September 20, 2018

The Only Magic Bullet I Have Found

Sometimes stroke survivors tune people out, but not necessarily for the reason you think.  When I am struggling with a task, I start talking to myself.  For example, when I heard my toe scuffing the floor because I did not lift my leg high enough in the 1st year I silently said "knee up, knee up."  If someone was talking to me at that moment I did not hear what that person said.  I cannot listen to someone while I am talking myself through a task that able-bodied people do without any thought.  For a stroke survivor multitasking can be walking and talking at the same time.  If you wanted me to process new information or I wanted to participate in a discussion, I needed to sit down.
I call avoiding multitasking a magic bullet because it has an immediate effect.  By not dividing my attention, I can focus all my energy on the part of my brain I need to use right now.  When I take a hot dish out of the the oven I stop talking to guests.  I need to make sure my hemiplegic hand maintains a firm grip on the 400 degree handle.  When I drive during rush hour I turn off the radio.  I need to respond quickly to aggressive, unpredictable, impatient drivers.

I am not saying stroke survivors can never multitask.  However, it can take 100 repetitions before a task becomes so automatic that I can simultaneously pay attention to a second task.

September 12, 2018

Compensation Does Not Make Me Sad

I want my deficits to disappear but current science cannot give me complete recovery.  In addition to remediation I use compensation which is a modified way that lets me do a task.  I would lose my will to live if a long-term care facility required me to meet a nurse in the snack area 3 times a day because "seniors feel safer when a nurse gives them their medicine."  Can you spell c-o-n-t-r-o-l?  Independence is a core value that makes me who I am.
Focusing only on remediation for clients with chronic conditions that will never go away does them a disservice.  For example, making clients with a chronic lung condition (COPD) walk on a treadmill for 5 days in the hospital is not a long-term fix.  Clients with COPD need energy conservation 
so they can stay active when they go home instead of letting fatigue and shortness of breath turn them into couch potatoes.  Perhaps this is why OT had a significant effect on reducing hospital 
re-admissions for clients with COPD while PT did not (1).

1. Rogers, A., Bai, G., Lavin, R., & Anderson, G. (2016). Higher hospital spending on occupational 
     therapy associated with lower readmission rates. Medical Care Research and Review, 1- 19.