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First-Rate Rehabilitation- Inpatient

road to recovery

Prompt Rehabilitation after a stroke resulting in impairments is essential to recovery. In this entry I will discuss the importance of rehab, the difference between a hospital inpatient Rehab program versus a Skilled Nursing facility, the environment of my inpatient rehab, the providers and all the challenging hard work it takes to move forward.

I learned that whether or not as a stroke survivor you’ll be given the opportunity for inpatient rehab therapy in this country is like all medical logistics, hit and miss, unless you have a strong advocate working for you. Between respective insurance policy’s, state and federal guidelines and laws, individual hospital policy’s and the patients individual prognosis it’s not guaranteed that a patient will receive the best program for their recovery. Or even at all.

Rehabilitation as soon as possible is indicated for progress in recovery, the brain is creating new pathways around the injured part of the brain, neuroplasticity, and the sooner we through therapy begin to use those new pathways the better chance for recovery.

In my case I had a great prognosis for recovery, was in a first-rate hospital, had an amazing rehab physician (and social worker and physical therapist) who for a week pulled no punches with my insurance company to get me approved for the hospital’s inpatient rehab program. Why my insurance company dragged their heels for 6 days is anyone’s guess, there was of course a bit of absurdity in the beauracy on the business side of medicine, I really had no need to be on a medical support floor those 6 days, and my team was ready to move me to the rehab unit the day after my stroke. I was blessed to have a rehab doctor who was adamant that the hospital program would best serve me and he didn’t want me transferred to a skilled nursing faculty. ( I later learned that the quality of care and actual rehab in these facilities is sub standard and can actually impede recovery) My doctor so believed in my prognosis as well as my own determined motivation that he’d confided in me on the 7th day that he was moving me to the rehab unit regardless of my insurance company’s approval, with no financial liability to myself if needed. That’s how firs-rate my experiences across the stroke board were.

The Universe works in mysterious ways, that same day we received approval and I was moved to the rehab unit.

Let the games begin!

My accommodations were as lovely as they were on the medical floor, a private large room with a beautiful view of the early November Fall foliage outside the full wall length windows beside my bed. It was comfortable, especially with My Pillow from home.

As I keep saying the program is first-rate. It’s very structured with three hours a day of intense therapy, three different disciplines; an hour each of Physical, Occupational and Speech therapies with amazing therapists.

The unit has a real community feel and I especially liked the community dining room for meals as an option to eating alone in my room. Gathering three times a day to share meals with other rehab residents was medicine in itself. Having others who are being similarly challenged sharing thoughts and feelings is another form of necessary therapy. From the moment of my first breakfast with the other residents I was warmly welcomed and shown the ropes. I came away from 12 days in the program empowered and with a few new friends.

While fighting “Neuro Fatigue” there were a few days that I had to pep talk myself into attending therapy, napping was my first instinct; but I had a mindset that I had limited time there and my recovery depended on my participation, AND I was not about to throw away what had been so fiercely fought for me.

Therapy involved re-learning and retraining how to first navigate life safely despite my impairments and how to keep moving forward in recovery. Physical therapy for movement and coordination, Occupational therapy for taking care of myself, and speech therapy for cognitive abilities. I was very fortunate in that compared to how bad it could have been I have some mobility issues but I could still walk and could move my affected limbs

Cognitively I had no real issues,thankfully, in fact after the assessment my Speech therapist told me since I was testing above average it would not be ethical for her to keep meeting with me. I did initially have some speech irregularities because the stroke also affected the muscles in my right cheek, I had a slight droop on the right side of my mouth. With exercises and the advice to slow down and over enunciate my words I rapidly improved. Droop gone. A technique given to me that really helped was to think about how Barack Obama speaks, slow and methodical, he doesn’t worry about taking a brief pause in his speech. This has helped me begin to lose the annoying life-long habit of the fill in sound of “umm” when I lose my train of thought or searching for the right word.

See? Old Dogs can be taught new tricks.

I won the lottery in Rehab, the last week I was there I was offered to move to a studio apartment in the unit. It’s intended to help transition all I had learned for going home. The studio included a gallery kitchen, gorgeous natural light from two wall lengths of windows and a REAL BED!!

rehab apt collage

Finally November 12th arrived, it was my discharge date.

As happy as I was to be going home I have to admit I was also sad to be leaving the new friends I’d made in the residents and the staff. There was a sense of safety there I’d not have at home. I was even going to miss the food. Really. For a hospital albeit a Hilton of hospitals, the food was better than some 5 star restaurants I know. I had favorites and I was going to miss 3 meals a day being prepared for me.

The program prepared me well for going home and to resuming living alone.

I couldn’t wait.

©taylor-helser2019

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Impact

impact

Being impacted from a Stroke happens suddenly and it happens over time. I am 3 months post stroke and still being impacted in new ways, all while learning how to navigate life on my Brain Injury’s terms.

Physical Impact:

Once the event happened and the blood clot went to my brain (left side) I had immediate deficits on my right side. I was incredibly fortunate in that I had just coordination and compromised muscle tone problems in my dominant right hand,(fingers mainly) and my right leg (knee down to foot). I could still walk but needed the aid of a Walker due to my balance being comprised.

