Neurological fatigue after stroke affects the majority of stroke survivors. In my interview with Occupational therapist David Norris, we discuss the ways that you can minimize the impact of fatigue after a stroke.
Highlights
07:38 How sleep quality helps reduce fatigue
16:02 The Bank Account analogy in terms of energy and fatigue
18:12 Investing your energy
18:51 Knowing where you are in recovery after a stroke
21:26 Communication helps people understand your situation
23:58 Anxiety makes fatigue worse
25:09 Planning your daily activities to manage fatigue
28:53 Nutrition and its role in your quick recovery after stroke
Transcript
Bill 0:00
My experience has been that when I was eating highly processed carbohydrates like bread, consuming sugar and sugary drinks, and trying to get that short quick burst of energy because I was experiencing a low.
Bill 0:16
What it was doing to me was creating a vicious roller coaster of energy drop and then energy spike and then energy drop again. Every time I had these very fast working easily digestible foods I was creating some fatigue myself.
Intro 0:43
This is recovery after stroke with Bill Gasiamis helping you go from where you are to where you’d rather be
Bill 0:52
Are you a stroke survivor who wants to know how to heal your brain overcome fatigue and reduce anxiety? By the time this episode goes to air, I will have been eight years into my stroke recovery journey. Three brain hemorrhages and brain surgery created similar challenges for me.
Bill 1:07
The thing is very few people understood what it was that I was dealing with only people that did understand what other stroke survivors did.
Bill 1:15
One of the unexpected nice things, though to come out of my stroke is that I have been asked to share my story several times in newspapers, in the national news, and as a speaker at various corporate events.
Bill 1:26
In the hope of raising awareness and supporting other people who are going through stroke now, most recently, I was involved in the launch of a joint advertising campaign by the Cancer Council of Australia, Queen Victoria, and the Stroke Foundation.
Bill 1:41
Which was called smoke leading to two strokes. The aim was to encourage more people to quit smoking and decrease their risk of stroke. Being involved in these campaigns made me realize that prevention is important.
Bill 1:55
However, what I needed when I experienced a stroke was to help bridge the gap in that critical time after I went home, Realizing that the amount of support drastically declined once stroke patients left the hospital motivated me to create a way to support stroke survivors.
Bill 2:12
So that no one has to do it as hard as my family and I did. If you have fallen in the cracks between hospital and home care, and desire to gain momentum in your recovery, but do not know where to start, this is where I can help.
Bill 2:28
I’ll coach you and help you gain clarity on where you are currently, in your recovery journey. I’ll help you create a picture of where you would like to be in your recovery. 12 months from now, I will coach you to overcome what’s stopping you from getting to your goal.
Bill 2:44
During coaching. I’ll also teach you the 10 steps to brain health for stroke survivors and guide you through each step with supporting interviews from experts and information that is based on the latest scientific research.
Bill 2:58
Some of those steps include training on the type of mindset required for an ongoing successful recovery and how to decrease the anxiety created by the thoughts of another stroke. There’ll be a module on emotional intelligence which will help you manage your out-of-control emotions.
Bill 3:15
Information about the gut and how a healthy gut is the first step to a healthy brain, we will cover nutrition and the kind of food required for reducing fatigue. And there will be a module on how to improve sleep and much much more.
Bill 3:31
If you are one of the first 10 people to join recovery after stroke coaching, you’ll get a one-on-one private coaching thread with my access to the course 10 Steps to Brain Health with Stroke Survivors when released.
Bill 3:44
Member access only monthly group training calls and access to the stroke survivors private forum be one of the first 10 people who apply for recovery after stroke coaching now and get the first seven days free.
Bill 4:00
After the seven-day free trial, you will pay the annual amount of only $149. And the price of renewal will never increase for as many years that you remain a member. Once the first 10 coaching packages are sold, the price will never be offered again.
