91. Importance of continuing contractions for stroke patients

"See his shoulder is sloped to one side," Mrs Lam pointed to a classmate who had a stroke on the left brain some 8 years ago and was now seated on a sofa, "I have the same condition and my head could not be upright." Mrs Lam lowered her head such that her chin touched her neck. Mrs Lam had physiotherapy in Australia where she migrated with her husband some 15 years ago.

The other stroke classmate had stopped going for physiotherapy in Singapore.

The other is around 70% recovered, judging from my observations of their ability to converse and walk normally but I am not professionally qualified to assess them.

It was a cool Saturday, Oct 27, 2007 evening to meet the classmate who had migrated to Australia some 10 years ago and is now retired with rental income and money and a good sense of humour. He referred to others commenting on his bowl-shaped hair cut with an even front horizontal fringe, said, "it is not what you dress but whether you can pay the bills."

He also said to me when I asked if his Australian house was big, "I guess all of you live in bungalows with swimming pools, landscaped gardens and ceilings higher than 2 stories as I have had been invited only to two classmate's houses."

Of the group, 3 are now living in bungalows with land of over 20,000 sq.ft, but the others had humble residences.

I attended a dinner meeting of a group of classmates from Raffles Junior College to catch up with one who had migrated to Australia. They were around 53 years old. I was the spouse.

2/3 lawyers in the group had a stroke. One was Mrs Lam who had stroke some 15 years ago and is around 90% recovered. She was driving some 9 months after the stroke as she had to take her children to school. The children are now grown up.

"I had 5 botox injections into my right arm," Mrs Lam told me. "I stop after this one botox injection as I don't want to get addicted to this drug."

Apparently, stress triggered her muscle rigidity. She was no longer working but stress could come at any time. She stretched out both hands and said in "sometimes a need to think first voice" that the normal left hand was "longer" than the right hand which was the result of her left-brain stroke.

"Do you still go for physiotherapy?" I asked. I mean, it was some 15 years since she had stroke as my lawyer in Singapore and I assumed that she did not need it. But she still has this muscle contraction in her right hand and arm. She needed physiotherapy and it seemed that she was fortunate that she had a good physiotherapist in Perth where she had migrated.

"How did you locate a good physiotherapist?" I asked.

"One day, an old Australian woman noticed me limping," Mrs Lam said. "She asked me what was wrong with me." The woman asked her daughter who recommended 2 names. As she had seen the doctor before, she chose the other. This is Ms Julie Peck in private practice using the "Feldenkrais" method. Half an hour of massage once a week would relieve her right hand muscle pain.

"Any oil used?" I asked. In Singapore, Chinese nationals and others doing massage for stiff neck for busy executive women use oil to rub out the muscular kinks.



"No," Mrs Lam said. She was satisfied with a physiotherapist. "It is hard to get a good physiotherapist in Singapore," she said. As for the other classmate, he stopped going to the physiotherapist.


From this encounter, I believe that muscles of one side of the body, after or with no stroke, need to be used continually or they contract from lack of use. Otherwise, the person cannot stand straight, like the tree in the picture. Muscles need continuing contractions, like professionals need continuing education.