Friday, January 22, 2016

Talkin' 'Bout (the Circle of) Willis

Let's talk about the back of the head.

The Circle of Willis is a series of arteries connecting critical feeds of blood to the brain. When a connection like this is created in the body--whether it developed that way or was created--it is called an anastomosis. An example of a synthetic anastomosis would be if someone had a section of intestine removed, and the two remaining sections were joined together.

In the Circle of Willis there are smaller arterial sections that would allow certain sections of the brain to be fed at least a little bit by arteries that wouldn't normally be tasked with doing the job, in the event of a failure like a stroke or other trauma. Smaller segments within the Circle of Willis are fed by the internal carotid arteries and the vertebral arteries. The internal carotid arteries are split off from the carotid arteries.

Here's a video. If anatomical terms aren't your thing, just watch as the video highlights where the blood goes.

We always talk in martial arts about protecting your face. Keep your hands up. Protect your jaw. Keep your chin slightly tucked. But all we say about the back of the head is not to let anyone get behind you. We know it's important not to get hit in the back of the head, or in the spine. Perhaps a lot of us would get psyched out if we all knew how catastrophic any blow can be.

Some of the people I support at work have survived a traumatic brain injury. Knowing the science behind their situations may not be at the forefront of my work with them in rehabilitation, but it does help me to be compassionate about what they may be going through, because I know what is damaged and why. I also know more about what can be rehabilitated and what can't. Because I am not a neuroscientist I cannot allow my novice understanding of anatomy to impact the recommendations I make, but it can help me ask better questions of those who are qualified to provide better information, and /that/ can improve my outcomes.

In karate, I use my knowledge of anatomy and physiology--and my knowledge about how my body breaks so many of those rules--to learn, grow, and adapt. When I know how serious a consequence can be, I know to sit out. Knowledge is power, and as Uncle Ben said in "Spider Man," "With great power comes great responsibility."

Last night I made it to karate and I'm glad I did! I did my first successful groundwork. It feels good to have studied anatomy and physiology. It feels incredible to see it in action. Best of all, it feels sublime to watch my lawless body doing what other bodies can do.

There are so many factors involved in success as a martial artist: how my body is built; how bodies are supposed to work; how bodies don't work; how bodies can be improved; how bodies can degenerate; how adaptions can be made; how practices can be improved; and so on, that it makes sense to say that karate is a cradle-to-grave activity.

The body has a lot of little fail-safes like the Circle of Willis. I enjoy learning about those redundancies, and I think it's a worthwhile use of study time because it also reveals the vulnerabilities.

Saturday, January 16, 2016

No Excuses

"No excuses" bugs the hell out of me. Some "excuses" are bona fide reasons, and this saying hurts what is already tender enough. It does not motivate me one bit. It's doubly offensive when it's superimposed over a person with a disability going about their workout routine in an effort to get able-bodied people motivated by their guilt about not going to the gym. There, I said it.


How Can I Do Karate?

Last Tuesday I made it to the dojo for the first time in two long, miserable months! I was excited and terrified. No one around me seemed particularly surprised to see me there, and no one seemed to notice (until I opened my trap about it) that I was on hyper-alert. I was afraid of dislocating, passing out, or having my blood pressure plummet. For the start of the class I had fluids running and was parked on the bench until I could no longer sit up. Then I sat on the floor, propped up in the corner. Eventually the spasms got to be too hard to stifle, and I lay down on the floor, continuing to work in the air. For the end of the class, while we practiced kata in small groups, because I was able to take care of myself, I finished the class on my feet, leading Seiyunchin kata. I felt like a million bucks, and if anyone was fighting that day like H-E-Double-Hockey-Sticks, it was this guy. Nobody hassled me, nobody even looked, except to see that I was okay whenever I cried out in pain. Nobody thought it was unusual, or was distracted. After class was over, I got a couple of "Nice to see you"s and that was that.

EDS makes a person self-conscious. EDS does not have to make a person self-conscious. EDS does not deserve to make me self-conscious, because I am a Titan. Better still, I am a karateka. One is fictional, and one is not.

My blood pressure has been crashing to scary-low numbers, so I have been eating bouillon cubes to keep my blood pressure up. Chicken bouillon cubes. Normally I just drink the broth, delicious and sensible. But broth means volume, and volume means vomit. So, while my guts aren't Barfatron Central, I don't want to do anything to rock the boat and start the gastric spin cycle over again. My aid has been working with me to organize small meals that are what the medical field calls "nutrient-dense," but foods that are low-volume and easy to keep down. The easy solution seems like one would write a list of foods that stay down, and work from that. While that's a sound start, gastroparesis doesn't work that way; at times it doesn't matter what your intake, your output will always come out in the wrong direction, and you'll just have to have a little mercy for the fact that biology still has many mysteries.

My friend asked me, "How can you do karate with your health?" First I came up with a very fancy, clinical answer, then I came to my senses:

It's quite incredible, really. I have strict rules with my Sensei about every little thing: where is the best place to keep water and medical supplies, where to stand in front so I can lipread, how long to bow out for care and recovery. I only work with black belts, as they have the best control over their flying limbs. I keep my promise to take a break when I honestly need to. If I need to drop to my knees and finish a drill that way, or on my back, I can. As long as I keep doing whatever I can do, I get to play the reindeer games. :) When my legs don't work and everyone's kicking, I do punches that are similar to the kicks. Usually I'll do a few rounds of each drill as best I can, and then adapt when I know I'd peter out if I were to continue. Certain things are off limits, like being dragged around by my head, or certain conditioning that is deliberately intended to damage nerves. If it's not something I can adapt I just politely bow out and people reshuffle. I have a hiking backpack that I can secure well to my back while I'm exercising if need be, as well. Sometimes I'll do that, sometimes I'll just crawl to the floor next to the bench, put my feet up to push blood back to my brain, and work with my arms.

You know what? The real answer to your question isn't what I just wrote. The real answer to your question is that everybody supports me and adapts with me. Not even once have I been given a hard time for not being able to keep up. I have asked myself a thousand times whether I really deserve the belt I have. The answer is that I do, and I don't know anybody who would be able to perform like I do if they had my challenges. It's because of my dojo, that's how I am able to do karate.

His response:

I love both your answers to my question - particularly the second. "Everybody supports me and adapts with me" pretty much sums up the ideal society, whether it's a dojo or a nation. In a culture that reifies "individualism", it's great to know the community still has a place. And frankly, I think this is good advice for anyone: "Nobody drags me around by my head".

I also love your blog. More precisely, I love your love. It makes your life rich and full, and makes people like me want to be your friend.

That's a pal.

This morning I missed karate because of exhaustion and pain. But sleeping until 2pm seems to have given me a little energy to care for myself, and to refresh my brain. I'm not going to miss karate forever, and I'm starting to forgive myself for the absence, because every move I make is aimed at getting me back there, while doing good works in the meantime. I'm working on projects and learning new skills, which is working for me. Additionally, although I'm not ready to do drills, I still do juunbi undo (warm-ups), read Higaonna-Sensei's books, and study my kata. Today the class was not to be. Tuesday I'll try again. Twice a week is the target, but once a week may have to do for now.

Karate is not something you study on your own, you need a community. My Sensei has given me a worldwide community to learn with and connect with, including some people like me! My dojo is right here in my neighbourhood, and my community at large is just a few keystrokes away. This is good for me, and I'll keep at it, looking forward to returning as soon as possible.

Be well.