Sunday, November 10, 2013

The Vanillaization of Your Recovery

I'm not a big fan of WebMD. I'm not even sure why people read it. I guess if you just "Google it" -- whatever "it" is, WebMD is one of the first things to show up. But imagine if you had to rely on this site for serious information about anything medical? It seems that everything I read on it is a sort of a whitewashed, dated, vanilla attempt.
 
For example: I read an article on WebMD recently entitled, "Stroke Recovery and Arm Rehab: Important Questions." Poststroke arm rehab is one of my areas of interest, so I at least wanted to see what it said. Here's what the article says: Nothing about: arm rehab. Which you think it would've said something about arm rehab. Because it's in the title.

What I found instead was a bunch of, you guessed it, whitewashed, dated vanilla. The article is in a question and answer format. Below, I paraphrase them, and then add my
.

1. What caused my stroke?
What WebMD says, paraphrased: Types of stroke, relative incidence, etc.

What I say: This is the same information that can be found everywhere on the web. By the time most stroke survivors leave the hospital they are going to know most of this stuff.

2. Am I at risk for a second stroke?
What WebMD says, paraphrased: Yes, you are, talk to your doctor.
What I say: Yawn

3. What is the stroke recovery process?
What WebMD says, paraphrased: Your rehab program will be tailored to you. You'll do "assisted exercises" in the hospital. Then you may go to a rehab hospital, and then home. Rehabilitation takes place for 3-6 months. But "patients" can continue to make gains after this if you "... practice the skills (you) learned in rehabilitation."

What I say: "Assisted exercises" is meaningless. In the hospital survivors will generally be called upon to do whatever it is that they can do, assisted or otherwise. The article does say that you "may go to an inpatient rehab facility" but it does not add "if you are lucky." It also has says that you'll go home. Nursing homes are full of people that didn't make it that far. 

The idea that you will continue to make progress if you practice the skills that you learned in rehabilitation is nonsense. The reason that people plateau is because they continue to practice the same thing in the same way.

4. How long will my recovery from stroke take?
What WebMD says, paraphrased: Recovery is different for everyone, but for most it's a lifelong process.

What I say: If it's a lifelong process you're doing it wrong. Recovery ends at the point in which you have recovered enough to spend too much time living to spend more time recovering. Maybe they mean that exercise should continue through the end of life.

5. Am I at risk for depression after a stroke?
What WebMD says, paraphrased: Becoming depressed after stroke is common because of the changes in the brain and because of the lamenting of losses caused by the stroke. Depression can be treated with medication and/or counseling.

What I say: You know what else is a great treatment for mild to moderate depression? Exercise. I would think that's pretty germane to this article. Just sayin'.

6. What medications will I be taking and do they have any side effects?
What WebMD says, paraphrased: You'll probably be put on a blood thinner. Talk to your doctor.

What I say: Hopefully you are not reading an article to find out about post stroke medications.

7. When should I call my doctor?

What WebMD says, paraphrased: If you have symptoms of a stroke. They then list the symptoms.


What I say: No quarrel with this one.

So there it is. Now you know how to use your arm again. Off you go!

1 comment:

Billy Ethridge said...

Slightly over 5 years ago, I had a massive hemorrhagic stroke at my age 60. Almost all the medical professionals I have encountered are "Vanilla Ice (perhaps particularly the neurologists). Many are very cordial, but ALMOST TO A WORD each and every one I have encountered repeats the same lame lingo. Virtually every step of progress I have made in spite of some MD telling me that I cannot do what I asked how I could do it! Truly!

I am extremely grateful to a handful of rehab therapist, nurses, nutritionists, and thoughtful friends.

Much of what I have been able to do has been focused around the hub mindfulness meditation.

Nutrition in the hospital and and in the SNF (Skilled nursing facility)was, by and large, completely and gratuitously insufficient given the wealth of specific dietary emphases needed by a stroke patient. Much remains to be scientifically known, but institutional nutrition is woefully behind the times.

As I am a high-level black belt in judo. aikido, and tang soo do. I have spent a lifetime studying, teaching, and practicing related arts. Far too little adaptation and use is made of the depth of psychophysiological knowledge that is available to the medical and rehabilitation communities from such disciplines. Some adaptation and cross-fertilization of martial attitudes as well as martial arts skills would be of enormous benefit to stroke survivors.I am not arguing, I am reporting and witnessing that fact!

On a very simple level, so VERY LITTLE is adequately explained to the stroke patient and his/her caregiver/s in any timely, systematic or relevant way. No once did ANYONE mention spasticity or explain what it was while I underwent care under one of the best known MD/PhDs in a highly recommended stroke center her in the greater San Diego area. And that is just one of the many ludicrous ommissions of my stroke medical care. Ah...

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