Not par for the course

Not par for the course: After suffering a debilitating stroke, most people would at least consider giving up on their most athletic hobbies.But for Walpole’s Musa Pam – who rehabbed in Norwood – the stroke didn’t slow him down. Pam earned his spot as one of the best one-armed golfers on the continent after winning the North American One-Armed Golfers' Association annual net championship tournament this summer in Gaylord, Michigan.Pam suffered a stroke in January 2012, and since then has

2017 Massachusetts Maritime Academy Alumnus of the Year - Musa Pam

Former men's soccer standout Musa Pam named as Academy's 2017 Alumnus of the Year https://t.co/m9GnzSFe70 #d3soc #BucNation pic.twitter.com/W50eRcCmYF

— MMA Buccaneers (@mmabuccaneers) November 2, 2017

          What an honor - the greatest of my life - it was to be named the 2017 Massachusetts Maritime            Academy Alumnus of the Year!

Does Botox Work for Stroke? A Holiday from Botox and Baclofen

Does Botox Work for Stroke Spasticity Treatment? A Holiday from Botox and Baclofen

As I sat in the busy waiting room of the Neurology Center of New England for the 17th round of quarterly Botox injections in my arm, calf and quad since my stroke over 5 years ago, I pored over the bulleted questions I had drafted for Dr. Salvatore Napoli on my phone's One Note app. Dr. Napoli was running behind. Vivian the Nursing Assistant took my vitals next, and I was pleased to see a low BP of 115/62. Back to waiting.

Shortly after, I went into the exam room, and Dr. Napoli was his usual effusive self. "Musa!  How are you?" What's new?" Then he proceeded to apologize because Cigna hadn't sent the right dose of Botox. I told him I'd received a letter from Cigna saying they had approved  Botox for a year. I then told Dr. Napoli about my doubts regarding the effectiveness of Baclofen. For some reason, the request for a new Baclofen prescription from Express Scripts took longer than normal, and I'd waited till the last minute anyway. I'd called Nancy, the awesome quarterback (she hates football) of all things out front, and she took care of it last week. I was quickly running out and was tracking the medications online on their trip from Arizona up to New England, but the weekend put a damper on things. I knew I could get a short-term supply from Walgreens around the corner, but I decided against that. So I tapered my dose from 12 to 4 a day towards the weekend, then about 2 a day from Saturday to Monday, resuming with 12 on Tuesday when they arrived. I thought it odd that I had not felt any ill effects or increased tone or spasticity. In fact I was continuing with my activities of daily living (ADLs) as normal. I was getting reasonable finger extension in the pinky, index finger and thumb as usual, more than the ring and middle fingers. I had also researched Baclofen withdrawal online, I told him. Plus, I recalled how we had kept increasing the dosage to the point we got to, while I was looking for the effects to show, and he had said we could go as high as possible until I felt too much fatigue and other negative effects.

Dr. Napoli then asked if I'd noticed that the Botox was wearing off. I told him that since we started the injections 16 quarters ago, I'd never seen that effect kick in about a week or so after, as was to be expected, so there was nothing to wear off. He asked if I knew about the Baclofen pump. I said I did, and we'd talked about it before, that it it was implanted and administered intrathecally (through the spinal cord). I asked about the Botox alternative he mentioned before called Dysport.

We discussed occupational therapy with Maureen, and I told him she was great, but at $50 per visit, it was not tenable for me. I'll continue exercises and working in the gym 3 times a week.

I learned a new term: my affected side is 'hyperreflexic,' meaning it's more jumpy than my unaffected right side. After watching me walk in the hallway and examining my reflexes, strength and tone, he suggested given what we know, whether I shouldn't just go on a holiday from both Botox and Baclofen. I agreed and didn't see why not. I live just 5 minutes away, and could come in on short notice if need be. 

I told him my insurance would also be changing, so we'll see what happens with a new plan, but I'll try and replicate what I have now.

So there it is... for the first time in over 5 years, I'll be off Baclofen, and for the first time in 51 months, off Botox. He'll see me again in about 8 weeks. 

I told Nancy all about it on the way out, and in her sweet, affable, grandmotherly way, she said "Are you sure? well he's a doctor and he knows what he's doing. You've made so much progress, we don't want to backward!" I agreed, reminding her how I had first been wheeled in on a wheelchair back in February 2012. No, we're going on a holiday, but we're not going backwards.

Stroke Survivor Activities of Daily Living - Replaced Toilet Flapper One-Handed

Stroke Survivor: My Three New Years, Five-Year Strokeversary Edition

Stroke Survivor: My Three New Years - Third Edition, Five-Year Strokeversary Edition

MUSA PAM·SATURDAY, JANUARY 21, 2017

This is an update to the first two notes I first wrote about in 2014 and 2016. My

“Three New Years” all occur in January. They are the traditional New Year, my birthday, and my stroke anniversary, a.k.a. strokeversary or re-birthday - on the first, sixth and twentieth respectively.

