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Knowing which muscles to build up!


catbeleu

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After Mikes stroke he was released from the hospital with only a little bit of therapy twice a day for about 30 minutes. They taught us how to transfer him from bed to toilet and how to dress him but that's about all we got from them. Now most of you know he has issues with his left side where he can only do very limited movements with his hand and arm. Well if we had known sooner just which muscles needed to be built up and which ones needed to be stretched this could have saved him a lot of heart ache and maybe just maybe he could have regained the use of his arm and hand without all the issues he now has. We have been in therapy now for just over three months two times a week both ot and pt. We have thankfully found an ot that actually knows what he needs to do to regain some if not most of his arm and hand but it is gonna take much longer now. When we came home from the hospital we had inhome therapists that told him to build up the muscles in his arm called the bicep, this was totally wrong for the issues he had. Spastisity had caused his arm to draw up and kept his elbow bent almost to his chin! The more we worked the less he could do. The bicep became so strong that it was over powering the tricep and the tricep was totally lost! His therapist now says that the bicep is so short and the tricep is so weak that is the reason he can't reach out with his arm. He still can't reach out and pick stuff up yet but he is getting there. He has the ability to move the right parts, his brain is connecting with the right muscles and nerves to move them it's just that they are so weak and some are so tight and short that they have to be rebuilt! This wonderful lady has been in the field for 30 years and is so knowledgeable! I wish we had found her months ago! Anyway the reason I have posted this is because Mike has insisted that I let everyone on here know that you have to know the right way to exercise and just because they call themselves a therapist doesn't mean they know what they are talking about! This lady tells us what to do and why we should do it! She explains which muscles, tendons and nerves are suppose to be working and which ones are not. If your therapist can't do this then we suggest you find one that does! She has told mike with hard work she doesn't see any reason he can't do most of the things he use to do! I wish we could afford to see her 5 times a week!!! He may not like that but it sure would help him recoop faster! LOL. I know this has been a long blog but I just wanted to let you guys in on this. Just another reason why we have this site, to share the things we have learned and pass them on to hopefully help someone else in their journey through this thing called STROKE!!!!! Love you all and you are in our prayers!!!!

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My PT and OT were like that and it helped me to get better but also to not harm myself in my attempt to. More isn't always better. I'm happy for you and Mike.

 

Jamie

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It takes very knowledgeable OT, PT and rehab personnel that knows what a person needs and how to apply what is needed over a period of time over and over again. The biggest thing is the brain is no longer connected to the body to give movements to the muscles anymore. It's your eyes now that is telling you what and when to move each muscle.

 

That's how we fall, we take the eyes off the foot thinking it knows when and where to move to but it doesn't. So we got to exercise all those muscles the brain used to control like reflexes. We lost that ability so now it takes the survivor and the care giver to make a routine to accomplish what's needed to make the muscles trained to move.

 

We can't get much PT paid for very often so home exercises must be done often or that part of our body stops working at all or slowly at best. You need to establish a schedule of stretching muscles day or night before bed or when we awake to give them a chance to work in our favor to help us do things. A bike is my go to item and the over the door pulley for my arm muscles daily is what keeps me doing pretty good physically.

 

You are only going to recover strength if you work at it using those muscles daily not every now and then. I use my scooter but I still do a fair amount of walking with the little puppy during the day on her leash! On her 16 foot leash she will go so far then wait for me to catch up to her. In the house she will go just so far then wait for me to get downstairs to put her leash on. So Mike got to walk, exercise and move around more everyday!

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He only had OT people that were interested in teaching him(me) to shower and dress. They were not really knowledgeable about what to DO with his hand/arm. I think part of that was, when the entire side is down, they know they only have a limited amount of time, and they focus on getting you walking. He really can't do none of that dressing/taking care of himself anyway, because of sequencing problems.

 

I'm so glad to hear you are having success with someone who is knowledgeable about Mike's problems! I am going to be putting Bob back in therapy very soon, and we'll see how it goes.

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A lot of the pts and ots are general: they treat all problems and disabilities. If you can find one that is primary stroke care you are lucky.

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Cat: Bruce's shoulder was subluxed, so in Rehab and In-home OTs could only work on dressing, grooming. Actually in-home OT discharged us so that PT could pick up the extra allowed time.

 

When the shoulder was back in position, Outpatient OT took over. Bruce has two and loves them, plus his pool therapist showed us what to do for the arm in the pool. In all fairness, Bruce's Neuro told me very early on not to expect much from the arm-hand.

