stroke rehab

[lnch]

my husband had massive stroke on right side.  he is paralized on left and the eye doctor at the skilled nursing facility told him he is blind and nothing can be done.  He claims he can see at times but not good. SHOULD I get a second opinion? His ability to swallow came back (feeding tube being removed on Jan.17.  He had the stroke on 11-10. There are times that he is able to have a intelligent conversation. He always knows the answers to the usual (date,where are you,etc) He keeps rolling out of bed or wheelchair because he says he is going to walk. He is 67 and was an avid sportsman. He is a concrete mason and was on a job when he had the stroke. By the way, in november his icu doctors suggested hospice.

[oc1dean]

The whole problem here is that the medical world does not have any clue as how to approach getting stroke survivors back to full recovery. They are hoping that your spontaneous recovery in 6-12 months is enough to satisfy you. What needs to be done is idenfify the penumbra and those functions, these are helped by standard therapy protocols because you still have a limited ability to  do those functions and repetition will help recover them. The second part is to identify the dead brain area and the functions they covered. This requires a totally different approach, mainly you need to neuroplastically move those functions to another part of your brain. Some therapies than might be able to accomplish that are; mental imagery, passive movement, mirror-box therapy, thermal therapy. I would say your crucial answer is to completely understand neuroplasticity and find therapists who understand how to do that. But what the hell do I know, I'm just a stroke-addled survivor,

[mj656]

I'm not an expert, just the spouse of a stroke victim that is fighting the system tooth and nail.  But, IMO, yes, you absolutely should get a second opinion.  And, if you have insurance or can find a way to afford it, get your husband out of a skilled nursing facility and into an acute or post-acute care rehab facility, preferably one that specializes in brain injuries.

My husband had a severe stroke in August and is currently in a neurorehab.  He was paralyzed on the right side, lost his ability to speak intelligbly, had no sense of balance, couldn't swallow, short-term memory loss, and had many cognitive issues.  I was told initially that he'd never walk, would probably never use his right hand, etc. etc. etc.  Now, nearly six months later, he's walking unassisted, has regained short-term memory, has most of his balance back, is regaining some use of his right hand, is learning to talk again, and has made a good deal of progress with cognition.  He still has a long way to go, but I see improvement every day - sometimes small things, sometimes huge.  Will he ever regain 100%?  Maybe, but probably not.  90% is more realistic, but believe me, I'll take the 90%.

The key to his recovery has been - and will continue to be - intensive rehab.  The facilities he has been in specialize in brain injuries and he receives 6-8 hours of therapy each day - physical therapy, occupational therapy, vision therapy, neurocognitive therapy, and speech therapy as well as sessions with neuropyschiatrists and psychologists.  It's working.  And I see miracles being worked at that facility every day.

Don't take "nothing can be done" for an answer - the fact is that nobody knows how much an individual can recover after a stroke until many years have passed.  Most recovery will happen in the first 4-6 months, will continue at a slower pace for a year or two, but improvement can still happen for years.  Your husband is still in the window where the most recovery is possible.  Every stroke is different, but who's to say that he won't be one of the ones that can make a substantial recovery?  Do everything you can to get him into a brain injury rehab program as soon as you can.

There are places that can help.  Educate yourself - start out with the National Stroke Association.  See if there's a brain injury association in your state.  Find out what resources are out there and see if you qualify for any financial assistance.  And don't give up.  

I've had to fight the insurance company every step of the way.  They deny coverage, I appeal, they deny again - it's an exhausting battle.  For the most part, I've prevailed although I've had to foot a few of the bills since we don't qualify for any assistance.  It's not easy, but it is possible.