Stroke Survivor Bootcamp With Dr. Phil

Stroke Survivor Bootcamp with Dr. Phil: "That First Therapy Session"

• Dr. Philip Lamoreaux, OTD, OTR/L, CPT

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In this episode of "Stroke Survivor Bootcamp", Dr. Philip Lamoreaux, OTD, OTR/L, CPT, talks about what to expect from your first therapy session.

NOTE: Be sure to check out some of the helpful worksheets that can be accessed by clicking here, or by going to www.StrokeSurvivorBootcamp.com.

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Hosted by Dr. Philip Lamoreaux, OTD, OTR/L, CPT, Stroke Survivor Bootcamp is a practical, hope-forward podcast for stroke survivors and caregivers, built to help you understand what’s happening, ask the right questions, and take back control one step at a time. Each episode blends real-world hospital and rehab guidance with clear, compassionate coaching so you can turn fear into a plan and progress into momentum.

For more information on signing up for a one-on-one Stroke Survivor Bootcamp session with Dr. Phil, just go to www.StrokeSurvivorBootcamp.com


Created & Produced by Christopher Ewing
Hang On to the Dream Foundation

Written by Dr. Philip Lamoreaux, OTD, OTR/L, CPT

Listen each week to the Stroke Survivor Bootcamp podcast with Dr. Phil, the OT Professor, where he will share with you practical tools, real stories, and the mindset to keep moving forward on your road to recovery! 

If you are a stroke survivor, sign up for one of Dr. Phil's Stroke Survivor Bootcamp sessions.  These sessions are proven to help stroke survivors regain more mobility following a stroke.  Just go to www.strokesurvivorbootcamp.com for more information.

SPEAKER_07

The comments expressed in this program are the personal opinions of the participants and not meant to diagnose or treat any medical condition that you may have. Please consult your doctor or healthcare professional before making any changes to your current medical routine.

SPEAKER_08

You know, I'm looking at my husband, I'm looking at the therapist, I'm looking at my husband, I'm looking at the therapist because I'm trying to decipher what is going through their mind scale and unknowledgeable is like not a good place to be.

SPEAKER_07

And uh I am so excited to bring Jeffrey back into this podcast. And it's so cool that we're gonna be able to get three different perspectives on this podcast. So uh I just want to welcome you guys to the podcast.

SPEAKER_08

Thanks, Doctor.

SPEAKER_01

Nice to be here.

SPEAKER_08

Yes, very excited to be back this week.

SPEAKER_07

Yeah, I am, you know, this is something that I've talked about for a while of wanting to do. Um, because I I I feel like I feel like in the world of um, you know, and those of you guys who are listening, you know, maybe you know, hopefully you guys uh agree with this, but I feel like in the world of therapy and rehab and the recovery process, you know, we get a lot of um, like as a therapist, I get training and I hear and I learn from other therapists about how to be a better therapist and about my, you know, how how I come across and how everything uh is is from my perspective. And then I think I get to hear some little bits and pieces from you know different stroke survivors or different care partners about you know their experience. And I just, you know, the thing is I really don't know. And so what I thought would be a really interesting podcast and something that I think would be very helpful, not just for I think, you know, survivors and care partners, but even more for us clinicians, you know, for those of you guys that are listening, like you know you'll you'll appreciate what I'm you know, what I'm doing here. But like to be able to see from each individual's perspective when you experience a particular situation. And the situation that I want to bring to this episode is the first session that you have with a therapist. So you know when you come in, you you know, and let's let's take let's take the let's take it um from the um yeah, just just right right after the like in the acute setting. So I was trying to decide between inpatient or acute, but we'll just take the acute setting. So it's really your first session. Like you have not had therapy come in, you've had the stroke, half of your body isn't really isn't, isn't working, you know, as the care partner. You are sitting there going, like, okay, what the crap is happening? I don't really know what's going on. And therapy, you find out therapy is coming in at some point today, let's say 10 o'clock. And now here is what I want to do. So, first and foremost, I'm gonna direct my questions to Jeffrey. So, Jeffrey, you get to answer these first. But if you go back to your first session or first few sessions, what do you remember feeling before therapy even started? Like what was going through your mind?

SPEAKER_01

I I I personally was pretty excited about it. I I just I was you know, I was in a pretty decent place. I was in Thailand, so I didn't know I didn't have anybody setting my therapy up. And uh, you know, I was just in a care almost like a care home. And I just I was paying for therapy, and I just wanted to see my therapist, and and she came in and I was just anxious to get started, and I was just you know, a little bit um, I don't know, ashamed is the word, really, but I was feeling kind of um like I should have been better, even though it was like my my first therapy. I was just like, I mean a bit of an overachiever, I guess, but I was like I I wanted to do better than I did, and was very kind of excited to start. But it by the time it was over, I was just in a realization of oh, I got so far to go, you know. Basically, I I just I felt a little bit of failure at the end and uh a little bit of excitement at the beginning. So that's kind of where I was. I mean, um and I wasn't I because I was in Thailand, I didn't have the belief that I was gonna get the best therapy possible, that I was kind of gonna get short it a little bit, but I was okay with it. I just wanted to get on my feet. Walking, I think for a lot of us, you know, stroke uh survivors, I think walking is like our first goal that always comes into our minds. I mean, that is like the big one, like you gotta walk. And I and I was somewhat walking within a couple months, which felt good. But that first thing you want to do is just like get me on my feet. I want to move my legs, you know. Get me up, get stand me up now.

SPEAKER_07

Yeah, it's kind of like so so. If you're thinking about like right before you know, before the therapist even came into the room, you're sitting there with anticipation, maybe of like maybe some excitement because nobody had really gotten you up prior to that, or like maybe a little bit, and you're sitting there in bed and you've tried to move, but you can't quite move your legs. You're like, oh my gosh, how is this gonna go? Is that is that fair to say?

SPEAKER_01

That's very fair to say. I mean, I I don't think I had stood up, I don't remember standing up before that time.

SPEAKER_07

So it's like this big moment that's that you're just like you're like, oh my gosh, like it's gonna happen.

SPEAKER_01

But then you have the reality of oh, we'll get to the reality.

SPEAKER_07

We'll get to the reality in a in a minute, but I was excited to get started and to to start that journey.

SPEAKER_01

You know, they hired a uh a Filipino guy to come in just to take care of me because I was so big. You know, I was 6'3, 260 pounds or so. So they these little Thai nurses couldn't really deal with me. So they hired a uh a guy that was like six foot five and you know, a couple hundred pounds to to muscle me around. So it was I was glad to have him there because you know I I just felt unstable. And so he he made me feel a little safer.

SPEAKER_07

Yeah, no, that makes sense. Now right before you know the therapist came, did you feel like yourself yet? Or did you feel like you were somebody else?

SPEAKER_01

Yeah, I still don't feel like myself. So yeah, that's a pretty obvious answer. No, I was I was not feeling good. I was not really, I hadn't really accepted the fact that I had the stroke yet. I had, and because it's my first day of therapy, I really don't know how far I got to go. In my mind, I'm thinking, I'm gonna be back to work in two to three months, you know, everything's gonna be great. I'll I've done this before. I've been in motorcycle wrecks where I had to recover and went right back to cutting hair six weeks later. I've been in cancer, I've had cancer where I was like, okay, so the amount of therapy you take in cancer radiation and chemo and all that, you double it, and that's when you'll be back to work, kind of. And I went back to work and I was weak. And I said, okay, this might take a little longer, but I'm gonna be back to work soon. And in my mind, that's that's what's going through my head. So I had no no idea that I was in for this, you know, Billy Ganes Island three-hour tour thing. It's like I've been stuck on this island for three years now, not working, and it's like really irritating.