Bill 4:17
So take advantage of the seven-day free trial now by clicking the link below if you’re watching on YouTube, or by going to recoveryafterstroke.com/coaching if you are listening online. Bill from recoveryafter.stroke.com this is Episode 76 and my guest today is David Norris from Brisbane Occupational Therapy Australia.
Bill 4:39
David’s primary focus is on memory health supporting people with Parkinson’s disease, stroke deficits, dementia, aging, and how to maximize independence through rehabilitation. Welcome to the show, David.
David Norris 4:53
Thank you, Bill, for having me.
Bill 4:55
You’re welcome. When I asked the question to Instagram, about what the people on my Instagram page who follow me would like to ask an occupational therapist, they came back with some questions which I thought were amazing.
Bill 5:11
Fatigue is a big issue with stroke recovery and any neurological recovery. And one of the things that they asked about was the very simple task of fatigue interfering with walking and running. Somebody came to you David in the clinic and said to you look, I want to be able to get back to walking and running.
Bill 5:35
But fatigue is stopping me from doing that. How would you begin to respond to that person and support them in being able to find you know, be able to get their walking and running back? Yeah,
David Norris 5:47
Great question Bill. I’ll try and make a very complex experience or symptom for folk in a simple way as I can, I think it’s worth putting out there Bill that post-stroke or after-stroke fatigue is a very common symptom experience.
David Norris 6:12
Whilst It is very common, 50% of people will experience post-stroke fatigue, the factors that influence that appear to be quite diverse. And it’s not so crystal clear on an easy way to pinpoint it. So what I take folks through when I try and answer the question for them.
David Norris 6:36
Because there’s a goal, there’s an outcome, I wanted to be able to run, I want to be able to walk I want to do my work better. There’s an outcome that people are wanting. And so we go through a bit of a checklist on how are people tracking and this is what I would encourage the folks that are listening today.
David Norris 6:57
Is to think about the many factors that are either adding up to your experience of fatigue because we could probably, you know, point the finger at it and say, Hey Dave, I did not experience fatigue before my stroke. After my stroke, I’m now experiencing fatigue, therefore it’s the stroke.
David Norris 7:18
That makes sense. There is certainly a mechanistic a structural change, a cellular change that’s happening there in the brain. And there’s a whole host of emerging mixtures around the role of inflammation, genetics, etc. I’m not going to go there.
How sleep quality helps reduce fatigue
David Norris 7:38
That’s something that’s under you know, that’s occurring, but what influences that? And what do you have control over? I think number one worth going over and double checking on as a checklist is sleep. What is your quality of sleep? How are you sleeping? And many will have a handle on that.
David Norris 8:01
But it’s worth being aware that around 50 to 70% of people who have a stroke, experienced sleep disturbances, and commonly, sleep apnea. So being mindful that this could be one of the factors that are contributing to a person’s experience of fatigue, and investigating it.
David Norris 8:02
Well, what could I do to investigate it? Well, simply you can start tracking. You know, there are various apps out there on various devices that can support you or even your partner could potentially give you some quality information on what’s going on with your sleep.
David Norris 8:43
You found yourself in a separate bedroom, you know, something’s up.
Bill 8:48
Yeah.
David Norris 8:50
So sleep and you can go down the medical pathway Bill I know that your audience sometimes feels malaligned, not connected in that system anymore. So I think some real sleep 101 things that we could do is are you having caffeine after midday, anything with caffeine in it.
David Norris 9:12
And that’s going to be a challenging one for a fight because, hey Dave, I, you know, I’m fatigued, I’m going to reach for anything I can to get my performance and caffeine, maybe that sort of stimulant of choice. But it will play out and impact the quality of your sleep.
David Norris 9:32
That said, alcohol, alcohol as well. We’ll have a sleep-changing effect. If we’re having alcohol at nighttime as a way to wind down or relax or socially connect with people or that’s our that’s our tool a way that we’re just trying to feel, you know, a sense of peace again.
