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The New Normal, Part II

Updated: Nov 2, 2023


I wasn't embarrassed that I'd had a stroke, but I just didn't want people to think I was milking it or looking for sympathy. It happened, and I dealt with it. Afterwards, I tried to do what I could for other people who had strokes, speaking at hospitals that treated stroke victims.

Rod Laver


Rod Laver, an excellent tennis player in his day, provides us with some sage advice. The only word I’d change in this great quote is “victims.” I don’t believe we’re victims; that’s why I use the term survivors. I believe the term victim sells us short and could set us up for a “victim mentality.”


I would also recommend heeding his advice on ‘helping others.’ It’s a wonderful way to get outside of yourself and your problems. When you help others, it’s a win-win! Helping makes you feel better, as it does for the one you’re helping!


My blog and my upcoming book are my ways of helping others. You may or may not be in a position to help others at this point in your recovery; if not, do your best to help yourself, appreciate your friendships, and give a word of encouragement to others in your therapy clinic. That last one is easy and a meaningful thing to do for the recipient..


ATTITUDE


I believe our mental attitude is our driving force! It’s what propels us forward

when times are the toughest!


As with all challenges, it’s all about our attitude toward those challenges! As stroke survivors, we have a depth of character that propels us to climb an

enormous mountain. It’s a tremendous opportunity to overcome the biggest challenge of our lives; and to choose how we want to accomplish it.


Before I outline my particular way forward, I want to say again - my way of managing my recovery may not be yours, which is completely fine. I’m sharing these thoughts, hoping one of them might spark your interest and/or provide you with a helpful idea.


I’ve divided the following information into these categories:

Movement

Physical Therapy

Occupational Therapy

Speech Therapy

Your Responsibilities


MOVEMENT: I had no idea how critical moving your limbs as early and as often as you can in the early days and onwards. If you don’t, you’re opening yourself up for a painful complication called contractures.


Contractures are a condition of shortening and hardening of muscles, tendons, or other tissue, often leading to deformity and rigidity of joints.


Contractures are extremely painful, so please do your best to move those limbs ASAP!


In-Clinic Therapy


There are three types of therapy for stroke survivors:

  1. Physical (lower half of body)

  2. Occupational (upper half of body)

  3. Speech (addresses all forms and degrees of aphasia)


PHYSICAL Therapy (PT)

This is a must to get a handle on managing your drop-foot to reduce or eliminate trips and falls; activating and strengthening the hamstring on your affected side, as well as improving your balance, leg strength, and stamina.


If you’re unfamiliar with the hamstring’s function, here you go:


Hip and knee movements in walking;

Tilting your pelvis.

Bending your knee joint.

Extending your hip joint.

Rotating your hip joint.


All of the above functions are necessary for walking.


I was clueless about this! Were you? No wonder we have issues walking! :-)

These are a few examples of the exercises you’ll be performing in PT:


Treadmill: Fondly known as the “dread-mill,” is an excellent and safe way to improve your stamina, walking speed, and your walking gait; thus increasing your confidence. Your safety is ensured because you’re in a harness that protects you

from falling.


Obstacle Courses: Your therapist will have lots of ideas for helping you maneuver various sizes and shapes of obstacles.


Outdoor Walking: Once you’re fairly steady with your walking ability, your therapist may take you on walks around the clinic. This really helped me feel more secure when going outdoors with my caregiver to restaurants, movies, etc. It’s also a nice change to all the indoor activities in the clinic.


Testing: For insurance purposes, you’ll be tested on a regular basis. These tests also help your therapist monitor your progress which helps them know where to focus. Trust me, these tests aren’t a lot of fun, but they’re critical to your improvement. Another very important benefit to testing is the fact that you won’t improve if you don’t constantly challenge yourself. I heard this advice constantly from my therapists.


One final word about testing. Please don’t fall into the trap of feeling depressed if/when you score poorly on a test. I’ve fallen into this many times! It’s easy to do, but counterproductive. When I fell into this, my therapist would always remind me with “It just gives us a roadmap to follow, that’s it!” If you’re competitive to any degree, this advice will refocus you and will replace your defeatist attitude with a more realistic and uplifting one!


Your therapy efforts will improve if you’re able to afford devices to help you.


Personal Devices: The correct devices can help tremendously! Your therapist will know the best to assist your unique deficits and your financial situation.


