Since 2013 Bill Gasiamis has been sharing about the early stages of his stroke journey to the third-year occupational therapy students at Australian Catholic University. The students were learning about assessment for stroke patients.
02:54 The first stroke symptoms
10:07 Unable to go to the hospital due to busy work schedule
15:11 The sudden loss of memory
17:05 Getting into the 3rd hemorrhagic stroke.
22:55 Occupational therapy and stroke
27:04 How we treat ourselves can impact our stroke recovery
34:47 Family is the key to recovery
38:05 Occupational therapy assessment
By November 2014. Now nearly three years after the first incident, I was feeling amazing. I got to the point where I was healed. And there was a lot less blood in my brain than there was after the second episode, and this one morning I woke up and I decided that I’d go for a bike ride. And I think it was the first time in nearly three years that I had done anything strenuous.
And I went through this firefight, it was the best bike ride ever. The next day, I woke up, with no pain in the legs, no muscle aching nothing, it was just really odd. And as I wake up in the morning to go to work to meet a client in the city again. I started noticing this burning sensation on my left side. It was like I had been in the sun and half of my body was in the sun and the other half was in the shade. It was burning.
This is recovery after stroke with Bill Gasiamis, helping you go from where you are to where you’d rather be.
Bill from recoveryafterstroke.com This is Episode 87. And today I bring you a recording of a presentation I delivered to the third-year occupational therapy students at Australian Catholic University some time ago. Before I get started, did you know that now you can download all the words of any of the recovery after stroke podcast episodes as a PDF?
It’s perfect if you prefer to read and take notes or highlight different parts of the interview for future reference. It is a great way to learn and helps retain new information in memory. Just go to recoveryafterstroke.com and click on the image of the episode you have just listened to. At the very beginning of the page, you will see a button that says Download transcript.
Click the button, enter your email address and the PDF will begin downloading. Also a few weeks ago, I launched the recovery after stroke coaching the people who have signed up and are now being coached by me and are being helped to overcome challenges including fatigue, anger, and isolation, amongst other things.
So if you’re a stroke survivor who wants to know how to heal your brain, overcome fatigue, and reduce anxiety, recovery after stroke coaching might be perfect for you. If you’re falling 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.
I will coach you and help you gain clarity on where you are currently, on your recovery journey. I will help you create a picture of where you would like to be in your recovery 12 months from now, and I will coach you to overcome what’s stopping you from getting to your goal. Want to know more? Just send an email to [email protected] and I will arrange a time to speak with you in person about how recovery after stroke coaching can work for you. Now it’s all about the show.
The first stroke symptoms
Thanks, everyone. My name is Bill and one day in February 2012. I woke up and on the way to work, I noticed that I had a numb sensation in my big left toe. So it was no big deal. It’s just a numb sensation. It’s something that most of us have probably experienced. I have a property maintenance company so, put my boots on and went to work and did all the things that I do most days, which are lift heavy things, climbing ladders, and doing all sorts of physical activities.
So it didn’t stop me from doing anything. It was just a normal day and had a little bit of numbness in the foot, no big deal. As the day progresses. On the third day of the odd sensation in my toe, I started noticing that the numbness was spreading from the toe, all the way up to the ankle. And it wasn’t doing that all the time. I was just doing it from time to time.
As it was happening, I noticed that my footing was a little bit different, but again, nothing too dramatic. So that morning, I went for a run at the gym and I went and did my regular five kilometers, it was a Sunday. While running on the treadmill, I started noticing that my foot was coming down on the treadmill a bit, strangely and I had to pay attention and look down and notice where the foot was landing because I didn’t want to make a joke of myself and fall in front of everybody in the gym.
So got through the run and everything was fine. I went about the rest of my weekend as I normally would. And on a Monday morning, the numbers had spread to around about halfway up my leg and I now started noticing that the challenge of walking was a little bit more interesting. And I made an appointment to see my chiropractor because I thought that as I had normally done, I had tweaked my back when lifting something the wrong way or bending inappropriately.
When I went to the chiropractor that afternoon on a Monday, he asked me what it was that I was feeling and I told him that the numbness was coming and going from my toe, all the way up to my knee. He had a look. And he said, Look, it doesn’t appear like there’s any inflammation occurring in the back that’s caused the numbness. And it could just be that something is starting to occur.