David Norris 9:52
Alcohol will also affect the quality of our sleep. Having our house lit up brighter than a 711 or a Christmas tree will certainly impact the quality of our sleep or our ability to get to sleep. So, you know, some of the strategies that I often recommend that folks can be dimming the house down.
David Norris 10:13
You know, turn their lights down, one to two hours before sleep. Ensuring that the bedroom is a device-free room. No, TV, no iPads, no phones, no tablets, keeping that out of the bedroom. Because that will also affect our sleep and we could spend a whole discussion around why but you know if we’re looking at one of the levers yeah, that you can pull on an influence that could impact your experience of fatigue. That’s one of them.
Bill 10:48
Yeah. What I love about what you’re saying is a lot of common themes in people that I’ve interviewed previously, in the Fun Five series where I interviewed a nutritionist and a performance coach.
Bill 10:58
They talk about almost the same things to support performance and to support being well and support overcoming other issues, not just fatigue, because we didn’t specifically talk about fatigue with them just talked about the five foods people should avoid after stroke and the reasons why, and some of those reasons you’ve touched on already.
Bill 11:20
With regards to dimming the lights, you can just switch the lamps on in the corner of the room. You know, with regards to your phone, if you can stop using your phone or your tablet a couple of hours beforehand and switch to reading a book that’s going to support sleep instead of the opposite.
Bill 11:38
If you have to use your tablet, your computer, you’re phone, you know, switch the mode which a lot of manufacturers now have included in the software that takes blue light out of the back of the screen and makes the light warmer or closer to an amber color.
Bill 11:56
So the things that you’re saying are very commonly talked about by other people for other areas of improvement after stroke. So I love that you pick those things. There was a gentleman who was talking about on episode 19, he was talking about sleep apnea, Patrick McEwen.
Bill 12:16
He talks about how simply taping the mouth shut at night helps people sleep better. And if there’s no medical reason why you shouldn’t do that in so if the nasal passages clear and all that kind of stuff, there’s no medical reason why you shouldn’t do that, then.
Bill 12:33
Just closing the mouth at night means that you don’t wake up with a dry mouth. It means that you get better oxygenation of the blood, therefore the brain through the nose, and the right balance of oxygen is going through and coming out at night.
Bill 12:47
So it’s helping people sleep longer and better and have a deeper sleep. So really important things that you’ve just said. What else can people do to support fatigue? There was a question about keeping on pushing.
Bill 13:06
So what they meant by that was, they’re getting to that point where to find the limit, they push to the limit and then go beyond their limit to see how far they can go. Now I did that I remember sometimes when I was experiencing deep fatigue.
Bill 13:24
However, pushing myself to the limit meant that I would crash quite badly and then I would be wiped out for a day. And I would need to take a long time to recover. So what do you do when somebody says to you, you know, I’m going to get to my limit then push on how do you manage them and try to keep them from getting to that limit and suffering the after-effects of that?
David Norris 13:51
Bill, I think you touched on a very common experience I used to see quite a lot in the hospital setting and the rehab settings. And now I’m in my practice that when working with folks will often bring that mindset that I’m just going to grind it out. I’m just going to hammer myself to get the best results. And I guess that kind of aligns with that sort of exercise, gym-type training philosophy.
Intro 14:24
If you’ve had a stroke, and during recovery, you’ll know what a scary and confusing time it can be, you’re likely to have a lot of questions going through your mind. Like, how long will it take to recover? Will I recover?
Intro 14:38
What things should I avoid in case I make matters worse, Doctors will explain things, but, because you’ve never had a stroke before, you probably don’t know what questions to ask. If this is you, you may be missing out on doing things that could help speed up your recovery.
Intro 14:54
If you find yourself in that situation, stop worrying, and head to recoveryafterstroke.com, where you can download a guide that will help you. It’s called seven questions to ask your doctor about your stroke.
Intro 15:08
These seven questions are the ones Bill wished he’d asked when he was recovering from a stroke, They’ll not only help you better understand your condition, they’ll help you take a more active role in your recovery. head to the website now, recoveryafterstroke.com and download the guide It’s free.
