different shoes

shoes

It is almost three and a half years since my stroke. Conventional wisdom about post-stroke recovery suggests that the first neurological adjustments and improvements after a brain injury are very rapid, and then tend to plateau off after the first six months. The importance of this “six month window” was often repeated to me by various medical practitioners, and I remember very clearly that one of my biggest fears in the weeks following my stroke was that, some point in the future, I was going to feel retrospectively guilty about not having done enough to maximise my recovery during that time. But every stroke is different, and looking back now, it seems to me that these arbitrary post-stroke “recovery windows” are really of most use to those involved in making ethical / financial decisions about resources and the provision of care. Telling someone who has just had a stroke that they have six months in which to complete the difficult work of neurological recovery to the best of their abilities is frankly not that helpful and can, as it did in me, heighten the general terror and desperation of what is already a pretty desperate time. Very little research exists into long-term post-stroke improvement, and, after the OTs and physios have done what they can, one is pretty much left to one’s own devices. But from my own entirely partial perspective I would say that, though the pace of recovery is certainly much slower long-term, one can still notice improvements two and even three years down the line. Though I am resigned to the fact that my damaged left leg is never going to enjoy running, and that my balance issues will probably always make riding a two-wheeled bicycle impossible, I still occasionally discover that I can do something now that I couldn’t say, six months or a year ago.

Footwear is incredibly important if you have a neurologically damaged leg and foot, and I have found that a really effective way of making improvements in my mobility is simply by changing shoes. A different pair of shoes can initially impede one’s mobility — the gait alters, the foot drags, the limb refuses to make the routine movements that it made just yesterday. But, although effectively heightening one’s own disabilites in this way can be both uncomfortable and annoying, walking in different shoes forces the damaged limb to adapt to different billateral rhythms and movements. The good limb also shows the bad how it has to deal with the minute alterations in weight and pressure forced upon it by its new environment. The good limb helps the bad one on its way.

I tend to walk around 4 miles a day, and until very recently, my choice of footwear was limited to sturdy boots with a lot of ankle support. I could certainly walk a little in flat shoes (with orthotics) but found it difficult and tiring. Often, after a mile or so in flats, my left leg would simply give up and revert to its dead, dropped state while the right one carried it hesitantly and judderingly along. Then, in February this year, I decided to try an experiment. I would alternate my footwear daily, completing my normal walking routes in several different pairs of shoes and boots, including flats. This wasn’t particularly easy, but I noticed that after just a couple of weeks that my left foot was adapting to the changes forced upon it more rapidly, and that I could walk further without problems in shoes I was unable to before. I also found that these continual changes and adaptations helped with other, non-walking activities, such as pointing my toes in order to put on a pair of socks or pants (a gesture I have found frustratingly impossible for the past three and a half years). Then I discovered that I was able to hop (albeit briefly and inelegantly) on my left leg for the first time since my stroke. I continued with the footwear changes: things continued to improve.

In March, I bought the pair of sandals that you see above (shamelessly copying Jen, who had recently acquired a pair). They are a great fit and very comfortable but when I first stuck my orthotics in and started to walk, my left foot flapped about, clown like, and after a mile or so I’d be limping and dragging the foot quite badly. But I gradually forced the unruly foot to adapt by including the sandals in my alternating-different-shoe routine. By April, they had become my go-to shoe, and since then, I’ve walked over 350 miles in them. Last week I encountered one of my good dog-walking buddies, an elderly gent, who I first met three years ago when I was still getting about with a leg brace. As we were passing the time of day, he remarked on how very much my walking seemed to have improved of late. I was aware of this, but it was nice to hear it. “I’ve just been wearing different shoes,” I said.

I am repeating this experience for those with brain injuries or other neurological impairments who have been told that their recovery period has a window, or that it is somehow at an end. I honestly don’t think that the work of neurological recovery or adaptation will ever be over for me. I will certainly keep forcing the parts of my body and brain that were damaged by the stroke to make whatever small improvements they can. I’ll keep on wearing different shoes.

