Brief Answer:
So glad to hear that after so many years you can still regain function

Detailed Answer:
Thank you for your question which as I understand is your desire for a neurological explanation of some improvement or return to normal/near normal functioning of your right limbs which had suffered from what seems to have been a major stroke in 1974. You were 18 years old at the time. This would suggest that your MCA (middle cerebral artery event) event was likely caused by a blood clot phenomenon and this could've been due to either being HYPERCOAGULABLE for some reason such as metabolic derangement, enzyme deficiency, factor disorder, or a even anatomic disorder such as a patent foramen ovale. Of course, there are other reasons why you could've had your stroke and I am not really trying to pin down the exact cause in this discussion.

At any rate, back in those "old" days of stroke therapy....we had very little to offer patients except aspirin and of course, heparin and coumadin which we overused like crazy for patients who we now know should never have received those drugs since we've learned so much more 30 years later.

However, in your case since I'm going to assume you had an EMBOLIC type of stroke due your young age I am also going to say that typically speaking the long term residuals (especially in younger patients) are easier to come back from and even recover completely depending upon the severity of the initial insult, rapidity of treatment and intensiveness of initial physical therapy.

Stretching exercises from weakened or even paralytic limbs are always recommended since this action causes a POSITIVE FEEDBACK to the area in the brain which has been stroked and since embolic strokes in young people tend not to be as devastating in the long run it is possible to keep the peripheral regions of brain matter to the stroke core active and functional just by doing stretching exercises. Of course, my opinion as a neurologist is that I prefer to see my stroke patients get involved with not only stretching exercises but full blown exercise activities as well as utilizing electrostimulatory devices and in select cases FINE ELECTRICAL STIMULATION implants into paralyzed or severely weakened muscles that can be constantly or near constantly stimulated without having to go necessarily to physical therapy sessions.

I 100% concur that if you have experienced improvements over the past several years by learning techniques of relaxation and stretching that those actions themselves can have a large impact on overall mobility, however, it doesn't entirely XXXXXXX me that you can tell this story. Whether it is really due to a dopamine surge or not is unclear at this point. I would add that applying techniques of stress management and relaxation induction not only to muscles but to the psyche can alter neurohormonal and neurotransmitter levels. Getting good sleep and protecting the circadian rhythm in order to help hypothalamic set and reset function (especially after strokes) is also critical to good and complete healing.

Keep doing what you're doing and even set a goal of GAINING strength and stamina doing aerobic and cardiopulmonary types of exercises...swimming is one of the best followed by cardio circuit training. Weight lifting is not THAT ESSENTIAL to stroke rehabilitation but using light hand dumbbells doesn't hurt if you can lift the weights.

If I've provided useful and helpful information to your questions could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating? Again, many thanks for submitting your inquiry and please let me know how things turn out.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 44 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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Brief Answer:
Many thanks for your complimentary comments

Detailed Answer:
Many thanks for your appreciative comments. I am glad that the answer was of value to you and helped you gain some assurances in what you were looking for; to be sure thank you also for clarifying the clinical situation because it was a bit challenging to try and guess exactly what you were referring to as I was thinking about your story and how to possibly explain things.

Let me respond to your comments in reverse order and tell you that to my knowledge I've never heard nor read about a case where a patient produced EXCESS dopamine to the point of causing serious complications or even death as you seem to be asking. Certainly it is true that dopamine in the circulation has positive hemodynamic effects on the cardiovascular system and one might choose to hypothesize that such a surge in this neurotransmitter could cause the heart to beat stronger or faster with an increase in arterial blood pressure. But in reality the amount of dopamine that the brain produces is rate limited by the stores of certain amino acids such as phenylalanine and tyrosine which are necessary in order to produce dopamine by the striatal neurons.

There is no chance that the body (no matter how well it might be feeling or functioning) could produce enough dopamine to cause some type of cardiovascular collapse. The amount of the precursor amino acids needed to produce the final product is simply too much.

You've pointed to an important physiological principle known as RECIPROCAL INNERVATION where reflex movements or muscle contractions of one muscle or group of synergistic muscles (muscles that coordinate together to move a limb or body part) can be overcome by STRETCHING those muscles (usually forcefully) to a point of overriding the signal of contraction in the opposite muscles. This is the reason why a XXXXXXX Horse (spasm of the calf muscle) can be overcome by pulling on the toes in a forceful backward movement of the foot. That STRETCH will neutralize and "cancel out" the spasm going on in the calf muscle and there is near immediate relief. I believe the same phenomenon is what explains your situation as you've described it.

Stretching exercises as YOGA teaches is often an overlooked but very iimportant piece of the rehabilitation puzzle that few patients or doctors really buy into but you are the proof that this activity is absolutely essential and worthwhile to perform on a lifelong basis following any sort of injury whether it be from a STROKE resulting in an MCA stroke ( HA!)....vs. a motor vehicle or pedestrian accident..also MCA in your neck of the woods.

I would love the chance to meet you one day in the Southern Hemisphere of the globe...or perhaps you'd find a fancy to take a jaunt up North of the Tropics of Cancer and Capricorn and visit here in lovely XXXXXXX OH!

I applaud your tenacity and perseverance and hope you will keep this up into the future which will keep you limber and help in maintaining symmetry and smoothness of movement.

Cheers!

Once again, I've hope that I've answered a question or 2 more and provided some insights to your condition that will be useful to you in the future. Any additional feedback on these thoughts are greatly appreciated and as always you may contact me at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 80 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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Brief Answer:
Many thanks again for your kind remarks

Detailed Answer:
I once again- thank you for the opportunity to offer my services and am honored and flattered by your belief that my comments have helped you in some way. I am confident that you will continue realizing improvements and changes into the future because indeed the central nervous system is indeed adaptable to ongoing stimulation.

I will leave you with information on an actual published study some years back which took aging laboratory rats considered to be suffering from advanced forms of dementia and showed that after about 8 weeks of intensive work and supervision with trainers and "teachers" that they were able to successfully run the mazes....DESPITE BEING CONSIDERED DEMENTED!

Moral of the story? Perhaps, the old adage, "You can't teach a dog new tricks" is true and well respected from the 20th century lore of knowledge and common experience BUT perhaps the 21st century scientists have found a way to "Teach Old Rats new tricks" based upon the time tested principle of REPETITION, PERSISTENCE, AND NEVER GIVING UP even when your body says that's enough!

You Go Girl!

Cheers young lady!

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