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Recently I was asked if I would like to participate in AUT (Auckland University of Technology) physio 3rd-year student training once again.  The request came right in the middle of a really busy time.  I was in the throes of another big project (hush-hush, the subject of a future article), also about to participate in two separate walking studies; one for University of Auckland, and the other was Auckland University of Technology  – I was able to fit both of them in my schedule.

My pottery and sculpture activities had been put on the backburner...

Ominous black clouds marched across the skies as we drove over the harbour bridge to AUT North Shore campus. 

The clinics for 4th year student-training physios had their sessions in the gym nearby, from what I recalled, though they could have shifted buildings, being some years since my last visit.  The 3rd year student-training remained housed in the same building as previous times.

 The senior lecturer organising my participation, greeted us in reception, and ushered us through the multiple corridors towards the lab.  All I had to bring to the table was myself... and medical (physio) woes, in this case, stroke related topics.  I'll be assessed and based on the students findings: a course of treatment is proposed and hands-on rehab therapy.

These sessions provide Year Three physiotherapy students the opportunity to use and receive feedback on assessment and treatment skills. The sessions develop students’ interaction with the public and appreciation of a range of people and abilities.  The first is an “assessment session” where you will be asked “interview” type questions where they will obtain a history from you, observe how you move and then carry out some “hands-on” assessment. The second is a “treatment session” where students will use the information gathered the previous week to develop some rehabilitation strategies..

One of the first few questions was how I'd coped, and if there were stairs at home.  I had the AVM-brain-haemorrhage/stroke in the UK, on our extended OE there.  I was happy, healthy, did exercise, didn't smoke, ballroom danced with my husband, skied in Austria, travelled extensively… and worked as a computer analyst-programmer in a progressive software company. 

 Then out of the blue, a massive stroke hit; I had had the AVM since birth, I was later told – a time-bomb; it was only a matter of when it would go off – I was only a mere 34 years old.   Emergency admission, nine hours open-brain operation, to stem the haemorrhage; a linear accelerator radiosurgery procedure 6 months after the initial bleed.  A catastrophe?  I was paralysed on my right side, in a wheelchair, couldn't: talk, walk, read, write, remember; I had severe aphasia.  I've had to relearn life from scratch.

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To answer the question - yes, there were steps.  We lived on the first floor flat in London, at that time.  I wouldn't have been able to reply if I had been asked that question, after the stroke – if I was able to remember how to say it, speaking slurred words before the thought of what I was going to say escaped me, two words into a sentence..., time after time.  Stairs were a challenge for my walking, climbing up and down stairs (video), then and now, though I'm improving.

''A stroke is a disruption of blood flow to a part of the brain''; an AVM-brain-haemorrhage (Arteriovenous Malformations) is composed of an abnormal collection of blood vessels with weakened walls, and have a tendency to bleed. ... About 4 in 100 people with an AVM will have a bleed (haemorrhage) every year.  Risk of dying from a bleed is about 10% while the risk of a disability may be as high as 40% with each bleed. …'' - via google research.

The stroke-incidence happened at work.  While I was talking to a couple of colleagues, I suddenly realised that though I was still in-the-motion-of-talking, i.e. my jaws were still moving up and down, my voice-box had ceased to work.  While I was puzzling this thought through, my thoughts were in s-l-o-w  motion but were still surprisingly lucid.  After the split-second, perplexing surprise that I couldn't speak, for some strange reason ...I keeled off my chair and fell unconscious to the floor.  My body had shut down completely.  That was in 1995.

The ambulance came almost straightaway; all the while I was unconscious, transferred to two hospitals, it took seven to eight hours before the life-saving operation by neurosurgeons: this means that I'm very lucky to be alive, then and today.  

When you suspect a stroke is about to happen: Facial drooping, Arm weakness, Speech difficulties and Time to call emergency services.  F.A.S.T. campaign and initiative, began life in the UK by a group of stroke physicians, ambulance personnel, and an emergency department physician in 1998;   the more likely brain damage could be reduced and a better outcome achieved.  It can't be stressed enough, but was not thought of as yet in 1995, when I had my AVM-brain-haemorrhage stroke. 

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The students were interested to see how I adapted to change; for instance, in posture, and balance.  The physiotherapist lecturer fully engaged with his students with the question-answer session.  Students asked questions triggered by my posture and balance when I was doing some activity interspersed with comments, which in turn prompted more probing.  Twists and turns to test my flexibility.  They tested my right foot without the legbrace.  One group of students tested the range of movements of my affected arm.

Then came the treatment exercise the week after, at the same location at the Akoranga campus.  Groups of two or three students, brainstormed from the previous'  weeks assessment, devised plans to treat the patient, in this case: me.  There were lots of factors to be concerned with, and wide range of techniques they could have used, as my challenges were many. 

Stepping upand down; extending forward for conical shapes, to the side; reaching upwards on my tippy-toes, for a ball just out of my range.  Strengthening exercises were great, with the Thera bands.  Stretches, squats, mirror therapy...   I performed the tasks to the best of my ability, … all too soon, the end-of-session, time to go.  Refreshed and energised - I was put through the paces, as each of the sets of exercise dealt with different sorts of challenges and responses within my body.

All in all it was an enjoyable and beneficial time for both the students and me.

Many thanks to the 3rd year physiotherapy student community at AUT/AIH and the Physiotherapy Lecturer and Programme Leader, Todd Stretton.  Best wishes for their continued success.