1) On the first day of the year on the modern day Gregorian calendar, I joined billions around the world in that ritual of shedding the old, while welcoming the new. As usual, I had many blessings to count - including life and limb; health and wellness. I had a roof over my head, nourishment, access to many luxuries and a job to help provide those things. More than most, I enjoy the love of family and the support of friends. This year, I also welcomed the opportunity for other new beginnings as my fifth resolution.

2) On January 6th, I celebrated my second New Year. Being so close to the more popular New Year, it's always offered me an opportunity to re-calibrate the commitments I made five days earlier. This also marked the eighteenth anniversary of my dear Mommy’s calling to be with the Lord. It offered yet another opportunity to reflect upon the values she instilled upon her seven sons, and the example she set by her faith, words and deeds. As I remember the eulogy I gave at her funeral in 1999, some of the lasting memories I recall were that of her selflessness in serving those who were less fortunate than her. She was a devoted member of the St. Piran's Church (Jos, Plateau State) Choir, served her country on a major Nigerian financial services board - National Economic Reconstruction Fund (NERFUND), regularly visited prisons, helped beleaguered women and children, helped countless relatives, housegirls and houseboys (household help) attend school and establish meaningful careers, volunteered with the Red Cross, serving as Plateau State Chair, chaperoned many a young bride through the protocols of her wedding day, child birth and child-rearing, all the while regularly giving to the needy - Christian and Moslem alike. She was absolutely the best mother in the world.

3) On this evening five years ago, I suffered a cerebrovascular accident (CVA), a.k.a "Stroke" after arriving home from work. This year, I mustered the courage to visit Norwood Hospital to obtain records of my hospitalization, so I could better understand what I presented at the ER. Without going into too much boring detail, I was a 41 year old Nigerian/African/young/pleasant male (yes, these were all descriptions in the notes) with no history other than GI disease. I was a social drinker, and a pack-a-day (conservatively, I’d say) smoker). It was noted that I had a family history of stroke, given that Dada (my dad) had suffered a stroke (in Jos, Nigeria) at age 55, from which he never recovered, dying 3 days later. Additional history that I reported noted also that mommy had died (also in Jos, Nigeria) at age 57 from a brain tumor, and that our youngest brother Timothy also had been diagnosed with a brain tumor (which was successfully surgically treated in London in December, 2008). We thank Almighty God every day for Timothy’s life, and for the intervention of our late Aunt Elizabeth Pam in ensuring that he received the very best care befitting of her late little sister’s “baby.”

The official cause of my stroke? It wasn’t immediately apparent. I was transported by Emergency Medical Services (EMS) and presented at the ER between 9:30 and 10:30 p.m., having called EMS to report that I felt I was having a stroke. In the ER, I exhibited signs of a right brain stroke, with left side weakness ranked on the National Institutes of Health (NIH) scale as a 2.0, which was relatively low. I had demonstrated some strength in my left lower extremities, as well as my left upper extremities. This development, along with the time that had elapsed, essentially took me outside the window for administration of TPA, a clot-busting drug administered to stroke patients within 3 hours or so of showing stroke symptoms. The ER physician and the on-call neurologist consulted with the Stroke Team at Boston’s Brigham & Women’s Hospital where I’d been a patient, and the determination was that outside of the time period, TPA administration would be considered “off-label use.” After an initial set of lab and radiological exams, I was administered Aspirin, Lisinopril and Simvistatin (drugs that act as a blood thinner, high blood pressure treatment, and cholesterol lowering respectively), then admitted into the Cardiology Unit 33 for ongoing observation and telemetry. Thereafter, by 5 a.m., I’d gotten worse, losing all movement in both my upper and lower extremities, but “there was nothing the could do.”

It took a while thereafter at Norwood Hospital following an X-Ray, CT-Scan, MRI, and finally a transesophageal echocardiogram (TEE) on the second day, to determine the official cause of my stroke. The TEE confirmed a Patent Foramen Ovale (PFO), also known as a hole in the heart as the cause. We’re all born with one, but it closes naturally in about 90% of the population (read more from my note “We Are the 10%” here: https://www.facebook.com/notes/musa...). My PFO remained open, and thus allowed a blood clot to travel to my brain, bypassing the lungs and causing a clot in a part of my brain called Corona Radiata. My dad, a.k.a. Dada suffered a similar fate in March 1989, but sadly, did not make it. This is why when I took a nap after experiencing stroke symptoms that I hadn't recognized, I believe HE woke me up and guided me to call 911 from my home phone (enabling paramedics to immediately ascertain my address without me having to talk much). For this reason, I consider myself as having received a new lease on life on January 20th, 2012. I've chronicled my journey towards recovery on these Facebook spaces, and appreciate all the words of encouragement and offers of support from all of you as you’ve tolerated all my posts and updates.

