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Back To The Future.

Updated: Mar 27




It is generally thought that the earlier you start rehab following your stroke, the better (even while you're still in hospital).


Unfortunately, in my case, I was too ill for this to happen. I was delayed by four months; the first six months are when recovery happens the fastest, and then it slows down. It doesn't mean recovery will stop completely!


SPEECH THERAPY

When it comes to speech therapy, I ended up having my trach for six months. I had to learn to swallow and talk again. When I began learning to eat, I started with things like a chicken casserole blitzed to the extent that there were only the tiniest slivers of meat. I was taught the technique of swallowing three times, drinking water and repeating the same thing until I finished eating. Now I eat a completely normal diet (still being careful)! I use the technique I was taught for chewier foods like sourdough bread. Last year, I started drinking apple juice; I dribbled a lot due to my facial palsy. I don't dribble these days and have taught myself to use a straw. I've gone from holding my lips closed to clamping one between my teeth.


Having the trach for so long meant learning to talk was a unique experience. I was focusing on how to enunciate my words and the clarity of my voice correctly. These sessions did make me think of "Do Re Mi" in the Sound of Music. A year on, I've been using a microphone with my computer due to my loss of ability to touch type. This has become a very effective form of speech therapy; I think it is probably more of a perfectionist than a human therapist! You have to be very clear and enunciate properly. So now I've gone from trying to imitate Julie Andrews to being controlled by a machine. My speech has come on leaps and bounds; I've even attended two events this year where I've had to do public speaking. I was nervous before both of these, but they went smoothly, and people appeared to understand me!


When I was in rehab, my speech therapist gave me facial stretches and showed me facial massage. Both of these are designed to help me work on improving my facial palsy. I'm now continuing facial massage with a lady who lives locally. This helps keep my face shape in as good a state as possible.


OCCUPATIONAL THERAPY

When I arrived in rehab, I had minimal use of my left hand and a lack of sensation in both my left hand and foot. I started trying to hold a stress ball while working on increasing my grip strength. My occupational therapist gave me Theraputty. It's similar to Play-Doh but comes in different strengths, and you can do various exercises with it.


To help with my hand sensation, I had a bag full of random items, ranging from a beanie hat to a plastic cup. The idea behind this was that the therapist would have me close my eyes, and they would put a random item in my hand, and I had to guess what it was. Now I'm home; my bag consists of cards, metal buckles, sandpaper, beads, and buttons. This is the area with the most minimal improvement.


To help with finger manipulation, I started by playing cards, simple board games, and Connect Four. I've been using my left hand to practice fine motor control and try picking up small items like a Connect Four counter. Now I'm home, I am making all of this more complicated. I'll sit further away from the table if I'm playing cards and dealing with them. I've also been playing more advanced board games, such as Cluedo.


Since I got home, I've practised touch typing to help my finger flexibility. Admittedly, going from 80/100wpm pre-stroke to, at best, 10wpm post-stroke is rather disheartening. At least I’ve got ten years to write my autobiography!


In rehab, I learned how to adapt with regard to personal care and cooking. I learned that putting my left arm in first is the best way to get a coat on. It's easier as I don't have to pass my left arm behind my back and try putting it through without looking at it. I put my jumpers and cardigans on like this as well.

I always tie my hair up, and I'm trying to use a hair tie. I can just about do so, but I tend to use an alice band instead. I struggle with buttons and laces; leggings and slip-on shoes have become a lifesaver. I've also been using a shower chair if I’m tired and a stool by the sink to brush my teeth, and we have grab rails installed around the bathroom.


At rehab, I began learning safer ways to cook in the kitchen. I hold the panhandle with my left hand, allowing me to stir with my stronger right hand. I've also been using a spiked chopping board, which holds items in place (meaning I don't chop my fingers off)! Lately, my balance has recovered enough to cook basic things unaided. I have had to make adaptions to cooking "post-stroke"; I can't lift a pan of boiling water, and I have to be careful with hot trays and heavy items.


Going into the community while I was in rehab was very simple; I would go to a local shop in a wheelchair, and the therapist would point out hazards to me. When I came home, community access was different as my new occupational therapist focused on specific areas, such as my local supermarket. I've worked up to using a trolley and picking items off a shelf myself. I've learned techniques such as using my core, standing balance, and being able to transfer my weight. I've also learned to walk on uneven surfaces and use a stick to judge the height of a step or the kerb. I've also been practising walking in different types of weather.


PHYSIOTHERAPY

I had been bed-bound for so long that my weight had plummeted, and I had lost a huge amount of muscle mass. I learned to walk using the "Body Weight Support Machine". It's a treadmill with a harness suspended from the ceiling and a ramp to get a wheelchair up so the patient can get onto the treadmill. The fire alarm went off during my first session, which was more like an introductory go. As time went on, the support from the harness was reduced. After a few weeks, I progressed to walking on the floor with the help of a physio holding my hips and another in front of me to prevent a fall. I would also walk around the ward with the same support.

Roughly a month after I arrived in rehab, the physios set up a miniature assault course in the gym. It consisted of tiny traffic cones, hurdles, and small blocks, amongst other bits. This indoor assault course tested weight transfer ability, standing balance, and essential hazard awareness. I started walking outside by taking a few steps on the pavement outside the front of the hospital with a physio and a nurse. I would go to the High Street in a wheelchair, walk a few feet, and then return to the hospital in the chair. I learned outside obstacle navigation and other hazard awareness, such as crossing the road. This slowly progressed to teaching me how to navigate the obstacles of my own accord. Since coming home, I've learned how to check for obstructions in my local area. I now know what to look for in any new place and can find the safest way to get around them. This also includes techniques for walking on different services (uneven pavement, wet leaves, gravel, etc). My white stick has not only benefited my balance but also signifies visual problems to others and allows me to judge the height of a step or kerb.

Last year, I did basic exercises to help with my core, fitness, and balance. I would sit on a giant gym ball, try to keep stable, and then advance to sitting on the ball, keeping stable and being able to move to the side and pick up a dumbbell. When I came home, I was doing a group exercise class, which worked on core strength, balance, and general fitness. The activity would change each week, ranging from boxing to a circuits class. After coming home, I restarted Pilates (this is something I did before my stroke). This has been very beneficial, especially for my core strength, and has helped improve my walking. I have also taken up swimming. This has been a weird one; not only has the stroke caused my physical strength to take a beating, but I have to RE-LEARN how to swim (this isn't something I expected to happen). It's been helping me focus on not only improving general fitness but also using both limbs at the same time. It's the most tiring activity I've done!

EMOTIONS

Regarding emotional recovery, I've already done a more detailed blog post about it. Last year, I was so focused on getting through my busy day-to-day schedule in rehab. A year later, I'm still trying to get used to the "new normal" and also attempting to control my lack of patience when I can't do something or it takes me longer than before.


I am also not great at talking to people, so I've taken up writing in journals instead. I am a naturally self-critical person (even before last year), but even though I have these tendencies, I've concluded that if this is the "new me", I'm happy with what I have accomplished.










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