Angus is an 84 year old man with atrial fibrillation (AF) and high blood pressure which are under control, and is otherwise reasonably healthy. Prior to his stroke Angus walked unaided, was the only driver in his household and delivered local newspapers. He lived an independent and active life. He is left handed. On June 13, 2012 Angus felt weak; he got up and took some of his AF pills but collapsed and lost control of his bladder. He called for help and his family organised an ambulance to a major hospital. Angus was seen in accident and emergency by triage and had the appropriate neurological assessment and scans which showed he had had a stroke which was caused by a clot in an artery in his brain. After multiple tests he was eventually transferred to a recovery ward.
Angus will now describe the steps he took towards his recovery and the barriers he needed to cross along the way.
“I am not an optimist or a pessimist but a realist, and above all a thinker. Lying on a stretcher with my left arm and leg fully paralysed, my face drooping and dribbling, my left eye out of focus, my left eyelid unable to close unless my right was also closed, I realised that only my thinking was working. I was aware of the concept of a mind trapped in a broken body…
After further health checks I was transferred to a general ward where two physiotherapists approached me, strapped me into a walking machine and assisted me to walk up and down the corridor.
After 32 days I was transferred to a rehabilitation hospital. I was fitted with a wheelchair and introduced to their gym. I was surprised at the lack of equipment. In regular sit to stand exercise I fell twice – once being my fault. Progress in walking was slow – no more than a shuffle assisted by two physiotherapists. I wanted to get home and contacted the Department of Veteran’s Affairs (DVA) who advised that I was entitled to three weeks with a physiotherapist in a nursing home and then ongoing at home.
At the nursing home a physiotherapist approached and said ‘Hi Angus, my name is Emma from Advance Rehab Centre and I will be looking after your recovery’. Her business card said she was a senior neurological physiotherapist which gave me confidence. The next day Emma approached with a quad stick and took me for a walk which went well.
Once at home, Emma visited me three days a week. We then organised for me to attend Advance Rehab Centre via wheelchair taxi (now a normal taxi). I was pleasantly surprised by the equipment available to me and my progress continued to grow.
Exercise programmes were set and improvements checked. Emphasis was placed on designing a home exercise programme for me to complete outside of my sessions with Emma. Together with Emma the goal was set for me to walk around the house with a stick independently before Christmas – achieved. I now walk freely around the house without a stick. I had a long term goal of walking up the street with a stick within a year – achieved. In mid-September 2013 I walked with a stick around a shopping centre.
Arm and Hand- Neurological specialists recommend that physiotherapy for upper limb commence within two days after a stroke. This did not happen for me. When I arrived at ARC with my left arm virtually paralysed, extensive physiotherapy at the gym and at home in conjunction with Botulinum Toxin injections from a specialist Doctor the following improvements were made;
– I can now eat fruit without help
– I can use scissors
– I can help with food preparation
– I can carry small light objects (empty cups and saucers, remote control)
– I can open and close doors
– I can move mobile and light furniture
Based on my experience at ARC I believe that by following this plan it sets the speed and extent of RECOVERY.
– Opportunities – opens the ways to goals
– Goals – short and long term, central to recovery
– Professionally structured work and mulitple repititions
– Time- structured and efficient use of time is essential
Without dedication to keep going some potential benefits may be lost. I have an overarching goal to return to as close to my pre-stroke ability as possible. Some experts think this is nonsense because you will never know when you have reached your goal, but I don’t mind, I just keep on working. I have the time.”
Angus September 2013.