SPEAKER_07

Yeah, I I can I can definitely see that.

SPEAKER_01

Yeah, I mean, and I'm sure Yeah, at that time I was thinking, okay, this is gonna this is gonna help me get back to work. I'm excited to get started. Let's go.

SPEAKER_07

Yeah, and I'm wondering, you know, for those of you stroke survivors that are listening, you know, it's it's one of those pieces that uh I'm I'm grateful Jeffrey's on here because you know, to be able to speak to this because you know, uh from the therapist side, and then I'm excited to hear from the care partner side, you know, but you know, it's I I can only I can only imagine what it would be like and what you're feeling and what you're experiencing. And you know, I think that's really important for us therapists, you know, that that we recognize and realize a couple of things. One is that there's this big anticipation of that first time that you're going to be working with with therapy. There's a huge anticipation. And almost it's it it kind of set it it's going to set the tone for everything moving forward of whether you believe that there is something that can happen or not. And so that is, I mean, honestly, there's a lot of there's a lot of weight on that from the therapist side, but like there should be, right? I mean, it's like if you've never had a phone before and you've heard about the fact that you can call somebody and do FaceTime with somebody in Hong Kong and you're just like, oh my goodness, I am so excited to do that. And it's this new phone, and you're just anticipating to get it. Well, you know what? The phone better perform, right? I mean, I I think that's I think that's appropriate. Um, now there were some things that Jeff said that I I mean, Jamie, you you've said it before, you know, something, some of those similar pieces. But I mean, what what were you feeling? Like what was going through your mind that first time when, you know, before Gabe had even worked with somebody.

SPEAKER_08

Well, I think if there is any care partners that are listening, and disclaimer, I do, I refer to myself as a care partner rather than a caregiver. So that was on last week's podcast. But um a lot of anticipation, you know, a lot of things I think, you know, Jeffrey was saying is, you know, anticipation, but I was waiting for them to come in the room because it does, it feels like the moment of absolutes, like waiting for the doctor to give you the diagnosis, right? And in my husband's case, he didn't even have a diagnosis. And so we're thinking, okay, this therapist is gonna kind of come in here and drop the finish line flag, and we're gonna be like, ah, I just need to get from here to there. But what you what we kind of learned throughout this whole stroke recovery is that I I hated this phrase, by the way. It's a marathon, not a sprint. And the first time somebody said that to me, I was like, I just wanted to flick them. I just because I thought you were gonna say you wanted to flip them off.

SPEAKER_07

That's what I thought you were saying.

SPEAKER_08

I was gonna be really nice about it. Um, but but I kept hearing that phrase. It's a marathon, not a sprint, it's a marathon, not a sprint. And in what happens, at least in the care partner world, it seems like, is the rest of us care partners, we all kind of find each other and then we go, okay, well, how long ago did your person have their stroke? And then we all try to line everything together and see how fast or how further along.

SPEAKER_07

Interesting because you're looking for that that end line, right? You're looking for a finish line.

SPEAKER_08

And that's what I was looking for. Like, so to go back to the question, when a therapist walked in, I was basically looking for her to go, okay, your husband is is here at point A. He needs to get to point M. And this is approximately, I'm wanting answers because I think everything in that moment, especially if we're talking about like that acute setting, I think the first time we saw therapy with my husband's condition was probably week three and a half, three, um, by the time they really came in. And at that point, we're looking at like, what is life going to look like? Somebody give me something to grab onto here. And and I do feel bad for the therapists because I'm sure they get it all the time, as we're just like, can you give me something? Give me anything. And especially in that acute of a stage, they were like, you know, for my husband, he he had his biggest challenges. He did have right side hemiparesis, but he had a lot of speech aphasia, right? Which is the loss of the ability to communicate in a bunch of various ways. But they were like, we don't know. He may never, he may not do anything because the body is so miraculous, anyway. I think it's hard to tell what someone can do that early on for sure in their recovery. But that took me over two years of working with therapy to learn. Like in the beginning, I was just scared, and I wanted someone to give me an answer.

SPEAKER_07

Like now. See, and I think that's really it, it's this is cool because like as a survivor, yeah, I'm getting chills thinking about this because this is what I was hoping it would it would end up being, right? You know, okay. So, what from what I'm hearing from from Jeff is this there is a little bit of like that you you have kind of your own, like, I'm going to be back in this because I'm using my own personal experience and you know, what I am experiencing now, and I like this is the moment where I'm I'm ready to for you to show me what this is like. Like that I can that I'm gonna do this, and it's gonna be you're you're anticipating this moment. And then from the care partner, it's anticipation, but it's a little bit more of like, okay, you got to help me plan for what it is that I have to like. How do I have to set my mind? What do I have what do I how do I have to prep my mind, you know, for is it is it three weeks, is it six months, is it two years? Because now I'm trying to answer all these questions because I I need to know, because I need to start planning.

SPEAKER_08

Yeah, and you know what? I just had a thought, even thinking about like what Jeff was saying and then what you're saying. And then I had this moment flash back in my mind of my husband, you know, learning, you know, they would just try and get him to open his mouth and make the O sound with a mirror in front of him, right? And he, you know, trying to get him to do that. And I'm thinking back, yeah, he's he's like you, Jeffrey. He just wants to get it done. And so he was trying with all his might. Meanwhile, I'm analyzing what she's doing, and I'm going, am I supposed to be doing this? And thinking, what are all these different ways that I can get him back to where he was? Is that in trying, I'm trying to problem solve and figure it out. And I and I could be wrong, I'd be curious what you think. And I think he was just in the doing, like, okay, just tell me what to do, and I'll do it and I'll get better. Maybe.

SPEAKER_01

Right.

SPEAKER_08

Or at least that's the hope, right?

SPEAKER_01

I I just felt like if you tell me what to do, I'll do it, I'll get better, and we're back to normal.

SPEAKER_08

Right. That sounds like, yes.

SPEAKER_07

I I like that. So now this is interesting because now I'm gonna tell you what happens from the therapist side. So, you therapists, you guys can relate to this, but I think it's also important for you know survivors and care partners to kind of see like what goes through a therapist's mind in some ways. So here's the thing. I knew the day before that I was going to work with the individual. So let's say it's Jeff. I know I'm gonna work with Jeff. I know uh I know a couple of things that I'm reading. I am reading where the location was of the stroke. So if it was an MCA, if it was right or left, um, you know, I'm looking for if it, you know, if it's in the frontal lobe or in the back or on the brainstem or the cerebellum, like all these different pieces. And the reason is because I'm prepping and planning for what I'm likely going to see. Right? If it's on the cerebellum, I'm likely gonna see somebody that's you know, maybe most likely they're gonna be able to move everything, but then they're gonna have a hard time coordinating it all together. Or I'm you know, sitting there going, okay, if it's you know the left hemisphere, then I'm likely gonna start, I'm I'm gonna have to go in and I'm gonna have to try to have this mining communication, trying to have a conversation, but not getting either they may not hear what I'm or understand what I'm saying, or they I may not, they may not be able to get it to me, right? And to get it across to me. And it and so now I'm sitting there and prepping that. And then the other piece that's happening is I'm going, okay, um, I need to find out how much assistance this person actually needs, or do they have any movement? I actually don't know. But I'll go through and I can see some of the nurses' notes. Right now, I also understand that they likely have been going to the bathroom in a bedpan or a urinal for a day or two because nurses waiting for me. And so I'm like, okay, so they haven't actually experienced it. And as the therapist, the other thing, like I'll I'll be I'll be honest, at the beginning of my career, Jeffrey would have terrified me. Not not just because you know Jeffrey can be a wild card sometimes, but more so because 260 pounds, six foot three, and uh having hemiplegia. Like that's terrifying from the as a therapist. So then I'm like, okay, well, how much can I actually push? How much can I do? And and you're just you're just afraid to some degree. And this is all before I've even met you. So now I'm sitting there and I don't know your personality, right? I don't know all of that. So I'm sitting there going, okay, I'm gonna go in with this kind of an approach. Which would be more my norm, but I'm gonna be a little bit hesitant because if I go in and you're somebody who needs a direct, like, this is what needs to happen, you know, this is what you're gonna do, I need to be able to pivot really quickly. Or if you need something that's a little bit softer because you need help going through some of the emotional pieces, then I need to not be so overbearing at the beginning because that may ruin the ability to help otherwise. So those are all the pieces that start going through my mind. And then on top of that, I'm sitting there thinking, okay, I have in the acute, it'd be like 20 minutes, 30 minutes maybe. That's not that long.