After 18 days in the hospital, 12 of those days in intensive rehabilitation, when I came home I was getting around my little apartment pretty well with the Walker and I was able to flex my fingers open about 70% of the time. I started cooking most meals for myself and trying to rebuild some structure to my new life. Unable to work I had hours I needed to fill.

It was more challenging being home than I expected it to be.

Everything takes more exhausting effort, getting dressed and making breakfast first thing in the morning. Then I need a nap. Another Learning curve: Neuro Fatigue is like no other fatigue. Rest does not leave the Survivor feeling rested no matter how much sleep. It takes enormous amounts of energy for a brain to heal, and it takes time. I soon learned that I’m not able to”just get over it.”

Emotional Impact

This has been the toughest of impacts. While in the hospital I was doing great, even said to the Rehab Psychologist that my obnoxiously happy nature was serving me well post stroke, I was rocking it. But..alas… once home and past the thrill of being on my own in my own home again the emotional turmoil struck me.

First came the anxiety, it didn’t just creep up on me, it hit me full force like a storm, a full on panic attack one evening while simply eating dinner.

It was just me and a close friend, a simple dinner in front of a movie. One moment I was eating, talking and the next I thought I was having another stroke. Let me add here that when I did have the stroke I was asleep, I don’t know what it feels like to have a stroke, only what the results are. The symptoms from the panic attack were so intense and so frightened me that I called the emergency 911. In the next 5 minutes while waiting for the paramedics I experienced rapid heartbeat, my entire body was tingling and going numb, I couldn’t catch my breath and I was shaking so bad I couldn’t stand up.

The paramedics arrived and immediately established my blood pressure, heart rate and oxygen saturation while also performing a stroke assessment. I was not having another stroke…. it was anxiety. One of the paramedics pointed out that when I used deep breathing tests that I was bringing my blood pressure down 20 points. I’d had no prior experience with anxiety but I believed him.

In weeks to come I began having more anxiety symptoms, although more subtle. My injured brain was remaining in a hyper alert fight or flight mode, every day noises like my phone ringing would startle me so badly I’d literally jump. My brain is having to relearn to filter out alarming sounds that are not alarms. It helped to know this is what it is, but I am still unable to reason with my brain when panic strikes.

Since I have been diagnosed with being on the Post Traumatic Stress Disorder spectrum from a life threatening medical event. I was prescribed an anti-depressant to treat the anxiety, but after several weeks I wasn’t feeling any benefit for the anxiety and more significant was ironically I was getting depressed, which was exacerbating the anxiety. I began to realize that I was isolating, even experiencing social anxiety and agoraphobia, my small world was shrinking even smaller. Just last week I connected the dots to the medication and tapered off it, by the fourth day without the medication I felt 95% better. The anxiety is improving as well. I’d had no prior experience with anxiety and in hindsight found the depression was paralyzing. I’m grateful for the first hand awareness about anxiety and depression,

I didn’t know.

Now I know

Being impacted by Learning Curves.

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taylor-helser2019

Posted in Uncategorized

The Blink of an Eye

I’d like to mention that the providers at St Charles Medical Center of Bend Oregon USA are by far the most professional, compassionate and kind staff any city is blessed to have. My experiences were nothing but positive and empowering. There is no dignity being in the hospital, especially when your mobility is compromised, yet the staff never lost sight of how important respect is. I’ve too many favorite doctors, nurses and therapists to name, but my rehab Doctor, Dr Eggert, my rehab Nurse Andrea and Meg my physical therapist indeed deserve shoutouts.

After 12 days (18 total hospital stay) of rehab, three different therapy disciplines the program readied me to go home with some confidence.

However that confidence was short lived once home. Learning just how much effort and emotional toll it took in trying to navigate life without the support of the hospital staff and structure blew my mind. I was fortunate that a close friend stayed with me the first two weeks home, I am not sure I could have even cooked for myself. Going to the bathroom, dressing, and having breakfast did me in, I began my day with a energy deficit.

I quickly learned about another deficit resulting from a stroke, Neuro Fatigue. Almost 3 months post stroke and I am still coping with being so tired that I nap several times a day.

I am still using a walker, my balance is iffy. I can now open the fingers on my hand, and am even typing now, I could not extend my fingers open at first, being right hand dominant I had to adjust fast to using my left hand while still attempting to use my right. I found it fascinating that when I intuitively tried to use my right hand without thinking about it more than often I could manage, when I put thought into it I could not.

Recovery according to my medical team will take 18 to 24 months, everything is a learning curve.

In the following future entries I will be touching on those learning curves, everything from ongoing physical and occupational therapy, Neuroplasticity, Anxiety, PSTD and Depression, inability to work, bills, inability to drive and having to depend on others, just to name a few topics.

My agenda is awareness for understanding, awareness for education, and more personally to use this format as a cathartic process for myself.

I am grateful for your interest and your time.

We all tend to think we are invincible, until a blink of an eye.

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