David Norris 15:36
But when we’ve got a brain that has dealt with trauma from a stroke, and it’s in recovery mode, and it’s trying to figure out, you know, healing and normal performance and maintain all the functions that it has to do this concept that I like to bring into people’s sort of awareness and have a discussion about.
The Bank Account analogy in terms of energy and fatigue
David Norris 16:02
Think about that you’ve got a bank account. And that bank account is one of energy. And for some people that bank account during the day is big. But compared to somebody else who’s, you know, recovering after a stroke, their bank account is a lot less.
David Norris 16:22
And if you’re going in there to make a transaction and draw down for an activity, it’s going to draw down that energy that you’ve got, and then play out that you won’t have it for other things. And as you’ve, keep going with that analogy.
David Norris 16:40
Bill in your experience, the day that you tried to push through you went down into negative territory. And it said in your body brain said, right Bill, and it’s in a piece to be more likely a central process, you know, something that’s happening in the brain.
David Norris 16:58
Bill you need to stop rest and recover and we need to, you know, we need to go into recovery mode. And that’s going to now take a day, two days, three days before you start to feel cognitively on, emotionally, even, and physically able.
David Norris 17:17
Because, you know, being aware that a cognitive task one that is mentally demanding of your attention of your processing of your problem solving of your manipulation of information is going to be a record, you know, pull down on your energy an emotional element.
David Norris 17:41
The one that you’re dealing with a conflict in a situation or that there are tenuous things that you need to navigate or somebody suffering and you’re having to attend and be present, emotionally, that might be affecting your bank account.
David Norris 17:56
And then of course, physically, you know, getting up and down out of the chair. You know, some folk in the early recovery find a shower, even just having a shower a herculean task that draws down on the energy.
Bill 18:09
I can relate.
Investing your energy
David Norris 18:12
So thinking that, that you’ve got this finite resource in a day, the strategy that I encourage people to consider work through is where you want to invest your energy. And I would caution, you know, sometimes around drawing down too much that you go negative that requires that it means your several days on the couch.
David Norris 18:34
And you can’t talk to your partner, you find TV hard to follow because it’s just too much. So, being mindful that you’re going to have a negative you’re going to have a consequence or drawing down Now, how does that play out in your recovery and your achieving your goals?
Knowing where you are in recovery after a stroke
David Norris 18:51
Well, it may mean it takes longer if you go into that territory all the time. I think there’s a real happy zone and medium zone and coming up With a sense of where you’re at, on a day-to-day basis, because you’ll find it like a bobbing cork on a scene, that some days you’ll have more other days you’ll have less.
David Norris 19:10
And so riding that and being mindful, where am I at? And if I could see a picture dial in front of me, and my gut, the dial right at the bank account is full, or am I looking down a lot lower than the bank accounts a little bit less for my energy today and therefore, where am I going to invest it?
Bill 19:32
Yeah, I like that. My biggest drain on energy these days is emotional energy. If I argue with my wife when I’m wrong, which is always, and if I can’t come to overcome that argument or that issue with my wife very quickly.
Bill 19:54
If I can do that, I noticed that cognitively I can do a lot less the next day or however long it takes for me to resolve that issue with my wife, You know, they’re usually very small minor things, but they draw down the emotional energy that I used to have that discussion with my wife slash argument draws down on my cognitive energy.
Bill 20:14
And I struggle with that. And that means I’m getting nothing done. For those two days, nothing constructive or that I need to do constructive now can do physical things. That’s not a problem. So seems to me that I don’t impact my energy too much when I do physical things.
Bill 20:31
I seem to recharge my cognitive energy when I do physical exercise. Now, early on, it was different. So I love the way that the conversation continued when the first thing we spoke about was sleep because when I have a bad sleep day, then all of my resources are lower and I have way less energy to put into arguments.