SPEAKER_01

It's crazy how short that is.

SPEAKER_07

Oh, it's ridiculous.

SPEAKER_08

How short that is. It's ridiculous.

SPEAKER_07

From the therapist side, I'm like, what am I like, what am I supposed to do in 20 minutes? Right? Like so here I am. I'm like, so so can you guys see the interesting piece about this, right? Here you are, you have Jeffrey who's like coming in, he's in this and he's like, okay, this is the big moment. What am I going to do? And then you have the care partner that has a billion questions and wanting to know what the what the timeline is. And then you have me as the therapist coming in, and I'm sitting here and I'm like, okay, I have 20 minutes. What am I going to be able to do in 20 minutes?

SPEAKER_08

Well, you know what another question is? I was wondering why y'all left so fast. And when and when are you coming back?

SPEAKER_07

Right. See, and and and from my side, you know what I'm doing? I have a sheet. I have a sheet of paper. It's like, you know, it's it's a full it's a full page. Full page of paper. And on that is a list of 20 people I have to go see. 20 people. And I have to go and somehow figure out in those 20 minutes. Because really, my purpose is not to actually give you this great big treatment session. My purpose is to find out if you qualify for inpatient rehab or if you should go to a skilled nursing facility, or if you're far enough along that you could probably go home and do home health or outpatient. That is literally my focus when I'm going in.

unknown

Wow.

SPEAKER_08

May I ask a question about that? So part truly, is there a reason from the therapist's perspective that that is not shared? Because I think part of the disconnect on the care partner side, at least, and I think maybe people might agree with this, is that we have this anticipation that while our loved one is laying in a bed, we have no idea how to help this person that we care about. And we are just kind of aloof in what we are doing. We're just trying to be there. And what we want to do is help the person. And we're not shown how to. And our thought is when we hear therapist, that a therapist is going to come in and we are going to have a quote unquote therapy session. Thinking back to that time, it would be really nice. And I know it's probably not you, Dr. Phil. There's probably a lot that goes into this. Would have been, it would have been nice to say, hey, they are going to come do therapy, but it's not what you're expecting it to be. Um, I would encourage you to look, you know, for this or for this. Is there a reason why? Is it just is it taboo to share or is it not appropriate to share?

SPEAKER_07

That's a good question. And I mean, if you're man, I I would love for to get like to do this and see what other therapists would say, and like you know, to get therapists' thoughts on this. Um, I can share really from my perspective. I did try to do that. Um, I I tried to say, hey, here's the thing. Like my job, I'm here to just kind of show you what's possible. That's it. And then the goal would be you know to find out to get how can I get you to some place where the setup is actually designed for you to get that intervention. But sometimes you know, it it takes longer than maybe it should. And sometimes that's medically, that's usually the thing that's holding back, is medically the nurses and physicians are wanting to make sure that you're not gonna tink, you're not gonna go down. Um, so yeah, what were you gonna say, Jeff?

SPEAKER_01

I was just gonna say that it seems to me that like the caregivers, and of course, this is different because I don't want to generalize anything, but they truly are clueless, right? They could use a little education, it's like, you know, it's almost like they need their own therapist to walk them through the emotions that they're gonna go through. Um, you know, so should there be dumps, right?

SPEAKER_07

Should there be a care partner therapy session in the acute setting? I would think so.

SPEAKER_01

That's that's a big, big uh left-to-do list. Like, I mean, the you walk in, and like she says, she has these questions, and I have these anticipations, and they walk out, like you said, 20 minutes later or a half hour later, and you're like, uh, okay, now where do we go? And it's like, you know, it's like, what do I do for him? What can I do for him? What should I do for him to make him feel better? And yeah, and none of these questions get answered at all, especially if they get asked. It's like, you know, I mean, I can't imagine being lost on that. I knew what my job was as a patient, but the but she might not have known what her job was as the person taking care of the patient, you know.

SPEAKER_08

Yes, I agree. Yeah, the patient's job is to heal. And I think any, you know, a care partner is gonna say to the pay, you know, to the person who had the stroke or whatnot, your job is to heal. The only person that really is doesn't have they know a care partner from my experience knows that they need to do everything, but they have no idea where to start or what to do, but they know all of it needs done at any given moment.

SPEAKER_07

So here's the hard part. I'm I'm so coming from the therapist side of this, the reality is I have no idea. So here's the thing: you want an answer. And as the survivor, you want you want to be given this is what needs to happen. Like, what you know, what do I need to do? And oftentimes I don't know yet.

SPEAKER_01

I would I would think that by from from the caregiver's position, it'd be like driving down the freeway, and then all of a sudden you're the driver's saying, Here, grab the wheel. Seriously, though.

SPEAKER_00

Okay, I just what are you talking about? Grab the wheel.

SPEAKER_07

So, okay. I mean, yeah, let me float this by you guys. You know, uh the the the thing that um you know it would be interesting is if it's like, okay, here is worst case scenario, and have like a training of like worst case scenario, this is what you're going to be doing. Like you are going to be helping change briefs, you're gonna be emptying urinals, you're gonna be you know, you're gonna be getting him dressed, you're gonna be showering him, you may be having to do a bed bath, you may be do you know what I'm saying? Like, if we were to do like worst case scenario, or we're and then we say, but best case scenario is he's up and he's walking and he's out of here in two weeks. But I don't know yet. And especially at this point, what am I like how do I know, right? So it's interesting. So this is where this is where my perspective is just maybe a tad bit different, is that my whole thing is well then what should you be doing in this moment right now to maximize? Right? Not what are you gonna what do you need to be doing two weeks from now, because we won't know. But in this moment, where he's at or where she's at and where you're they're showing their ability, this is what you can do to maximize. So start making them do this, start making him do this, start making him do this. Don't do it for him. Right? Or something along the make sure that he's out of his bed. Make nursing come in and put a you know, put him in his chair instead of sitting in that bed. And the only time he gets in that bed is at the end of the day when he's ready to go to bed. Right? You know, just some of those little little things that can help create the environment to create more demand, to make it so that more can more more change is likely to happen. That could be that could be an answer. I mean, for those of you guys that are listening, like interesting to hear your thoughts.

