Home Winsights
No. 67 (April/May 2003)


Proposal for Rehabilitation
of Stroke Patients

by Win Wenger, Ph.D.

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We are not medical physicians. Further, we've seen amply demonstrated to us and to others the apparently absolute unwillingness of the medical establishment to consider any inputs from outside itself. So, perhaps, to publish the information below is only an act of futility.

Yet we have been asked often enough about how to repair the brains of stroke and accident victims that I will save us much time by putting this information up here on the Web for anyone's easy reference. And possibly, if certain basic information circulates for long enough, some member of the medical establishment will suddenly discover it as his own, and human lives can begin to get repaired.

Or, if in enough situations families and close associates of enough stroke and brain-injury victims can venture this information within their respective situations, sooner or later a curious and cooperative neurologist or neurophysiologist can be found to act upon it and begin such repair.

O

Overall health, condition and functioning of the brain

One of the main determinants of how well the brain functions, and what its physical condition is, is circulation to the brain — cerebral-spinal fluid to and from and within the brain and, on the other side of the blood-brain barrier, blood circulation to and from the brain.

Oxygen, nutrition, food-energy, and the removal of toxins and wastes are crucial to the brain's functioning; the brain is highly sensitive to the levels of circulation reaching it.

Nature has endowed our physical bodies with extraordinary special mechanisms to keep that flow high. Cold water on the face increases circulation to the brain as part of the Diving Response which all mammals have in response to being immersed in water. Extra carbon dioxide in the bloodstream widens the carotid arteries supplying the brain, increasing circulation. That response was built, presumably, as an extra measure of protection during extreme exertion while nearing the end of the hunt and for living in smoke-filled caves during caveman days.

The best known combination way to increase circulation to the brain is held-breath underwater swimming.

Frequent practice of held-breath underwater swimming, over a brief but intense several weeks set aside mainly for that purpose, will train permanently wider the carotid arteries supplying the brain, greatly improving its physical health, well-being and functioning.

With stroke patients, however, several additional very serious issues arise around the slight momentary stress such held-breath underwater swimming can place on the circulatory system in and around the brain. Whatever the type of stroke, the held-breath underwater swimming should be done only under close supervision by a competent physician. Held-breath underwater swimming is likely to be fine for those stroke patients who suffered occlusive (blockage) strokes, but even there close supervision by a physician is mandatory.

Held-breath underwater swimming is fairly likely to NOT be appropriate for victims of hemorrhagic (bleeding) strokes. I'm sorry about that, because such swimming can accomplish so very much for brains. If you heard doctors talking about a "subdural hematoma," they were talking about bleeding that had escaped an arteriole or vessel within the brain and thus likely a sign of hemorrhagic stroke.

Subdural hematomas resulting from mechanical injury to the brain, as in a car accident, once the patient is recovered are not as likely to be susceptible to the slight stress engendered by held-breath underwater swimming, but it is up to the supervising physician to determine this in each case.

The great majority of strokes are occlusive. Relatively few are hemorrhagic.

Even with the bleeding kind of stroke, however, cold-water compresses around the face and the medical practice called "masking" — what I call "baggie breathing," re-breathing your breath in a bag for carefully controlled intervals — can help some toward recovery.

Where held-breath underwater swimming is healthful and risk-free, that activity can apparently greatly accelerate and extend the recovery of brain and mental functions, just as it can enhance brain and mental functions in normal, uninjured people. You will find some additional information on held-breath underwater swimming in our online book.

O

Integration of brain functions

Integrating between different regions of the brain, and between specific circuits and functions within the brain, is another and likely very powerful way to recover from the effects of brain injury, whether from strokes, disease, traumatic injury or other causes.

A rehabilitative strategy used in a number of clinics today is centered on a developmental model of human brain function. In this briefing I want to show you specific ways to build functional bridges between different regions of the brain and how to do so to span non-functioning gaps in the brain associated with injury.

External sensory feedback is much faster than internal sensory feedback. Stub your toe, or prick a finger, or touch something hot, or suddenly see danger coming at you, and you react much more immediately than you do to a headache or stomach ache or other internal physiological effect.

There is a good bio-evolutionary reason for that. If you didn't react instantly to seeing that tiger on the ledge above you, you didn't become an ancestor. There wasn't a similar evolutionary pressure for how instantly you responded to internal sensings.

The various brain functions that go into an externally expressed physical activity have to be coordinated. That requires a pretty immediate relationship between the regions of the brain involved with those respective functions. Indeed, a much more immediate relationship exists between those regions of the brain than between regions not so engaged.

What we at Project Renaissance call "pole-bridging the brain" is the principle of taking functions which are found in widely separate, usually not very related regions of the brain (the "poles," if you will) and expressing those brain functions externally in some combination way which requires their coordination. The much faster external sensory feedback from those expressed-coordinated functions forces a more and more immediate relationship between the respective regions of the brain so involved.

