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  • Paul Fink

My rehabilitation and the importance of goal setting

“I don’t aspire to be president of the United States, I don’t want to be an Olympic gold medal winner, I don’t want to be a major league ball player, but I do small things within my capabilities and set reasonable goals by just saying, ‘I’m going to do this,"

- John Merrill (Four-time marathon and half Ironman finisher)


My rehab focused mainly on three elements - Physio, Occupational therapy (OT) and Speech therapy including lots of re-learning and new things (eg speaking English, writing with left-handed, exercise, cooking, computer use etc) and lots of repetition exercises. I am a task-orientated person and I had a 'monkey see, monkey do' mindset and also I trusted the therapists implicitly.

In the early stages of my rehab, I was struggling... especially with goal setting. I thought it was obvious... My biggest goal: I want to be normal... period. I soon realised the importance of breaking down my big goal into smaller, short term goals and eventually I started to notice some improvements (maybe after two weeks moving in hospital) and with that I began to really enjoy my therapy sessions after. I was settled, in fact I instructed not allowed visitors with my sessions (except Loz and Oscar). My attitude was 'I'm working' - figuratively speaking - and 'best chance of improving is no pressure and no distractions'. My two priorities/goals - 1) my son; and my wife and; 2) get better [with therapy].

I sought feedback my progress very often with therapists because tiny feedback - (especially good feedback) - is essential. Because after that more motivation reaching my goals. Sort of snowball-effect eg. Good feedback -> more motivation -> more improvement -> more better-chance reaching my goals -> and more happiness with my life.

I was five months at Caulfield hospital and so many milestones and goals on the journey. I was allowed extending my stay because of my improvements - including ditched my wheelchair (one huge goal complete - 'walking'). I became so comfortable with my routine that I was anxious being discharged from the hospital because I heard that therapy outpatients less hours therapy (relative to inpatient therapy). I was slightly institutionalised by regular routine and easy access regular therapy.

Good word 'institutionalised' I reckon and I always reminded the 'Shawshank Redemption' movie.... specifically the scene:

In the hospital, each weekend, my nurse would put up a timetable for the week ahead. It included, Monday to Friday and every hour was accounted for, therapy, rest time, lunch. Everything was so structured and I was so set in that routine. My sessions always and purposeful guiding my goals to make it achievable and realistic. When I came home, I made Loz make me a timetable. She would get so frustrated, but I was so used to being told, and having it all written down in a timetable of what I needed to do when.

I was a hardtaskmaster with myself and I felt like I needed 'productive, structured therapy' all the time, and she would try to convince me that playing with Oscar, doing things independently around the house, catching up with friends was still 'therapy' and beneficial. I was putting what I'd learnt at the hospital into practice and I couldn't believe how much more exhausting it was. I needed so much more rest time to recover from some of the most basic tasks.

The exhaustion was most obvious to me with socialising. Prior to my stroke I was very social. I loved to see my friends, hang out in big groups and make lots of arrangements. Afterwards, I had to adjust my mindset. I had short visits from one friend at a time. This meant having one-on-one conversations, which was easier to follow than whole group discussions, but forced me to speak, so was like a solid speech therapy session, and afterwards always very tired! I have always found large group discussion very difficult since my stroke, as hard to follow the conversation with lots of people contributing.

Getting extra therapy time in was easy with Oscar. I would practice my speech and reading out loud with him, and the more I said funny sounding words or made mistakes with my sentences the more he laughed. He has always been my biggest supporter. Always there by my side. My therapists were amazing they helped me to set relevant goals around my time with Oscar and Loz.

Goals like, getting my son dressed, changing nappies, playing on the floor with him, putting him in and out of the pram or high chair. I even used cleaning his toys as a way to re-educate my right hand to start working. I would aim to pick up the toys, and then move my arm to place them in the bucket.

Most importantly, coming home allowed me to brainstorm more goals like how I could be more useful around the house and the most significant thing being more independent. I started to challenge myself to use my affected arm and hand to water the garden, hang up washing, and unstack the dishwasher. I could also start doing things I love like golf, walking, swimming, going to a normal gym and doing normal exercises like using the bike, weights, speedball and yoga.

I have a lot of goals in the future also eg. running, working, always improving, good example of my son, involved my child's education (eg. Take part in parent-teacher interviews)... make a difference and meaningful life... and lots more. It is important for me to balance my goals, my family, my friends, my therapy, my fatigue etc.

I am determined to get better, irrelevant how much time... But also I am a realist and eg. Playing test cricket with Australia - never happen- unrealistic. But both legs and arms working in unison is realistic - granted very ambitious goal - but can't hurt trying... what have I got to lose?

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