It was a typical sunny Friday, and Eddie had gathered some friends to play ball hockey in the ARBI gym. We got sticks in the hands of some staff (an eager bunch, but whose talents evidently lie elsewhere), and for one client with limited function in his hand, we taped it to the stick. We had a smelly, old goalie mitt, a lacrosse stick and no face protection for the unlucky/brave soul who got stuck playing net. We made do, and had a sweaty good time.
And that’s how it’s come to be with Eddie around. He initiated that. When he first came to ARBI, the plan was to work on his speech. He could walk without much trouble, so by the standards of his previous rehab programs, he had recovered well enough. But, he was a physically and socially active 40-year-old father of three who, because of stroke, had been robbed of a lot of his favourite past times, hockey just one of them. He kept busy as an actor (in Jitter and Earth and Sky for Workshop Theatre, just to name a couple), a model, a musician, a self-described amateur lawyer, and a journeyman parts man.
Early in his program at ARBI, he struggled with motivation. Eddie has aphasia, which is a language disorder usually resulting from stroke or injury to parts of the brain (typically the left side). Aphasia does not affect intelligence, but it can cause trouble with areas of communication, including understanding what others are saying, speaking, reading or writing. His speech progress was plateauing, though, and he was missing appointments and showing little interest. But his therapists discovered that he had additional goals for physical rehab. He wanted to run again. He wanted to play hockey, and ride a bike.
So, his physiotherapist, Teresa, told him to bring his rollerblades. With assistance, she got him rolling around the gym with a stick in his hands. That’s when she noticed that something began to change.
“It was like a light switch went on,” she says. He wasn’t missing his appointments anymore. He was enthusiastic, and his speech was noticeably better while doing things he enjoyed.
“I think we started to believe in him, and when people believe in you, and there’s this positivity in this place (ARBI)…I think it started to lift him up,” she says. “We let him do things other people didn’t let him do. Putting someone on rollerblades is a little crazy after they’ve had a stroke! But, we let him challenge himself, and supported him to be safe doing it.”
Eddie agrees that his attitude changed when he moved to an activity-based program because, simply, “it’s just more fun.”
Eventually the rollerblades became real skates on real ice. At first, his therapists were cautious and kept hands on him. But, true to his progress in every other area, he made it on the ice soon enough, too. A two-person assist became a one-person assist, became none. He began skating by himself, without any assistance. Actually, he got so strong on his feet that he’d get one of his male volunteers to lock arms at centre ice and sort of simulate an old-fashioned hockey scrap, pushing and pulling and spinning in that beautiful dance. He said he liked the resistance, that it challenged him more than just skating around.
Teresa started Eddie on a bike, too, slowly pedaling from one end of the ARBI gym to the other, carefully flanked on either side by helping hands. It had been years since he rode a bike, and the first time since his stroke.
But the gym is a crowded place, and it’s hard to ride a bike really slow even if you haven’t had a stroke. Eventually they moved outside to the parking lot. More space equals more speed, and more trust. At first, they flanked him just like in the gym in case he got wobbly.
Then they let him go.
“When I let him go, I specifically said ‘I am trusting you, please be safe.’ And he was. He respected that,” Teresa says. “He didn’t go nearly as fast as he did when we were running beside him.”
And he loved it. He has since bought his own bike. The drive was in him all along, and the activities were bringing it out.
He also hasn’t forgotten how to work a crowd. Before his stroke, Eddie was quite musical. He was a performing singer-songwriter (he once took the northern Alberta crown at the Bud Country talent contest, with original songs) and a karaoke DJ. So, being a pro, his speech and occupational therapists tasked him to organize and host a Halloween karaoke party. He managed everything from food to prizes to music and stole the show as zombie Buddy Holly, inspiring others to get up and do their best, too. It was a thoroughly embarrassing and hilarious time for all involved, and it was perfect. Clients who could hardly walk, were dancing. Staff who perhaps could sing in a former life, were singing. Everybody was smiling. Eddie made it happen.
If it sounds like fun and games, it is, but it’s also rehabilitation. We just do it a little differently. Activity-based therapy, while more fun, is intended also to help clients see the little things they can and should be doing.
With activity-based rehab (rather than, say, sets of squats), the lessons you discover are more obviously applicable, and easier to practice throughout the day.
“Every time you do a sit-to-stand, be on both legs, because they’ll sit-to-stand umpteen times during their day when they go to the kitchen, the bathroom, their bed for a nap,” Teresa says. “They’re up and down. So it’s those little practice things that you can educate them about.”
The skating offered an opportunity for his therapists to point out to him how much he was favouring his left leg over his right, and to encourage him to practice at home. If you’re standing, stand on both legs. If you’re going up the stairs, step with both legs equally. For Eddie, the motivation to practice at home might be to improve his skating, but for his therapists, the skating is a way to motivate him to improve his walking, which, though not as fun, is a more useful skill.
But human nature, for a lot of us, is to use our strong side. When you’re kicking the soccer ball around with your kids, you kick with your strong foot. When you’re throwing the football, you throw with your strong arm. For Eddie to get better, he has to choose to throw with his weak arm, and kick with his weak leg, which is the case for many of our clients. Would you do it?
“All the people who nagged him (his therapists), hopefully once in a while he hears our voices in his head saying ‘use your right side!’ That’s what we want,” Teresa says. And, even if he doesn’t always choose his weak side, “at least he now has the toolkit and the knowledge to recognize it.”
Teresa might tell you that effective rehab is about tough love. In Eddie’s own words: “ARBI is 98 per cent loving people, two per cent doing time.”
Now, in a lot of ways, it’s up to him. He’s got his driver’s license again and is back behind the wheel. He rides his new bike, and walks over to the neighbourhood pub every Saturday to sing karaoke, so an active and involved life is there for the taking.
Judging by the size of the smile when he rides that bike, or scores a goal top shelf on his under-protected volunteer, or rustles the hair of his young son, Riley, life can be enjoyed, too.
Eddie has a saying that he uses often to describe where he’s at: “I’m not done yet.” Typically understated, the obvious connotation is that, hopefully, we’re never done.