What steps need to be taken for appropriate stroke rehabilitation?
My 30 year old sister had bi-lateral thalamic stroke about 2 months ago due to a rare syndrome caused by the Lupus she's had for 8 years. The syndrome is Antiphospholipid syndrome. She currently has a Tracheostomy, a feeding tube and a catheter. She doesn't move much, but does have some movement on her left side and does not speak. My question would be - what steps need to be taken for appropriate rehabilitation? We feel that after her discharge from the hospital, we were pretty much "left on our own" to try and find her a good rehabilitation facility. She has been home for 1 month, and it's been hard to say the least. We try to make her as comfortable as possible, but find it very challenging to do so without her being able to communicate or move (though she moves her left side a lot). Any help or suggestions would be greatly appreciated.
Expert Answer
Very sorry to hear about this situation.
I think the best thing to do is make an appointment as soon as possible with her Internist (Primary Care Physician). Although the Internist will likely not be able to help very much for these specific issues, he/she can refer your sister to a Physical Medicine and Rehabilitation Doctor (Physiatrist) urgently, who could hopefully come up with a "plan of attack" for her rehabilitation. This would likely involve some combination of physical therapy, occupational therapy, and speech therapy, done either at her home or at a facility. Those therapists are essential for her long term improvement.
In addition, if by "catheter" you mean "foley catheter", this needs to come out very soon. I would also ask for a referral to a Urologist at the earliest convenience, so that her foley catheter can be taken out and diapers used. Foley catheters are not a good long term option, leading to innumerable urinary tract infections and weakening of the urethra and bladder. I would ask your physician how that can be removed ASAP.