Because I know you will ask, the sandals are made by Red or Dead, and are a style called “Jade”. The socks are a pair I knitted from Rowan Fine Art sock yarn, and are holding up remarkably well to their daily mileage.

foot forward


(Photograph taken January 9th, 2010. I had my stroke a little further along that same path a couple of weeks later.)

Well, for those of you who were interested in the coat, it is from Cabbages and Roses Autumn/Winter ’09, and it is probably my favourite garment in my wardrobe – I absolutely love it – not least because its fine woollen cloth was woven in a mill in Delph, close to where I grew up. I was actually wearing that coat when I had my stroke on February 1st. It says something about me – or perhaps just about how much I like it – that one of the first things I did when poor Tom appeared, ashen-faced at the hospital, was to ask him to check if my coat was ok. There was a small tear in the lining from when I fell over, but the coat of dreams was happily otherwise unscathed. That anecdote will suggest to you (if by some miracle you didn’t know already) that I am very attached to my clothes. I suppose this is true of everyone, to a greater or lesser degree, and everyone has their preferences and foibles. I think of myself as someone who loves coats and dresses most of all, but I am also very fond of shoes. I’ve now decided to get rid of all the pairs I can no longer wear.


(Remember these?)

The bits of me that have been most obviously physically affected by the stroke are my leg and foot. I can mostly get about just fine, in a lopsided sort of fashion, but the ankle has no stability and the foot and lower leg have quite a limited range of movement. I have some great orthotics which stabilise the ankle, and with them I can now walk in a reasonable range of shoes that are entirely flat – any sort of raised heel sends me woefully off kilter. Now, I really feel very lucky to be able to walk at all, and, being a committed walker, appreciate the sturdy, reliable qualities of a good, comfortable shoe or boot. But I have many shoes in my wardrobe that do not fall into this category. Even the pair pictured above – whose virtues I celebrated in a couple of posts from Philadelphia last year – are now unwearable because of their unsupported sides against which my left ankle flops uselessly. If I can’t walk in those shoes, imagine the insurmountable challenge that is posed by these babies:

When I came home from hospital, I put all such shoes away so that I didn’t have to look at them. But I’ve been unable to pretend that they’re not there. For several weeks now their dumb presence has been really annoying me. I feel that there are things I have to do – big things like looking forward – that these shoes are preventing me from doing. Somehow I have to get rid of them, to accept that I am now a person who will walk into the future on the flat and not in any sort of heel.

In all cultures, footwear is deeply symbolic, and I can understand many of the obvious Western feminist arguments that have been made both for and against high heels. Personally, I have never regarded them as agents either of empowerment or oppression, but they are certainly bound up with my identity, if not my femininity. Like all special objects, they are invested with individual significances, and each pair has their history – a set of meanings tied up with the moments of their wearing. There are the shoes I kept for conferences and interviews, and regarded as being ‘lucky’; there are the shoes I liked to to teach in; the whacko pair bought just for fun. . .

. . . and the pair I got on a whim, and had been sort of saving for a very special occasion.

This blog has also kept a record of my shoes, and different pairs have accompanied many different hand-made garments and occasions over the past few years. There are blue shoes in this post; the fun red pair that I am wearing on my birthday here; the suede stilettos I wore when modelling Manu, and another green pair of which I was particularly fond.

Perhaps this all seems rather vain and self-regarding. Perhaps it is. I say again that every day I feel immensely lucky to be able to walk – and indeed to be alive. But I wouldn’t be human (or perhaps I just wouldn’t be me) if I didn’t have the the odd wallow-y moment of regret for what my leg and foot could do before. These shoes – these objects, these ornaments – are bound up with that regret, and that’s why it is now time to say goodbye. So a few days ago I took a deep breath, photographed seventeen pairs of shoes and boots, shed a few tears, and put them up for sale. When I mentioned I was thinking of doing this a few weeks ago, several of you emailed me to ask about it, so if you are in the UK and fancy a pair, you can find them all here. Please don’t feel weird or sad about this – I’m sure you can see that it is an entirely positive and necessary step for me, and I intend to buy myself a fabulous pair of flat-heeled boots with the proceeds.

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