9 People that you NEED!

To recover physically and mentally after stroke, you need a team of healthcare specialists.

Stroke affects the brain and is the leading cause of adult disabilities in the United States.

Thanks to treatment advances, 85 percent of Americans who suffer a stroke will survive, joining 4 million other U.S. stroke survivors. Just over one-third will experience complete recovery or have only minor stroke-related deficiencies, according to the National Institute of Neurological Disorders and Stroke. Strokes occur when blood stops flowing to part of the brain due to a bleed or a blood clot, causing physical and mental disability that takes time, and help, to heal.

What happens after you or a loved one have a stroke, and what can be done to improve chances of recovering?

As soon as possible after a stroke, a specialized team of healthcare providers steps in to help you regain strength, mobility, and the skills you need to live independently. The earlier rehab begins, the better your chance of regaining the highest possible level of independence and productivity.

Rehab doesn’t end when you check out of the hospital after a stroke. “The brain has the ability to rewire or rechannel bodily functions so that another part of the brain can take over and make the body work,” says Cheryl Miller-Scott, an occupational therapist and national director of therapy operations for HealthSouth Corporation, a network of rehab hospitals and home-care providers. “That sometimes can take six months to a year.

Each member of the rehab team, whether in the hospital, doctor’s office, or at home, helps maximize recovery from a stroke. Here are nine essential people who should be on your recovery team or that of a loved one who has had a stroke:

1. Physician

A physician will orchestrate your rehab program and manage your medical needs. “There’s a myriad of complications that can occur in the patient during the rehab phase,” says James C. Grotta, MD, director of stroke research at Memorial Harmon Hospital at the University of Texas Medical Center in Houston. Physical medicine and rehabilitation physicians are specially trained in rehab, but general practitioners, internists, neurologists, and others can also manage the recovery process and oversee the rehab team, he says.

Depending on the patient’s overall condition, complications can include:

At the same time, a patient may have existing medical needs that must be addressed, such as high blood pressure, diabetes, or high cholesterol.

2. Physical Therapist

Depending on the part of the brain affected, you may have weakness or even paralysis of your arms and legs after a stroke. As soon as your condition has stabilized, often within 24 to 48 hours, a physical therapist will begin helping you to move and strengthen stroke-affected limbs. This initial rehab may include passive exercises, in which the therapist moves your limbs, and active exercises, in which you move on your own.

Post-stroke physical therapy is intense, requiring three hours of exercises daily. Because of this, some people are too weak or confused to be candidates for physical therapy immediately after stroke, says Dr. Grotta. “These patients often go to a skilled nursing facility for a period of time until they’re qualified for rehab,” he explains.

The goal of physical therapy after a stroke is to get you up and moving on your own, as much as possible. “The physical therapists are going to do the gross motor things, the walking, the trunk control, the balance,” explains Lynda Shrager, an occupational therapist and Everyday Health contributor who offers tips for caregivers on her website, Otherwise Healthy.

3. Occupational Therapist (OT)

Taking up where the physical therapist leaves off, occupational therapists help stroke patients continue to rebuild their muscle strength and flexibility. Occupational therapists also work with stroke survivors to find ways to adapt to any lasting impairments. These therapists visit you soon after you return home, and may continue for several weeks or months.

“We look at their activities of daily living — how this stroke has affected their ability to take care of themselves and do the things that they normally did [before the stroke], from the minute they wake up to the minute they go to bed at night,” Shrager says. “The long-term goal is always to increase their independence to their maximum ability and get them as independent as they want to be for whatever they want to do with their life.”

Occupational therapists help stroke patients with activities of daily living, including:

  • Bathing
  • Going to the toilet
  • Dressing
  • Preparing meals
  • Eating

They identify any assistive devices that will help a person with these activities. An example is using a grab bar on bathroom walls to help you get in and out of the shower and use the toilet safely.

With an OT’s help, a patient who has weakness in one hand can learn tricks to make dressing easier, like avoiding clothes with zippers and buttons. OTs also find helpful tools to assist stroke survivors, like specially-made cutting boards designed for one-handed chopping. Shrager calls these adaptations “hacks for health and home,” things that allow people to get back to doing the things they need and love to do.

