PTAG Blog

When Doug Deadwyler returned home for lunch on Dec. 1, 2006, he recalls feeling that “something was not quite right.” As he sat down to eat, his intuition kicked in and he placed the cordless phone next to him as a precaution. As he went to dial his parents’ number, however, Doug realized that something was very wrong.

Doug was in the early stages of an AV fistula – a type of stroke that affects the parietal and occipital lobes of his brain. His motor skills quickly become compromised, and while he could still think and speak clearly, he was only able to dial “0” for the operator to connect him with emergency responders. Doug stayed on the phone while paramedics broke down his door.

The last thing Doug remembers was the cold air as the paramedics wheeled him out of his house. He was transported to Emory, where he underwent two lifesaving surgeries and began a long recovery process. After 23 days in the Intensive Care Unit, Doug was deemed stable enough to move into in-patient rehab. His first memory is of Christmas Day when a physical therapist came in with reindeer antlers on to perform his evaluation.

As soon as movement was detected, Doug began the long road ahead of relearning how to use both sides of his body. Therapy began with small movements in his hospital bed. And when leg movement was detected several days later, daily PT began.

Doug’s goal was simple: to walk again.

Early therapies – including speech therapy and occupational therapy – concentrated not only on moving his left arm and improving his cognitive abilities, while Doug’s goal to walk again remained steadfast. A physical therapist visited Doug daily to assist with activities and exercises to strengthen his left leg, which he struggled to move at all. He suffered from “left-side neglect,” meaning his brain ignored all stimuli from the left side – creating an interesting challenge as he navigated his way in a wheelchair.

After Doug established his goals, therapy became a routine part of his life. He met with his PT and other members of his therapy team daily, focusing primarily on strengthening his left side to improve his function. He worked in the parallel bars to build his strength and endurance, eventually graduating from the wheelchair to a walker. Doug’s days of out-patient therapy were long and filled with appointments, but also gave him the opportunity to meet others in the same boat – providing him with additional support and appreciation for his family of caregivers.

His physical therapy appointments were one-on-one, consisting of a program designed specifically for not only his activity limitations, but also his strength and goals. Doug practiced using handrails to go up and down stairs. He practiced on ramps and used equipment to continue to strengthen his left side.

Upon “graduating” from out-patient therapy, Doug progressed to forearm crutches, providing him with more flexibility, as well as leading him one step closer to his long-term goal of walking on his own. Finally, Doug was able to move through narrow doorways and navigate a restaurant. He was free to use either bathroom in his home, rather than the one with a wide enough doorframe to accommodate his wheelchair or walker.

With the introduction of aquatic therapy to Doug’s plan, he began to learn to walk again without the use of a walker or forearm crutches. The flexibility that Doug found in the pool where, if he “fell,” it didn’t have any consequences, provided the push, strength and coordination he needed to begin to walk again independently.

While much of his progress in function peaked within the 6 – 12 months following his stroke, today, Doug continues to use physical therapy on an “as-needed” basis for back pain and building strength. He still attends Promotion classes – The Shepherd Center’s fitness center. He still visits his office twice a week, which provides a regular schedule and routine, as well as a piece of what his life was like before his stroke.

People who suffer an AV Fistula like Doug have a 50/50 chance of survival – and among those, only 25 percent have a meaningful recovery and return to a “new” normal life. Doug credits the quick action of his doctors and therapists, as well as his active lifestyle prior to the stroke, for his remarkable recovery. While his priorities and recreational activities have changed, Doug considers his life meaningful. It never crossed his mind that he wouldn’t “get better.”

Click here to learn more about how physical therapy is an integral component of stroke recovery.

Pain management is one of the biggest discussions in the medical community today. The New York Times has dedicated numerous articles to discussing the chronic pain problem plaguing our nation, and campaigns like #ChoosePT serve to educate consumers about the dangers of misdiagnosis and over-prescription of opioid drugs.

This is why we spoke with esteemed physical therapist, Herb Silver, PT, DSc, MBA, to discuss his decades of experience managing – and eliminating his patients’ chronic pain.

According to Herb, many patients often arrive eager to focus on segmented, isolated pain. While, admittedly, his back, head and shoulders also hurt, the patient wants to focus on pain in his neck. Herb aims to eliminate this frame of mind by focusing on the systemic problem of chronic, wide-spread pain. Rather than focus on one area, Herb takes in the big picture with the goal of eliminating the root of his patients’ chronic pain.

A patient should expect his first PT appointment to begin with a standard exam, including an orthopedic, neurological and a manual therapy exam, as well as identifying pieces of patient history that may contribute to chronic pain. Perhaps he struggles with sleeping or anxiety or balancing work and play. Many times, these factors can intensify pain from an injury.

By incorporating a mindfulness of the entire central nervous system, Herb is able to lead his patients into recovery – one free of both pain and pills.

Mindfulness does not suggest that pain is just perception. It incorporates shifts in neurotransmitters as well as an injury or an area that physical therapy can address – which is why it is unique. PTs have the tools to treat localized pain while also being mindful of the central nervous system.

And these “mindfulness” techniques are quantifiable.

When treating an issue stemming from the central nervous system without being mindful of the root cause, the “bear” – as Herb describes it – will keep attacking. Patients begin losing sleep, suffering from anxiety. The brain remains in a state of attack. A PT may recommend something as simple as refocusing throughout the day – focusing on breathing, for example – or may even recommend more elaborate lifestyle changes.

When your brain perceives an attack, it reacts. But by incorporating techniques into daily life to eliminate the “bear,” a patient can eliminate the root of his pain.

Moving forward, Herb anticipates a continuous shift in the medical community to incorporating a holistic approach to pain management, one that includes physical therapy in its core. If you suffer from chronic pain, find a physical therapist near you.