And as it’s starting to occur, you’re noticing this numbness, you need to pay attention to whatever it is take some anti-inflammatories for the time being, and call me if you need to make another appointment. So feeling great about the result of the examination by the chiropractor the next morning, I went to work everything as usual, doing all the regular things that we did. And it was around about this time that my wife started to notice that I was walking funny according to her.
And I said she’s mad just you know why you’re walking funny, I thought how am I walking funny? And I imagined that she said that I was walking funny kind of like dragging my leg or, you know, acting like some kind of an ape person. But it wasn’t that it was a very subtle difference in my gait that she noticed that I wasn’t able to pick up.
So by Wednesday, the following day, we’re into about day five. And number six spread beyond my knee, it was starting to get to about my hip. And at that time, I started to get a little bit more concerned. However, it didn’t stop me from going to work climbing ladders, lifting heavy things, and doing 16 hours a day.
As a result, I thought that it might be a good idea to make another appointment and see the chiropractor again because he had to sort me out. He had to get me feeling good and get back to work as I had a really busy week coming up, I needed to make sure that nothing was going to get in my way from getting these jobs done that we needed to do because our clients were a little bit difficult.
And they were giving us a small window of opportunity to do all our work. And I didn’t want to let them down. I don’t want to disappoint. So when I rang on Wednesday, the chiropractor, the person who answered the phone, asked me whether it was urgent. I said, no I’m feeling quite fine actually. There’s nothing wrong with me other than my legs numb and I can feel it.
And he said you need an appointment today and I said well, not really because I can’t get there today. The chiropractor was also busy and booked out that day, and they usually would move appointments around for me if it was urgent. I told them it was urgent it was no big deal. We’re going to continue doing what we normally do.
A couple more days had elapsed before I was able to get to the chiropractor on Friday which is when I made my appointment it was Friday afternoon at around three o’clock because I wanted to have the majority of the day to myself so I could get to my clients and get everything sorted. I was going to see the contractor at the end of my day so that it wouldn’t interfere with my work.
While at work on Friday, I had some guys on a ladder, and I needed to tell them what to do specifically above this quite high doorway. So I went to climb the ladder. As I was climbing, I noticed that my left leg would slip off the ladder, and I couldn’t make it stay on the bottom rung to begin the climb.
And I looked down and I noticed that there was some water on the ground. So I figured that the water was causing my leg to slip off and I picked up my leg. I physically put it on the first rung of the ladder and continued to climb up the ladder. When I got to the top of the ladder appointed to what it was that I needed the guys to do, and I got down and I left the northern suburbs of Melbourne traveled into the city to meet another client.
I drove there, met the other client organized everything I needed to organize, and had a big day prepared for the Saturday there were going to be 15 people, who were relying on me to be there on this particular day, there wasn’t going to be any other window of opportunity. The client had given us 10 hours to begin and complete the job including the repairs and painting.
I wasn’t gonna miss it. So in the evening, I went to the chiropractor, and within about a minute of having me on the table, he said to me, there’s nothing wrong with your back. You need to go to the hospital. I said hang on a second. I can’t go to the hospital. I’ve got a really busy day tomorrow.
He said, well, you need to go to the hospital because whatever’s happening on your left side has got nothing to do with your back and your back is perfectly fine. So we argued for about five minutes. And I went home. When I got home, I met my wife. And she said to me, okay, what did the chiropractor say?
Unable to go to the hospital due to busy work schedule
He said to go to the hospital, but I can’t go to the hospital I’m busy tomorrow. There’s no way I’m going. When I get there, you know what’s going to happen? The hospital is going to say, you know, the doctors aren’t here, I’m going to be there in the hallway, then they are gonna find nothing. And then I’m going to have to go. And then I’m going to miss my opportunity to do this job for this client and it’s worth too much. I’m not doing it.
So my wife being a little bit smarter than me, said, Well, why don’t I take you to the hospital they’ll tell you there’s nothing wrong and then you can go to work tomorrow. That was a great idea. So that’s what I did I went to the hospital and when I turned up to emergency. The lovely triage nurses asked me what was going on. How can we help you? What are you here for? So the moment is pretty good I feel quite well except I can’t feel my whole left side now.