As you know from my videos and blog posts, I use the Bioness L300 GO (www.bioness.com), an electronic stimulator that lifts my foot and thrusts it up and outward, thus eliminating the effects of drop-foot.


That’s only one device - there are many others. Ask your therapist for recommendations. You can also check out very helpful products on a few pages, click here to view this list that continues to grow!


OCCUPATIONAL Therapy (OT)


Boy, this is a challenging area! The muscles in the upper body are smaller than those of the lower body; thus, they’re more difficult to strengthen; thus their recovery is much slower.


These gifted therapists can assist you with many daily activities, like:


Eating with a knife/fork

Working again

Cooking simple foods

Emptying the dishwasher

Lifting a laundry basket

Bathing/Showering

etc., etc., etc.!



YOUR RESPONSIBILITIES

Now that you’ve seen what the therapists will be helping you with, you have certain responsibilities as well.


Your 1st responsibility: SETTING REASONABLE, REACHABLE GOALS, along with your therapist.

What do you need/want to re-learn 1st, 2nd, 3rd, eventually?


Examples: (PT)

1st: I want to be able to walk on the treadmill for one minute without resting.

2nd: I want to be able to walk on the treadmill for 5 minutes without resting.

3rd: I want to be able to walk on the treadmill for 10 minutes without resting. Eventually: I want to be able to walk on the treadmill for one mile without resting.


My current “eventually” PT goal is - to be able to ride my new trike, which requires an up/down movement in my left leg; which will currently not bend due to lack of strength in my hamstring.



Examples: (OT)

1st: I want to be able to bend my arm ½ ”.

2nd: I want to be able to bend my arm ¾ “

3rd: I want to be able to bend my arm 1”


Eventually: I want to be able to bend my arm fully, enough to bring a fork up to my mouth


The same incremental set of goals would occur for your hand and wrist, both affected areas.


My current “eventually” OT goal is to play my guitar again!

Your 2nd responsibility is to implement what you’ve learned in therapy into your daily routine, which involves your home,, of course.


If you’re unsure how to implement these new learnings in your home, ask your OT for a home visit.


Home visits are common. What happens is - you request a home visit for the OT to visit your home to see what they can help you with and what they can recommend for you, in your home environment! These are invaluable!

So, don’t be afraid to ask! You have every right to do so and it’s vital if you want to get better.


SPEECH Therapy (OT)


Speech therapy falls under the umbrella of occupational therapy, which is a shame because OT requires an excessive amount of insurance funds due to the nature of the smaller muscle recovery; and, those funds must be shared between all upper body and speech therapy.


Believe it or not, this is due to a grammatical error in the way it was written in the insurance policy manuals. A very important comma was left out of this equally important sentence:


“Funds are to be used for occupational therapy (comma missing) and (additional funds to be used - missing) for speech therapy,” So, they lumped the two complicated-to-recover side effects altogether!


Additionally, occupational therapy is a highly-specialized field, as is speech therapy, but they’re completely different disciplines. Speech therapists are specialized in their specific field and OTs in theirs. Yet they’re lumped together in one pool of funds, as well as therapy session limitations.

It’s amazing this has never been noticed or changed!

Another example of America’s woefully inadequate healthcare system.


Let me quickly provide an example of how this impacts a survivor. Let’s say you have a massive stroke, causing severe aphasia and severe one-side paralysis, and severe hand spasticity and edema (which takes months to treat - I’ve had it). So, just think of all the OT that’s needed in that situation! How do you spread those limited dollars out amongst those three severe side effects, all of which will require extensive therapy?!


Aphasia. Many of you are suffering from various stages of aphasia. I know how frustrating it is to be unable to speak or think clearly. Therefore, I want to share with you a wonderful article by a gifted speech therapist, which I hope helps ease your pain a bit.


To help with your understanding of and empathy with, aphasia, here’s an article written by an expert speech therapist.


A FINAL NOTE

Many of you are in countries or U.S. cities that don’t offer neuro therapy; or, perhaps your insurance refuses to cover the amount of therapy you need, please visit these sites that offer FREE online PT, OT, brain, and speech exercises and apps for you to perform at home. Some of the apps are not free.


Flint Rehab


Saebo


Aphasia


APPS







*Another helpful exercise:

PUZZLES For Stroke Survivors

There are many on Amazon and other sites!



Thanks for reading!

Maureen


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