SPEAKER_01

I don't know that I would put that much pressure on a uh person because I know that even though I was sitting there going, you're not doing much for me, um, but don't make me do anything at all because I don't feel good. And I, you know, I mean that is such a twisted thing for somebody like her to go through with um, you know, it's like how much is too much and how much is too little, and and the person that's letting that I'm in charge of that that I need to work with is not letting me know. And the person that's supposed to be teaching me isn't letting me know. The doctors aren't letting me know. You know, it's like again, like grab the wheel and just steer. It's like, where? Where am I where are we going? What kind of trouble are we in here? You know, I can see that because I know I'm guilty of demanding something be done for me because I just didn't feel good, but at the same time thinking, you know, and she's trying to tell me, uh, you need to go swim or you need to go walk. Or I mean, like, yeah, yeah, yeah. But you know, at the same time not being able to physically throw me out of bed and make me do things on my own. I mean, I really feel for you guys in that situation. That's really gotta be so difficult to maneuver that.

SPEAKER_08

Well, I think it's I keep laughing because I know exactly what you're talking about. And I laugh because it is so absurd that, yeah, you're just thrown a car and they're just like, you better get in. It's already going 80 miles an hour down the freeway. But just hop in and start steering. And I just know that feeling so well. And it it and I I think that that was the big one is how how much is too much? Um, and not understanding how fatigued, if we're talking about just stroke right now, how well it's the you know, how fatigued a stroke survivor is, not understanding how yeah, how we I want to push him to his limits to help, but not go too far. And it would be nice if even if somebody wasn't in the room, um, because a nurse, I find that a lot of the times I couldn't get the answers from a nurse that I wanted. And I was really always hanging on to that therapist coming back. And I'm gonna tell you guys a little secret. So I was so persistent in the hospital, I would be like, where is this therapist and when are they coming back? Because I don't know what to do with my husband. I don't know what to do with this human being that is laying there, and I'm not gonna just let him lay there. Um, and there is this from a care partner's perspective, I don't know if anybody can resonate with that, this sense of urgency that I'm that something must be done now. Now it almost feels like I couldn't save him from that, but something must be done now. Somebody help me. We need to do it now. And um I transmuted, I took that energy and I studied, and then but then I got worried that I we weren't getting enough therapy. And then I worried, well, what if I'm implementing things and I'm rewiring his brain the wrong way? He ended up being fine, just disclaimer, you know. But but we just get worried, we want to help and we want to, it's it's beyond helping. The best way I would use to describe it for therapists that are listening is we want to fix it and we want to fix it now. And when we are thinking, at least my brain, when I was thinking of how can I fix this, my brain immediately goes back to how do I get my husband back to the way he was before? Not realizing that there will always be a new version, I guess, in terms of recovering. But I'm getting my brain was that specific, especially that early on, three weeks. I'm going, no, there's gotta be a way to get him from here back to who he was before this stroke. And it takes took me a while to to accept that. It's it's interesting, it's interesting.

SPEAKER_01

Oh, go for it. What's interesting about something that you said is as the stroke survivor, I was learning things like years later that I should have known going into it. Like I had no reason to understand why I was so exhausted all the time. Yeah. And you know, why I was in a hotel and and they mistreated me a little bit, and I pulled the fire alarm. And that's something I would have never done before my stroke. I just lost it a little bit. And I'm trying to explain to people that this isn't who I am, that this is this is part of my injury, but it took me three years to understand that. So I can't imagine that you knew you know all the things that were flying at you from your husband and from lack of lack of empathy from other people, especially, because it took me as the survivor researching my own things, you know, looking on TikTok or Instagram or whatever, wherever I could find it, that I could come across it, that these are stroke things that are happening because of stroke, and and I had no idea. I had no idea that I was supposed to be exhausted after going to the restroom and back. I had no idea that I was supposed to be tired, not supposed to be, but I that that I could be tired after waking up. I mean, it was just lack of information, is shh is a big problem, I think.

SPEAKER_07

I agree with that. I'm gonna throw us, I'm gonna throw a wrench into this from the therapist side. I know that there are therapists, I know you guys are listening and sitting here, and what's going through your mind is, but I did say that. I did share, I did explain that. And I think this this is really valuable information, just from I think for all sides, because like let's be real. If I'm going through a lecture, how much should I expect my students to remember of what I said? It's going to greatly come down to the strategies that I use and how they're showing up to the actual lecture. And I think that one of the things that is really difficult is that the gravity of the situation, I will tell you, as the therapist, I don't really feel the gravity. I understand the gravity. I know it's big, but guess what? I get to go in and come in, and I have this perspective, I'm working with you for 20, 30 minutes in a queue. 30 minutes if I'm lucky. If I'm really like, really lucky, I get a 45 minutes to an hour with you. That's like very rare. And then guess what I get to do? I get to leave. No, I'm not trying, that's not I'm not trying to be callous about that, but like that's that's the reality. I can, you know, we have these conversations of as care, you know, as as a therapist, you know, there's there's you know, therapist burnout. Right. And part of it and some of the strategies, strategies are how well can you leave what's happening at work at work and not bring it home. Which shows that I mean, really, from us as therapists, like we come into the situation, we just do our very best. But the reality is we don't get the consequences of what happens and the experiences. The people that have to deal with that are the therapists and the care partners. Those are the ones that end up having to deal with it after. And so there is a little bit, I'm afraid, in some situations, these therapists are not the ones that are going to be listening to us most likely. But you know, there's a part of it that it's I've been doing it this way for a long time. And we get numb. We do. I mean, it's the same thing, like I don't here. You go. This I have showered hundreds of people. I have sat next to people while they poop. I met 30 seconds before. And for me, it's like it's nothing. Like it's just normal. That is not weird to me at all. But so many, like that when you go into society, that's like, uh, no, please, out of this, out of here. Right? But so I when when we look at it from like the therapist side of things, there can be a lot of those things that go into this situation, which plays a role in in how we show up in this, especially this first session, and where we may not have an urgency. Because we've seen this over and over. In some ways, it could be that we're feeling a little numb, we're overwhelmed, we're stressed, and we're coming into this situation and we're just we're literally just trying to do the best that we can. But you know, sometimes what we've talked about is I would say majority of the time, you know, there's things that don't get talked about. Hey, this is Dr. Phil. If you're a stroke survivor and you want to regain motor function, improve mobility, and build real confidence in your recovery, then I want you to check out one of my Stroke Survivor Bootcamp training sessions. These are intensive, hands-on experiences designed to push performance, improve function, and help you get back to doing more of what matters in your life. Go to www.stroke survivorbootcamp.com and let's get you back on track one step at a time.

SPEAKER_01

Yeah, I've never really thought about this before, but you guys are kind of walking into a no-win situation most of the time. Yep. Because I mean, really, I mean, we are expecting so much, even if we've been told not to expect it and what not to, uh, you know, how how we're supposed to feel, we're still can't help but be a little bit of like just needing, not wanting it as much as just needing to feel better about what's going on. Because, you know, our whole life has just been upset, upside down, and and and everybody does just go on with their lives, you know. It's just like when you lose somebody you love, you know, like a parent or a child, and you look out the window, and everybody else is just doing what they were gonna be doing anyway, even though you've gone through this huge crisis, and and so when you're coming through that door as a therapist, I would think that you're not gonna come even close to accomplishing or giving me good news for the most part. And if you do give me good news, it's exciting to see. I mean, it's it would change your day as well if you got somebody that you're like, Oh, okay, this guy's gonna do pretty well. And this lady's gonna, you know, do pretty well. I think I can do something here. But that's what we hope for. How often do you leave that door going, holy mackerel, this is a two, three-year experience, you know? Yeah, so I can imagine that's kind of sad on your guys' heart, I would think.

