Macon County Senior Games

The start (photo Linda Mathias)


Crusing along (photo Linda Mathias)


The finish (photo Linda Mathias)

I had my stroke training for the 2008 Macon County Senior Games. So, when I got back on my bike in February 2009, I decided I would ride in them in May 2009. If I'd known I would be one minute behind the winner, I probably would have trained. I think I can go to the NC state finals in September where lots of people can beat me, none who have had a stroke though.

Thanks Linda for coming out with your camera!

Here is a link to the story The Franklin Press did.

http://www.thefranklinpress.com/articles/2009/05/15/living_in_macon/01living.tx

Here it is, also.

The Franklin Press
Living In Macon
Resident hopes to create needed resource for stroke victims
By Colin McCandless
pressreporter@thefranklinpress.com

A local resident is working to develop a video project that would empower stroke patients to take charge of their own recovery, while helping address a gap in the health care system.

A professional videographer and photographer with 30 years experience, Ralph Preston of Franklin is collaborating with the Tri-State Stroke Network in seeking a grant from the Centers for Disease Control and Prevention (CDC) to develop a DVD on the various aspects of stroke recovery.

Preston wants to bring attention to the issue of strokes and help make information more accessible to stroke victims and their caregivers.

He knows firsthand what it's like to experience one. Preston suffered a right-side hemorrhage stroke last April at age 58 while he was training on an exercise bike for the North Carolina Senior Games competition.
"My stroke was completely preventable," Preston said. He had marginally high blood pressure and chose not to take his blood pressure medicine, he recalls.

Preston spent 5 days at Mission Hospital in Asheville and then 17 days at CarePartners, a rehab hospital (also in Asheville).
Following his release from CarePartners, Preston discovered a gap in the health care system concerning strokes: it proved difficult finding critical information to facilitate his own recovery.

He found there are no "stroke doctors" in the area, that family doctors often do not have much knowledge about strokes and that the information a patient needs to medically manage their recovery is spread out over a large number of sources.
Upon seeing this problem and experiencing the frustration as a patient, Preston derived the idea of creating a DVD to try and address that gap. The project would allow him to utilize his video production skills to develop a user-friendly, accessible resource that will help others like him in their respective road to recovery.

According to Preston, the purpose of the DVD would be to compile in one place most of the information a stroke patient needs for their total recovery. All of the information would be menu-driven so the patient could watch just the sections that pertain to their individual needs.

The DVD would be designed to provide useful information to patients at any stage of recovery and would contain, among other things, outpatient facility information and therapeutic exercises to do at home. The program would be aimed at patients just released from a rehab hospital and could be given to them as they are discharged from the facility, according to Preston. Because recovery continues over the patient's lifetime, Preston said the program would be valuable at any stage of the process.

It will feature interviews with psychiatrists and psychologists, stroke patients and their success stories, doctors, rehab-center managers, etc.

There would be sections on therapies and modalities for the most common stroke issues, post-stroke medical information, physical therapy and stroke prevention. Additionally, there would be a section geared towards family caregivers on how to equip a home for stroke patients, along with information on blood pressure, cholesterol, clots, blood thinners, etc.
In addition to stroke professionals and stroke victim testimonials, Preston has gone after spiritual/motivational teachers that he intends to interview for the video, including Ram Dass (accepted), author of "Be Here Now" and Dr. Wayne Dyer.
He also plans to ask seven-time Tour de France cycling champion and cancer survivor Lance Armstrong to appear in the video.

Preston emphasizes that the video would exude a positive tone and stress the importance of maintaining a good attitude during the recovery process.

Preston hopes he can get the CDC grant money for the stroke recovery video this year and put together the DVD by May 2010. (May is "Stroke Awareness" Month). If the CDC funding falls through, he will seek other funding sources (foundations, etc.).

His wish is that the video can serve as an inspiration to others. "It's not about me," Preston said.

He has shopped the DVD concept with stroke professionals in the state and region who have been supportive of the idea, including the executive director of the Tri-State Stroke Network (who are funded by the CDC), and the North Carolina Stroke Association.

Preston explained that he also learned during his research for the DVD that the tri-state area of South Carolina, Georgia and North Carolina is part of the "Stroke Belt," usually defined as an 8-12 state region (typically including Alabama, Arkansas, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, and Tennessee), according to the Stroke Network's website www.tristatestrokenetwork.org/facts.html.

