1. Feel. (Even if it feels bad)

That’s right. You read this correctly. Go for it. You do not need to be professional or precise with your life. You’ve had a stroke or your loved one has had a stroke and your life has imploded in front of you. This is a messy and challenging time. Allow yourself to feel the worst-case scenario. Label it as just that. Give yourself an allotted amount of time each day from 5-10 minutes to check in with how you are feeling emotionally. Really feel the good bad and the ugly, then begin to imagine. Imagine yourself at the beginning of your journey. Begin to shape your stroke survivor narrative. This is the beginning of your hero’s journey: this is where you will meet your limits and redefine them.

2. Sleep.

I know. I know. Sleep?? Coming from an OT who drags people out of bed for a living? I’m sure your thinking: “that’s rich coming from you.” Listen, I get it. In the hospital you got woken up every couple of hours to get your vitals read and then some pesky OT, ST, or PT woke you from your nap to start therapy. On top of that, you might have insomnia or bladder issues complicating your sleep. If you returned home, every midnight trip to the bathroom is scary keeping you up at night or you can’t get comfortable because you can’t use one side of your body. Sleep can be difficult to come by post stroke, but it is VERY important. Even resting in between therapy and your meals is vital to your progress during this time. When we sleep we flush out our toxins, and simply put, give our brain a break from voluntary commands. Wherever you are in your recovery, two years or two months, your brain is working harder than ever to heal and to rewire itself. Commands that were once involuntary are now very voluntary. It needs a break. It is just as important or dare I say MORE important than your therapy. Sleep. Rest. Repeat

3. Find a Neuro therapist: that YOU like.

What does a neuro therapist mean? Well, there are a couple credentials such as NDT Neuro developmental therapy, Neuro-Iphrah like NDT (but with electrical stimulation), and PNF (Proprioceptive Neuromuscular Facilitation). Explanations of each of these are forthcoming in a new article, but these are credentials you can look for; however, I have worked with some incredible PTs’/OTs who do not have these credentials and are extremely adept at working with stroke. The biggest thing is: have they worked within this population? Ask questions. Has your therapist worked with someone like you? Has your therapist worked with spasticity(high tone), flaccidity (low tone), aphasia (difficulty speaking or understanding speech), hemiplegia (inability to use one side of the body)? Perhaps the MOST important thing is your “fit” with the therapist. You could have a young fresh therapist who has had limited experience with stroke inspire you to take ownership in your treatment plan. You could also have a seasoned therapist make you feel comfortable and relaxed in the knowledge that you are in good hands. Find the person that matches you and work WITH them. This is a partnership. Show up, put the work in, and expect that from your therapist.

4. Acknowledge small Achievements.

Oh brother, this is a tough one. Sigh. Sigh. SIGH. This is hard to drill into the fragile psyche of a stroke survivor. I shake my fists at the fates every time I find myself sitting with a new client who is determined to 1. Know when they will be better? 2. Say “no pain no gain” several times in a session. 3. Focus only on the end goal and forget the rest. This last one. KILLS ME. I feel like screaming and every hair on my body goes on edge when I notice this habit developing. Achievable small goals are key to this process. Celebrating them is the difference between a stroke victim and a stroke survivor. A survivor acknowledges that they can place their hand on a table, even if it is stuck in a fisted position. A survivor recognizes, when they can scan several words in a row. A survivor, understands how wonderful it is to give someone a thumb up or the finger. They acknowledge the miniscule and celebrate it.

5. Integrate therapy into your everyday life

This is perhaps the hardest step and I should preface it with a disclaimer; you may not be ready for it. If you wake up every day forgetting that you had a stroke and then remember in a sort of nightmarish cycle, you are not ready. Integrating your stroke life into your “regular” life: your roles, relationships, loves, hates, duties, and joys comes with ACCEPTANCE. I could write book on this subject. Suffice it to say, it isn’t what you think. Acceptance isn’t giving up. It isn’t resignation. It is similar to acknowledgement, but more fluid. Acceptance of the fact that you had a stroke allows you to begin your new narrative. Same life, same person, different chapter. Like I said, it isn’t what you think. After you accept where you are, with all you can and cannot yet do, you are ready to integrate. You can begin to bring therapy home. Your therapy becomes less exercise and more “doing.” You begin to self-analyze (different than criticize) and transform your daily activities into tiny therapy sessions. This is when you cross the bridge from patient to person who experienced a stroke or neurological event. Real healing happens here.

Five Things to do After a Stroke