Tuesday, 28 March 2017

Rehabilitation - Icanho

In my last post I said I would do a post about the rehabilitation I have undertaken and what it has achieved. 

Fairly soon after my stroke it was suggested that I wold benefit from attending a rehabilitation service in Stowmarket. It was called Icanho and specialised in brain injury rehabilitation and this includes stroke. It was interesting that all the people involved in my stroke care recommended Icanho including a Neuropsychologist, my stroke consultant and my GP. Each of these people wrote referring me to Icanho. 

I had to wait until 6 months had passed before they would see me. This was not a waiting list but they recommend that this amount of time passes so that things are fairly steady. Acceptance onto the programme was not automatic and this was quite concerning. I did think that they may believe that I was too well for them to help me. After all I could do a job at a certain level but I just couldn't do my job. I had spent many years training and gaining experience in my chosen field of finance, more specifically 24 years working at a senior level in NHS organisations.  I am not prepared to give up all that effort to spend the latter part of my working life in a job that although capable of doing I didn't find as rewarding.  Therefore getting into Icanho was very important.

The process of getting into Icanho involved a number of assessment sessions including Speech and Language Therapy, Occupational Therapy, Psychology and Social Work. I found these very taxing and slept quite a lot afterwards. I even fell asleep in the car on the way home which is very unusual.

Stephanie and I were invited back to hear the result of the assessment. I think we were both concerned about the outcome. If they didn't accept me I had nothing to fall back on, there were no other options, no other services that were appropriate. It was a massive relief when they said that they would offer me a programme of care. I think that they were surprised that we had any doubts about being accepted. However, when you have so few options you end up fearing the worst no matter how unlikely. 

I was initially offered a six month programme that focused on Speech and Language Therapy, Occupational Therapy and Counselling. Physiotherapy was added at a later day when they found I had a minor balance issue, another impact of my stroke.

It's hard to understand how tiring rehabilitation is for a stroke survivor. One of the consequences of the cognitive difficulties is that I struggle with neurofatigue.  It is not simply being tired, it is totally debilitating beyond anything a non brain injured person can really understand. I can end up being incoherent, making absolutely no sense at all. I would not complete words, sentences or get the words all mixed up. My Yoda impersonation would be in full flow. I might do silly things without realising it, although I have not hurt myself badly, there have been some close calls including putting my hand on a hot plate to see if it was on and cutting my forehead with a kitchen knife.

Rehabilitation is not an easy option and you have to work hard to get the best out of it. The one thing that has always been in my favour is my desire to recover and return fully to work. This determination has always been there and has never wavered.

The staff at Icanho are truly exceptional, I have always felt very comfortable with all the staff there, including the office staff who have always been welcoming and helpful. The clinical staff are wonderful and they have made a massive difference.

Speech and Language Therapy
I was told by the clinicians that I should not have a problem with speaking given the location of the stroke. However, when I started with Icanho I had aphasia and they were clear that they see many people with speech problems when these would not be expected. This was a relief to hear as up to that point I didn't understand why speaking was a problem. The improvement in my speech has been the most dramatic. It is still an issue but i have learned that I don't always have to find the perfect word that there are many words that are just as good. There is definitely a psychological element to my aphasia as when I am in a more pressured or busy environment it gets worse. I am not sure whether this aspect will ever change but I will continue to work at it.

Occupational Therapy
This is the biggest element of my treatment programme and is specifically targeted at getting me back to work. It was clear fairly quickly that the main aspect of my cognitive problems was attention ie the ability to concentrate on something. To do this, the brain needs to decide what to focus on and what to ignore.  Sometimes when I focus on something, other things catch my attention despite my best efforts to ignore it. The distraction could be a noise, something I see or even a thought. This sounds simple to overcome but despite trying as hard as I can it still happens all the time. As part of this rehab I have had to develop strategies for dealing with even quite simple tasks such as making a cup of coffee, cleaning the aquarium taking my tablets. Even so I regularly have problem completing these tasks. 

I have described in earlier blog entries about my struggling with depression. It is so common after stroke and yet as with most mental health problems it is the most neglected. Having counselling has helped considerably in coming to terms with my stroke. There are many things I could say about what I have learned such as the stroke was not just my fault alone. Up to this point I blamed myself entirely for what happened to me. If I had not pushed myself so hard at work or had asked for help. These were all things that made me blame myself. Counselling made me realise that there were so many other things that were contributors to my stroke that it was simply not right to blame myself.

Before I came to Icanho I didn't realise that I had a balance issue. While there I had an physio assessment and it showed that balance was a minor issue. I was given a range of balance exercises including standing on one leg with your eyes shut. You should try it its harder than it sounds.

I am not sure how much I can thank Icanho and there support and treatment. I am trying to thank them a bit by running a 10k to raise funds for them. If you want to donate please follow the link below.

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