SPEAKER_07

I will add to that that it's it usually has to do because we understand the process, like the rehab process, and the the like one of the things that I love about the boot camp setup that I do is that I mean, I literally get to spend as much time as you need. Like, I mean, I obviously you know, like I can I I get I spend I get to spend all day with you. I I get to go to lunch, you know.

SPEAKER_00

We get to I actually get to ask you to leave.

SPEAKER_07

Right? It's very true.

SPEAKER_00

Did you find something else to do for a little while?

SPEAKER_07

You're just tagging along like a little puppy. Like, let me sit. Stop asking me to do things, but I think that's a really important piece is that the the context or the environment, you know, we also know as therapists, it's not set up for you to win.

SPEAKER_01

Gotcha.

SPEAKER_07

Yeah, so when we come in, it's it's hard.

SPEAKER_08

But that's I think to go back to that from the care partner perspective, it would almost feel better to because that it when watching somebody, I don't know if it's a not so much a nurse because you get them in and out, but watching a therapist or like the doctor after they would do their rounds, walk out that door, it almost feels like the air is being sucked out of you. I'm like, there's the hope, there's the answer walking out the door, and now we're now what? Because I feel felt like the only person that could give me any information. I think it again it goes back to time. I'm like, I know that you know more than I know. Right. I need to know what you know, but it's now, but now, but it's not set up that way, and I think that you know, to have great. With that, I wish there was a way to, you know, the biggest thing that's that a therapist did for me in that acute setting was, and I don't know how we got there. And to go back to your point, Dr. Phil, I think therapists do say more than I think I heard. A lot of it, I was hearing so much information. I don't know how I could actually properly understand everything that you were telling me.

SPEAKER_07

Plus, it's in a whole nother language.

SPEAKER_08

It's in a whole nother language. But one thing, and I don't know how we got here, but this I I said, I was trying to figure out what I could do, and she gave me something very basic and very repeatable that I could do with my husband after everybody left. And I was able to build off of that as I was kind of looking into things.

SPEAKER_07

What was it? Would you mind sharing?

SPEAKER_08

I it was very specific letter sound. So my husband had hemiparesis also. So we were focused on that. But since he was completely nonverbal, I mean couldn't get out the mm sound, the oh sound, we were really hyper-focused on his speech because we had a lot more um faith that his hemiparesis was going to resolve. Uh so we were hyper-fix fixated on that. But she had given me choice syllable or sounds, and I can't remember what they were, and we would just repeat those. And she said, you know, get um his phone out, get out a mirror, and then we're just gonna repeat them and then have him look at you. And that was very helpful. And I like that. I repeated all of that until we found until we got him to his next therapist. Those are the things that we would do independently. And she was a therapist that had come in probably about four weeks in, still in the hospital.

SPEAKER_07

So, I mean, Jeff, did you ever have anything like that? That was like something where somebody said, Okay, do this same thing over and over, you know, push this and get as many repetitions as you can. Because I'm I'd be interested in what like your side would be.

SPEAKER_01

I um the place I was staying had a little gym, and I was just going through my videos the other day. I would go down to the gym and just kind of do myself. I took my big old uh Filipino nurse down there and had him just I just kind of forced it, you know, into the situation. I really didn't, I mean, I had nurses, like 24 hours nursing when I was in Thailand, which was you know very affordable, but I didn't have anybody that cared for me really. I mean, she had a bit of a crush on me, but I didn't really come on, right? And so um I was just thinking for Jamie that it must be rough to have somebody like walk out of the room and then he's just gonna basically look directly at you and say, Okay, what are we doing now? I mean, and not be able to even verbalize it for you must have been extremely, extremely terrifying.

SPEAKER_08

Yeah, I was gonna say, cool, because yeah, as a care partner, all you're doing is saying, It's okay, don't you worry, who's gonna figure it out? I'm gonna figure it out.

SPEAKER_01

Right.

SPEAKER_08

Because that's what you're supposed to do.

SPEAKER_01

And I'm did you see the fear in his eyes, though? Was there fear in his eyes as far as that goes? Or was it just like we're in this together kind of look?

SPEAKER_08

You know, he was still pretty out of it. But I mean, looking back now, that that look in his eyes is kind of um it's it's challenging to describe, but it is that look of not maybe even desperation, close to that, where they're just looking almost through you, like uh like I know you're gonna figure it out, kind of like trust, but kind of like somebody help me. Or and you when you're looking back, you go, I know that you're not gonna be able to figure this out. I don't expect you to figure this out. And I know that I'm you kind of know in that moment I'm gonna do this. Um, and then be and I think that's kind of the chain, you know. There's the chain, you have the patient, right? Like Jeff, I can't imagine how helpless probably you feel, or out of control of your own circumstance, your own body, your own mind, and all of those things. And then that trickles to the care partner, whoever's next in line, and then that care partner, we're looking to Dr. Phil. We're we are just it is just moving.

SPEAKER_07

And right. And then how often do you actually have access to me? Right or to the therapist?

SPEAKER_02

Never.

SPEAKER_07

So so then, so then the reality is is you go, like you, you kind of are. I mean, tell me if I'm if I'm wrong, but like, especially after that first one, that first session, you leave feeling in limbo. You started feeling in limbo.

SPEAKER_08

And you left any better when you guys leave.

SPEAKER_07

Yeah. But yet, so now it's like that that first session, it's interesting as we've gone through this, and I I've really loved this, this, this dialogue, and this, you know, this uh this journey. And those of you guys that are listening, you know, this is this is so eye-opening. I'm this this this podcast, I'm going to uh take clips of this to play for my students because I think this is so critical in just being able to understand how the different perspectives are interacting with each other. And this is just at the very beginning, right? And you know, there's some of these other pieces that it's like, okay, so now um I'm here, and let's say I even I I because here's a typical. Tell me if this was not your first experience. Um the very, very, very first one is I'm gonna help get your husband or get you know you as the survivor to sitting on the edge of the bed. And we're going to possibly transfer to the chair. And then I'm gonna leave you there. And then nursing will get you back. And that's kind of like a common theme because it takes about that 15 minutes to get to you know the edge of the bed, and then a quick transfer over, gets you positioned, and then from that I know whether or not you can handle going to an inpatient rehab or acute is kind of a common like practice of what actually happens, or I can at least make a good guess. And like as I'm just sitting here thinking through it, like from my side, I'm sitting there, okay. I'm looking at, okay, how much did the left side actually help if that was the hemiproadic side? How much, you know, did they actually push when we tried to transfer? How did they, you know, were they able to find midline? Were they able to find, you know, center and stay in center? You know, um, did they uh you know, were they able to try and scoot themselves back in the chair or get themselves out of bed? Like what were they actually even trying? Were they alert? Were they present? Like those are all pieces that I'm looking at, not at all thinking about your questions, Jamie, which is really interesting as I think about this. And I know there are some therapists that are better at this than I am, but like I am so hyper-focused on that moment of like I am with the survivor. And as a care partner, like I'm sorry, but you're off on the side. I don't mean for it to be like that, but it's like, you know what? I can, I can, man, this is interesting because as I'm thinking through this, because I'm like, as I'm sitting there thinking, I'm like, because look, if I don't do my job and I don't impact him, then you are gonna have to do way more. And so I'm sorry, you're off on the side for a minute, and I'm going to put all of my effort into the survivor. That's interesting. Like, as I'm thinking about that, and as the care partner, that first session, and that's what happens to you.

