Saturday, February 28, 2015

“Therapy” Without Insurance

Rocky Mountain Stroke Survivor
Posted on March 19, 2013

Many people with stroke have such devastating injuries that they feel blessed to be able to feed themselves.  Cerebellar stroke is a little different.  I can move everything, do everything…just in the wrong place and at the wrong time.  And when I fatigue I can’t get messages through.  It’s not that I’m weak…it’s that the communication between my brain and body is off.

Because of this quirk of cerebellar stroke, I simultaneously feel really guilty for complaining and also generally misunderstood.  In general, the best therapy I can have at this point is to do coordinated movements over and over and over.  Compared to someone with a more normal stroke, this is easy.  Compared to how I was before, this is very, very hard work!  Because I’m cognitively fine, I also find activities like tapping cups or cones (common occupational therapy) not only boring, but somewhat irrelevant.  I learn tapping cups very quickly…but tapping cups isn’t what I need to fully function.  Cognitively speaking, I can function as a doctor but I need to practice language and memorization and could probably due to improve my focus as well.  Playing computer games just doesn’t do it for me.

A few weeks back I started an art therapy class at the local non-profit stroke center.  It was an amazing experience!  I have never been noted for my artistic ability.  My mom’s infamous comment when we were sitting around doing an art project together as a family: “Well, dear…medicine is your art.”  But no one at the therapy class cared about my abilities.  It was all about learning to use my hand and being able to express myself in another way.  I’m on a huge tree kick right now.  I’m working on my third set of trees and have several more in my mind’s eye.  Doing the art is exhausting!  I hold my poor, tired hand in my lap several times during the class just to rest it and then need a nap when I get home.  But it is so much fun and has been a huge help in using my hand.

It also gave me a new perspective on therapy.  I’d been paying $85 a session for physical therapy when I had insurance.  We are currently uninsured and the cost goes up to $110 per session.  My physical therapist was a huge help at first because my abilities were less and she was the first person to really take my strokes seriously and show me all my deficits.  But at this point, I was getting bored with PT/OT and wanting to do something fun.  Art therapy has been an ongoing challenge for me and continues to be fun and interesting.  From the others at art therapy, I learned about music therapy, gardening, balance classes, and speech therapy.  While I certainly need to work on all the same skills as everyone else at the art therapy, because of my type of stroke, I also have slightly different needs.  So here is my new therapy plan:
  • Art therapy every week.  This is taught by a woman who also teaches “real” art workshops through a local guild so she is able to tailor her instructions to each person’s needs.  I like the therapy part of it though because unless I ask for help (“I don’t like my trunks, what can I do?”), she just lets me mess with the supplies.  ($15 a session)
  • Dance!  I’ve always wanted to learn to tap dance but was too busy taking math and science classes.  There is a local studio that charges a monthly membership fee.  I was going to just sign up for an hour of tap a week ($60 a month) but the price goes down the more you do and I thought ballet would help more with the coordination of my arm and my balance so am doing an hour a week of that as well (total for two classes $90 a month).
  • Violin.  I took one quarter of violin in college because I always wanted to learn it…but in elementary school I was one of the only kids who could make a noise on a flute so I got stuck playing the flute.  We own a violin, so I’m going to start teaching myself to play again.  I think the bowing in particular will be really good for my proprioception.
  • Gardening.  I love gardening but have not been outside much because walking on the irregular ground is difficult.  But it’s just what I need.  Digging, planting, weeding, harvesting…they are all great for coordination, balance, reaching over midline, increasing my strength.
  • German.  I bought the introductory CDs for the Pimsleur Approach for German back in December and (not knowing that I’d had a VAD and stroke already), couldn’t figure out why I was having such a hard time re-learning the German I already knew.  I’m pulling those back out and will plan on getting the next level at the library when I’ve mastered this one.  The language learning helps not only my memory and retrieval, but also my focus and attention to learn something new.
  • Counseling on a sliding scale.  Let’s be honest; it’s been a really stressful couple years.  I rate through the roof on the Holmes-Rahe Life Stress Inventory (as does everyone in my family).  I’ll let my husband decide for himself if he wants counseling…but I know I could use some. There are several therapy programs that provide counseling on a sliding scale with their senior students.  I’m paying $5 a session for mine and love my counselor!  I just don’t want her to graduate. :-)
I’m incredibly excited to start this new routine.  I was frankly anxious and relieved to not be able to afford PT anymore (over $400 a month was just not in the budget!)  But with these other “therapies,” I’m getting many more hours of therapy, having fun, and not spending a lot of money to do it.

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