. our parents are our foremost visions of God. Hindus worship the omnipresent Divine in any form. Although I am not committed to any one religion, the idea of thinking of my father as an incarnate God appealed to me and helped to relax and serve his needs in the spirit of worship. People can be a source of strength to others in a literal sense. I recalled a BBC 999 Rescue program in which a farmer, who was in critical care when his lung was punctured by a barbed wire, said that he had drawn physical strength from his son holding his hand.
So, during the first few days, I concentrated on :
cleaning his eczema with herbs (elderflower and chamomile in particular)
massaging his left leg with a few drops of peppermint oil in almond oil
cleaning his foul smelling mouth with a dilute solution of cider vinegar and honey, which he also sipped a little of. He also sipped some herbal teas.
giving him a nightly dose of homeopathic Mag Phos 6x diluted in few drops of warm water; please see my page on strains and sprains for more information
holding his hand and asking him to visualise that he was drawing my strength from me.
My father was an atheist and detested pious rituals. He had already requested that there should be no priest or ritual when he died and that his ashes should be disposed of where it could disperse into the oceans of the world. However, I felt that some prayer would be physically, and not just psychologically, helpful. I then told him about John Blofeld's 1977 book In search of the Goddess of Compassion : the mystical cult of Kuan Yin (Unwin Paperbacks). Kuan Yin, known to Tibetans as Tara, is a nature spirit. I said that her personification offered us a way of focusing on the healing power of nature and on the capacity that our own bodies had for healing. Healing was something our brains and body had to do. Even when medicines kill off bugs, the process of healing has to completed by our involuntary selves.
I told him about Kuan Yin's mantra and how when I recited it mentally it had a physical effect on me. I asked him if he would like to try reciting it. We could use it to focus his breath and abdominal muscles. He seemed interested - it was better than lying there waiting for death. He was to use my hand for leverage, and imagine that some energy was entering his body from the base of his trunk and below as he drew in his breath while I recited Om mani padme hum. I then asked him to focus on tensing his abdominal muscles when we came to hum and direct his breath upwards. During each session when we did this, he was to imagine and sense his strength returning to him. We prayed that divine will prevail and that the Goddess of Mercy would direct our minds and reveal what we ought to know. I do not know if he was just humouring me, but he seemed comforted and more cheerful. He also asked me to stroke him in various places like his head and tummy in circular motions, without giving any explanations. To me all this was initially just a way of occupying his mind and having some physical contact with him.
My father had always been a courageous and detached man and was undaunted by the prospect of death. He was, however, a bit concerned about the shadowy figures that he said were lurking about. We reassured him that he will come to no harm. My sister (a devout Hindu) suggested that in case they were malefic elements, a picture of a deity blessed by the temple priest would offer protection. We asked my father if he would be happy with a picture of Ganesha. I suggested that he need not worship Ganesha or seek his protection but merely dwell on his image as the Lord of Wisdom who is symbolically the root source of one's own vital energies, essential for healing and enlightenment. I recounted how my Ganesha (at the head of my bed) found me in 1984 in a charity booth in Burton Constable Hall in Yorkshire. I have no alter for Ganesha but the serene image of him is a reminder of the divinity within all of us, which we need to connect with. My father did not have much time left to do this. With my father's consent and with the permission of the landlady, we hung a painting of Ganesha near his head on the wall.
Counterpressure
Stroke victims, especially the aged, need the touch and support of someone else - hopefully someone knowledgeable and confident, but above all someone loving and compassionate. I had come across the book by Chaitow (1993) quite by chance in a charity shop- and had read it out of curiosity. This text describes self-help osteopathic techniques called muscle energy techniques (MET), which alleviate pain and overcome restrictions to movement to provide a greater range of movement. Please see my introduction for links to useful resources. My father's mental faculties were still intact and I described the gist of the techniques and suggested that we try an improvised version of isometric counterpressure based therapy to relax his thigh muscles, which were still rigid like bone. He was keen to give it a go.
I had already massaged my father with peppermint oil and mopped it off with relaxing warm elderflower tea. Before we started the exercise, as I prefer to think of it, I asked my father to join me in invoking divine guidance through the image of Ganesha. We then focused initially on controlling his breath and directing his mind with Kuan Yin's mantra. I then asked him to take a deep breath and, while holding it to a count of seven, push against my hands which were holding his foot so as to exert some tension against his contracted muscles. It did not matter if he could not do what was asked physically, but he had to focus and will his mind on the task. I would exert sufficient counterpressure to provide physical feedback. He was to stop his mental straining when commanded and imagine that his muscles in the thigh were relaxing while he let his breath out. He did co-operate as best as he could. When he relaxed, I tried to straighten his leg and to my amazement the thigh muscle relaxed and I could straighten his leg. We were both excited. Exactly why such post-isometric relaxation occurs is not fully understood but it is no longer believed that this is due to a simple spinal reflex. Anyway, we were not interested in explanations but in outcomes. So, we persevered with repeat sessions until the muscle was completely relaxed and no longer hard or stiff. This gave my father more voluntary control over his left leg and enabled him to vary its position to make himself more comfortable.
