When God Closes One Door…
Nothing strikes greater fear in our hearts, than the possibility of lifelong disability. Sadly, modern medicine’s many advances, are yet to guarantee complete recovery from paralytic strokes, with the sceptre of lifelong disability looming large for stroke survivors.
Mrs L , an 80 year old housewife, was taken to one of Chennai’s major hospitals, after she suffered a brain haemorrhage. The event had rendered her unconscious, paralysed on the left side, unable to speak and swallow. Doctors in the hospital had done a wonderful job of saving her life- using a ventilator, tracheostomy and Ryle’s tube to allow her to breathe and receive fair nutrition. Three weeks on, when she was transferred to our care in a partner hospital, Mrs. L was barely conscious; had a tracheostomy tube, feeding tube and catheter in place, was severely paralysed on the left side (not even a flicker of muscle contraction), had excessive throat secretions and severe chest congestion.
After the TriMed comprehensive 360* assessment overseen by our neurologist and rehabilitation physician, supported by our chest and ENT physician, we optimised all her medication including broad spectrum antibiotics and nebulisation, and introduced moderate dose intravenous steroids to kickstart brain function. We also started to deliver to her, on her bedside, an integrative therapy program, including twice daily sessions of physiotherapy in the form of passive and active exercises and Naturotherapy interventions such as acupressure, acupuncture and reflexology. We started work with her family, helping them cope with her condition and setting graded realistic goals. Over two weeks Mrs. L responded well to our treatment approach; her consciousness and comprehension improved, and she began to respond and obey simple commands. We were able to make her sit with support, with which her chest secretions reduced. She regained urinary sensation and gradually her catheter was removed. She started to show response in the paralysed limbs, first flickers of contraction, later movements with gravity eliminated and then against gravity, finally against resistance. She stood with support, even walked a few steps. However, there was persistent left vocal cord palsy and a trial of tracheostomy removal failed. For this reason we also had to leave the feeding tube in place.
She was discharged to home care with a nursing partner team, and continued to undergo integrative therapy. Sessions of Ayurveda therapy in the form of oil massages and medicated foments were now introduced to improve limb power and movement along with continued physiotherapy and naturo-therapy. The psychological therapist engaged her in cognitive therapy and motivational enhancement, apart from helping her caregivers deal with their distress. Over 6 weeks, she began to walk with support , express herself with gestures and swallow small amounts of soft solids. Apart from a minor bout of aspiration pneumonia in the interim, requiring brief hospitalisation, she made good progress.
Mrs. L was back in hospital for a team review last week. During this visit her tracheostomy tube was removed, and she regained her ability to speak, albeit hoarsely. Her chest is clear and she is progressively able to swallow more each day. Her gait has improved and she walks with support. She is on course to having the feeding tube removed. She appears bright, sprightly and ready to engage with the world. Her children and grandchildren are delighted to have their beloved grandmother back, now that the TRIMED Way has rehabilitated her and restored to her, a reasonable quality of life. What is truly remarkable is that 3 months after the onset of a paralytic stroke with severe neurological deficit, this lady of 80 summers has planned and presided over her family’s Pongal (harvest festival) celebrations, with zest and happiness.
She found TRIMED’s integrated approach and in her we found the steely determination needed to conquer the sceptre of lifelong disability. Truly, when god closes one door, another does open!