Miguel's Story
Miguel Ramirez, an active 34-year-old husband and father, balances time between his family, his work as a welder and his dedication to fitness.
While driving home from the gym one day, Miguel experienced sudden weakness on the left side of his body. He made it home, but when he tried to get out of his car, he fell to the ground. His family rushed to his side, but Miguel could only communicate with slurred speech. They immediately called an ambulance.
Miguel had suffered a stroke.
Once he arrived at Ochsner Main Campus, doctors diagnosed him with a hemorrhagic stroke which occurs when a blood vessel in the brain ruptures and bleeds. Following a two-week hospital stay, Miguel was deemed medically stable. His physicians recommended a comprehensive inpatient rehabilitation program to help him regain mobility and independence. Miguel chose to transfer to Ochsner Rehabilitation Hospital based on its reviews.
Upon arrival at Ochsner Rehabilitation Hospital, the physician-led rehabilitation team assessed Miguel’s condition. His speech was slurred and he showed decreased awareness of objects on his left side. Cognitively, he struggled with problem solving – particularly his mental focus and ability to work through multi-step tasks. Physically, he could not walk. He required assistance from two people to roll or sit up in bed and to transfer in and out of his wheelchair. Once in the wheelchair, he was unable to propel himself forward with his arms. He required physical, occupational and speech therapy.
Miguel’s multidisciplinary care team of a speech-language pathologist, physical therapist and occupational therapist met with Miguel and his family to customize his care plan. The challenges seemed daunting, but with his loving family by his side and the guidance of his therapists, Miguel dedicated himself to reaching his main goals—walking and regaining independence. Indeed, recovering from a stroke may be one of the greatest challenges a person will ever face.
The weakness on the left side of his face and mouth caused Miguel’s speech to sound slurred. To address this and his inattention, Miguel’s speech-language pathologist guided him through exercises to work the muscles in his mouth and face in front of a mirror. The visual feedback helped his brain process the activity on his left side and helped strengthen his facial muscles to improve his speech. To help overcome his problem-solving skills, Miguel was tasked with solving time management and mathematical problems to improve his speed and logic in problem solving and recalling word lists to strengthen his memory.
His physical therapists focused on increasing his muscle strength and mobility. First, they helped him stand up and work on balance in the parallel bars. They also attached electrodes to the muscles in his weak left leg to deliver low-level electrical stimulation, helping to increase blood flow and “wake up” his affected muscles. After a few days of working in the parallel bars and receiving stimulation, Miguel progressed to walking with a hemiwalker (a special one-sided walker that supports patients on their weak side) with assistance from his therapist.
Concurrently, Miguel worked with his occupational therapist to help restore his everyday skills and tasks of daily living. Initially, he required almost total assistance with transferring from sitting to standing, bathing, dressing and toileting due to the weakness on his left side. To help him compensate, his therapist guided him in one-handed dressing techniques. Stretching exercises improved range of motion and flexibility and strength training increased his muscle tone. Low-level electrical stimulation to his muscles during therapy increased blood flow and stimulated nerve response, helping his weakened muscles to contract and expand more effectively.
To help strengthen muscles, improve coordination and increase the range of motion needed for activities such as eating and getting dressed, Miguel was introduced to the ArmeoSpring. This robotic arm supports the weight of a patient’s arm and helps the muscles move while they engage in interactive therapy. While using ArmeoSpring, he played videogames to strengthen the connection between his brain and his muscles. In addition, Miguel practiced his standing balance performing functional activities such as folding laundry while standing.
After three weeks at Ochsner Rehabilitation Hospital, Miguel’s attention and problem solving greatly improved. He now walked over 200 feet with just the support of a four-pointed cane to assist with balance. He managed stairs with someone standing by for light assistance, if needed, and he was nearly independent with his self-care needs including transferring positions, dressing, toileting and bathing.
With all his gains in therapy, Miguel looked forward to returning to his active life. In preparation, the team met with his family for training through the Care Partner Program. These sessions prepared the family to safely support Miguel's needs once he returned home.
Miguel’s road to recovery was challenging, but with the support and encouragement from his family, he developed the inner strength and determination to recover.
Moreover, to build on his progress, he planned to continue his recovery with outpatient therapy services.
As he prepared for discharge, Miguel shared these words of wisdom for others facing stroke recovery: “Have faith in the therapy team. Be calm and it will come one day at a time!”