Jose’s Story: Five Flights Up - The Road Home After Stroke
From the start of rehabilitation, even before he could reliably sit up in a wheelchair unattended, Jose was committed to getting stronger. He had TheraBands, resistance bands used in strength training, tied to all four corners of his bed, and he was motivated to get up and move as soon as he could. Jose had a destination in mind: the fifth-floor walkup apartment he shares with his wife and three children in the Bronx.
Jose suffered a stroke at work in early October, which left him with a tracheostomy, a feeding tube, and significant weakness. Following acute care at Henry and Lucy Moses Division of Montefiore Health System, his family requested a transfer to Burke Rehabilitation Hospital for intensive inpatient rehab. After more than four weeks of steady progress, he has returned home.
“In the beginning, I wondered, are we going to make it?” says his wife, Ileana, who stayed by his side every day. “Now I know he will make it.”
We are telling Jose’s story in March, during Brain Injury Awareness Month, to call attention to the people, resources and education that go into the complex rehabilitation journey following a brain injury, which includes the damage left by stroke. Accidents and falls can also cause a Traumatic Brain Injury (TBI).
One Step at a Time
When Jose arrived at Burke, even getting out of bed was exhausting. His extensive interdisciplinary rehabilitation team coordinated carefully to schedule sessions with plenty of rest in between, so he could tolerate three hours of therapy a day.
“He always wanted to do more,” said Physical Therapist Rebecca Anderson, who, with PT Rachel Seiden worked with Jose on walking and climbing, building strength and endurance. Occupational therapists addressed fine motor skills, especially hand function. Speech, language and swallowing therapists worked on swallowing and tongue strength, which had been severely compromised. The medical team monitored and treated his complex physical symptoms throughout.
At Burke, the rehabilitation plan is guided by the patient’s goals. Jose’s goal of getting home meant climbing five flights of stairs, so Rebecca and Rachel were guided by the strength and endurance that demanded. They used harness and support systems to get Jose upright and walking as early as possible. “It was really powerful to see him walking,” Rebecca said. “It gave him the confidence that he can do it, reduced the mental barriers to returning to that activity.”
While at Burke, the team also had to account for the specifics of Jose’s building, which has only one railing on the stairs. Practicing on the therapy gym’s stairs, they developed modified strategies, including sidestepping upward using both hands on a single railing.
More Than a Visitor
At Burke, our care team also includes family. His wife attended every therapy session, managing the oxygen tank, following in the wheelchair, learning the ins and outs of transferring Jose from bed to wheelchair and back again—educated by the therapy team to be a skilled partner in his care. “His wife has been incredible,” says Rebecca. “She’s as much a part of the team as anybody else. We’re all honestly blown away by how special she is.”
The respect and gratitude is mutual. “These people are so caring, all working to get him better to go back home,” Ileana said of the Burke team.
The Homecoming Ahead
Prior to discharge, a wheelchair, walker and hospital bed were ordered. Jose went home with a feeding tube and suctioning equipment. The team made sure Ileana knows how to manage all of it, including assisting with activities of daily living such as dressing, bathing and eating. Beyond managing equipment and physical care, the team worked to prepare Ileana for perhaps the most important role: being Jose’s advocate, his voice, with whatever comes next.
As she prepared for the long road ahead, Ileana is encouraged by the remarkable progress Jose made. “My goal is to see him getting better every day—and I am,” she says. “He’s more stable, doing much better, can at least do a couple steps.”
Jose was always planning a party for his return home. Before leaving Burke, he told his rehabilitation team that he wanted to invite them all over for his wife’s cooking. That celebration will have to wait as his homecoming was quiet—Jose still cannot eat yet by mouth.
But one thing is clear. His children, ages 16,13 and 12, couldn’t wait to have their father back, to all gather around the table, to watch TV together. “The couple’s 13-year-old daughter said to her mother “Papi’s getting better!”