It so named because the region typically features higher death rates from stroke than the rest of the country.
Within the stroke belt, the highest stroke death rates are clustered in the coastal plains regions of Georgia, North Carolina, and South Carolina; this region has been called the "Stroke Buckle." The stroke death rate in the Stroke Buckle is two times greater than that in the rest of the nation, according to the Stroke Network.

This has become an added focus for Preston's DVD since North Carolina shares in this dubious distinction.
In April, Preston also started a blog at strokedvd.blogspot.com that describes his own recovery experience and the plan to produce a stroke recovery informational DVD.

Preston said he hopes the website will eventually feature some type of stroke resource section either with a question and answer page, an interactive place where people can pose inquiries to stroke professionals and get feedback or a link to stroke information.

Preston's Road to Recovery

Since suffering his stroke last year, Preston has relearned to use his cameras again, including his 26-pound broadcast camera, which as a professional photographer is most important to him.

Along his road to recovery, Preston did walking exercises daily, and it took him a couple months before he could build up to walking two miles.

Three months into his recovery though, he was able to walk three miles out and three miles back on the Appalachian Trail to the top of a mountain with 1,500 feet of elevation gain. He has also walked seven miles on the beach.
Ten months following his stroke, Preston was also back riding his bike again.

Preston recently rode his mountain bike 22 miles on the beach in less than two hours and rode a 20-mile bike trail in an hour and 15 minutes.

He walks or bikes every day in addition to doing his daily occupational therapy exercises.

Additionally, Preston intends to ride in and be a letter writer to raise money in the NC Stroke Association's annual fundraising "Cycle for Life" bike ride event this October.

The NC Stroke Association is also featuring him in the June issue of Update Stroke. Preston has been asked to be a motivational speaker at Life Care Centers of America's annual meeting in June.

On May 7, thirteen months removed from his stroke, Preston completed a 10-K bike race in the very same Senior Games competition for which he was training when he had his stroke.

"It was kind of like completing the circle for me," Preston said.

My Recovery

I had a right-side hemorrhagic stroke on April 4, 2008. I spent 5 days at Mission Hospital in Asheville, NC and then 17 days at CarePartners, a rehab hospital also in Asheville. I have made quite the recovery. I am a photographer and videographer and have relearned to use my cameras, which is most important to me, including my 26-pound broadcast camera. I have walked 7 miles on the beach. I have walked 3 miles out and 3 miles back on the Appalachian Trail to the top of a mountain with 1500 feet of elevation gain. I got back on my bike. Recently, I rode my mountain bike 22 miles on the beach in less than 2 hours and rode a 20-mile bike trail in an hour and 15 minutes. I walk or bike every day as well as doing my OT exercises every day. I am enterd in the NC Senior Games, which I was training for when I had my stroke. I am going to ride in and be a letter writer to raise money in NC Stroke Associations “Cycle for Life” bike ride this October. They are also featuring me in the June issue of Update stroke. I have also been asked to be a motivational speaker at Life Care Centers of America’s annual meeting in June.

I live by this attitude quote. It saved my life and allowed me to make the recovery I did. I am in the process of making a poster with this quote and a "magic moment" shot between a patient and therapist at CarePartners. "Transferring Knowledge, Power, and Love" is what I made up to describe the magic moment I am looking for. I think it should hang in every rehab facility in the country in the staging area where everyone will see it.


Attitude

“The longer I live, the more I realize the impact of attitude on life. Attitude, to me, is more important than facts. It is more important than the past, than education, than money, than circumstances, than failures, than successes, than what other people think or say or do. It is more important than appearance, giftedness, or skill. It will make or break a company…a church…a home. The remarkable thing is we have a choice every day regarding the attitude we will embrace for that day. We cannot change our past…we cannot change the fact that people will act in a certain way. We cannot change the inevitable. The only thing we can do is to play on the one string we have and that is our attitude…I am convinced that life is 10 percent what happens to me and 90 percent how I react to it. An so it is with you…we are in charge of our Attitudes!”

Charles Swindoll


I have developed methods for integrating PT & OT into normal life. For OT I do everything with my left hand. I dubbed it, "The Affected Hand Olympics". For PT, I balance on my affected leg when standing in lines. I look at the horizon, close my eyes, or look left or right while walking on the beach to improve balance, etc. Of course, this is in addition to walking or biking every day and doing my OT exercises every day. I believe you are either going forward or you are going backwards. See the post called "Integration: Beyond Involvement" for more on this.


