When caring for stroke survivors, balancing realism with hopeful enthusiasm is important, says Andrew Buxton, who shared his personal experience with health professionals at the South Island Stroke Study Day. “Reality is good, but hope is essential.”
Andrew spoke alongside his wife Peta about their journey following his stroke, at the annual event held in Christchurch. “One day I was fit and healthy and had no known risk factors, then two days later I’m in hospital, looking at a very different future. Somewhere in the first week, I knew I had a choice – I could either give up to self-pity or turn it somehow into a positive and make the most out of anything that happened.”
In August 2018, Andrew lost the use of his left arm and leg after a stuttering, slowly progressive stroke at their home in Christchurch. Following an unsuccessful clot buster treatment, CT scans and an MRI, he was told improvement wasn’t expected and the loss could be permanent. “That was very hard to hear. You’ve got to keep a bit of hope there or that’s where there could be an entry for depression.”
Andrew felt there was also some room for improvement with the transition from hospital to home. “After being discharged, I felt very much on my own. There was a delay in community services. Some form of therapy and physio needs to be offered straight away. We were lucky because we are well resourced, but not everyone is.”
Andrew’s engineering background, positive ‘can-do’ attitude and problem-solving skills have been useful during his rehabilitation. He can now walk and has also partially regained the use of his left arm. He joined other community groups and has ‘Exercise as Medicine’ sessions with a personal trainer, and now has a specially designed and built ‘recumbent trike’ (very fast!) to maintain his fitness.
After initially looking at a possibly bleak future, he can now cycle with Peta, drive, go camping, and play golf with one hand. “Relying on others to get around was a pain, and I really wanted to drive my truck again. So, I went through rigorous testing and passed my licence. It was wonderful to be independent with wheels again.”
The role of positivity is ‘everything’ during rehabilitation, says Peta. “Andrew is an optimist. This helped him stay positive and push himself. I’ve had profound moments of sadness watching him at times, but it’s important not to give in to self-pity, to keep perspective, and to be grateful for what you still have.”
During Andrew’s stay at Burwood Hospital, he wrote the words Normalise and Conquer on the whiteboard at the end of his bed. “In other words, accept the new normal and get on with life,” he says. “How did that work for me? Pretty well. I achieved a lot. Not everything I wanted to though. I had to compromise on some things. I can still go fly fishing, but I need to use a specially-designed chest harness.”
Andrew’s inspirational story exemplified what one of the key note speakers of the day, Southern DHB physiotherapist Dan Harvey, spoke about – encouraging independence in rehabilitation and increasing practice outside of therapy.
Dr Carl Hanger, Geriatrician and Stroke Physician at Burwood Hospital in Christchurch and Clinical Senior Lecturer in medicine at the University of Otago, Christchurch, says health teams need to encourage patient practice in-between rehabilitation sessions. “Being actively involved helps to rewire the brain.”
Delivered jointly by the Stroke Foundation of New Zealand and the South Island Alliance, South Island-wide stroke service providers, stroke teams, GPs and practice nurses from across the continuum of care learnt about a wide range of stroke-specific topics on the day, including post-stroke depression and grieving, maximising communication and increasing socialisation for patients with aphasia, and optimising community rehabilitation.
Dr Hanger, who is also one of the organisers of the event, says feedback from the day has been positive. “The speakers were all excellent and one of the attendees said they have been involved with stroke service delivery/development for more than 30 years, and they still learnt so much.”