Saturday, October 26, 2013

Rehab From Rehab

I'm learning to walk all over again — again. This time, my privately hired therapist and I have the same goal: to get me walking normally.

My therapist at the insurance-provided rehab hospital where I spent 21 days in the weeks after my stroke had a different goal: to get me functional. That meant walking however I could manage it. It didn't matter that I was locking my knee; didn't matter that I contorted my torso; didn't matter that I balanced all my weight on one strong hip. Didn't matter. What mattered was getting me functional enough to send home.

Today it matters. I don't want to erode the cartilage in my knee, or develop spinal and hip problems. As I work to undo the bad habits formed over the past three years, I think about the whole post-stroke rehab industry and wonder what could be done to improve it? Why didn't someone take the time to help me recover my muscle function correctly from the beginning? Was I incapable? Would that have taken too long and cost too much? Isn't cutting corners going to cost my insurance company more later — when improper function leads to knee surgery? When drugs used to control spasticity cause complicating side effects?

One way to improve stroke recovery is to avoid permanent brain damage in the first place … climb on the Dean bandwagon and demand a stop to the neuronal cascade of death. But how do we help those for whom that’s too late? How do we align the goals of rehabilitation providers with rehabilitation patients? Because yes, after 21 days of insurance-covered room and board at rehab, I wanted nothing more than to go home — except to someday again be normal.


  1. A lot of our medicine is short sighted unfortunately. Get from A to B without considering C. I'm very glad to hear you're getting this new rehab.

  2. Doing by any mean (adaption) is less costly than recovery the right way.. Glad you have the chance to relearn the right way.

  3. Hi Marcelle,
    Your knowledge and understanding support you going forward.
    I so admire your willingness to begin again and your courage to change the things you can.

  4. I may have to do this myself before I destroy my bad side hip and knee. Not sure that a PT will be able to help because they have no clue on how to stop spasticity.

  5. It's my good side knee that's causing most of my troubles these days - "resting" it means no rehab for my affected side. Demanding too much from my affected side walking (distance/speed) causes too much pain and swelling in my unaffected knee.

    I wish I could have a PT who focused on me walking properly. I envy you. Best of luck - I hope you found a good one!

    I LOVE Dean's bandwagon.