This year in particular, I want to continue to bust the myth of the Two-Year Plateau when it comes to Stroke recovery. It refers to the notion that one gains as much movement and function in two years, as one is going to get, and then one hits a plateau. Nothing tangible supposedly comes after this. This proud stroke survivor and son of Plateau State, Nigeria says “No Can Do!” to that, and Amen to God’s miracles in my life that have seen me through one adversity after another, given me the will to live and love, and enabled me to spread the word and hopefully helping others along the way.

Since my stroke, I’ve been blessed with recording the following highlights/improvements. To able-bodied folks, they may seem like nothing, but to a stroke survivor coping with disability or facing uncertainty, they can mean a lot:

•         Lost 80lbs since my stroke
• Visited and worked out at the Answer is Fitness - Foxboro, MA gym 499 times since my stroke

Often the #LastOneOut of an empty gym after working out and #BreakingASweat

• 
  
• Opening the refrigerator and round door knobs in the house using only my left hand
• Effortlessly cutting/chopping vegetables on a cutting board, without assistance.
• Operating the windshield wiper and turn signals in my car with my left hand
• Reached and exceeded a personal best of 100 pushups https://www.facebook.com/musa.pam/v...
• Reached a personal milestone of 4.2 mph on the treadmill at the gym https://www.facebook.com/musa.pam/v...
• Installed two window air conditioners with mostly one hand

Stoked to come

within 6 inches of my first ever hole-in-one on the Par 3 6th hole at Brookmeadow Country Club, Canton, MA

Stages of a one-handed golf swing at Brookmeadow Country Club, Canton, MA

·        

1.         

• Made the playoffs in the unassisted division in my first year of playing in the North American One Armed Golfers Association (NAOAGA) Golf Tournament, in RI, whose motto is “Never Quit!”
•         
• Recorded approximately 32 patient visits of fellow stroke survivors at Boston’s famed Spaulding Rehabilitation Hospital
• ·        
• Played in my first alumni soccer game at my alma mater, Massachusetts Maritime Academy
• ·        
• Received the 16th round of quarterly Botox injections over 4
• years to help combat muscular stiffness or spasticity on my left side

I have traditionally had four New Year’s resolutions in the past few years. This year, I added a fifth. They are:

1.       Improved Health and Wellness: I’m proud to have lost 79 lbs since I started tracking my weight loss. I’ve committed to a lifestyle that shuns complacency and sedentary tendencies. I’ll continue to aim to walk at least 5,000 steps on non-gym days (Tuesdays, Thursdays and Saturdays), and 10,000 on gym days (Mondays, Wednesdays and Fridays), as recorded on my Fitbit Flex, with a day of rest on Sundays. I’ll continue to log my meals on MyFitnessPal, and proud to have logged in my meals for 1,173 days in a row! Last but not least, I use the Withings smart Body Analyzer Scale, which communicates seamlessly with My Fitness Pal and Fitbit. As the famous saying by Jack Welch or others goes: “You cannot manage what you cannot measure.”

2.      Becoming Organized: Organization takes on many forms, and in my case, I aim to become better organized in terms of physical organization of my home, office and car, scheduling and planning.

3.      Pay It Forward and Help Others: I’m blessed to be in a position to volunteer as a Stroke Peer Visitor at Spaulding Rehabilitation Hospital in Boston, gaining immense joy from being able to regularly visit with and talk to patients who are also stroke survivors and their families. The hospital president recently told me how valuable it is for stroke patients to obtain validation from seeing us, about the possibilities of recovery as they embrace Spaulding’s motto: “Find Your Strength.” I’ll continue to sound the clarion call for health, wellness and awareness of stroke and heart disease, and hope you’ll indulge me while I do. I also hope to continue to support and encourage learning outcomes and program success at Massachusetts Maritime Academy through volunteer efforts on the Men’s Soccer Team, Hall of Fame Committee, Engineering Advisory Council, and International Maritime Business Advisory Board. I’ve also committed to helping improve the institution’s record on diversity and inclusion. This year, I also plan on launching a blog to help raise and spread awareness about strokes and stroke recovery.

4.      Believe me, your likes, words of encouragement and feedback have all been valuable, and they help drive me, especially on those down days that inevitably come from time to time. Know that sometimes, FB provides the only medium of interaction I have with others.

5.      Self Improvement: A firm believer that one can never stop learning new skills, I hope to use all of the avenues available to me to build on, and learn new skills, means and methods.

6.      Pursue and Achieve Success In Management & Business: Leveraging all the lessons learned from my education and networks at Massachusetts Maritime Academy, Boston University Questrom School of Business, Harvard Business School, MIT and others to help change the world by creating and supporting better, more efficient and valuable organizations, embracing disruptive technologies and innovation, and spurring new beginnings in the form of creative talent and unbridled energy).

God bless you and thank you for reading thus far, and thank you for your time. I cannot emphasize enough how thankful I am for everyone who has helped me along the way in my recovery journey. I’d appreciate your feedback and comments.

Cheers, best regards, and I remain humbly yours

Musa Pam