4. Speech-Language Pathologists

Stroke can change your communication abilities in several ways. A stroke can damage parts of your brain responsible for producing and understanding words and sentences. Some people have difficulty reading and writing after a stroke. And many have weakness and poor coordination in the mouth and throat, which can cause swallowing problems, as well as difficulty with speech. Speech-language pathologists can help you with all of these issues.

After a stroke or other type of brain injury, people may have aphasia, which is difficulty understanding and speaking words. When you have difficulty controlling the muscles that produce speech, but no actual weakness or paralysis in these muscles, this is known as apraxia. Stroke survivors may have aphasia, apraxia, both at once, or no speech difficulties at all.

Speech-language pathologists will perform a swallowing evaluation and, if you have problems with drinking or eating, they will work with you over time to improve your ability to swallow a greater variety of foods and liquids.

5. Dietitian

One of the most important aspects of post-stroke care is taking steps to avoid a second stroke, and that may include consulting with a dietitian. Healthy eating combats three key stroke risk factors:

  • High blood pressure
  • Excess weight
  • Unhealthy cholesterol levels

According to the American Stroke Association, eating five or more servings of fruits and vegetables every day may help prevent strokes.

Besides guiding you on the best way to eat in order to avoid future strokes, a dietitian can also provide suggestions to you and your caregivers on how to make food more appealing, because many people have a poor appetite after a stroke. Good nutrition is essential for optimal recovery.

If you have difficulty swallowing, a dietitian will work with a speech-language pathologist to adapt foods to make them safe for you to eat.

6. Rehabilitation Nurse

Rehab nurses work to educate you on the big picture of life after stroke, including:

  • How to take your medications
  • What you can expect during the recovery process
  • How you can prevent another stroke

“It’s kind of an extension of what we’re able to provide in therapy,” explains Miller-Scott. “A patient might get three or four hours of therapy in a day, but there are 24 hours in a day. Nurses make sure those philosophies are carried out through the 24-hour day.”

7. Neuropsychologist

After a stroke, it’s not unusual to experience symptoms of depression, anxiety, post-traumatic stress disorder, or a combination of these. “Depression is common after a stroke, as is cognitive impairment,” says Grotta. “Sometimes it’s hard to tell the difference between them, and a neuropsychologist can help with that.”

A neuropsychologist can assess you for mental health concerns, as well as issues with cognitive function, such as poor attention span and memory loss.

“A neuropsychologist is more concerned with cognition, memory, problem-solving ability, and the ability to perform all these tasks we’re talking about,” Miller-Scott explains.

Once your mental health and cognitive function have been fully assessed, the neuropsychologist can work with your rehab team to develop an individualized care plan.

8. Support Groups

Attending support group meetings can be very important for stroke patients. “It helps to interact with people who have been through a similar experience,” says Miller-Scott. Many hospitals offer support groups for patients recovering from stroke, and the American Heart Association/American Stroke Association (AHA/ASA) runs support groups in many communities. You can find a stroke support group in your area by zip code through the American Stroke Association. The AHA/ASA also offers an online support network for family members of stroke patients.

9. Caregivers

 Family and friends play a very important role in the stroke rehab process, says occupational therapist Glen Gillen, doctor of education and associate director of regenerative and rehabilitation medicine at the Columbia University Medical Center in New York City. They may be the most valuable player on your stroke rehab team.

“The optimal stroke rehabilitation includes the care partner as part of the team, which means training them if the person who has had a stroke needs any physical or cognitive assistance at home,” Dr. Gillen says. “That really facilitates the recovery process, when there’s a caregiver involved as well.” The goal is to help you become independent after a stroke without the caregiver taking over for you.

Other members of the stroke rehab team will work closely with caregivers to make sure they’re well prepared and well educated for their role in supporting the patient, Miller-Scott says. “They are going to serve as the person’s advocate, so caregivers need to make sure the person recovering from stroke gets all the resources they need to continue to be as independent as possible and to live a meaningful life.”