Once that faster bridge for brain traffic is built, the resources and abilities of each region of the brain so involved will be that much more accessible to the other involved regions, and vice-versa. Some might call this "intelligence." We won't talk today about the controversies over intelligence-building; we're simply going ahead and giving you here simple ways to do so and simple ways also to speed and extend, potentially very greatly, the recovery of lost functions in a stroke or brain injury victim.

One blessing:  once established, the higher level of inter-accessibility remains. Demyelination — deterioration of brain circuits — due to non-use is a matter of some years; myelination — building those circuits — is usually a matter of hours or days.

Image-Streaming, freely and completely self-taught here, is so far as we presently know the one most effective activity and practice for integrating the brain generally, just as held-breath underwater swimming appears to be the one most effective activity and practice for building the physical health and functioning of the brain. Image-Streaming expresses externally and coordinates our language and thought functions, our inner sensory image functions, several different kinds of ratiocinative process and types of "making sense" within specialized areas of the brain. Our external sensory feedback from this Image-Streaming activity builds bridges of tighter communications and greater inter-accessibility between these regions of our brain.

Learning to sight-read and play music is another good example of Pole-Bridging — building higher inter-accessibility between sensori-motor functions, the optic chiasma, auditory functions, pattern-recognition and aesthetic function regions of the brain.

This is one of several reasons why otherwise equal children who learn to sight-read and play music develop higher intelligence than those who don't. (There are additional reasons why involvement with the arts enhances intellectual and "practical" functions, but we'll have to address that topic another time. See also Winsights articles No. 39 and No. 41.)

O

Pole-bridging around specific injury sites in the brain

In each case, one would need to determine (or have the neurophysiologist or neurosurgeon in charge specify):

  1. the specific damaged tissues and their functions.
  2. The actual behavioral symptoms associated with the strokes.
  3. The behavioral functions of the brain tissues still functioning which are closest to the damaged area, on each side of the damaged area.

The purpose of this is to devise bridging combination activities — Pole-Bridging. You want to bridge the functional gaps. You want to set up a demand which brings obtunded tissues back into full functioning, and/or to recruit other tissues outside the damaged area to replace the functions of those damaged.

If the behaviors of two healthy but very different tissues, on either side of the damaged region, can be expressed together in some external combination so that their coordination via faster and external sensory feedback forces a closer relationship between those two tissues, neural pathways will be built close enough nearby to the injury that some of those pathways can then take on also some of the lost functions of the area of injury.

This would be a very simple and obvious procedure, but I've never heard of anyone doing it. It is very hard to find a physician willing to act outside of doctrine. The key to press here is harmlessness — that, at worst, such activities may be ineffectual and do no harm; this will humor the family that's urging this for the patient. And, on the face of it, there is a high likelihood that this can, in fact, do a great amount of good. But you need, for this approach, the three points of highly specific information cited above, in order to devise highly focused specific exercises to bridge where needed.

Pole-bridging theory — and, with it, the theory of this potentially rehabilitative treatment — remains to be formally tested, however much sense it makes and however obvious it seems. The only forms of experimentation in humans which can be permitted have to be in activities which are totally and obviously safe for the patients. Formal testing should compare recovery rates of patients with whom the procedure is worked with closely matched patients in conventional treatment programs who have not been so treated or exercised.

You may want to take with you a printout of this brief paper, to refer to or even to show to the neurophysiologist in charge of the case you are concerned with, which is why I now emphasize with how complete a freedom our unique copyright notice, below and on other Winsights articles, provides for you to printout, copy, or otherwise reproduce this present paper. For the same reasons you may also want to print out and take with you copies of the held-breath underwater swimming article.

If you can get the neural physician in charge to humor you on this as regards the patient you are now concerned with, you may by that example and its results help countless other human beings as well. Please keep in touch and advise me of your situation.

O

Postscript:

Two physicians thus far have responded to this article. One physician and medical biologist was afraid that breath-holding would raise blood pressure, which of course would be a major no-no for susceptible hemorrhagic stroke patients. The other physician, a general practitioner, was afraid that the mammalian diving response — which he called the "bell reflex," presumably after diving bells used to go down hundreds of feet — would so lower heartbeat and pressure as to theoretically cause cardiac arrest in patients with cardiac insufficiency.

These two physician responses appear to this writer to be mutually contradictory and offsetting. The experience of this writer just from being a few feet underwater is very calming, peaceful, all physiological feelings and parameters I would associate with lowered blood pressure rather than heightened from the breathholding. This has also been reported by others. In no instance of just a few feet down has the effect been anything near like "the rapture of the deeps" from sustained "diving bell dives" hundreds of feet down.

The phenomenon referred to by the second physician appears to be from dives to a depth of hundreds of feet. I don't think anyone would see this as a problem at six to eight feet depth. Nonetheless, I hereby include these few paragraphs as a further caveat, this time to cardiac insufficiency patients, with the added very strong suggestion that IF you have ANY health concern or condition which might in some way pose problems for held-breath underwater swimming, no matter how beneficial the indicated effects of such swimming may be, work only under the very close supervision of a physician, preferably not only one who knows you and your condition but who knows something about these underwater and CO2-enrichment effects.


Related Reading:

O

Comments to:
Win Wenger



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