Physical activity levels in people that experienced a stroke do not meet general activity guidelines.
After 20 years in practice, I’ve evaluated and treated many patients with a stroke. On the flip side, I have family that have experienced a stroke. I’ve learned that each person is unique. Each person has a unique personality and drive. Each person has a different “why”.
When I say “why”, I mean “why” try to get better”? “Why” go through therapy? “Why not” just sit around and get busy dying.
My uncle had a stroke. He was a pillar of health before the stroke. He was a gettr done guy. Why wait for someone to do that which I could do. I have major respect for my uncle because his life and my dad’s parallel each other.
With that said, after his stroke, is still determined to be independent and is back to living his best life. He has physical limitations, but he worked hard to figure out how to get around those limitations. He is back to volunteering and helping other veterans like himself.
On the flip side, I have seen those patients that fall into the “why…me” track. These patients struggle to get better.
My first patient as a student intern was in a subacute rehab. I was given the choice of two patients. I could’ve treated the patient that just had a total knee replacement (back when I first started in this profession, patients stayed in the hospital for days and then went to a skilled nursing facility or subacute rehab commonly after the surgery). Instead, I chose to take the patient that experienced a stroke. I knew in my career that I would see thousands of patients with knee replacements, but I wouldn’t be in the setting to see as many patients that experienced strokes.
I remember this patient vividly. He was a business owner and he had a name and business that used alliteration in his introduction. Once he introduced himself, the glitter in his eye disappeared. He started crying almost immediately.
THIS WAS MY FIRST PATIENT AS A STUDENT!
WTF!
I had a lot of experience working with people that had struggles, having grown up either at a private bar or local VFW.
This guy was told by his doctors that he would never walk again (doctors are not God). If you’re a physician reading this…be careful how you speak to patients. This also applies to physical therapist that are reading the blog.
The patient went on to tell me how he lost his business, his wife divorced him and took everything he had but the crucifix on his neck. His van broke down and he would have to live in his van (not down by a river for those old enough to get it).
Also, for my first day at the rehab unit, my clinical supervisor told me that she just got a promotion and wouldn’t be able to be with me at all during my internship and that she was sure I’d do well.
That sucked and added a little more pressure to my clinical. I almost got kicked out of this clinical twice, which is better than the time that I do get kicked out of an inservice later in my student career.
Back to the alliteration introduction patient.
He was crying, sitting in a wheelchair, and feeling horrible for himself because of what he was told by God…I mean the doctor.
I had a choice to make. We always have a choice to make when working with people. Which version of me dos the person in front of me need at that specific point in time.
I flipped the coin between empathetic shoulder to cry on and ear to listen and “eat lightening and crap thunder” (this is Mick from Rocky for those young whippersnappers).
I chose Mick. I was as hard as I could be without being an asshole (which was good that I didn’t have a supervisor because she may have thought I crossed the line on day one when I said “you want to cry or you want to walk!“).
This guy chose to walk. By the time he was discharged after 4 weeks, I took him for a walk around the outside of the hospital grounds. Realistically, I sat in the wheelchair and he pushed me for about 15 minutes.
This guy not only walked, but he regained his freedom in life. He changed his perspective. He didn’t have to live by a river, but was able to get a job and get back on his feet.
I’ll never forget alliteration introduction guy. He got that sparkle back in his eye by the time he was discharged.
THE PATIENT IS THE ONLY PERSON THAT MATTERS!
Not the stroke! The patient may always have disabilities, a limp, an inability to walk, but it’s sour job to help them find the “why”!
That “why” is what will help the patient to increase physical activity levels. We may not “fix” the problems, but we need to do our best to not let problems compound on problems.