In less than a month it’ll be a year since I had an hemorrhagic stroke and I was thinking about putting together the stroke ABC! My families experience on this journey is insane googling (which continues to this day), because Estonia has not been very helpful. So if even just one person finds below helpful and useful, then this post has served it’s purpose.
There are two different types of stroke. One is an ischemic stroke, cerebral thrombosis. The second one is an hemorrhagic stroke, brain artery rupture - which is much less common but much more devastating.
In Estonia, however, the emphasis is only on ischemic stroke, because it occurs more often. In the early days of my case, my mother, finding a stroke patient's treatment guide where they had to get treatment guidance, support and financial help from the health insurance fund, etc., she began to ask the doctor for more information about this, but sadly got a reply “Oh, it’s not for your daughter, because it's only the case for an ischemic stroke patients”. So if then my mother dared to ask, where to find help and support in case of an hemorrhagic stroke, she was told that she had to look it up herself. Cool right?
But that’s that, let's get to the point, because I'm not here to slander, but to help people - at least as much as I can!
After the intensive care, I definitely recommend going to Haapsalu Neurological Rehabilitation Center. If still weak and distressed, then this place helps you get you stronger again. Going there was arranged for me by the hospital I was in. In HNRK there is no speech therapist (at least not during my time) - so it was also organised there extra for me. Probably from my hospitals speech therapist, Veronika Raudsalu, who was fantastic. Definitely a lot of emphasis should be put on speech therapist and facial massage - from day one - feel free to contact me, I can even share my facial massage!
In my eyes, quite fast there was too little to do - at least for a young person like me. Already 3 months after the stroke, I felt like how I could and would do so much more than HNRK allowed me. And the exercises I did from my ward, I could easily do at home also.
Paperwork… Stroke patient can be registered as incapacitated for work at töötukassa and disability and invalidity must be applied for. The last two were also done for me by an töötukassa agent. You can then ask the parish for a VIP parking card (I call it a little different because it gives VIP rights and such word is more encouraging and forward-looking).
Heads up! Applying for incapacity for work took me a long time. I had to dispute the decision twice before they finally agreed to declare me incapable of work. So, if at first they say that you are still 100% able to work, then dispute the decision until your application reaches someone with sense.
Social rehabilitation can also be applied for.
So much (little) I am aware of this world…Let’s move on… What is worth looking into and what has helped me…
First off. I'm very-mega-gig sad that I didn't start researching CBD oil straight away in the beginning. This is a product you should consume IMMEDIATELY! Even just a healthy person - for protective purposes. It has helped me so much. I even wrote a separate blog post about it - go read!
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I know how cliché this sounds, but movement - movement - movement!
From the first day, the stroke patient's limbs must be kept moving. Few escape without spasticity. If spasticity pulls the body together, the muscles pull together and limbs inwards, then it is necessary to make movements away and outwards - stretch.
Spasticity vs. spasm.
Spasticity is a symptom, that causes your muscles to stiff and difficult to move.
A spasm is a sudden stiffening of a muscle that can cause the limb to kick or contract suddenly.
If the leg is spastic, it is worth trying night orthosis. It’s purpose is to stretch the tibial muscles. I went to try different night splints, but the orthosis from the ortoosikeskus suited me best. Certainly people are different, but I suggest you start with that. The important thing to keep in mind is that the heel must stay on the orthosis!
With spasticity of the hand as well - especially the fingers - there are orthoses so that the fingers do not hold in the fist all the time. I have been searching for them all over Tallinn, but I haven’t found a suitable one where all my fingers - including thumb - would be kept in place. I ordered something from one place, but I have been waiting for it for too long and so far I have not reached it, so you are on your own with this. Definitely, if I find something, I will update this post.
If the toes are crooked - hammer toes - I have not yet found the perfect product for them. The night splint has helped to stretch the toes a little bit, too. However, if the hammer is very strong and it hurts to walk even with shoes, there is a silicone pad that can be placed under the toes to make the ground a little softer. There are so many different ones that you really need to find the right one for your foot through testing.
If the foot keeps inward due to spasticity, or is unable to perform dorsal flexion, or has a harder drop foot, I recommend neuro orthosis. You can try it at Terveline with physiotherapist Pille-Riika Lepik. Yes, it is expensive. But if you are incapable to work and disabled, you can submit an application to the Sotsiaalkindlustusamet for Estonia to help pay 90% for it.
To request it, you need to send them an email:
Videos - show it is necessary and useful for your everyday life.
Doctor's - physiotherapists letter confirming the need for it.
Completed aid specification request - form here!
Neuroorthosis is also available for the hand - it has both a training functions and daily coping functions. All the same thing as for leg neuroorthosis.
It is very very important to keep the body moving and to soothe it well - yes, massages, physiotherapies, workouts, etc. Honestly, the more the merrier! This is not the place to hold back if you really want to recover!
I found a fantastic physio in Tallinn who is in it for the right reasons. I recommend to others - Rainar Vahtrik from Reakt.
While in Haapsalu, I realized how well manual therapy works on very closed body parts. At HNRK, it worked wonders. Done by Siiri Peetris and in Tallinn I started visiting her trainer Andrei Kipper. After hearing peoples amazing reviews, my mother got in touch with Ivo Kolts for ultrasound therapy where I also attend monthly.
Again. Everyone has their own, but I dare to recommend these names.
With exercises I found really useful Rehab HQ.
To up my recovery at home, apart from the stuff I have already mentioned, I have gotten myself the following:
Electrostimulation Machine - Chattanooga Rehab
Blackboard - look
Bits and bobs, which are also available in the gyms stretching areas normally
I have heard so much that the warm climate would be insanely beneficial to my recovery. If spasticity makes the body stiff, then the cold really doesn’t help. Already as a healthy person you feel how you stiff up with cold. Since there is no such possibility to move to a warm climate, I was looking for a solution that could still help. I found it recently. I started going to a warm infrared therapy at Bodytherapy. Infrared radiation reaches a depth of up to 5 cm in our body and warms it internally. Thus, it helps to alleviate spasticity. I now have the blanket at home so I could use it often - it really helps.
Let us not forget the mental health either. Yes, when visiting Haapsalu, I paid visits to a psychologist, even though the lady there was amazing, I feel that Biofeedback is more suitable for me, because I don't have to repeat what’s bothering me there. This can be done at Ülle Toomeoja therapy center in Tallinn. My therapist is Ivar Leiten and I’m so chuffed with him.
At home, however, I have found help by meditation (especially Joe Dispenza) and Wim Hof's breathing.
EXTREMELY IMPORTANT is to set goals and visualise them. Often you are faced with moments where you just want to give up and these are the moments where it’s crucial to remind yourself the set goals and repeat them to yourself again - the only thing that will get yo going again!