• Paul Fink

Stairway To Heaven

'Yes, there are two paths you can go by but in the long run, there's still time to change the road you're on - and it makes me wonder'... (Led Zeppelin - Stairway To Heaven)

My life was planned out nicely six years ago - a new seven-month baby and a bigger brand new double-story house, but all of the sudden - six weeks after moving in - I had my stroke and our plans were unraveling before our eyes. Obviously, I survived the stroke (just!), and luckily my family (and the house) were waiting for me after six months of inpatient rehabilitation.

The bedrooms in my house are upstairs - including my bedroom and the kids' bedrooms - so using the stairs was very important for daily living. At this stage, I was walking (with a stick), my mobility was pretty poor but I was very keen to not change my house with modifications. Our staircase has rails but only one side (on the left side for coming up). My stubborn thoughts were still thinking about my independence and trying to be ‘normal’, so we decided to not change it. However tackling stairs was a little bit tricky in the beginning, but definitely not impossible.

I was able to climb the stairway upstairs - mainly using my strength and holding the rail - but coming down the stairwell was very difficult because I couldn’t use my (affected) right arm for balance. Therefore my strategy - with my physio’s advice - was walking sideways for every step in coming down the stairs because that way I can hold the railing. It was a slow progression - especially after removing my AFO dependency - but I was pretty happy because using the stairs was a necessity.

I used this method for roughly over three years after the stroke. Looking back, and living in my home for six years, our staircase was a blessing in disguise - basically every step (up and down) was a tiny bit of physical therapy. Funnily and pleasingly, this sideways method is still applicable for me in the current day and, in fact, I used this method during 1000 steps at the Dandenong ranges last year for tricky parts of the downward climb.

I lost lots of brain cells after the stroke and I have lots of deficiencies in my right side of my body and I think my genetics are still not communicating with my other body parts. I have a little bit of drop foot, spasticity and very poor sensation in my right leg and ankle, so if not using aids (eg AFO, ankle braces), I am prone to roll my ankle because I have inversion occurring at my ankle joint. Essentially sometimes I can't tell if I'm touching the floor or not.

It is a pretty scary feeling - especially when I can't physically see the leg and also trying to walk (or run) looking up - it is a better technique overall. Almost feel a ‘leap of faith’ in my legs, but I quote Dr Henry Jones Snr [at Indiana Jones movies]...I ‘must to believe’... I still have very poor sensation, but with repetition movement and help from my physios (and Dr Jones!) - ‘I believe more’ and it is a pretty good feeling.

One curious thing about using stairs is that it is a big difference between coming up and coming down [the stairs]. My natural tendencies are more scared of coming down the stairs because I'm risking myself getting hurt because of gravity and falling forward - but also my body uses different muscles and strength points. I have pretty good strength with my quadriceps muscles to propel upwards but my hamstrings and calves are not firing well yet and still problematic for propelling downwards. Basically I need my good leg to bear my body weight as lowering my affected leg. That’s why coming down stairs is so much harder versus coming up.

My physios at Caulfield Rehab taught me to lead with your stronger leg to walk up the stairs and your weaker leg to walk down. Or the common phrase of physio community uses the technique ‘up with the good to heaven, down with the bad to hell'.

This was very great advice and after starting my running group at Epworth rehab in 2017, I was exposed to lots of repetitive stair exercises including - Climbing up stairs, descending stairs, continuous flights of stairs, practised with no rails, two steps at the time, etc. Initially I was pretty terrible but, with practice and repetition exercises - I was improving a lot and I am still using these methods almost daily.

2017 was a big year with my family. My youngest son, Harrison, was born and I want to be more independent with him so I needed to carry him up and down the stairs. In order for me to tackle the stairs holding him, I had no free hand to hold on to the rails, so I had to take each stairs carefully, stopping on each one.

More recently - he is 2 ½ years and more mobile - and wanted to do the stairs himself, standing up. When he goes up the stairs, it's no problem for me but when he goes down it poses a bigger challenge. So my method is to walk down backwards while I have my functional hand supporting him if he trips.

So from six years ago only being able to walk down the stairs sideways so that I can hold on, I now can walk up forward, down backwards, down forwards without holding on and supporting my son (if needed), therefore I am very satisfied thankful with my continuing progress and I hope I will never plateau.

Paul

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