SURVIVAL AFTER STROKE

Mr. Dev Kumar Lama, a 45 year old man suffered from stroke 6 months back. He belongs to a poor economic background without basic education. Probably, that might be the major reason for lack of update of his health status including mundane and sedentary lifestyle.

The client residing in Kathmandu from last 15 years used to work in a hotel making and providing food to his customers. 6 months back, in the late evening, he got a severe attack leading to right side hemiparesis which apparently means paralysis of half side of his body. After this awful incident, the client was immediately taken to Bir hospital for the emergency care followed by no further treatment due to financial constraints. One fine day, he was luckily screened by the community worker in his locality during the field visit. After the keen observation of his disability and his need, the client was referred to the physical rehabilitation centre.

Once Mr. Dev entered the rehabilitation centre, the first and foremost observation by the team was his lifeless body, loss of charm and absence of motivation to survive after the awful incident. The major concern at that point of time was the inactive attitude elicited. Taking the case of right side hemiparesis with involvement of facial palsy as a challenge, the treatment protocol was immediately planned after the initial assessment. The first step was to provide a strong counselling to him in order to encourage him to regain the strength he once had and to achieve his active participation to initiate with the physiotherapy interventions.

In weeks time, the positive impact of the counseling could be seen as the service was provided to both the client and his wife (carer). Immediately, the wheelchair was provided to him free of cost as he belongs to a poor family. The reason for providing the wheelchair was to make him mobile in the wheelchair despite his inability to propel himself. Then the bed mobility and wheelchair transfer techniques were taught to him. At first, he could do it with maximal support by another person but gradually, he was able to perform the bed mobility and wheelchair transfer technique from bed to the wheelchair independently. This was achieved in one month’s time. As a result, his faith towards the team members increased and also, his desire to get rid of wheelchair and walk independently became more strong. Lastly, the goal to achieve independent standing and independent ambulation was his expectation. The team simultaneously worked upon strengthening his weaker side of the body with techniques to promote proprioception. By now, his participation in the home as well as in the society was better as he had started performing most of his daily activities independently. Finally, after 5 and half months he was able to stand for more than 5 mins independently and in addition, walk with support of elbow crutch and foot drop splint to prevent further tightness on his right leg and facilitate almost normal walking. Now, he can perform most of his daily activities (cleaning, toileting, etc) independently with maximum contribution at home.

Henceforth, he has become physically independent to the possible extent and with the further aim of not becoming a burden to his family, he has a desire to resume back to the work so that he can support his family and overcome all the hardships his family have undergone due to his physical challenges. He says:- “I had never thought in my dream that I could walk again independently. But, today I see myself walking independenly. I feel I have been blessed with another life. This is all because of the physiotherapy treatment, the support by the team of NDF and mainly, my wife. And the main concept behind my strength is “PATIENCE”. His wife says with tears in her eyes:- “ Only I know what I have gone through. All the pain, sleepless nights, tears, sacrifices, hardships have finally been repaid.