 

Bruce gets Botox four times a year in the arm-hand (as well as his leg) and I do insist on the allowed re-eval yearly therapy and the second time is always a "brace check." One of the two also gives the hand-arm a good going over to see if anything is new and check our Estim settings. The one thing Bruce does without fail is Estim twice a day. As you advised, just reminding the brain that the limb exists and reminding the muscles to talk to the brain.

 

We too will have a long haul back to the progress Bruce made before the overtoning, if it happens at all. But you can be sure I will be using Mike as an example to Mister. It can be done. Thank you. Debbie

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Cat, If you have found a therapist you are both comfortable with stick with it. I can tell you from my own experience looking around until you find such a person is vital to success. My left arm was curling up and I knew it was just a matter of time until I would lose all use of it. I asked my local therapist when we were going to do something about that. The answer was when you are ready.

 

I searched the net until I found out about active release therapy. It promised to be something that might help me. I called an active release therapist in Wisconsin the closest I could find to Minnesota. He had me do movements in front of a mirror and tell him what was happening. He then told me he could help, but I needed to find someone closer.

 

My search led me to Thunder Bay, Canada, about 75 miles away. Since I was going to pay anyway no matter where I went that is where I went. I told the therapist I did not plan to become his retirement plan, but would continue to come to him if I saw improvement after no more that four treatments. He answered that if I did not see improvement after the first treatment, he would not expect to see me back.

 

I wound up seeing him ten times. The treatments were painful and difficult. I came home with bruises and very sore. BUT I had a smile on my face. The muscles do "shorten" but only because they are curling up. They don't initially anyway actually physically shorten. Active Release stretches them back out. It hurts. But it works. It is not for sissies.

 

I shared my story with a guy in Colorado who had stroked a few years before I did. He had given up on seeing any improvement. He checked into active release and found out it was developed in the city he lives in. He is now traveling the country in his motorhome with his wife. He was ready to sell the motorhome because he could not use it anymore.

 

The treatment cost me about $50 twice a week. I did the exercises he gave me to do in between sessions with him at home.

 

When I told the local therapist about my success he said he didn't think I was ready for anything that streneous.

 

Cat sorry this is so long, but getting your life back is important and worth going thru whatever you have to do.

 

If you are seeing results with what you are doing, good. I would however not give up the search for things that might work better or in conjunction with what else you are doing. Good luck.

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Cat, I just can't stop. Sorry. I often wonder if I have anything useful to contribute to this forum when I read of the heartbreaking stories I read here. Then a story like you and Mike comes along. If my story can inspire just one person do reach higher and do more, it is worth it.

 

While I was doing active release I was also trying acupuncture (short term help but not long term), the hand stretching device Saeboflex which really worked, and the neuromove estim divice which was not effective for me.

 

The moral of the story is this: I tried whatever I could find. Some helped, some did not.My small retirement IRA is gone, it funded some of this stuff. Was it worth it? As we say here in Minnesota, you betcha!! I was told I might not ever carry my canoe again. Six months after my stroke I carried it. That was six years ago. I still carry it today and I am now 67.

 

I still exercise vigorisly three times a week. Do I enjoy it? Absolutely not! It is an effort to motivate myself to do it every time. But I do enjoy getting my life back and doing what I want to do again. I do not wish to interfere, but I would be happy to talk to Mike and try to motivate or help him if that might help Best of luck to you both.

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Thanks George for all your input and wisdom. I think I have read your story before and told Mike about the active release therapy but it was a good while back and at that point and time he could not stand to move his arm due to severe pain in his elbow and wrist. Now that we have actually gotten past that it may be something he would consider doing in conjunction with his therapy if I can find someone close to where we live that actually does it. How would I look it up to educate myself on it and how can I tell if the therapist that does this is knowledgable and trust worthy? Any help you can give me is greatly appreciated. Oh and don't worry about how long your response is to anything I post, I have nothing but time to learn about anything that will help my sweet husband regain anything he has lost due to Stroke! Blessings to you and yours.

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I just did a google search for active release therapy. That took me to a organization for active release. If a therapist doesn't help after a few visits try elsewhere or maybe it just is not for Mike. You won't know until you try. I wouldn't worry about whether or not the therapist is trustworthy or not. Follow your instincts. Good luck!

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