SPEAKER_08

Well, and I think I'm glad you brought that up because now I remember standing to the side thinking, and I and I think about it. I'd never thought about this until now, but I'm I am, you know, I'm looking at my husband, I'm looking at the therapist, I'm looking at my husband, I'm looking at the therapist because I'm trying to decipher what is going through their mind. Are they going to tell me? Because I think there's a part of me as a care partner that knows they're not going to really tell me what they think. So I'm trying to decipher it based on you know, based on reading them. And there was, I definitely his physical therapy sessions. Yeah, I was off on the side and didn't like you weren't really a part.

SPEAKER_01

I was not a part. You were just studying their body language. I was any little clue that she could get from them.

SPEAKER_08

And that's say, Jeff, were you just happy to be doing something? Because I felt like my husband was just happy to be there.

SPEAKER_01

Well, I but I wanted to know what it all meant. Mine was a demand. I was, you know, in my late 50s, and I had just pooped in a diaper laying on a bed, which for me was absolutely mortifying. I could not deal with the fact that I had just done that, and even worse, that somebody was coming in to clean me up.

SPEAKER_07

A female nurse was gonna have to some young 20-year-old girl who's coming to do that.

SPEAKER_01

I was just so embarrassed and so sorry for her and all that. So I demanded that somebody come in there and teach me how to get on to the toilet chair and how to get into the toilet. So, I mean, that was my first kind of like movement of any kind from you know, just being in bed to to that, because it was just to me, it was just mortifying, and and the guilt and everything that went with it was just um done. So they brought in a nurse to teach me how to get out of the bed, to kind of throw my leg over, and to you know, what to hold on to as I was getting out and to help me get to a chair that I could get used because I just and I never again went in my diaper ever again. It was like once I so motivation was quite a bit of you know, it was it was it was motivation that kept that made me do those first things, those first few days of getting to that toilet, basically.

SPEAKER_07

But see, that also you know that maybe that's the next person we need to bring into this conversation is nursing, because yeah, like from the nursing side of things, they have a huge demand. And they're the ones that are, I mean, as as a care partner and the survivor, you're asking them the questions because guess what? When I leave 20 minutes later, 30 minutes later, you still have those questions, and guess who comes in and is around?

SPEAKER_08

Yeah, the nurse. And you know what I've found out is that you sometimes don't get accurate answers. I asked a nurse when we were there how if my husband was ever going to be able to talk again. And she told me he had three months, and if he wasn't better in three months, then however much he recovered in three months, that was gonna be it. But you know what that did? That kicked my butt. I was like, well, we better practice all day, every day.

SPEAKER_07

Maybe, maybe that was her technique, maybe that was her.

SPEAKER_08

I know. I might have been. But I mean, it shows that like good as a care partner, you're just kind of naive. You're just you're grasping at straws, trying to grab anything that makes sense.

SPEAKER_07

So I'm I'm trying to think through this, you know, as I'm as I'm going back through our conversation, and you know, the focus of this, you know, we've we've gone on a couple of little tangents, but I think that's because it shows the the um how everything kind of strings together. So when you go through this this experience as the survivor or as the care partner, you guys see this as a one big experience and it bleeds together. So it's not like you were feeling this one thing at this time, right? I mean, maybe you were, but it's it's connected to the next however many months to years after, and you know like how that has evolved and led. So it's hard to stay in that moment where I'm sitting here and I'm finding it actually very easy. It's very easy for me to sit there and go, what is that first moment like? Because like I have a lot of those. I have a ton. In fact, I have new moments every day when I'm working in when I'm when I work in a hospital or something. You know, it's the very first moment. I know what that's like.

SPEAKER_01

So I only had one of those moments, right? And you've had several thousands. So I let me ask you this, Dr. Phil. How many of those moments are pretty much the same? I mean, besides the little differences of the stroke being different, you know, different problems with this with the survivor. But overall, generally speaking, when you're walking through your life of first timers, how many of them felt the same? And did you leave with the same kind of feeling? And is that different from the way you handled or you feel about boot camps? Because I know boot camps are much more emotionally, I would think that you're much more emotionally tied to the patient by the time you finish that first day.

SPEAKER_07

Oh, there's no question. Yeah, I mean, I I naturally get attached, but like if I know for a fact that I can't like here's the thing, it's interesting. I truly cannot contact you after you have your stay. So after you're in the hospital. I cannot, as a therapist, let's say even we even get really close and emotionally attached and all of that, and we go through all this crap together. I mean, it's like trauma bonding in some way, right?

SPEAKER_01

Like, I mean, there's there's a little bit of allowed to contact me? No.

SPEAKER_07

Oh, I didn't know that. It's it's hip hop. So if I contact you, I doesn't hurt me. No, she doesn't. No, but if if I if I contact you, I am in breach. Oh my goodness. And that makes sense though. You ready for this? If I see you, the the the the care partner or the survivor. If I see you out in public, I have to pretend I don't know you.

SPEAKER_01

Devastating. Devastating.

SPEAKER_07

I have to, unless you come up to me. If you come up to me, then all bets are off for the most part. I then then it's good. But that first initial thing, or like if I can't ask you for your number and say, hey, like, I want to hear about what's going on. I can't offer that. You have to say, hey, I want to talk, I want to keep in touch with you. And we love it. We love hearing about it when you come back.

SPEAKER_01

Wow.

SPEAKER_07

But but yet we don't get that. So it's an interesting piece to this whole journey that as I'm watching your guys' reaction and hearing it, I'm like, you guys didn't know that. I learned something new right now.

SPEAKER_01

Yeah. Yeah, I I had no clue because I, you know, regardless if the therapy was good, I've built some really strong bonds with those therapists. And again, uh, people go on with their lives, and and I've wanted to talk to that person or reach out to that person and see that person again, but I just haven't been able to. And and sometimes you get like I even had a therapist that I'm like, because I was really depressed and suicidal, and the therapist, the mental therapist that I was going through, I was like, You better not drop me, you better not drop me. You're you're a guy, I like you. We have some of the same values, you know. What you make me laugh, you better not drop me. And boom, he dropped me and without any explanation, and I'm just like, geez, you know, and it was like, so it's interesting to know that maybe, you know, maybe he couldn't explain to me, or maybe he just wasn't able to do a certain thing. And yeah, when I get a chance, I am gonna go back and see my therapist that I was that I was working with in the hospital because I really just enjoyed her as a person. And and in my mind, I'm thinking maybe she would be happy to see me too. But you you don't know she would be.

SPEAKER_07

Here's I will tell you from the therapist side, even if all I did was saw you in that first session, like I I remember in particular, there was this, there was this guy. He had um he didn't uh he was not a stroke survivor, but he had what's called an external fixator. It's it's the you know the bars that are screwed in to the bone to keep it super stable because it's not stable because he had been on like a motorcycle accident and it had like crushed his ankle. And so they were trying to figure out what they were gonna do to reconstruct his ankle because it was just all shattered pieces. And I I was the first therapist to get him to standing on the side of the bed and actually getting him to like get out and to move. And like I wonder, I wonder what happened to him. He was young, he was like 19, but I have no idea. And the individuals that came back, and even the ones that like the uh brain survival brain injury, traumatic brain injury was a snowboarder, wasn't wearing a helmet, crashed. I saw the actual video, they had it on video, it was crazy, crashed into a tree. And now he's going on, he wants to be an OT, or he wants to, he was washing windows and watching that journey of what it was like after. Like I had no idea, and there's no way I would have known if he hadn't have kept in touch with me. I remember I remember you know taking him to his house and like him like running into a wall, or like like I I remember those types of things. And now seeing you know that he's going to school and he's driving and he's doing all these things. I'm like, man, like I think at that moment, I would not have guessed that that's where he would have been when I saw him.

