Happy Holidays All,
Let’s begin with a lovely, heartfelt message from Chris Bishop:
Seasons Greetings everyone. Usually we send out a family photo and perhaps a letter describing our year. Well it’s pretty obvious how our year has been. With the challenges of Jodanna’s health, everything else has been pretty good. Max and Beau are both doing well in school; Max at UC San Diego and Beau at Nevada Union. Jo has improved enough with her condition that Chris can return to work after the New Year. With that being said, we cannot express enough how grateful we are for the response everyone has shown during our ordeal. There is no way we can repay everyone’s gratitude, thought’s, prayers and time. Thank you and Merry Christmas.
Jodanna continues to improve gradually in all areas. All the medical professionals agree that Jo’s recovery will be most significant in the first two years. Recovery is her job, everyday, and she takes it very seriously. The next six months are particularly important for making progress with her motor skills.
After a stroke, the road to recovery is not a straight line. Often times there is rapid recovery during the first three months, but then progress slows down. This is the model that Jodanna follows. This model eventually leads to the dreaded “plateau” in recovery, after about six months. Today we are going to dissect that plateau…
Is the “plateau” a real thing? Before we go any further, let’s get the hard truth out of the way. Plateaus during stroke rehabilitation are real and well-documented. Basically what this means is that there will come a time when things get difficult. Very difficult. And for awhile. For many years, doctors and scientists believed that the”plateau” was the end of the road. The good news is that the science has progressed significantly, and happily, we now know that they were wrong.
Why do plateaus occur? In order to know how to break out of plateaus, it helps to understand what causes them. Immediately after a stroke, the brain goes into a “heightened state of plasticity.” This gets complicated, but you can think of it as a defense mechanism for the brain. When the brain is damaged by a stroke, it reacts by temporarily making it easier for itself to reorganize. This reorganization is responsible for a lot of the spontaneous recovery that happens in those first three months after stroke. Unfortunately, the brain eventually reverts back to a less pliable, but still plasticity state. Month Four can feel like a flat line at first, but additional recovery is still absolutely possible.
Another reason plateaus occur is the basic fact that any time we try to learn something, whether we have had a stroke or not, we experience “diminishing returns.” As an example, say you want to learn to play the guitar, so you sign up for guitar lessons. If it is your first set of lessons, once you have finished, say, ten lessons, you will understand ten times more about playing the guitar than you did before you started. Now fast-forward a year. The difference in your ability to play guitar between your 100th class and your 101st class is going to be much smaller. But again, that doesn’t mean you are not improving. You are improving. Just not as dramatically. The same goes for recovery after stroke.
The number one most important thing a stroke survivor can do when things get tough is to keep working. There are days when Jodanna feels discouraged, stalled, as if any further recovery is out of her reach. But, that is not the case. Study after study has shown that if she continues to work hard, she will continue to get better. Jo’s patience and perseverance are crucial.
In reflecting over the past year, the beautiful memories of June 22d are haunting, and the painful memories of June 23d are unavoidable. Life is amazing, yet fragile. Love your family and your friends. Plan that trip, write that book, hug your kids, celebrate birthdays, practice walking and learn to play the guitar.
Happy New Year.