The circumstances of each individual and degree of recovery vary widely. There is one common pattern, however, that leaves many survivors of stroke or TBI with a persistent [chronic] speech or cognitive deficit. For the purposes of this post, I'll coin the term "Attention Deficit."I selected a photo of me working in a pool to provide context for where and how the one hour sessions of speech therapy three days per week fit into my entire rehabilitation effort.
The physical rigors of therapies to re-acquire coordinated movement of my affected leg to walk more than 200 yards without a cane took months and were exhausting: Weeks of work on a treadmill suspended on a harness...THEN weeks performing sets of stepping drills in hospital hallways
The effort devoted to physical therapy was an uphill battle - due to the cumulative fatigue of day after day negotiating getting shaved, showered dressed,and fed with only one functional hand.
AND....
Each physical therapy session required a family member to transport me to and from my day at outpatient therapy.
AND....
My family spent endless hours with paperwork that shuffles between the service providers and insurance to assure I was getting the care I needed without exposing me or my family to financial ruin.
BACK to the setting of the pool.
Feel the burn. Smell the chlorine. Imagine all the frustration knowing that some anxious relative is pacing nearby....take a deep breath.
OK. Now sit down.
Shift your attention to speech therapy or "Brain exercise."
You are now reading a passage rich in details: names of people performing various tasks in possession of various objects. Now, try completing a grid that represents who was doing what with?
At some point, I began to make choices about priorities. My attention was overwhelmed by prospect of work on a host of deficits and no clue as to how I ought to prioritize ALL the work. One day, with NO dramatic "I quit" moment, I just didn't care if I couldn't finish some childish worksheet. I was exhausted from the time working on my shoulder in Occupational Therapy and already woried about working my fine motor control after dinner by practicing picking up coins with my limp, weak hand.
I guess that quiet surrender that day surfaced in the quality of my work with speech/cognitive therapist. Because I put cognitive therapy on a back burner, my therapist had no choice but to report that I ought to be discharged - as insurance often will not cover certain therapies once a patient is no longer demonstrating progress.
The moment when I "dropped my pencil" captures an inside view of the circumstances that leave many survivors of stroke or head trauma with chronic communication deficits...AND few options to re-qualify, afford, or access the care that might help.
For many survivors, attention and energy for work on "intangibles" like speech or cognitive issues falls to the bottom of a long list topped by work on issues like mobility or self-sufficiency with preparation of meals.