SPEAKER_08

I would assume the people that go into this line of work isn't because they don't care about people.

SPEAKER_07

Correct.

SPEAKER_00

And I'm sure let me get that. What did you just say?

SPEAKER_08

I said it it I mean, everything that Dr. Phil just shared, it's I'm sure that people that go into this line of work being a therapist of any kind isn't because they don't care about people. Yeah, I'm kind of being like back. I mean, I you you you know, just kind of flipped it.

SPEAKER_07

I I I you're assuming that we do care.

SPEAKER_08

Yeah, you do care about people. And I'm and so it makes sense that you guys, you know, after you shared all of that, to me, it would make sense that you would think about those moments because those are the human moments of it all. I think that we all just get stuck in that scenario where we get kind of boxed in by a system where there is box checking going on and there is list thinging and there is paper filing that has to happen. But as I I can only speak from the care partner side, we're in such a real human moment. It can be, it's there, and I know that that's real, but I am in such the depths of a real human moment that um, you know, I can it can feel I can feel distanced from a therapist, and I know that you guys care, but it just feels far away sometimes. Because you guys are doing you guys, it's also a job and and a respectful one.

SPEAKER_07

And I get to leave. Right. It's not my it's not my problem. Right. But many therapists do make it their problem. They they do take on, but the problem is that's not healthy because they can't do anything about it.

SPEAKER_01

Right.

SPEAKER_07

Right.

SPEAKER_01

So Yeah, I I think I would be that type of therapist, unfortunately, that would kind of bring it home with me, unfortunately. I I can see myself doing that.

SPEAKER_07

I think there's I think there's a lot of value to it because I I I'll tell you this, I have maybe only woken up maybe one time in 11 years of being an OT with, oh my gosh, what am I gonna do with this person? Or like having an idea because I had just been thinking about it in my mind all night. I I I learned very early on in my life how to how to separate, you know, and and essentially coexist. And I could just step back into that role, and in that moment, then I think about it when I'm on my way back to work. But like it which has helped. Me not ever feel burnout. So you therapists, I mean that is a that is a big skill. As you're listening, you know that's a big skill. But I just I it it's a hard thing. It's a hard thing to if we actually stop and think about what we're doing and the situations that we as therapists, and nursing is no different than this. But if we sit we actually stop to think about it, we'll cry. Like we will sit down and just baw. We'll go crawl into a corner after a day. We'll go to the stairwell. I've I've gone to the stairwell and and bawled. I remember taking a kid home who was really young, had like C5, C6, like way up high. You know, he's had quadriplesia. Taking him home to where I had to essentially drive him up a ramp that was too steep for him to get in and out, and it was a portable ramp that I bought into his house, and then taking him to his room that they hadn't finished painting yet. The only thing that was in the room was a hospital bed, and then in the middle of the room there was paint on the table, and I I had to leave him there with no way to get out of the house. No way, like I like and I but that was that was the system, that was what I had to do. And it was so bad that I bawled on the way back because I just could not believe that I had to do that. And there are so many situations, even just after this, after that first session, there have been so many of those situations that I sit there, I've sat there and I I know other therapists that are listening feel the same way. Like you know, where you just walk out and you're just you just feel devastated. Because you just know, you know the gravity of what's happened, and you know, because you've seen time and time again people that have show these specific characteristics that they typically don't do as well. They didn't have great coping skills, they don't have this internal drive. They don't have loved ones that are actually there pushing them. All of those pieces they don't have it. And you just know the chances for them to get somewhere is so low. So this this has been, man, I I freaking loved this because it's opened my eyes in so many ways. I thought I knew certain things, and even then, like I I there were some things that from both of you that I was like, oh my goodness, like this is this is cool to see from my side. And um, so here's what I want to do. Uh in closing um this this uh this podcast. Um Jeff, if you could answer this, if you could finish this sentence in that first session, I wish people understood the blink. What do you wish people understood?

SPEAKER_01

Just how unknowledgeable I was and the people around me were. I mean just because my friend was there, but you know, he had no clue, and I had no clue, and I just had no knowledge, and and like you said, they might have told me some things, but I just wasn't in the place that I could have comprehended it, I guess, maybe. But I mean, for me to find out, you know, that you know that this was going to affect me more than just walking and more than just uh moving my arms around, that it was going to affect me mentally, well, I would have enjoyed that information. I mean, I could have set myself up for that because I was really later on in, you know, two, two and a half years later, I'm saying to myself, why are you acting this way? Why are you being this way? You know, and and I would have liked for the people around me that knew me and loved me before my stroke, would have the ability to understand that I'm still who I was, but in a lot of ways I'm not. So, you know, it's just like it seems like the world lost patience with me, and I had no idea why. But when when I was able to go back and and look through um the mirror and the looking glass, I was able to see that um, I mean, I just wasn't prepared and I had no knowledge. It's kind of like I grew up ADD, right? Very much ADD, and my whole life was awful because I was ADD and because I did these things that were not normal, that were, you know, abnormal, and I was always persecuted for them. I felt persecuted for them because they were just not in the norm of messiness and just forgetfulness and these things. So my whole life I felt that way, but then later on I discovered and learned, you know, through education that I actually had other skills that people that were normal didn't have. My creativity, my level of uh being able to look at things differently. So if I had known, you know, before I was acting out or before I was suffering from exhaustion, that you know, I felt lazy going into it. So I wanted to be, I think, being educated on the fact that I wasn't lazy and that I wasn't just being a slob of a stroke victim that was just like laying around and watching TV and asking for food in bed and and this type of thing. I think if I would have been educated on that a little bit more, then I would have I would have been able to do a little better. I think lack of education is my first thing that I have to complain about as far as that goes.

SPEAKER_07

I I man, I appreciate that. That's really good insight. All right, Jamie, I'm gonna ask you the same.

SPEAKER_08

In that first session, I wish people understood what I was going to change my answer because it's the same as Jeff's, but my verbiage was when you first read the sentence that I have no idea what's going on. So I'm I'm not gonna change my answer because I think it drives home the fact that there is just a huge gap in either I I consider myself, you know, a pretty knowledgeable person. I can catch on relatively fast and things like that. So, you know, whether it's just you're in just such a high emotional state that you're not able to grasp what's going on or pick up the nuances that you would normally pick up or different things like that, it's that is understanding maybe that if there was some other way to get information would have been really helpful, you know, even if it couldn't come from the therapist, but another another place to go. If they just understood, I I didn't understand. I heard you, but I didn't hear, I didn't really hear you. It takes a while for that to truly set in. And I think hearing it a few different times, and I think you know, just being in such a high emotional state is probably another it's hard to learn.

SPEAKER_07

It's hard to learn when you're when your uh your nervous system is in that fight or flight response. Yeah, it's actually impossible to learn.

SPEAKER_01

You know, you know, when you go to jump out of a plane, they show you a video. I mean, I think even a video, uh standard video that stroke patients and caregivers and loved ones would be nice. I mean, I don't know that there's anything like that out there that kind of covers the whole gamut. You know, it's like no, because that's what I felt like is like I'm jumping into unknown here. I really don't know what's going on. Am I gonna be better? Am I not gonna be better? I mean, I've heard of this thing called a stroke before, I've seen other people that have had it before, but this is me now, and and I'm really uneducated. And I actually go as far as feeling bad for the way that like I have a buddy who's also uh handicapped, and I remember going to his house and like being, come on, let's go. What's taking you so long? And you know, 40 years later, I'm like taking 45 minutes to put a shirt on, and I'm like, All right, wait up, I'm coming, have patience. So, I mean, just knowing that these things are I just yeah, it's like scared and unknowledgeable is like not a good place to be.

