Monday, November 7, 2011

Stroke Rehabilitation Begins

Here, I will compose a very general timeline of what has happened over the past 10 months to bring you up to speed on where Al is now.

The stroke occurred on January 5, 2011.

January 11, 2011: Al was transferred to the Sparrow Inpatient Rehabilitation Center. Same floor, same hospital, different feel - more like an asylum than the cozy, hotel-room feel of the ICU. The original estimates of Al's hospital stay were 2-3 weeks, and I had the ignorant notion that he would be all better in those 2-3 weeks. Soon the 2-3 weeks turned into 4-6 weeks of inpatient therapy, and the "all-better" estimate, in my mind, was becoming more like 6 months. I figured that Al might be able to go back to work by June 1. The doctors and therapists let me go on in my naive thinking for a while, but gradually let on that stroke rehabilitation takes many months, and even years. In fact, a stroke victim isn't considered fully recovered until after the 2-year mark.

(To read more, visit my other blog and read, Chronicle of a Stroke, One Month and Beyond.

February 17, 2011: Al came home from the hospital, 6 weeks and 1 day after his stroke. The stroke had left him moderately paralyzed on his left side. He came home with a wheelchair, which he didn't need in the house, but was very useful for trips outside the home. He was able to walk with the aid of a leg-length brace (a knee-ankle-foot-orthosis, or KAFO), a quad cane, and a gait belt, which I used to help him keep his balance for the first several weeks. He was unable to do much except sit down and watch TV and use his laptop one-handed.

I stayed home from work to be with Al for several weeks. I mainly helped him work on daily exercises, drove him to and from his outpatient therapy appointments, and tried to keep on top of parenting our 4 kids, which was pretty well outside of Al's skill set for several months.

(To read more, visit my other blog and read: Chronicle of a Stroke, Month 2 and Chronicle of a Stroke, the 3-Month Mark.)
February - June, 2011: Outpatient Rehabilitation at Sparrow Professional Building. Al attended outpatient therapy approximately 3 times a week for 2 hours a day. One hour a day was spent in Occupational Therapy, practicing upper-body useage and everyday activities, and Physical Therapy, which focuses on the lower body, walking, and balance. During this time, Al made some improvements, but we were discouraged by the lack of encouragement from his therapists, as well as the apparent lack of experience that most of those therapists had with stroke victims. They seemed to treat Al as a victim of a sports injury rather than a stroke patient. And neither did they send him home with exercises to do or goals to try to reach.

June 2011: We sought the help of a physiatrist, a physician who specializes in physical and occupational therapy. He began treating Al with Baclofen, an anti-spasticity drug. His primary focus was to get the spasticity and tone under control before prescribing further physical and occupational therapy. His reasoning: going to PT and OT without getting the spasticity under control would be like trying to drive a car with the parking brake on. We spent a good portion of the summer tweaking the Baclofen dosage, as well as adding Ritalin to stave off Al's chronic sleepiness and potentially boost his stroke recovery, a theory that is supported only by various anecdotes from other stroke survivors.

September - October 2011: Al entered his second round of outpatient physical and occupational therapy, during which he "tweaked" some of his skills. During the last week or two before his discharge, the OT challenged him to become more self-sufficient in his ADL's (activities of daily living), specifically to take a shower by himself and get himself dressed. Al passed both tests with flying colors.

That all brings us up to today, November 7, 2011. Al regained quite a bit of his mobility, balance and independence, but he is far from fully recovered. He has the use of his left shoulder and minimal use of his upper arm. He has no use of his lower left arm, hands or fingers. The left side of his face is still numb, although he can still speak fairly well and just needs to be careful about chewing thoroughly and swallowing. He still uses a cane to walk, although he challenges himself to walk without it regularly, and the KAFO has been broken down to be an AFO (ankle-foot-orthosis). He is beginning to drive, cautiously and only short distances. Otherwise, it seems as if we're at a standstill. Hopefully that is not really the case, but it's difficult to tell how things will progress from here.

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