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Reflections on My Stroke Recovery

How I Came Back from a Massive Ischemic Stroke

As soon as the incident of having a stroke is under control, stroke recovery begins. The brain starts to slowly respond to the damage done to it, and will change its way of functioning. But each person experiences a stroke as a unique incident and will have a different recovery journey. It’s up to you how you decide to recover, but the most important thing is to decide to do it.

Stroke recovery is not a clear trajectory. It can be slow and unpredictable. It will seem as if recovery stops, but whether you accelerate or slow down, you’re still moving forward. How the brain repairs itself is still largely a mystery, and each stroke survivor’s prognosis is different. But in reality, even if it seems like you’re not progressing, your brain is doing something.

After my massive ischemic stroke, I focused on what had just happened to me. I remember being grateful I was alive. I thought about how bad the stroke was, wondered if my wife was okay, and considered what recovery meant to me. I began working on my mental emotional state first. This was important: it’s key to recognize the reality of your situation as soon as possible, acknowledge it, and accept it. For me, as soon as I came to an acceptance of what had happened, it felt like a ton of bricks was lifted off my back. That’s when my own recovery process started to pick up steam.

Determination, Passion, and Creativity

For years, I was a project manager at Price Waterhouse in New York City, working in financial services. My Fortune 500 clients wanted their problems solved. They called on me to take charge, analyze the problem, resolve it, and create better solutions. After my stroke, I drew on that experience: I took charge, transferring that “steps to solve” approach to my own physical and speech problems. I looked for ways to better spend my time than sitting idly watching television and tapped into the concepts of determination, passion, motivation, and creativity. No matter how big my tragedy, or how long the hospital stay, I stayed positive and I had faith. I believe those 2 factors are vital for a successful outcome.

Beyond the hospital walls, I continued to find creative ways to improve. For instance, I wanted my right arm and hand to be able to function again, so I practiced a constraint-induced therapy: to make myself have to practice moving them, I had my left arm and hand restrained. One day soon after my stroke, just before dinner, I asked my wife to tie my left hand behind my back so I’d have to use my right hand. At first it was frustrating and emotionally draining, but soon, slowly but surely, I began to see improvement. Every other night, I would make myself read a book using only my right hand to turn the pages. Again, it was frustratingly difficult at first. But it got better.

Different Activities, Same Routine

When I’m talking about recovery, I use the concept of osmosis: a gradual but continuous, successive, piecemeal process. After I was released from the rehabilitation facility in Chicago, I organized a schedule for myself that included going to the gym to do cardiovascular and weight exercises, and then trying to work on my brain. The brain work included trying improve my speech, intonation, fluency, and memory skills; get better at listening and following instructions; practicing speech workbooks; and reading books. But it wasn’t a new routine, it was the routine I had always had prestroke. I always had an exercise regimen, I had always socially interacted and talked with other people whether in a group setting or one-to-one. I had always needed time to work on my own and prepare for a presentation or a project. Now, instead, I used my down time to practice my speech or educate myself about strokes and the brain.

Among the specific activities I found critical to recovery was being involved in a Chicago-based voluntary program, Archeworks, which stretched my abilities. I worked on a mini-project with a project team to build and implement a movable stage for the arts community in Minnesota for 2 months. Just as important was joining a gym, Crunch Fitness, where I jogged on the treadmill and began working with a personal trainer who knew I was a stroke survivor. He gave me instructions to retrain my body using simple weight exercises and muscle memory, which I did every time I went to the gym.

Another invaluable step was working with a private speech language pathologist: we concentrated on my conversational speaking and I learned conversational techniques in addition to regular speech exercises. The rapport I had with my speech language pathologist was tremendous—I could ask any question related to my stroke, aphasia progression, or my daily life of activities. It was like having a confidante. All of these activities got me working my brain in different ways and boosting my physical mobility. I fired up the neurons in my brain by switching between the right brain and the left brain. I was building new synaptic pathways to replace the ones I’d lost. Now, nobody can tell which side of my body was affected by the stroke, unless they’re a physical trainer who knew me from the beginning.

Know the Patient

As someone who worked with so many clinicians, therapists, and other health professionals, it strikes me that recovery depends on the patient. Perhaps there is a way for the neurocritical professionals to read a patient’s medical history, and to speak to the survivor, as well as loved ones, family, and close friends. They need to first find out what the survivor is like—what is his or her emotional state and mindset prestroke, and then his aspirations for recovering? Each recovery plan should be based on the individual. Clinicians in neurosurgery and neurocritical care should also take into account how a stroke survivor responds following a stroke and his or her comprehension.

Stroke Recovery Takes Time

In my case, I figured if I really wanted to do something, it was up to me. There was no prescription or set therapy, no panacea to fix the issues I wanted fixed. But I stayed motivated and resolute. I found that the recovery process was really a journey: there were difficulties along the way and even continuing hardships.

That’s part of recovery. You have to be willing to work hard toward improvement, no matter what. You may find it’s a “two steps forward, one step back” process, with some days of remarkable progress and other days when you feel at a loss. Doctors, nurses, caregivers, and therapists can only guess how a patient will respond based on the location and severity of a stroke.

But having the support of loved ones, family, friends, and caregivers helps tremendously. I am living proof of having a great support system—they are why I can be here writing this. So set your life up so you can do the work toward improving, gather your network of supporters, and commit to the journey. It’s up to you.

**Originally published at ScienceDirect

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