Like you, their alarm bells went and they said, well why don’t you just come straight through sir, they gave me the red carpet treatment right through straight into CT. I thought this was a bit odd going into, CT they’ve done a scan they found after several hours, and when the doctor finally came to tell me, on the right side of my brain, a bleed, and the bleed was caused by a faulty blood vessel that had burst and was bleeding over the previous seven days.
And as it bled and the larger the bleed became, and the blood that was assembling in the brain became the more and more of my left side was switching off. So we had seven days in the hospital from then on, and they did the whole gamut of tests every possible tissue could imagine. And at the end of seven days, they sent me home.
And they sent me home on a drug called dexamethasone, which was designed to decrease the inflammation in the head. When I google that, after experiencing three weeks of the most amazing side effects, it has 16 side effects including hallucinations, and felt like things were crawling around my body. I gained seven kilos from the amount of food I was eating in three weeks.
That was a pretty amazing time. I wouldn’t recommend that for anybody if you’re looking at gaining weight. So as the next six weeks unfolded, doctor’s orders were no working, no driving, no physical exercise, no gym, no anything. I got to around the six-week mark when my follow-up appointment was coming up. I was getting so bored being home doing nothing.
And I decided one day to go to work and this particular day, I turned up and rang my mates to come and pick me up, I needed to get out of the house for that. I’ll just come on what you guys work, I won’t do any work. And they love me going there and watching them work. And I was sitting on a chair facing them while they were painting this large wall about the size of this wall behind us.
And at the time, I started noticing my left side was dying to sleep again. And I didn’t know what to do. I didn’t know what was happening exactly. I didn’t understand what was going on to me again. So I found myself slapping my face. Something woke up. It didn’t work. And I left it for about an hour and a half because the guys had to finish what it was that they were doing before I interrupted them to take me to the hospital.
So after about an hour and a half, I hurried them along. They finished then packed up and I jumped in the car with one of the guys and he was driving me from the city. To the Austin hospital, which is about 13, 14 kilometers away. On the way there, I started noticing that I was getting dizzy. I felt the need to vomit. I had become white. And I needed to throw up.
And I asked the guy who was driving me to pull up and let me go and throw up so I didn’t drop in his car. And we parked the car outside the gardens, in the city, when they run the Flower Show, I think it’s the World Exhibition Gardens or something. And I went to a tree and I threw up. It was across the road from St. Vincent’s Hospital just down the road, not that far from here. So then we jumped in the car, and I continued to drive to Preston.
So I can go home, tell my wife to take me to hospital. And she was waiting for me not knowing exactly what condition I was in and when I got there, she said how are you feeling? Knowing that I wasn’t feeling too well of course, quickly put me in the car and drove me a couple of kilometers away to the Austin hospital. We got to the Austin.
The sudden loss of memory caused by stroke
It was a 20-meter walk where she needed to go and park the car, She told me to walk to triage announce yourself and I’ll come and meet you in a little bit. I went to triage and when I got there, the lady asked me what I was doing there. And I said I don’t know. She asked me what my name was and I couldn’t tell her. And the next thing I remember is waiting, waking up in a bed before the tubes and all the things attached to my chest and, my face.
And there was a strange lady at the end of the bed who asked me if I knew who I was. l and said no, it was my wife. So that began another three-day stint in the hospital and this time, the CT scan revealed that the bleed had gone from bringing about the size of a 10 cen peas to being about the size of a golf ball.
And surgery wasn’t necessarily an option then because they didn’t exactly know what caused the bleeding. And it was in a really difficult place to get to. So at this time, I was suffering from memory loss. I couldn’t write a type an email, I couldn’t remember who had been to visit me. So it was several challenges that I had to overcome and I had debilitating fatigue. I couldn’t get to the toilet without being completely exhausted for the rest of the day.
As time went on, and the bleeding started to decrease by getting absorbed by the body, all these little things that I had lost started to come back on board. Started to get my memory back, and I started to be able to get a little bit more physically active. I started to be able to remember things and the pieces of the puzzle started to come back together.