SPEAKER_07

I you know, that's that's one of my big takeaways from this this episode is you know, from my standpoint, you know, I just barely taught a course um at UNLV, you know, to doctoral students on how to basically uh increase what we call uh health literacy. So making it so that it's easier for people to understand the health experience. And using multiple avenues of of learning, whether that's handouts, videos, uh written, you know, written word, um modeling, teachback method, lots of different things like that. And I just here's the thing that I wish people understood in that first session from the therapist standpoint. I don't have the time to do what I really want to do. What I, as the therapist, want to do. I don't have the time. Because of the demand of the system and what's making me do something. I have to do it a particular way. That doesn't make it right, but it is something that I wish, you know, in that first session people would understand. And then the other thing is that I wish people would understand that I want so badly to just spend as much time with you as I can. And and I I am. And at the end of the day, I likely have spent ten minutes extra in every person's room that I didn't actually get to see everybody. Because I actually spent more time with people than I was supposed to. And so I I it's it's an interesting piece because as we've gone through this, I think that there's this this we're seeing it's kinda it's really interesting. We're seeing that from your guys' side, that even though it's unique, it's still a I want I I need more time to be educated. I need to know what's going on, I need to know what I can do. And from my side, it's I want to. I really do, but uh I have external demands that are preventing it from happening because I actually get in trouble if I don't. And and I think that's I mean, I that that's obviously something that I don't think is right, but I think it's a piece for us to to kind of you know to to think on, you know, especially when you were in this first session. First time you're about to see somebody, as therapists, we should approach this with I'm just gonna come straight out and tell you I don't have a lot of time. But if you can come up with a list of questions that you need answered, I will make sure that the next time I come, I will have answers for those. That's number one. Number two, I need to set your expectation that I am here to find out really where you are at. That is it. I am not here to get your get you better. I'm not here to do a therapy session. I am here to find out where you can go so that you can get better. Because the sooner I find this out, the sooner you can get there. And if I set that expectation very early on, I think that it would allow for the experience to maybe be a little bit more uh cohesive. And not so much like you know, this panic, and more so, okay, what I'm getting from what you're saying is this first session, I'm not supposed to learn everything. Okay, then I'm not gonna set that expectation. I need to learn in everything. Oh, you were gonna give I I have a whole list of questions, I'll write them down. And if I set that boundary, then what happens is it can set some expectations and it can be better. No, that's not the best answer. The best answer would be yeah, I have three hours with you right now. Let's go. But unfortunately, that's not how it goes. Guys, thank you, thank you, thank you so much for this. I think you know it's interesting because as I've been going through this, I kept thinking about so many avenues that we went through that I was like, man, I want to know what you guys think about you know what like about this area, about this experience. Like, what about at this point in the journey or this point or this point? What is it that you experience? What are your thoughts? How do you how do how does how do things change? It got me thinking about all that. And so I I would, you know, it, you know, you guys who are listening, I want to know if you if you enjoyed this. If you did, let me know. You can uh in the in wherever you're listening, there's usually a place that you can uh give comments, you can you can uh ask questions. If you have questions or things that you would like any one of us to answer, please go ahead and put them in the comments because I would love to provide that opportunity. And um, you know, the thing is, you know, we didn't really talk much this episode about uh about a boot camp or about anything. We didn't really highlight a uh a survivor. I I do want to highlight um, you know, I I'm gonna highlight Gabe, if that's okay.

SPEAKER_08

Amazing.

SPEAKER_07

Because so Gabe, uh Gabe is Jamie's husband. Uh before this podcast, he uh he got on and we were chatting back and forth. And one of the things that I was most uh inspired by is the tenacity that he attacks this experience. It is one of the coolest things to see because uh it's very likely uh the reason I I would say it's probably one of the most important reasons or factors uh into where why he is where he is at. And him talking about how he's making these phone calls, and you know, he it's it's it's still it it's it's hit and miss in the way that he's speaking, but uh you know what he's gonna do it. And he's exhausted, he's tired. But you know what? I just I find that very, very valuable in in just the the the experience. And so I wanna I want to highlight Gabe. We need to get Gabe on one of these episodes because oh, I would just love that. Um and overall, if you are somebody who's listening and you go, okay, I I want to improve, I want to find the strategy, I want to find out, I want to find out, I want the education, I need time to have questions answered. I need uh I I want to I want to know the the pathway that I need to go in order to increase my mobility. What do I need to do? What do I need to do consistently so that a year from now I'm not where I'm at right now? Go to Strokesurvivorbootcamp.com, fill out a request form, I will get in contact with you and we can discuss multiple ways and avenues that are possible for you to get that. If you are a therapist and you would like to know how to actually implement high-intensity gate training, please, please reach out to me. Same exact process. Or you can reach me on TikTok or Instagram at the OT professor. If you have any questions for either of these two awesome people, you just uh send send it in the in the comments in the um in the podcast, whatever platform it is that you're listening from, whether that's Apple, Spotify, iHeartRadio, there's usually a place where they can send you can send a question or add a comment. Um and just any last words that you guys want to say?

SPEAKER_01

Yeah, you know, Dr. Phil, I think that um the thing is, is that we're all so different. Like you are not the average therapist, you're not the average at all by any means. And I can tell just by the short time that I got to see Jamie interact with her husband and and listening to her talk, that she's not the average either. I mean, I can see the pure dedication from her. And we should have all been so lucky to have that. So I think that it's important, and you know, I do feel like I was kind of an average survivor. Whatever.

SPEAKER_07

I really someone who just decides to go to Africa, you know, with your stroke. I mean, yeah, that's not average.

SPEAKER_01

Okay, but I mean the fact that, you know, I mean, you can just hear the dedication in Jamie's voice and and the and the plight she was going through and the panic. I mean, I can really pick up on that. And you can see by the way Gabe is now that the work was done. I mean, oh yeah, there is no way that woman sat around and didn't do anything. And I just think that that's important to know that I know that not every woman or every man is going to be doing that, or every child is capable of that. But I'll tell you what, if you are capable of it, give it your all because.

SPEAKER_07

Oh no. Oh he's leaving us on a cliffhanger.

SPEAKER_08

I know. I've got tears in my eye.

unknown

I know.

SPEAKER_07

So if he if we we lost, we lost Jeff. His uh, I wonder if his uh if his phone, if uh battery died or something like that. But man, I we need to have him finish that. But any last any last thoughts?

SPEAKER_08

No, that's the high. I wish I could tell Jeff that's the highest compliment that could ever be paid. That made me extremely emotional. And as hard is as it is, it is worth every single minute to watch your loved one get better and get paired with a really great therapist. It's amazing. And I just feel thank you so much for allowing me to be a part of these conversations. They are absolutely beautiful moments, highlight of my week now for the past two weeks, and so meaningful, and and I know that they're helping so many people. So just thank you for the opportunity to be here.

SPEAKER_07

Well, we'll end we'll end on that and with the the uh typical Dr. Phil uh Stroke Survivor Bootcamp ending with just remember your recovery. All it really takes is focusing on taking one step at a time. I'm Dr. Phil, and this is Stroke Survivor Bootcamp.

SPEAKER_06

Breathe in count it on every score.