Routine is so important. So is sub routine.

There are so many similarities in Amanda’s situation and recovery to the way a computer works.

The brain bleed was like a piece of badly – written code; corrupting existing data and stopping the program from working correctly –  stopping it from executing existing code, saving information and subsequently retrieving it.

But somehow, luckily in all the chaos and uncontrolled trauma her brain, most likely assisted by the early intervention of the paramedics, managed to save a backup somewhere else.

At some point a few hours after her initial bleed, her brain initiated a ‘reboot’ –  and started to re-install the saved data. But instead of using the operating system she previously had –  Windows 10, her brain was now running on an old saved copy of Windows 95 –  on dial up.

Over the last 7 months Amanda’s brain has been slowly and steadily reinstalling, recompiling and downloading new versions of the data and information she has spent the previous 53 years using to run her life.

On some occasions she has gone straight to the latest software version ( language, vocabulary, grammar etc).  In other instances she is gradually working her way through old versions until her brain is ready to install a newer one. This applies both to physical capability and mental agility.

Thinking of stroke recovery like this helps to accept you don’t get the same person back. you get a different version depending on how much of the original programming gets reinstalled.

It’s like the story of the gardener who proudly boasts he’s had the same spade for 50 years. “I’ve only had to replace the handle four times and the blade twice.”

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Routines, repetition and sequencing are vitally important in re-enforcing everyday tasks; dressing, showering or making meals. Over the last few months Amanda has progressed by remembering routine and relying on her brain to recall what she used to do before the stroke.

The importance of this was demonstrated to me on Saturday.

Monday to Friday is an almost identical routine which helps to heal her brain. While weekends are slightly different (the times are different and the speed a bit more relaxed), the sequence of actions is generally the same.

But this Saturday was different.

Since last week’s visit to the local hydrotherapy pool was so successful we’ve decided to make it a regular event. 8.00am, before all the small kids start arriving for their weekly swimmimg lesson.

After 45 minutes of gentle bouyant exercise we were back home and decided to have breakfast before showering. Finally, as Amanda entered the shower she was back into her usual routine for the first time that day.

She washed her hair. Then…stopped. For a moment it was as if her brain had hit ‘pause’ and she stared at the blank wall of the shower.

“Now you wash” I prompted her as she looked at the various bottles.

“Pick up the shower soap, the white bottle and squeeze it on the sponge.”

…and she was back online.

I’d broken the routine. Altered the sequence of her usual morning ritual, and the program didn’t now what to do next.

 

We take our daily routine for granted. But we have it for a reason.

If something slightly different happens, it throws us off balance. An unexpected diversion on the drive to work, the first night in a strange bed or the sensation of new shoes. We all react in small, almost imperceptible ways to these small changes to our everyday lives and move on, often without even noticing.

But in the brains of stroke recoverers, these can be impossible to deal with…yet.