Me & Kathy (my PT) walking out of CarePartners
photo by Deborah Thomas


Standing on a 2 x 4 with my 26-lb. Betacam at a Habitat build
photo by Andy Leonard


Doing an interview in the mud at a Habitat build
photo by Andy Leonard

The pictures here are all post stroke. I am told I am the one of the few in recent memory that walked out of Care Partners. In the first Habitat picture, I am standing on a 2" x 4" with my 26-lb. Betacam. Look at that left-hand involvement in the Habitat interview shot. The Habitat pictures were taken 5 months after I left Care Partners.


There is Always Hope for the Future
(Great Spangled Fritillary at the Cowee Mound)

My therapist asked me one day if I had hope for the future. I replied, "That's a silly question, there is always hope for the future." She said not everyone felt that way. Two days later when I was at the Cowee Mound (an ancient Cherokee site and my favorite place on earth) taking this picture of a Great Spangled Fritillary, it made me think about hope for the future. So. I named the picture "There is Always Hope for the Future" and made her a print. This was at about 7 weeks on my own, when I was getting better at getting up from kneeling, like I did to take this picture.

Integration: Beyond Involvement

When I was at Care Partners rehab hospital in Asheville, NC, they preached "involvement" with your affected hand. Not an easy thing if you can't pick up anything or use your arm. First, I had to build up the strength and the coordination in my hand to be able to hold anything. I did this by squeezing putty and stretching rubber bands, the ones that come with the mail. I kept some of each in the car, so as my wife drove me to doctors appointments I could work my hand. I did a lot of wrist-stregthening exercises, too. I kept a hammer with me when I was sitting on the porch or riding in the car.

I also had to build up my shoulder to where I had some range of motion and some strength. I did that by holding a light weight by my side and drawing circles with it, both clockwise and counterclockwise. I also got a wooden dowel at the hardware store and used my unaffected hand to raise my affected hand over my head.

Eventually, I could raise it on my own and I could keep my hand on the computer keyboard. I wanted to be able to drive a car again. I had had a field of vision test at my eye doctors before the stroke, so I had one after. I lost very little, so I headed out with my wife as the driving instuctor. I passed, That was a big day. I started driving with my left arm. I found things like driving, lawn mowing, and vacuuming where you are holding something steady and steering to be beneficial. In the begining, my arm would sway for no reason, so I was careful every time I met a car if I was driving. Eventually that went away. You can't do too much damage with a vacuum cleaner. Yes, I vacuum left handed. I always will. Mowing was good in the early days after I learned to walk well enough to take it on. It involves pushing and I live in the mountains where there are always hills. I found it good for building up stamina. I had to push myself continually to rebuild my stamina. In the begining simple tasks and anything that used my brain drained me. Eventually, I could ride my bike for a couple hours without stopping. Next, I want to learn how to run again.

Once I got some function back, I could start to think about involvement. So, I got down the vitamins with my left hand and arm. I had trouble doing it, so I'd get them all down and then put them back. Get them down and put them back.

Every time I have trouble doing something I do it over and over again until I was satisfied I am doing it right once. So, if my hand shook when I was going to pick up something and I didn't like it, I repeated the motion until I was happy and picked it up.

Once I achieved involvement, I tried to figure out ways to use my affected side in everyday tasks - integration. I got tired of how long it took me every day to do all the exercises I was doing at the time. When you integrate it's like free PT or OT time. It doesn't come out of your time like pulling on a rubber band does. If you balance on your affected leg while your gas is pumping, you are doing PT and the time does not come out of your life, it's extra therapy time.

I walked and walked and walked some more. I walked on my toes I walked on my heels. I hopped in place. I hopped from side to side. I hopped laps. I high-stepped laps. I did ankle dips and raises on a step. I practiced going up and down steps. I walked on every kind of surface and terain.

How could someone is a good a shape as I was get his stamina wiped out? SImple answer, stroke. I believed in pushing myself a little every day. Steady pushing yields steady progress and soon I was able to do some things that meant a lot to me. Walking to the jetty and back at Hunginton Beach State Park was my first big accomplishment. When I got there I thought, "Can I make it back?" I had been so sigle-minded about making it to the jetty, I forgot I'd have to walk back. But I made it, and that was just another step and another confirmation that if I set my mind to it, I could do it. I could recover.