Bill 20:56
Therefore wireless energy to put into all the cognitive stuff that I need to do so when I’m tired, I do tend to find myself trying to resolve conflict a lot quicker. So that I’m not sitting in that conflict space for too long, and it’s impacting everything.
Bill 21:12
Now I benefit from that. But of course, my lovely wife benefits from that, because we don’t want to be nasty to each other. Or angry at each other. So, I love what you’re saying about that now.
Communication helps people understand your situation
David Norris 21:26
Sorry Bill can I add to that? I think you’ve touched on a really important point. And this is one way you can use this is that it’s a way to communicate to your family and friends about where you’re at. You know, if there’s a dialing up conversation, if there’s a physical activity, if there is a cognitively challenging situation in front of you, you could just raise your hand and say, Hey, honey, Hey, friends, whoever it is, I’m sitting (inaudible) today. I just Don’t know if I’ve got in me to be able to fulfill this.
David Norris 22:04
You know, I want to be present, but I feel this is going to wipe me out and I won’t be able to do it. That’s important to me. Later. So this becomes a nice way to start to let folks know in your circle, about where you are, how you can perform, and how you can participate.
David Norris 22:28
Because this is an invisible experience. They don’t know folk don’t know. And what you’re trying to let folks know is that this is the world that I’m living in right now. And this is where I’m at and to touch on the emotional component and depression and fatigue are almost a hand-in-glove experience.
David Norris 22:58
That fatigue is often a symptom of depression. Now, I don’t want folk to go, I must be depressed. And I want folks to be looking at that from, you know, how am I tracking? And asking the question, do I need to look at this as a symptom?
David Norris 23:22
Because if it is, then we can treat it. There are options to treat depression, so coming full circle back to that chapter and wanting to run a walk, this is another one to tick off. Where am I at on this? And am I depressing?
David Norris 23:40
People might say, Well, I don’t have a negative world outlook. And I’m blah blah, I’m optimistic, but I’m fatigued. That’s one thing but there are also other factors in depression. Have I lost the motivation to perform tasks that are important to me? Is that hard?
Anxiety makes fatigue worse
David Norris 23:58
So again, This is worth investigating in a checklist way about what’s going on. Anxiety also is another thing that can play out and rob us of energy. So being mindful of those factors that influence our mood can draw down our bank account of our energy.
David Norris 24:23
In coming to thinking around physical demands, coming up with a priority wrenchy of what’s important for you for the day, and what is meaningful for you. And thinking about, well, I want to invest my energy there today.
David Norris 24:43
Can help people get control over energy and fatigue, but also, they are then investing in things that are going to generate pleasure and experience a sense of achievement. Joy, can-do, independence, and all-powerful emotional qualities help support us in our recovery.
Planning your daily activities to manage fatigue
David Norris 25:09
And thinking through physical activities, those that are going to require, you know, frequent moving, sit distending, carrying, combined with maybe some cognitive demands that are challenging me could potentially be high on the bucket list of what’s adding or what is taking away from our energy.
David Norris 25:35
And you might decide that, hey, I want to turn up for my rehab later this afternoon. Therefore, I won’t do x y & z in the morning. I’ll leave that for later. And if I’ve got the energy to do it after rehab, awesome, or I commonly experience fatigue in the afternoon. Why don’t I shift my rehab exercise to the morning Timing can be a real critical component.
Bill 26:00
Yeah, and using that time, if you can roughly predict when you’re going to have that fatigue experience, or when you’re going to have your little drop, you can use that time to sleep and have a cat nap or have a little nap in between to get you through that fatigue stage.
Bill 26:16
Even though you might have things to do, it might help you get through the rest of the day to the evening and then get you to bed. So I use the nap a lot more earlier on. I do it a lot less now. I used to try and fit it in at that time when I was going to be tired and feeling like a nap.
Bill 26:36
Rather than pushing through that time and trying to nap earlier or trying to nap, it was convenient. I felt like the best time was while I was experiencing that now I know that that’s sometimes an issue with people going back to work or being on a schedule of some sort I get it.
