My early experience with Stroke and other Head Injuries
I'm writing this article to benefit the thousands of Kiwis, including close friends, who have suffered life-altering neurological harm since the introduction of the mRNA experimental drugs two years ago. When reading my articles, I feel it is helpful that readers have an idea of my training and experience to comment and offer advice and guidance on topics such as TBI and stroke.
From 1975 I worked part-time and then full-time at Dunedin Public Hospital and Cherry Farm Psychiatric Hospital, providing rehabilitation services under the watchful eyes of two very supportive heads of physiotherapy, Margaret Brensell and Jan Skinner.
My work mainly aided patients' recovery in the vascular and neurological wards. Duties were varied and involved providing hydrotherapy and matwork for TBI patients. This was focussed on movement patterning work, designed to restore basic skills such as lifting one's head, rolling from back to tummy, crawling, then eventually walking and regaining the use of arms, hands and fingers: that sort of thing. Naturally, I was also increasingly responsible for rehabilitating the many orthopaedic injuries from sports like rugby and netball. In addition, there were many motorcycle injuries, including paralysis and head injuries.
My enthusiasm was rewarded in 1977 by financial support and a letter of introduction from the NZ Federation of Sports Medicine, arranged by Lindsay Dey, to study Sweden's sports medicine and rehabilitation services for not just athletes and the average patient but also those with intellectual disabilities. Professor in cardiology Ted Nye, who was my supervisor while I was assisting in exercise-based cardiac rehabilitation, taught me about Sweden's culture and the language in return for my assisting in his rehabilitation following knee surgery. It was a good arrangement and learning to speak their language and appreciate their culture was an enormous help once in Sweden. The Swedes were so flattered that a young bloke from the other end of the world could rudimentarily converse in their language and knew more about their history than most of them!
Much was learned as my gracious Swedish hosts, including prominent doctors, opened every door of some of their most prestigious institutions. I even spent a day at the Karolinska Institute-Medical School, Stockholm, at the invitation of the father of modern exercise physiology, Professor Per-Olof Åstrand.
On return to New Zealand, to my surprise, I was shoulder-tapped for the top job in New Zealand to set up ACC's sports and recreation prevention, treatment and rehabilitation services. I wrote my job description and held that position through to 1983. That was an incredible experience, and I'm still very proud of the work I did then and what continues of it to this day.
I then became one of the largest, if not the largest private provider of rehabilitation services to ACC and other agencies, employing more than 60 staff at one point, including medical, physiotherapy, nutritional and gym training personnel. In addition, we had a thriving hydrotherapy programme. My style of rehab influenced the programmes. We specialised in rehabilitating the "ACC Tail", the long-term and most complex of patients. I enjoyed the challenge.
Stroke rehabilitation today is too reliant on the new clot-busting wonderdrugs. Suppose their use and other emergency treatments are delayed or cannot be used. In that case, the stroke patient risks a future with a permanent disability that is more severe and incapacitating than it might have been.
Please take a few minutes to read this article:
Suppose the clot-busting drugs and other emergency treatments are delayed or cannot be administered when suffering a clot-related stroke. In that case, irreparable brain damage may be the consequence. If that were not bad enough, as you will gather, therapies to aid these patients' fullest possible recovery are now less varied and capable than in 1975. This is because the drugs reduced the need for these tedious and manpower-intensive therapies.
These days, physical rehabilitation in our hospitals is simplistic, focussed on getting the patient to ambulate safely, toilet and perform similar everyday tasks, then discharged from expensive hospital care. Those patients who cannot care for themselves spend their last days in nursing care.
Movement patterning skills have been lost and are no longer taught, as far as I know. Moreover, once found in all the leading public hospitals, the invaluable hydrotherapy pools are either closed or demolished.
If a patient stays in an institution such as a hospital for more than a few weeks, malnutrition becomes a factor because the food served lacks nutrient density. However, a healing brain requires a rich supply of nutrients: Brain cells are not manufactured out of thin air.
Modern, comprehensive stroke and TBI rehabilitation programmes must include not only clot-busting medication and clot aspiration but also the following:
Antioxidant therapy to prevent or slow brain tissue death.
Hyperbaric Oxygen therapy.
Nutrient-dense food and supplementation.
Movement patterning, including hydrotherapy and matwork.
Speech and other cognitive therapies as required by the patient.
Rehabilitation following a stroke or TBI is probably never finished. It does not finish at the end of, say, a three-month stay in the hospital. Most patients will benefit from at least a year of intensive rehabilitation therapies.
So, given the increasing numbers of people suffering neurological harm these days, we need more investment in rehabilitation services, focusing on comprehensiveness and complete rehabilitation over the long term - not just emergency drugs and surgery-based treatments but not much more.
I realise I am asking for something that will not be delivered since there is an ongoing love affair with drugs. Furthermore, we have a multi-billion dollar debt from indiscriminate spending on a drug that is neither safe nor effective. However, despite no money left in the nation's kitty and our drug addiction, I'll still ask!