Getting into the 3rd hemorrhagic stroke
And in November, by November 2014, now nearly three years after the first incident, I was feeling amazing. I got to the point where I was healed. And there was a lot less blood in my brain than it was after the second episode, and this one morning, I woke up and I decided that I’d go for a bike ride. And I think it was the first time in nearly three years that I had done anything strenuous. And I went for this bike ride. It was the best bike ride ever. The next day, I woke up with no pain in the legs, no muscle aching nothing, it was just really odd.
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? 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 miss out on doing things that could help speed up your recovery. If you are finding yourself in that situation, stop whining, and head to recovery after stroke calm, where you can download a guide that will help you. It’s called seven questions to ask your doctor about your stroke. 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.
I wake up in the morning to go to work to meet a client and City again. I started noticing this burning sensation. On my left side. It was like I had been in the sun and half of my body was in the sun and the other half was in the shade. It was burning. So I pulled the car over. And I got out of the car and I went for a walk around the car just to see if I could shake it off because that’s what you do right when you’re feeling sunburnt.
So I walked around the car, and sure enough, it went away. But then I got back into the car and as I got in the car, it started to come back again. Now, I felt for the first time I felt that I was probably in a little bit of danger I didn’t know exactly what to do and it didn’t occur to me to look up at the street sign and call the ambulance on triple zero. But it did occur to me to ring the guy whose appointment I was going to miss to tell him that I’m sorry, I’m not feeling well. I have to cancel our appointment.
So from the CBD, I drove myself to the Royal Melbourne Hospital. And when I got there, I parked the car, you wouldn’t believe it. I found the car parked outside the front of the hospital. And it was an hour spot. And it was there all day and I didn’t get a parking fine. As I was walking to the hospital, insurance, I rang my wife and told her look, I’m on the way to the hospital. And I just need you to know, I think I’m having another episode.
And when I get there, I’ll let you know that I’m there. And you can come down and catch up with me and find out what’s going on. When I got to the triage nurse this time, it was a different story, and now asked me how we helped him and I said, I’m having a hemorrhagic stroke. You need to get somebody down here right away.
And they said alright give us your name first I said, oh, there’s no time for that. Get me in I need a scan, get me in straightaway. So give us your name, finally, they got my name out of me they brought up my history because I had transferred all my paperwork to the Royal Melbourne and they wheeled me back into CT rapidly for the red carpet treatment again and this time when you go into a radiology room for a CT scans only a couple of people hanging around checking you out making sure that everything’s okay this time the room was full.
There were 15 people in there wondering let’s have a look and see whether this guy is bleeding on the brain like he says he is otherwise they probably thought I was on some kind of drugs, right? Turns out I wasn’t on any drugs and had the third bleed in my brain. And a little while later I was visited by my surgeon and this time she said you’re not going to be able to get out of surgery this time.
The danger has shifted away from you now you are okay not to have surgery and as a result of that, we’re going to have to operate you okay with that? And I agreed to surgery in November 2014. It was around about the 25th. I think when I woke up after surgery, I couldn’t walk. The left side had been affected by the surgery the blood vessel was out and the blood was gone. I had fibro hyperception issues on my left side.
We only really realized how significant it was when a small nurse about this big about five foot and thin and petite came to support me to go to the toilet for the first time after surgery. I got out of the bed on the left side and I placed my left foot on the ground. Within about one split second, she was looking down and I was on the ground screaming because I hurt myself.
Occupational therapy and stroke
So that began a process of one month of physical rehabilitation. And I was moved to the Royal Melbourne Hospital rehab campus which is in Parkville. I went through occupational therapy and all the different therapies that I needed to get through to get my ability to walk alone back, and it took about three months before I was able to get permission to walk to the therapy rooms from the ward on my own.
And at that time, I did a whole bunch of different therapies, including, we played the Wii to get the coordination right. I did hydrotherapy. I did the standard walking up the steps and down the steps and holding onto the rail. I did balancing on the left foot on the right foot it worked on the right foot didn’t work on the left foot.
Eyes open and eyes closed eyes closed was just a weird experience. And on the 23rd of December, I ended up finding myself in a situation where I had exceeded the expectations of all the people that were looking after me. And I went home on the 23rd of December and they had me booked in until at least the beginning of February.