Bill 26:55
This is all about conversation is all about thinking about possibly what are some things we could do to slide in to support us in getting over the fatigue. Now, one of the things that you mentioned earlier on was sleep and not having a cup of coffee, you know, before bedtime or after midday or something along those lines.
Bill 27:21
And I know there’s a lot of food that interferes with managing the drop in energy levels throughout the day. And my experience and I’ll get you to comment on this in a little bit is my experience has been that when I was eating highly processed carbohydrates like bread, consuming sugar and sugary drinks.
Bill 27:42
And trying to get that short quick burst of energy because I was experiencing a low what it was doing to me was creating a vicious roller coaster of energy drop and then energy spike and then energy drop again, every time I had these very fast working easily digestible foods that I was creating some of the fatigue myself.
Bill 28:14
And by that, perhaps I wasn’t creating it, but I was making it worse. So, do you find that when people alter what they eat and when they eat it, sometimes it’s going to impact the way they experience fatigue?
David Norris 28:34
Certainly, yeah. Again, I think thinking of a person’s experience of fatigue, the stroke has been the trigger that caused an event and it’s created this condition and contributed to this condition called fatigue or the symptoms of fatigue.
Nutrition and its role in your quick recovery after stroke
David Norris 28:53
The things that influence somebody experienced fatigue to dial it up or down are these factors That we’ve covered and I believe and can certainly see in my clients that nutrition plays a powerful role in affecting our performance.
David Norris 29:11
And you know, simply as am I eating a diverse, nutrient-dense what does that mean? What food that’s packed full of information that supports our brain and body to work? And whole foods. What does that mean though and all that’s things like things that are as close to the natural source as possible?
David Norris 29:33
So that is, you know, things from the tree. things from the farm yard, that are not being aged and aren’t changed. They are essential as nature created them. Using those things as a simple way to navigate Through this can be a helpful way.
David Norris 29:51
There is a wonderful book put out by Professor Felice Jacka. If the folk don’t know they are called Brain Changers and Professor Felice Jacka is the head of the Mood and Food Institute here in Australia in Melbourne.
David Norris 30:10
Professor Felice Jacka has also founded the International I’ll get the name right. International body of nutritional psychiatry. And that’s looking at the role that food has in mediating and influencing our mood, and our cognition.
David Norris 30:37
And then without getting lost in the weeds on it, why we can now see the relationship that food has to our cognitive performance, our cognitive fitness, and if we’re eating things that have been changed from the natural form that have got added into them preservatives emulsifiers thickeners.
David Norris 31:01
They are going to then play out in various ways that influence our brain and body, our (inaudible) our gut, these are the factors that are contributing to our change in mental performance. So what can we do?
David Norris 31:19
Again coming back to eating whole food, so not changing my food diet. Another point that may be worthwhile investigating for folks who are listening is some of the work from Sachin Professor Satchin Panda.
David Norris 31:35
And he’s looked at time-restricted feeding. And what that is, is eating within a window of time during the day. Now, his early work was looking at mice. And interestingly, mice that were fed a horrible diet, the sad diet, the standard American diet, or you could call it a standard Aussie diet.
David Norris 31:57
Regardless of what they ate, they’ll limit it to a time that they ate, and they were looking at a fasting period or a restricted window of eating of around 14 hours. So that is from the time of the first meal to the time of the last meal to the first meal that period is around 14 hours.
David Norris 32:19
He observed regardless of diet, an increase in physical performance and energy compared to those mice that were on a diet and could eat whenever they wanted.
Bill 32:31
Wow, I am I was probably back in 2013. I did intermittent fasting. And basically, I would wake up in the morning and my first meal would be at midday, and my last meal would be at 8 pm. And the results were amazing.
