Part 13

Isaac

One situation I found hard to tolerate during my rehabilitation was the attitude of some of the professionals that I met at this time. I know I had some brain damage, but I was not mentally deficient. I felt disappointed that I was only given repetitive exercises to do. Having to screw nuts and bolts together only to then have to unscrew them again destroyed any sense of achievement that I might have had, Mentally stimulating challenges that exercised my mind as well as my body would have given me a sense of pride in myself.

My physics training tells me that Newton’s Third Law of Motion defines that work is done when the point of application of a force moves in the direction of that force. In other words, if there is no movement or progression, there is no work. If you keep hitting your head against a brick wall and the wall does not move, you have not worked. All that you have achieved is a splitting headache. Yet in all the effort that I undertook I never moved forward. My self-esteem would have been uplifted if some of the bolts and screws I had laboriously connected together had stayed together. They could have formed part of a toy or a useful appliance instead of being recycled for the next person.

Maybe each of us could have been given a crochet hook, or a pair of knitting needles and some wool and been encouraged to produce something useful. Knitted or crocheted squares could be sewn together to create a rug for a nursing home or sent to World Vision for a needy child in a refugee camp. Comfort bears, scarves or small jumpers could have been introduced into our program as homework pieces. The knowledge that we were helping someone less fortunate than ourselves would have given us a great boost to our confidence and proof that we could still be useful.

Walk in my shoes

I believe it would benefit all physiotherapy and occupational therapy students if they were given the opportunity to experience for themselves how our deficits affect our lives. Part of my training at Peter MacCallum Institute had been that as students we were to understand what it would be like to be one of our patients. We had to tolerate lying on the treatment bed, perhaps with our heads immobilized with heavy sandbags to prevent any movement on our part, while being wheeled into position under the large x-ray machine. We learnt how it felt when someone accidentally bumped the bed. An overwhelming sense of dread spread over us when we saw the huge machine hovering over our bodies. It certainly taught us to be considerate of our patients and aware of their fears. We knew we had to be careful moving the bed around and not jarring the nerves of its passenger. We could identify with the disorientation that occurs when one is lying down and is unable to see where they are going. Understanding how our patients felt gave us greater insight and we could empathize with them.

If it were possible for all the current Physiotherapy and Occupational Therapy students to only use one hand for a day, they too might gain in understanding how a stroke survivor carries out his daily tasks. If the dominant hand of each student was constrained into a clawed position for twenty-four hours and the students were expected to prepare and cook a meal, cut up their food and feed themselves, shower and dry and dress themselves they would learn some valuable lessons. More difficult to organize, but never-the-less useful would be to attach a thin blade, like one on an ice-skating boot, to the sole of one shoe and the students would have to balance themselves on this when they walked around.

Practical and helpful suggestions to make life easier for stroke survivors would be most appreciated. Offering advice that makes moving around more difficult and dangerous is not in the best interests of the survivors. One Occupational Therapy student suggested to one of my friends that she should rearrange her efficient kitchen layout, instead of the safe environment where she could move around without her walking stick in her one functional hand. The student considered that by moving the refrigerator further away from the bench therefore increasing the distance the stroke survivor had to walk unaided, the more she would benefit from the imposed exercise.

Cheers

Once when I was speaking to a group of recent stroke survivors, I emphasized the importance of continuing their rehabilitation at home. They had now finished their time of being supervised by the various physiotherapists and occupational therapists at this community health centre. It was time for them to take charge of their recovery and to do it without support.

I reinforced the necessity of continuing to do the exercises they had been given to do. However, unless they understood the reason behind each exercise and its relevance to their recovery, they would most likely forget to do it. One exercise I suggested they continued with variations was in having to lift up a glass tumbler and then put it down and repeat these actions over and over again. Instead of using an empty glass, I proposed that they do this exercise with a small amount of wine or beer in it. After ten or more repeats of the exercise they could reward themselves with a sip of the drink. The group responded enthusiastically to my suggestion and cheered loudly. However, the staff was horrified and shocked by my words. ‘You will turn them all into alcoholics’.

It is very important to set realistic goals for ourselves to keep us motivated. We also need to reward ourselves when we have faced these challenges and conquered them rather than berate ourselves for a poor performance. It might take some time to see an improvement, but we still need to keep on trying and not give up because we set our expectations at too high a level.

Our lives have been compromised by our strokes and we have to live within our abilities, but we can test the boundaries every day and challenge our limitations. It may work, it may not, but we need to try and never give up or settle for anything less than our very best selves.