So that began my journey after that, for rehab as an outpatient, at the Bundoora Center. Also, I had a visit from some occupational therapists at home, who were able to check out how I was getting around the house because we have a double-story unit. So wanted to see whether I could climb up and down stairs, whether I could get into the house from the three steps from the curb, and whether I was able to get to and from bed, the toilet cooking plan for myself because there were times in the day that I was going to be at home alone because I didn’t have a carer all the time.
One of the interesting things that I found was the amazing care, support, and nurturing that I received from the occupational therapists. I had the most unbelievable people caring for me. And the reason I felt that way is because it came from a place of what it was that I wanted to achieve what it was that I wanted to do, and how I wanted to go about my rehabilitation. So there were a lot of questions around about whether a certain exercise was something that I enjoyed doing, or was even comfortable doing.
And if it wasn’t, we didn’t do it, which meant that I was more committed to doing my version of recovery than I would have been doing theirs. I’m going to just share a story before I wrap up this part of the presentation, and then give you a bit of an insight into something that I picked up just purely because I was paying attention to the way that people were speaking.
Because I had done some work on myself to understand how I was speaking to myself and how I was going about, either interfering with or helping my recovery with the words that I was using. And there was this gentleman, I think his name was Ivan. And we were at the hand session around this table. And he was sitting there and he had a stroke as well.
His task was to pick up an empty toilet roll and move it from one side of the table to the other side, whoops to the other side of the table out dropping it and balancing it on the short side. So when he was doing that, he was looking at his hand and he was saying, come on you bastard move. And if you just imagine calling one of your limbs a bastard how that feels?
How we treat ourselves can impact our stroke recovery
At this particular point in time, I’m not sure what it was, but something alerted me to what he was saying he was having no success moving his hand. And I just said to him Ivan, tell me, mate, what would your hand be if it did pick up that toilet roll and move it? He said it would be my friend. So I said, fine. So I want you guys to imagine now noticing the difference between calling your hand a bastard and calling it a friend.
So when I asked him to do the same, he then started his next sentence with come on, friend, move. And sure enough, within moments of him saying that he was able to grab the toilet roll like he couldn’t grab it before and move it over and put it in a position where he didn’t have much success doing it before. So everyone went up in a roar.
He was excited. And then his friend was supporting him in the outcome that he wanted. And it was just something that because of how busy the OTs were, they missed because there were I think two OTs to six or seven of us. And they missed him saying that everyone picked up on him, changing his words and getting the outcome that he needed. So that’s not necessarily part of what you guys are learning at the moment.
But it’s something to keep in mind for the future. The way you speak to your patients, and the way you speak to yourself, have an impact on the way that we recover. And that takes that beautiful caring attitude that we get when we’re asked about how we want to take our recovery to the next level. And it gives us that 1% additional support we didn’t have that makes all the difference.
So nearly four years beyond now four years of my stroke journey, I still experience left-side numbness. And the more I got tired, the more I noticed the numbness on my left side. So it’s a bit of a signal to sit down and relax. And don’t do so much. The left side is colder than the right side. And it feels like this side belongs to somebody else, it doesn’t feel like it’s my side.
Because this side still feels the same. And I’m always comparing the two. It feels like they attached another person’s left side to me when I woke up from surgery. That being said, I’ve used all the skills of neuroplasticity and all the ideas that I could grasp to help my recovery. So I got a lot of that communication as well from occupational therapists they were telling me about neuroplasticity while I was recovering and giving me a brief understanding of what it was and how it could benefit from it and how I could use it to enhance my recovery. That’s my story about my stroke journey. Please feel free to ask any questions. I’m happy for you guys to ask me anything at all.
I find myself struggling to finish some sentences, especially when I’m tired. And I noticed my wife sitting there going to get it out. And it kind of, I’m not sure if it’s a memory thing or I’m not sure what part of the brain is affected or why it is that I can’t get the words out. It feels like it’s the memory but I’m not certain I haven’t had somebody assess that or give me their professional opinion on that.
A very good question. I don’t know if it was the same day. But I don’t know exactly because I kind of either blanked out or I’m not sure what happened between going to triage and then winding up. I don’t know what the period was. It was at least four or five hours. She’s never let me forget it.