All manipulations of this sort, including reflexology and acupressure, release waste products which need to be flushed out of the system by drinking water. He was soon comfortable enough to sit in a wheelchair, which he had not done for some months. We were able to wheel him outdoors and I trimmed his hair to smarten him up for his party. The neighbours came over to find out how uncle was and to watch the proceedings, all of which cheered him up.
The real challenge was the recovery of use of his left hand and arms, which flopped about as if they did not belong to him. There was nothing in Chaitow's book to help me work out what we needed to do to bring these back into use since the book does not really deal with stroke rehabilitation as such. Since the finger ends are sensitive and rich in nerves, we started with finger control, again with him imagining the desired outcomes while controlling his breath and focusing his entire attention on the tactile feedback I offered. Initially, it seemed a pointless exercise but we persisted. Slowly and progressively he regained some control of his fingers, hand and wrists. Flexing the muscles to lift his hand off the bed was a struggle and this was induced by doing the reverse, i.e. by him concentrating on pushing his lower arm down against the counterpressure I offered by propping it up at the wrist. Similarly, he found it easier to gain control of other muscles by doing the opposite actions to what we wanted to achieve. For example, to lift the elbow off the bed we focused on him pushing his arms against my hand holding up his elbow. The therapist has to assist the person achieve the desired effect during relaxation immediately after the effort. Subconscious recovery is most likely to occur during this relaxation when the patient's mind just lets go and lets nature take over.
Initially, his voluntary movements were jerky and tentative but once he had grasped the idea he started to use his right hand to help his left. Even before my arrival, he had been using his right hand to lift and move his left hand and arms about to induce circulation and avoid bed sores. Now, he was applying counterpressure to tone up the muscles in his left side. Instead of lying there waiting for death, he now had an aim and something to strive for, achieve, be proud of and marvel at. He was soon at a stage where he would ask those who visited to watch - and would proudly lift his hand and move it jerkily up to touch his nose with his finger. He and I knew that his conscious self could only try as hard as it could but that it could not achieve what it desired. But, as if by magic, his brain and body responded as if they had been waiting for the call. In many respects, it was like when I struggled to keep my sinking body afloat in the pool and then found on the next session that my body had learnt to float while it was away from the pool.
Unfortunately, I caught flu and had to stay away from him and slept right through his party, only getting up for photo calls. So, his therapy was suspended and later his attention was distracted by his large family. I could not stay longer than planned since I had other responsibilities in UK to return to. So I bade my final good bye sobbing unashamedly. But, through his willing co-operation my papa had fulfilled the Mah Jongg's prophesy. Chaitow's book helped to bring some optimism into a seemingly hopeless situation. Papa proved that even at the age of 93 with death lurking in the shadows he (and we) still have vital energy and reserves we can draw on. I had learnt important lessons of lasting value.
Conclusion
I initially thought that this was an isolated case pertaining to a man with exceptional grit and character. It was not something I should write about. Then there is MM, who was deemed vegetative, who too was willing to grasp at straws to pull himself out of his locked-in state. Even now in November 2007 MM cannot speak. Since his wife said that he was not religious, we did not go through any rituals. Neither did he receive oral doses of Mag Phos 6x until he had already gained limited control over some muscles. So, although these tools are helpful they are not essential. It seems as if it is faith in one's own brain-body system and mental exertion which seems to be most important. Others can play a helpful supportive role by providing some tactile feedback through provision of counterpressure and encouraging breath control and mental direction. Hopefully, even therapists will be replaced by automated assistants. Although this will deny compassionate relatives and friends of a meaningful role, it would be a boon to the afflicted, especially those without such loving carers.
I decided to write and post this page after seeing 'One Life: The Waking Pill' (BBC October 2007) in the hope that it helps others. I hope that R & D on these Alternative Therapies (much maligned by science-based medical practitioners - see controversy), would also make people realise that life is a mystery and that we cannot know what our minds will reveal even in our dying days (see End of Life, Mystery). The Mah Jongg is not the only tool for divination. In much the same way in which our brain and body seem to be able to respond to physical and chemical stimuli, there is something in us which seems to respond to any established coding system to provide pertinent guidance when most needed. The I Ching and Mah Jongg did not save Chinese Civilization from subjugation through the Opium Wars or Mao's Cultural Revolution. Although the oracles cannot change our destiny - they help us learn from bad times, lead a constructive and meaningful life in good times, and cultivate a mind that is attuned not just to discovery but also to revelations.
© Mahes Visvalingam, 18 Jun 2007
Last updated on 23/06/10