That Moment of Inattention

How often do we let our minds drift off while we are doing something? Usually the results are benign. But sometimes they trigger a jarring setback. Mine came while I was riding my bicycle alone. My brain and hands were not focused on my handlebar, and when my front wheel encountered a dead rat, I turned abruptly and slammed into the roadway.

xrays after pinning of trochanteric hip fracture

After a week in hospital, there was a week in convalescent care at my parents' home in Vancouver. Then home to Surrey and re-deployment of my helping army. No shortage of work. Cooking, cleaning and driving. I continued to phone in to conferences and hold meetings in my living room. Office practice was out, and Dr Oriee kindly took over my patients for the next 3 months while she was building a practice of her own.

Recovery was complicated by infection, skin reaction, and high-dose antibiotics and steroids. But recovery did occur, and soon I was on my stationary bike and swimming in the pool.

Riding towards the light

During this time, there was ample opportunity to reflect. I was told, "You didn't get it the first time". Reading, planning and sleeping became the order of the day.

Greek Easter with lamb roasting on the spit

Peace Arch Foundation Fundraiser CODE BLUE

I'm now getting back to work, armed with new lessons learned.

Instructions for living a life. 

Pay attention. 

Be astonished. 
Tell about it.

― Mary Oliver

The Gift of Neuroplasticity

The lifesavers called chemotherapy and radiotherapy have side effects. One is chemo/radiation brain, also known as brain fog. If you get both treatments, as I did for lymphoma, that effect can be greater. 

So, what happens? We know that some of the connections between neurons—brain cells—are lost. That leads to losses in concentration, short-term memory and multitasking.  The effects may be compounded by depression and/or post-traumatic stress disorder as patients come to grips with their new reality. 

Functional MRI showing changes in the brain after chemotherapy

I certainly experienced this after my therapy and release. After four months in hospital, I was thirty pounds lighter than when I went in, and I could barely climb the stairs, let alone deal with complex cognitive tasks. Good nutrition and daily exercise enabled me to return to work after another year, but I was not up to my usual speed.

Then something happened. I changed my bike route, a trail through the Watershed Park that I routinely took for daily exercise. When a fallen tree blocked it one day, I took a different trail. As I rode along, a memory appeared, a joyful recollection of riding along that path years before with my then-young son. A connection to my earlier life had come back. I tried another trail. Same thing, that time with a painful memory of falling off my bike and dislocating my finger.

I explored trail after trail until a flood of memories overwhelmed me. It told me that the key to full brain recovery is rooted in stimulating old memories and challenging the brain in creative ways.

That led me to research. In the past, it was thought that damage to the brain is permanent. Over the last decade or so, the concept of neuroplasticity has gained traction. Neuroplasticity is the ability of the brain to adapt and change by modifying existing neural networks and creating new ones. The neural network is a pattern of connections of neurons that fire in sequence and allow us to accomplish complex tasks. "Neurons that fire together wire together" (D.Hebb).

The complex network of trails in the Watershed Park. Using a variety of trails has revived a variety of connections. 

The complex network of neurons in the brain (schematic). Using a variety of pathways strengthens a variety of connections.

This brings us to BDNF, or Brain Derived Neurotropic Factor, a protein that supports the survival of existing neurons and encourages the growth of new neurons in the brain. We know that BDNF is increased with regular exercise and the ingestion of omega 3 fatty acids as found in oily fish. It looks like that effect is far greater when the exercise challenges the body and mind in new and interesting ways every day.

So let's get out our old Eric Clapton albums or get out and Zumba or take some new old routes.

Steve with Al Jenkins after R2S