I was 37 I had my birthday in June. I was 37. And then 39 the next time no 40 the next time while the third episode was it when I was 40 I can’t even remember. Yeah, it’s a bit shaky. Without asking about nine months after the first episode, after the second episode, I jumped in the car and started driving again. And it was around about the time when I was about to see the surgeon again.
I contacted the surgeon after I had been driving And asked whether it was okay for me to drive down. They said yes. So all in all, I really shouldn’t have been driving for the first year. And I was probably driving around about nine months later. And one of those things again, logic is one of those things that was defying me. And I wasn’t able to make decisions around my health and safety. And when nobody was at home, is when I would jump in the car. not proud of that, but I’m just one of those things.
So, after the first incident, the likelihood of another stroke was low. According to the surgeons and the doctors and everyone that I met. After the second one, it was even lower, apparently because it’s very rare that they bleed twice. This particular version of Bleed three times was almost unheard of. They tend to heal themselves and get better. Now that the blood vessel had been completely removed, there was no chance of another bleed. So that was what had to happen to make it so that it doesn’t occur again.
Family is the key to recovery
Yeah, excellent question. So, family is the key to the recovery other than amazing hospitals, occupational therapists, and all the services that we’ve got available to us. And the reason being is that they supported me in being able to do the things that I had lost the ability to do. So I wasn’t able to get around or go anywhere, run any errands, go somewhere that I enjoyed to be, wasn’t able to, you know, do any of the things I had lost a lot of my freedom.
So my wife being amazingly supportive and understanding was able to manage the kids and keep them sort of calm and let them understand that dad is going to be okay, even though she wasn’t quite sure. A couple of times. And then the extended family was amazing as well. Even though little things like serving of food, or picking me up just to take me somewhere when I had been in the house for too many hours or too many days in a row.
Supported me. They also supported me to get to my appointments because I couldn’t drive to them. And I’m really lucky, I’m really lucky to have had such an amazing supportive family and you don’t realize how good your brother is until he steps up to the plate when you need him.
Bill, are you still able to do all the things that you did before?
So the question was, am I still able to do all the things that I used to do before the stroke? No, so the property maintenance business still exists, but I do not get on ladders. Getting on my legs wouldn’t work because I can’t feel my left side and when I’m tired, even less, which means that I’m very likely to fall off and have an injury.
Also, holding towards my left hand is a bit of a challenge. Because I can’t feel that tool and sometimes the grip is a bit of a challenge. We have fewer plates and cups at home these days. Every time I pick up something with my left hand could end up on the ground. So there are a few things that I’ve lost that are not key to my lifestyle or well-being.
But there are enough to sort of make it difficult as well, so physical exercise changes. So instead of running now I do bike riding and yoga, because I can’t you know, because the way the left leg goes down is a little bit heavier than the right side. And I risk jarring the knee and robbing the ankle.
One final question Bill we’ve seen this week on assessment. Do you have any comments about your experience of being fixed? And would it be whether anything helped you (Inaudible)
Occupational therapy assessment
Yes, so my assistant was pretty vigorous actually, and quite vigorous, not hard to get through, but it took a couple of days. And it took a couple of days when I was in the rehab hospital. And I was getting a little bit annoyed and frustrated actually. But I realized later on that until they exactly knew what I was capable of in every aspect of my life was hard to determine a process of how to go forward and what would be best for me.
So it included a lot of repetitive tests to see whether I was able to hold things grasp things, move things stand, and walk unaided. It included a lot of questions and a lot of me doing things That I thought seemed odd and weird. So a lot of explanations as to why we were doing something. So it was a relatively easy process to get through just long and tedious, really thorough.
And then when, when they said the assessment team came back said, okay, we’ve now put you into four different groups for different types of exercise. That’s when I understood what it wasn’t that they were doing. What made it easy for me was knowing that I was completely supported through that process and that they hadn’t chosen things for me that I wasn’t going to be able to do. And I was going to be scared off, for example, walking on my own, and falling over or doing any of those things.
So hydrotherapy helped. That made me feel really good about my ability to stand on my walk on my own and get to and from a different location on my own, even though it was in the water, it was a good way to do it. So really thorough, really gentle, and tailored to my needs specifically. So looking back thanks for asking it was a good process because at the time I was getting frustrated.
To discover how to support your recovery after a stroke go to recoveryafterstroke.com