Reflecting on Life: Subarachnoid Hemorrhage, Post-Surgery Rehabilitation (ST Edition)
I'm Myu.
Today, I will slowly write about the rehabilitation I received from a Speech-Language-Hearing Therapist (ST) after undergoing clipping surgery for a subarachnoid hemorrhage 13 years ago.
The ST in charge was a young woman. She mainly provided rehabilitation for my facial nerve paralysis, vocal cord paralysis, and swallowing paralysis.
It started with her wrapping my face in a warm towel to loosen the muscle stiffness. Because my neck would get stiff and I would feel sick if I lifted my head, she started by slowly raising the head of the bed. I still remember her telling me about the scenery visible from the window. Since I couldn't see it unless I lifted my head, she would boost my motivation by saying, 'It's sunny today and the mountains are so beautiful!' I was impressed by how she made me feel like I wanted to lift my head, even though I couldn't actually lift my heavy head. Still, she made me feel like I wanted to see outside as soon as possible.
For my swallowing paralysis, she did various exercises using my tongue. She would lick around my lips, stick my tongue out and pull it back in, and do many other things with me, which I was very grateful for. A week after surgery, I had yogurt in my mouth for an examination. It was so delicious! But I couldn't swallow it, and it just came right back out... My mind was saying 'gulp!', but my throat wouldn't go up. Why! Doesn't my throat want to eat delicious food? I was someone so obsessed with food that I always told my children that 'grudges over food are scary,' yet the reality of not being able to swallow continued for a long time. She tried various things, like thickening juice or changing the consistency of the yogurt... She even researched that twisting my neck might help me swallow and tried various techniques. My body must have been overjoyed just to have food in my mouth. Afterward, I produced so much saliva... I couldn't swallow the saliva either, so I wiped it away with a tissue every time. Then one day, while reading a book, I tried swallowing saliva and thought, 'Oh!? I think I did it!!' After trying a few more times, I confirmed I could swallow saliva. It was the 16th day after surgery! However, even the next day and beyond, I could only swallow about one or two spoonfuls of yogurt. A VF (videofluoroscopic) examination confirmed that my esophageal entrance was narrow, and we tried to widen it slightly with a balloon catheter, but I had such a strong gag reflex that it didn't seem suitable. My doctor began to suggest that, considering the long term, I should think about getting a gastrostomy instead of the current nasogastric tube feeding. Once that happened, my body finally started to get serious. On the 20th day after surgery, I was suddenly able to swallow!!! I imagined how a baby eating baby food uses their tongue and upper palate to push food to the back, and when I tried it, I was able to swallow successfully!!! I was so happy that I could suddenly swallow, and the ST and I were overjoyed. After confirming it again with a VF exam, I started eating. Being the big eater I am, I showed my true colors and gobbled up the meals served to me. That said, I hadn't chewed for three weeks, so chewing was incredibly tiring. It's surprisingly tiring to eat. Also, things like pumpkin and potatoes were easy to get stuck and felt like they were being pushed back at my throat. Surprisingly, taro was easy to swallow because of its sticky texture. Dry meat and fish were also hard to swallow, but they were easier when thickened. I was able to experience these things firsthand. I even thought I was super lucky because this is an experience an ordinary person can't have. I thought I could apply this to meals for the elderly. I think this way of thinking is part of my eccentric, detached, and optimistic nature. Even when there's a problem, I can enjoy the situation and always think it will work out somehow... Having cleared the swallowing paralysis, I was finally heading toward discharge. Since it takes time for facial nerve paralysis to heal, the ST in charge went out of her way to create a personalized menu for me to use after discharge. She understood my personality, which would likely lead me to massage my face too hard in a rush to heal, and instructed me to do it very, very gently to avoid 'synkinesis,' an abnormal nerve connection where the corner of the mouth rises when closing the eyes.
She also did vocal exercises from the beginning for the hoarseness caused by vocal cord paralysis.
The ST really, truly cared for me during my rehabilitation. I'm sure she thought about many things even outside of working hours. I have nothing but gratitude.
My autistic son had received ST rehabilitation at another hospital, but it was completely different from what I experienced there, and I learned that the job of an ST covers a wide range of areas.
13 years later, my swallowing is mostly fine, but sometimes when I'm tired, I can't swallow well, and I wonder what's going on. Especially after undergoing intensive chemotherapy, I sometimes found it hard to swallow. It makes me realize once again that chemotherapy affects the whole body. Also, when I'm too full from eating, my swallowing stops, telling me I'm full. The body is well-made, isn't it? It means I should be careful not to overeat! The facial nerve paralysis improved almost completely in about three months. However, even now, I don't produce tears in one eye. I've become a cold-blooded woman with no blood or tears... I think it's related to Wallenberg syndrome (lateral medullary syndrome), but I still have some trivial discomforts, like not being able to open my mouth wide to yawn, feeling like my mouth only opens halfway, and having trouble licking around my mouth. The raspy voice I had after vocal exercises has become almost normal, but I sometimes get hoarse when I'm tired. Since I have pseudoparalysis of the vocal cords, it can't be helped... I also get hoarse after chemotherapy, which is one of my important symptoms that lets me know I've taken damage. Also, strangely, I get hoarse when I talk to people about my husband's complaints or dissatisfaction. I think this is because King Enma pulled out half of my tongue. Since he saved my life, there must be a promise with King Enma not to speak ill of my husband, though I don't remember it... I have some minor aftereffects, but I believe they are all necessary for me.
By being hospitalized for a subarachnoid hemorrhage, I was able to see the work of the rehabilitation staff as specialists. Everyone was so studious and I respected them all. I would like to thank everyone who supported me through my illness. It's been 13 years, but thank you so much!!