Originally from Southwestern Ontario Stroke Network 2013-14 Annual Report. Full Annual Report available at www.swostroke.ca/annual-reports, email swostrokestrategy@lhsc.on.ca.

It is early April 2014. After a winter with unprecedented snowfall, the sun is poking through the clouds and farmers all across Southwestern Ontario can smell the earth. A few more weeks are required to thaw the frozen ground but they are already anxious to return to their fields.

The Recreation Therapist on Dave’s Community Stroke Rehabilitation Team knew he enjoyed time outdoors, and took him snowshoeing as part of his therapy.

The Recreation Therapist on Dave’s Community Stroke Rehabilitation Team knew he enjoyed time outdoors, and took him snowshoeing as part of his therapy.

The same is true even for those farmers who have “retired.” Farmers like Dave McCready who operated a dairy and cash crop farm. And who, not finished with agriculture completely, went on to work at the Huron Bay Cooperative, doing deliveries, working in the store and helping out in the warehouse.

For Dave, however, getting back to the business of farming is hindered by the complications of a stroke he experienced in late October, 2013.

Upon reflection, Dave believes he had experienced numerous small strokes over a period of five years. There were times when he was overcome with weakness, and although he had a family doctor, he never mentioned it. It seemed insignificant at the time.

Diana Williamson, District Stroke Educator for Grey Bruce Health Services, says this is fairly common. “There still needs to be more public awareness about the five warning signs of stroke and the necessity of calling 911,” she says. “There is a clot busting drug called tPA that can be given if a patient arrives at the Emergency Department within 3.5 hours of the onset of symptoms. If you recognize the signs and symptoms, call 911.”

“If we know that someone is having ‘small strokes’ or TIAs because they go to the Emergency Department, they can also be referred to the Secondary Stroke Prevention Clinics which will assess their risk factors and support patients in adopting stroke prevention strategies,” adds Williamson.

The week prior to his stroke, he had to sit down at work one afternoon as his legs were too weak to hold him. He went to the local hospital, but by the time he saw a physician the symptoms had resolved and he went back home. Two days after that he had another incident in which his wife, Marg, came into the kitchen one morning and found him clutching the counter, unable to stand. An initial CT scan didn’t show stroke but he was referred to a neurologist for follow up care. Before he could have that appointment, however, a third incident led to an MRI of the head and admission to the Intensive Care Unit at Grey Bruce Health Services in Owen Sound (Grey Bruce District Stroke Centre) under the care of Dr. B. Young.

Dave’s condition fluctuated quite a bit in hospital and his health care team spoke to his family about the possibility of further strokes. He couldn’t move his arms or legs. Dave’s wife told him he looked at her like he didn’t know who she was. He remembers almost nothing about that first week.

By week two, Dave had made progress and was moved to the medicine unit, where stroke patients have been clustered together to receive care from an expert interprofessional team. This was followed by five weeks on an inpatient rehabilitation unit. The entire hospitalization was marked by daily visits from his wife and multiple visits from his six children ages 24 – 44.

“It never really occurred to me that I wouldn’t recover,” he recalls. “The one thing I did learn from having the strokes – it made me realize how blessed I am with my family and my wife.”

Dave’s recovery was enhanced by the care he received in a District Stroke Centre, located 40 minutes from his home. “It’s an awesome facility with so many stroke experts – physiotherapy, occupational therapy, speech therapy, nursing – all working together. I had no energy, no stamina. But they got me sitting up in bed, and then walking down the corridor – even when I felt I couldn’t.”

And eventually this interprofessional team got Dave home.

On December 19, Dave returned to the “retirement home” he and his wife bought following the sale of their farm. They were soon joined by members of the Community Stroke Rehab Team (CSRT) who brought rehabilitation services to the home so Dave could continue to gain strength, and the members of the Closing the Gap team who helped Dave’s wife Marg make suitable modifications to the home to ensure her husband’s safety.

“A neighbour picked me up and took me to the walking group hosted by the Durham Legion three times each week and of course, the dog needs to be walked regularly, so I got out a fair bit,” he shares.

He’s returned to Owen Sound for medical appointments as well as for a support group for stroke survivors and their families – most recently as a guest speaker. “My wife found people going through the same thing to be tremendously helpful,” he says in favour of others joining a support group.

Dave would like to return to work this spring – it’s a busy time for the agricultural sector. His boss is supportive of a partial return to work and he has a letter of support from his physician in Owen Sound. Stephanie Hughes, the CSRT Occupational Therapist he worked with, had him complete a self-assessment related to his return to work in order to help him work through the various challenges he would face. They also visited his workplace together to assess necessary task adaptations and strategies for managing fatigue. Now he must wait for his driver’s license, suspended after the stroke, to be reinstated.

Dave and his wife have always been the givers and the doers in their community and family. At a recent meeting of the stroke survivors support group, he said it was difficult to ask for help but that the help he has received from his wife, family and community has been integral for his road to stroke recovery. For Dave, not being able to do the things he used to do has been the most difficult implication of the stroke. However, he knows that in addition to the support of his family and community, time and patience are important on the road to recovery. And if there is one thing farmers have plenty of – its patience.