Showing posts with label learned disuse. Show all posts
Showing posts with label learned disuse. Show all posts

Mar 23, 2020

"Instant gratification and how it may hurt you" OR "It works great (and that's the problem)"





You want to eliminate drop foot? 

You want the elbow to straighten?
Tap the triceps, done! 

  





You want the hand to stay open? 
Put a splint on, done!








You want to improve balance? 
Give 'em a walker, done!

You want to have them talk better? 
Give them a language aid, done!

You them to swallow better? 
Feed them thickened liquids, done!


In every case, and many more, short-term "instant gratification" often gets in the way of a more complete recovery. 

Why and how?

The irony of stroke is that deficits to lifting the foot, swallowing, balance, etc. are exactly what needs to be embraced to promote recovery. So instead of throwing an external aid at the problem, sometimes its best to challenge the challenge.


  • If you want to speak French better, do you get an app?
  • If you want to learn how to work on your car do you hire a better mechanic?
  • If you want to be better at driving directions do you get a GPS?

In stroke, sometimes it is better to use the aid, no doubt. But choose your acquiescence wisely.

Mar 12, 2019

I'm not drunk, "retarded", or mentally unstable

Its a pretty simple calculus: If you don't use it you lose it. But there's a corollary: If you don't try it you can't possibly gain it. For example, if you use an AFO to walk during the early days after stroke, you'll not easily not use the thing again. 

And if I choose not to play violin- an instrument I've never played- I'll not get better at violin. So, both learning for anyone and relearning after stroke involves taking your brain (where learning happens) out of your brain's comfort zone.

Which leads me to spouses. I've met a ton of 'em. The wife is aphasic, the husband loves her, knows what she's trying to say and finishes the sentence for her. (When its men I always get the feeling they're saying to themselves, "Finally, I get to do the talking!") The spouse can become the exact thing they don't need. 

I always liked talking to folks who are aphasic. I usually get trampled by conversations because I'm slow in the think department. Aphasic folks give me a chance to ruminate a bit. Try it. Slow the conversation.

But "I've gotta get on with my life. How is it good to have my wife talk slowly when we're trying to check out (or ask directions, or talk to the gas station attendant)?"

Here's how its good. Do you know anyone who doesn't stumble and bumble their way through conversations? OK, a few people are so verbally dexterous that they don't really have this problem, ever. But nobody likes those people.

Why shouldn't someone who has a language deficit struggle as much as we do? They should struggle. Once they don't struggle, you know whats that's called?

A plateau. 
Beside, aphasia can be fetching.