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!!
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.