Bill 32:49
And I didn’t just start it on a whim I read a book about it, understood the concept, and wanted to see what it was like and when I tried it, I figured that it was harming me in any way to not eat until midday. And because I didn’t feel uncomfortable after I woke up till midday, of course, I had tea, and you know, beautiful herbal teas, that type of thing to keep me hydrated and keep me going.
Bill 33:16
But I noticed that I had a massive impact on the way that I felt through the day. And it was something that I would recommend to people to look into and to get some nutritional advice as well, at the same time, so that they can maybe get curious about how making a simple change, like the time that you eat, changing the times that you eating, how that might impact the brain.
Bill 33:43
It’s got something to do with ketosis, and it’s got something to do with a whole bunch of other things that support the brain again, we won’t go into those, but I got good results from that.
David Norris 33:51
Yeah, and Bill, you know, whilst I highlight the point around Satchin Panda’s work with mice that had the standard Aussie Standard American Diet. I’m not advocating for that at all. Optimizing our nutrition for nutrient-rich food whilst combining with maybe a time-restricted feeding, exercise, and application in your life.
David Norris 34:20
Potentially two powerful leaders, that people have got to take control and influence their experience of post-stroke fatigue and I also support your bill to think that having somebody to provide advice around this is going to be helpful to navigate the wheat from the chaff in what is good health nutrition versus not in particularly where people are at.
David Norris 34:45
You know, if you’re experiencing other disease conditions as well like diabetes. These are things that would benefit from having somebody who’s qualified in the space to provide nutritional information.
Bill 35:01
As we begin to wrap up, wanted to touch on the topic of handling fatigue and returning to work, how do you begin a conversation with an employer? I know some people, unfortunately, will lose their jobs because they’ll be away from work for a very long time, and they will need to be replaced.
Bill 35:20
But if you’ve got an employer who’s waiting for you to go back to work, and they’re looking forward to you getting back to work, how do you handle it? How do you support clients to handle that conversation about, Hey, I’m going to come back to work?
Bill 35:31
But of course, that doesn’t mean that I’m 100% better yet. And that doesn’t mean that I can do eight hours of solid work and work the type of hours that I was before. Because that’s a big shift, getting people out of stroke recovery back into work.
Bill 35:51
There are a lot of things now that are going to change for that person and the environment in which they’ll be working is going to have a bigger draw on the energy Resources than being at home just trying to get through the day. What happens there?
David Norris 36:05
Yeah, Bill, great question maybe because the data is very, very clear that people who experienced post-stroke fatigue it’s negatively associated. So it has a negative experience with return to work, sales experience, or success rate in sustaining work and what we were doing before a stroke.
David Norris 36:33
And if we’re experiencing post-stroke fatigue, we are one of the risk factors that are going to compromise our success or getting a successful outcome. So, let’s engineer a better outcome because there are many, You may be individually talking to your employer and having that conversation and there is a trust thing there.
David Norris 36:58
There is a vulnerability thing that There of raising and saying, How much am I going to declare here? Now here in Australia, we have a scheme in Australia that supports people’s transition back to the workplace. It’s not perfect. There are many challenges in that.
David Norris 37:15
But the mechanisms that we have available to us go like this, you would have your GP, your local doctor, who can then draw up a list of what we would call suitable duties. And that gives a clear description of what a person may be expected to be able to achieve within a period.
David Norris 37:39
Now that program might be around say four to six weeks. Now, if you’re not in Australia, and you’re listening to this, it’s coming up with a plan with your employer. These are my current strengths. These are my current limitations right now.
David Norris 37:58
Having somebody in your corner who wanted to be an advocate or support you in this process and I can’t strongly, you know, recommend having somebody like me and occupational therapists in your corner to provide that advice in the context of work.
David Norris 38:16
And that’s your delegate to take up the baton to go. I want a work outcome where I get the opportunity to do meaningful things because work is such a powerful rehab tool for us. Such a rich tool that supports us physically, emotionally, and cognitively, stresses us a little bit but also encourages bringing change, adapting, and growth.
