When you experience a sudden onset of hydrocephalus, as I did in the spring of 2015, you learn that the brain controls many functions beyond thinking and perceiving. Such as, gait. I dimly recall (because much from that time is blurry) telling a doctor that I couldn’t seem NOT to walk like Frankenstein. Typically a brisk strider who left others in the dust, I suddenly found myself lumbering and shuffling like a stiff-jointed cyborg. Not only that. Stairs required two hands on the rail, and, in the dreaded absence of a rail, a steady companion to cling to (thank you, husband). Stepping into pants, a total non-starter. Equally alarming, basic arithmetic now seemed like advanced calculus. I’d been a fit, well-functioning 65-year-old, a writer, researcher and orchid nursery co-owner. I still felt like me, but a vastly impaired version who strongly exhibited the three W’s of hydro – wet, wobbly and wacky. Killer headaches were a bonus. The diagnosis was NPH, though not definitively.
Treatment was complicated by the discovery of a benign brain tumor (acoustic neuroma aka vestibular schwannoma), which may have triggered the hydrocephalus. After weeks in the hospital, growing debility and debate about how best to treat, I got my Medtronic programmable shunt. The tumor could wait.
I’ve never been one for exercise beyond an active lifestyle. I’d dutifully take note of local classes in yoga, Zumba, spinning, cardio, Tai Chi, etc. — and not find time. Yet the idea of Tai Chi had always appealed. There seemed something mystically magical about those serene-looking groups in parks or public squares executing fluid moves in perfect unison. I was vaguely aware that Tai Chi was a defanged form of an ancient Chinese martial art and that health benefits were claimed.
After shunting, I was assessed by a physical therapist who said I was steady enough for a cane. Learning to use it properly was surprisingly hard, and, early on, I sometimes reverted to the walker. A formal PT session provided me with modestly helpful balance exercises and the opportunity to ask if Tai Chi might be therapeutic. The therapist said absolutely.
It didn’t happen right away. The tumor had to be to dealt with (a month of daily micro-radiation zaps) and we were moving from Hawaii to Oregon, a major effort. But once settled, I found a Tai Chi class at a nearby gym. At this point, about eight months post-shunt, I was still a bit unsteady, though long graduated from the cane and driving again. My baseline state was “woozy,” like the tipsy feeling after a strong Margarita. (Not how you want to feel all the time.) Some days were “dizzy days,” others simply lacked the clear feeling I missed so much. Climbing the two steps onto our new front porch, I sometimes wobbled.
My first Tai Chi class was taught by a delightful septuagenarian couple who offered “tai chi for arthritis.” It was a specially tailored version of Sun-style tai chi, considered a gentle form, and it was challenging without being taxing. But after several months, the class was handed off to John McKinney, a certified instructor of Tai Ji Quan: Moving for Better Balance (TJQMBB).
TJQMBB is a set of eight exotically-named movements distilled from the dominant Yang form of Tai Chi by Dr. Fuzhong Li, a scientist at the Oregon Research Institute, now adopted nationwide. (The complete Yang form consists of 108 movements, swords and sabers optional…) Eight movements may sound skimpy, but each is designed to strengthen specific aspects of the three elements of balance: the vestibular system, located in the inner ear and brain; vision; and proprioception, how your body senses and connects with space. When one of these three functions takes a hit, the others can be trained to help compensate.
An official description of TJQMBB says it “… transforms martial arts movements into a therapeutic regimen aimed at improving postural stability, awareness and mindful control of body positioning in space, functional walking, movement symmetry and coordination, range of motion around the ankle and hip joints, and lower-extremity muscle strength.”
This is all well and good, and a bit dry. But to see John McKinney execute the TJQMBB moves is like watching Fred Astaire whirl through a sort of hula-ballet. My classmates and I felt like bumbling blobs in our early sessions. But John excelled at breaking down each part of each movement, explaining the therapeutic elements of individual swivels, slides and lunges. The entire series – including such moves as “repulse monkey” and “parting the horse’s mane”– takes about 10 minutes to complete. Add another five minutes or so for standard warm-up exercises and you have a doable 15 minute daily workout outside of class.
After eight months of instruction, John still adds fresh insight to each movement. Boredom never sets in and understanding deepens. The point, he says, is to integrate thought and motion so that you’re “actively taking control of sensory input.” The “evidence-based” results are improved balance and strength, fewer falls, reduced pain, better breathing and even sharpened intellect. Indeed, Tai Chi’s fusion of learning and performance has been shown to carve out new neural pathways in the brain. (Dancing has similar benefits.) John also notes that energy spent on maintaining balance saps cognitive function. Improved balance helps restore mental clarity.
Turns out, medication can’t treat the balance issues of Parkinson’s and other vestibular disorders, such as hydro and aging. This explains extensive grant funding for the study of non-drug approaches to improving equilibrium and reducing falls, which are a costly public health issue. Among all types of exercise studied, in dozens of trials, Tai Chi ranks at or near the top for physical, cognitive and even emotional benefits. It’s a proven de-stressor, mood lifter and confidence booster. And the social aspect of Tai Chi class is another boon.
Much research has focused on how Tai Chi helps the elderly and afflicted. Stands to reason younger folks dealing with the effects of congenital hydrocephalus could also benefit from the practice. This area appears not to have been studied.
Therapeutic Tai Chi experts recommend two hour-long classes a week for at least 12 weeks. Results pretty much guaranteed, though, of course, the more you practice, the greater the benefit. The Tai Chi form matters not so much. Any of the several types will help, though a certified teacher will assure quality of instruction. And, of course, there’s no shortage of courses on the internet. YouTube is rife with Tai Chi instruction, much of it very good, and free. The Harvard Medical School Guide to Tai Chi: 12 Weeks to a Healthy Body, Strong Heart & Sharp Mind, offers a comprehensive look at Tai Chi’s benefits as well as instruction. My teacher demonstrates his version at www.americanstyletaichi.com.
Unfortunately, I missed having a formal balance assessment when starting Tai Chi. Thus, I can’t offer ironclad proof of progress made. But I can report functional improvements in real life. I’m stepping into those pants in the morning and I’m able to climb stairs with hand just grazing banister. I’ve become a gardener who cruises in and out of plant beds with minimal collateral damage. Haven’t wobbled on those front steps in quite a while and handily navigate the narrow aisles of our new nursery. There are times when I do Tai Chi that everything clicks and I feel taken to a meditative realm where even physical grace is possible. I rarely have that woozy/tipsy feeling. Moreover, I doubt I could have written this, such as it is, a year ago.