I get a lot of questions about stroke recovery and try to answer the best I can given the fact that I have rarely met the folks I'm giving advice to. Here is an email I got recently. Hope the following exchange helps some folks!
Dear Mr. Levine,
In March of 2014 my friend had a stroke. She is 59, very gifted
and motivated. She has received physical and occupational therapy from local
facilities since then and has made a lot of improvement. We have obtained a
Neuromove unit and recently got a Walkaide device for her foot, but it is
looking like we are reaching the limit of local expertise to help her push
forward. She has been very motivated up to now, but upon not satisfactorily
acheiving some of her 6 month goals, has hit a rough patch. So we are just
searching for anything that might spur her on at this point. We have looked
into constraint induced programs locally, but not impressed with what we have
found. Also, she is very reluctant to undergo the frustration she thinks this
therapy will be. We don't want to encourage her to do something difficult
without knowing it has a good chance of helping her. I am writing to you
because your book has been a huge help in "coaching" her, and I
thought you might know someone in New England who we could go to for help.
"Joan"
Hi "Joan,"
A couple quick things; it looks like you're doing the right thing re:
NeuroMove, and the walkaid. I'm a pretty big fan of both of those.
Secondly, if she is
plateauing, that's to be expected. The general philosophy is that once the
plateau has taken place, gains can continue to be made, but of course, the
gains are much more conservative given an equal amount of work.
Sometimes it helps to work towards specific goals. For instance, your friend may
walk great with the walkaid, but may not walk fast enough to make getting
around outside useful. So increasing the speed of walking would be the goal. In
fact, quickness can generally be used as a goal; upper body dressing, cooking a
specific dish, making a bed etc. can all be goals were speed is worked on.
In terms of finding a place in New England, of course there are quite a few
good ones. Find the link on this blog on the right hand column [-->] you'll see something that
says "FIND A STROKE CENTER NEAR YOU?" Click on that, put in your ZIP
Code, and all the hospitals that are supposed to be good at stroke recovery
will come up- they should be able to direct you to the best rehab options.
There's other links on there (on the right side column [-->]) to help you look for
aggressive physiatry and other rehab clinicians.
One last thing, and this is a tough one… But your friend may be simply at the
end of recovery. This is one thing I struggled with in my book… And in fact had
somebody else write it; Kathy Spencer. I'll attach and image of her quote to
this email (bottom of this blog entry). And she talks about the point at which living your life gets in the
way of recovery. At some point there's not enough justification for the hard
work given the amount of gains that are made. It's a decision that everybody
has to make for themselves.
Have you looked into
the saeboflex? It may be appropriate.
But, again,there's no
magic algorithm here, it's just more work.
Please let me know if
you have any other comments, insights, etc.
Best,
Pete
Pete
(CLICK ON TEXT BELOW TO MAKE IT LARGER!)
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