Use the force Paul...

January 3, 2019

 

Being a very healthy man before my stroke, my first experience with Occupational therapy (OT) in my life was after my stroke, so starting my rehab at Caulfield Hospital - with a one-side paralysis - was a difficult to grasp - pun intended - relative to physio and speech therapy. It is important to me if you understand my rationale for this thinking re- ‘relative to’ other therapies, so I will explain.

 

After waking up at the coma, my speech was almost zero but, however I was accustomed to the English language because my first language was English, so speech therapy makes sense with my brain - luckily it was not a blank canvas (eg. I couldn’t talk but I can read silently - refer this blog). I was the same thing with physio - past sports injuries helped me to understand physio jargon also, but OT it was very, very foreign for me.  

 

I would describe OT as lots of repetitious hand function for improving in my right [affected] side; and finding ways to help people live more independently within the community and re-learning to do everyday activities eg. self- care, cooking, cleaning, driving, navigating public transport, leisure activities, and performing personal hygiene tasks etc.

 

 

After moving to Caulfield Rehab, I was taken to my first therapy session which was an OT group session - not one-on-one, therefore my initiation -  at my first day in rehab - was a difficult, upsetting day. I remembered other patients with different degrees of disabilities, unfamiliar people and weird gadgets and I thought it was like the stereotype of a 'mental institution'. I left early and frustrated because at the time I had no real understanding extent of my issues and how significant my deficits were. I cried on the way back to my room, with my wife pushing me, she also felt absolutely demoralised by the experience.

 

Speaking honestly, OT was my least favorite of all my therapy sessions. Mainly, I was disheartened because can't see it [the progress], while in the other areas, my speech and mobility, I was seeing lots of obvious and quicker changes.

 

Thank goodness all my occupational therapists were fabulous. Bianca was my inpatient therapist, and she was excellent, caring, fun (and she loves footy!). She took the time to get to know me and found ways to make my sessions relevant and as enjoyable as possible. Although OT was tough and very tiring, I was stringent and diligent and made the effort to go and try my best.

 

I found OT challenging because I was used to trying to give 100% (physical) effort and get in a sweat during (eg physio sessions), but I learned that it is not best practice in OT. It is about relaxing the muscles and improving my fine motor skills. Meditation helped a lot in OT - especially with my breathing.

 

 

My five months in Hospital included lots of upper limb rehab exercises, Saebo technologies, Botox injections [in the Caulfield spasticity clinic], re-learn kitchen stuff (making my breakfast etc) and also my family bought a ‘e-stim’ [electrical muscle stimulation] machine to re-educate my right arm and fingers to work. Bianca and my wife encouraged to use it at my hospital bed and in my spare time, I think, definitely helped my acceleration of improvement my hand and arm movement. I am almost five years post-stroke now and I am still using this machine.

 

 

I even tried ‘jedi’ tricks for my arm and hand - visualising the limb moving and try to ‘feel the force’ - similar to this scene at Star Wars (below), however I read somewhere that Star Wars creator George Lucas originally intended for the Force to be a spiritual, mystical or magical phenomenon, so hand motions are not required to use the force. In saying that, I think it is lots of resemblance for OT - mainly the concentration in the exercises and keeping faith in the processes, even if cannot see it yet.

 

 

Obviously, I am half-joking about the Star Wars references, but I remembered one day - almost after discharged at the rehab hospital -  all of a sudden my right fingers were moving… it was very subtle involuntary movements and captured with my phone camera [look my on the index and middle fingers]. I was very excited because it was a tangible progress in my movement. Everyone has to start somewhere I guess…

 

 

My OT outpatient and community therapists helped me tailoring my life to be more independent. That included prepare and cook dinner in the kitchen and the bbq, do the washing, clean the windows, watering the garden, take the bins out and same time they were encourage using at my right hand and arm (if possible) with any tasks. They showed options for adaptive devices to use at home to help do everyday activities more easily with either using one hand or using my affected side. They also introduced me back to using public transport because at the time I was not driving.

This year, I tried a different OT rehab because I was keen to try it new things. It is called a ‘Hand hub’ using OT technology available at Royal Melbourne Hospital. It involved 12 weeks therapy using computer games hooked in with Saebo technology. It is available this rehab centre only in Melbourne. I was excited about this new therapy, and something different, however the games are repetitive and the technologies are outdated… still it was beneficial and free to use (with a referral).

 

Being right handed (and right footed) pre-stroke, I am amazed how the brain re-wired (eg. neuroplasticity) adapt my conditions for living in a disability and basically I am left handed now. For example, playing kick-to-kick with my son - one goals was in the hospital - I use my left foot now, and my precision is improving all the time. Hopefully on the future, my right side will be more functional. The obvious tangible improvement is my handshake and I feel my right side is improving still.

 

In closing, thanks to my occupation therapists - especially - Bianca, Camilla, Anthony, Delia, Emma, Karen, Andriel, Tim, Jen, Ciara, Sarah, Tracey and Dr Mithu Palit (my Rehabilitation Physician) for helping me to be more independent. Thank you to the rehab centres (Caulfield Hospital, Epworth Hospital, and Royal Melbourne Hospital) and also thank you for my family because they were (and still are) very supportive for my recovery and they make every effort to let me achieve good outcomes, and I am very thankful for that.

 

My journey continues… and hopefully the force is strong with me :)

 

 

 

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