David Norris 38:40
And, not having that opportunity, I think is a huge risk factor for folk in getting back into life. So get somebody in your corner who can articulate can describe to your employer in a safe but meaningful way where you’re at and what are the structures or supports that need to be in place, either environmentally.
David Norris 39:06
Chair heights need to be this, the monitors need to be this (inaudible) need to be managed these glasses need to be worn to help with double vision, fatigue management strategies that x, y, and z that we put things in place that you’re not looking at a screen longer than, say 30 minutes.
David Norris 39:25
That you’re standing up walking away. When people are talking about group meetings are that if there is more than one speaker, I don’t take it all on. I need written content, the follow-up maybe a transcription of our meeting, and different strategies that are going to help a successful transition back to work.
David Norris 39:45
But guess what, over time, people’s skills will adapt and change. So it’s coming. It’s looking at rehab at work. And then over some time, it gets reviewed, changed, and modified. NET would be the good All the hands-on in your corner to help you work through that.
Bill 40:03
Yeah, that sounds excellent. That sounds like an excellent approach that therefore will make the employer feel okay about the process and what they’re discovering about the new employee or the new version of their employee.
Bill 40:16
Might stop them from getting frustrated with that person and saying, you know, why you’re doing the work that you’re supposed to be doing or why have you gone for a walk might allow them to clearly understand what is happening or to better understand.
Bill 40:29
And therefore that’ll make it better for the employee because they won’t have to feel so bad about taking a break more often, or stopping them more often or having a special monitor or a special chair, etc.
David Norris 40:43
Now, many not-for-profits at their bill can help folk get some resources together, to bring into the room to bring into the conversation. You know, they’re, you know, short, punchy descriptions on helping people with turned to work after stroke.
David Norris 41:01
Many employers may not have access or have even just the concept or the managers just it’s not on their radar, So using some of these tools that are freely available to say, Hey, you know, these are some of the resources out there, I really would like you to have a look at this before we have a conversation about me so that you kind of get a bit of a this is the world.
David Norris 41:24
This is the universe of recovering after a stroke. And then let’s have a chat about my strategy. And I’m going to invite my team member, my therapist, my GP to provide some comments on what this could look like for me and just see how the workplace could be modified, adapted, or changed to support me, and I’m hoping you’re up for that journey with me.
Bill 41:47
Yeah, that’s excellent. Man. I think that’s a great way to end the podcast. Before we ended we spoke about how sleep can support reducing the amount of fatigue so getting sleep right getting that checked out and making sure you don’t have sleep apnea.
Bill 42:05
We talked about, let’s not just push through barriers like we used to before, let’s work out where our barrier is and stop that. So that we don’t draw down on energy reserves that we need to put into tasks that are waiting for us for the rest of the day or the next day.
Bill 42:21
We spoke about how food can make a difference in how we can manage our fatigue. And then we talked about how we can talk to our employer about our limitations before we get back to work a good amount of time before we get back to work so that they can prepare for us as then so that then they understand what it is that we’re going through.
David Norris 42:45
Bill, I think you’ve captured the essence of our conversation and I will leave this with folk what we track and measure we can change and post stroke, the experience of fatigue after stroke. If you could track and measure it, you know, get a handle on it, record it.
David Norris 43:08
It’ll show you the change over time because more often than not, we feel that we’re just lost in the weeds. This symptom is still with me. But qualifying that and tracking that. Well, we can change and I hope today’s conversation has given people some line of sight on things that are within their control, that they can start to influence their experience of fatigue.
Bill 43:33
Excellent. No doubt that it will. I’m looking forward to releasing this and getting feedback from people who are listening about what they thought of the interview. And if you did like this interview, please do share it. And also give us a five-star review on iTunes. It’ll make a massive difference. David, thanks so much for being on the podcast.
David Norris 43:52
Thank you, Bill.
Intro 43:53
Discover how to support your recovery after a stroke. Go to recoveryafterstroke.com
