Part One|Part Two| Part ThreeCome along on the real life stroke recovery story of Mack Lowell. Witness his long journey back and the physical mental trials he faces along the road to recovery.
(Editor’s note: Any treatment undertaken to combat a medical problem has varied results for different individuals. The experiences portrayed here are those of Mack Lowell and would be different from the experiences of other stroke patients. A conversation with your doctor is the best way to determine the appropriate course of treatment for you or a loved one.)
By: Jean Johnson for Heart1
Frustration and worse inevitable for Mack Lowell? So far the jury’s still out, but it’s not looking very good. From the therapists two weeks after the stroke came, the word that the leg would probably come back but the arm was less promising. As the time moved on, though, hope grew less bright.
Still, with what pride Lowell could muster – and probably a goodly amount of denial – he acquiesced to an endarterectomy to ream out his clogged carotid artery so at the very least he wouldn’t have another stroke. The procedure lasted over three hours. Instead of a general anesthetic, they sedated him and used a local in order to monitor his cognition and make sure the procedure didn’t knock a blood clot loose that could cause another stroke.
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Learn the common effects of stroke:
Weakness or paralysis on one side of the body
Problems with speech and language
Poor balance or clumsy movement
Not knowing what happens on one side of the body
Trouble swallowing
Problems with bladder or bowel control
Problems with memory, thinking or problem solving
Poor vision and/or changes in vision
Numbness
Problems getting around and caring for yourself
For more information on the stroke rehabilitation process, visit
the National Institutes of Health. |
“They strapped me down so I couldn’t move and kept asking me questions,” Lowell said. “I’m claustrophobic, and it was one long panic attack – the worst thing I’ve ever gone through.” Perhaps so, but once the several days of recovery he needed to stabilize after the surgery slowly passed, Lowell discovered he had a new trauma in store. The acute phase of post-stroke therapy the hospital provided was ending. Despite Lowell’s persistent interest in returning home, it wasn’t in the cards. Instead, phase 2 meant what everyone dreads – the big black ogre of the nursing home.
It was a skilled nursing facility, and he would get therapy to learn to compensate for his left side, but it was still an institution. Lowell feared getting stuck there. “They’re just going to dump me in that place,” he said. “I want to go home.”
His physician, a family practitioner in Flagstaff, didn’t see it that way. At the skilled nursing facility Lowell would be able to progress as much as he could, albeit slowly. “What further progress you make will be minimal and quite slow,” the physician said. “What will come will be very slow and difficult to measure from week to week.”
Lowell’s sources of information are not limited to the 50,000-strong town of Flagstaff and the pronouncements of single family practitioners, and he is aware that hope and motivation are two critical factors in stroke recovery that surprise neurologists all the time. That said, an article in the April 2005 issue of the New England Journal of Medicine, “Rehabilitation after Stroke,” that pegs stroke as “the most frequent cause of adult-onset disability among people in the United States,” that affects 400 in every 100,000 people over age 45, tends to confirm the assessment of Lowell’s physician.
“The likelihood of improvement after stroke varies with the nature and severity of the initial deficit,” wrote Bruce H. Dobkin M.D. “Approximately 35 percent of survivors with initial paralysis of the leg do not regain useful function, and 20 to 25 percent of all survivors are unable to walk without full physical assistance. Six months after a stroke, about 65 percent of patients cannot incorporate the affected hand into their usual activities. Poor upper-extremity outcomes are probably after a hemispheric infarction when the leg cannot move by two weeks and the hand has no movement or only slight finger flexion with no opening by four weeks, consistent with considerable damage to the corticospinal tract.”
The skilled nursing home where Lowell stays at the moment is many notches above the dark, antiquated institutions of the 1950s and ‘60s that smelled of urine. Elk feed in the forest surrounding the sprawling complex on the edge of Flagstaff, Hopi and Navajo art fills the place, and there is a library with big print fiction that Lowell finds he is able to concentrate on well enough.
Still, the nursing facility is not home. And currently if he were to go back to his trailer, he’d need someone there around the clock. The hope, of course, is that this old hiker will find the strength to beat the odds. That Mack Lowell will be able to put together enough neuronal action to at least regain some use of his leg that could get him in good enough shape for his pals to help set up shop at home. But if that happens, it will most likely take months, and in the meantime, the strain on Lowell’s psyche is substantial.
“The worse thing is the boredom,” he said. “The hours go by like grains of sand.” His friends, of course, try to help. They brought in more tunes and a boom box. Put on the Grateful Dead and asked him how that sounded. Hunched over in his limp left arm as if trying to protect it from further assault, he managed to lift his head for a listless, monotone reply. “Not too good. Take it back home,” came his words. “I’m not in the mood for music.”
Continued in Part Four