Did you know that 50 million adults in the USA have a disability?

50 million adults in the United States who have a physical or mental disability.   I want to find a way to help this astounding number of brave men and women who battle more on a daily basis than many of us can understand.  Here are some web sites you can visit:

Information for Disabled Persons (HUD.gov

Disability Accommodation in the Home (Cost Guide

Certain Developments Housing Vouchers for People with Disabilities

A Guide for Disabled Homebuyers

Home Ownership for People with Disabilities

Keep Your Home through Debilitating Disease

American Association on Health and Disability Resource Center

Swimming and Special Needs

Stay Active with a Disability: Quick Tips

State-by-State Help for Family Caregivers

Guide for Family Caregivers

How Caregivers Can Take Better Care of Themselves

They are now stored in MEDIA CENTER under IMPORTANT LINKS  https://mybrainllc.com/links/

Putting the Public Back in Public Health
For more information, visit http://publichealthcorps.org/

We are answering your questions…3


How is your marriage now?
Our marriage is good!  It is a good thing because we spend all day, every day together.  All the things that made our marriage good pre-stroke are the same things that make it good now.  We appreciate each other’s strengths, work ethic, sense of humor, and willingness to compromise.  We have created new routines that work for both of us, giving us some variety in our days.  We have found our New Normal and we have found peace.

If you could give your pre-stroke self any advice, what would it be?
Buy more disability insurance!!  The financial pressures of disability are not fun.  Fortunately we had some disability insurance—thank God.  Without it, we would have lost our home, I wouldn’t have been able to stay home and take care of Gordon or be there for the kids.  Our outcome would have been completely different, and not in a good way.  We don’t have much, but we have enough to provide a stable, relatively normal home environment.  What a blessing.

How has stroke changed your lives?
Every part of our lives changed because of the stroke.  Gordon’s active, successful, productive life as a sales consultant is over.  My life of being active and involved in the community is over.  The plans and vision we had for our future are gone.  Our resources are limited so our opportunities are limited.  It took time to make peace with these changes.  We all mourned the loss of the life we worked so hard to build.  However, our new life has its blessings:  we appreciate each day we have together, we don’t worry about the future, we are grateful for what we have.  It certainly is not the life we planned but it is a life still filled with joy, love, and meaning.

Why did Jill write Painful Blessing?
I wrote Painful Blessing for several specific reasons, none of which were that I was dying to be a published author.  Reason #1: acquired brain injury, such as stroke, is devastating, scary, and lonely.  We can’t be the only people to experience the crazy unpredictability brain injury brings, but it sure felt like it.  Reason #2: even after all these years, recovery is ongoing.  There have been no shortcuts, just relentless hard work.  Reason #3: We want to bring hope to others going through their own challenges.  We encourage people to examine their life’s foundations.  Are those foundations unshakeable?  Reason #4: to encourage people to persevere through their challenges.  Life will probably be different on the other side but that is ok.

What role did your Christian faith play in your story?
Our Christian faith is the sole reason we are a success story.  When Gordon was lost in the fog of his stroke and I was facing the terrible realities alone, only the knowledge that my loving Savior was carrying me kept me from stepping in front of a bus and making the whole thing end for me.  Well, Jesus and love for my children kept me away from a bus.  Gordon’s is a story of recovery, mine is a story of surrender.  When I gave up thinking I had control, fully surrendered to God, fully acknowledged His power, and fully put my life and our future in His hands, everything was better.  Trusting Him allows me to accept our new life and embrace each day as it comes.  He has never failed me.

What are your favorite audiences?
My favorite audiences ask questions and engage in wonderful discussion after we speak.  I love the interaction with those who are willing to share, question, and relate to our talk. Each audience listens from its own perspective:  medical professionals, business professionals, young people, old people, men, women, survivors, caregivers, and everyone else.  The questions and discussions reflect the personality of that audience.  Everybody experiences obstacles at some time in their lives and our story is really about overcoming obstacles.  Our time together is meaningful and interesting and we all leave the room with hope.  I love that.

Jill Viggiano