Stroke: The Circle of Healing

- My name is Jaime Tafoya, and in 2017, I had a stroke.

[guitar playing] - Having a stroke or having any traumatic life event is a disruptor in your life.

- You're kind of like a deer in the headlights.

They say over a third of people who experienced a stroke did not get adequate rehabilitation.

- There's not a lot of areas that American Indian people score the highest in, but when it comes to health disparities, it... we're almost number 1 per capita, you know, in every category.

- The modern lifestyle, the modern diet, the stress of daily living got us where we are today with the risk factors of stroke, diabetes, hypertension, cardiovascular disease.

- Stress can be a major trigger for any type of stroke or cardiac event.

So, I was... I had just started a new job, and I had just broken up with my girlfriend, like, two days before, and so all these things were, like, crashing down around me, and I was just like a time bomb waiting to go off.

[guitar playing] [birds chirping] - I'm Jennifer Whitney Tucker, and I'm a psychotherapist, a licensed marriage and family therapist.

I've known Jaime for years and have been aware of his journey through this stroke and his recovery.

And, there are so many different aspects to something like that.

- Jaime first came to me as a patient, post-stroke, with also as being both Native American and leaning towards diabetes.

- Following a stroke, a lot of people take care of the person with kid gloves and protect them and keep them safe and not push them, and that's the worst thing to do.

The best thing to do is keep motivating them, push them, push their boundaries, let them look to what they might be able to accomplish, and just go for it.

- So, Jaime, I really want everyone to get to know who you are as a person and, like, your background, so could you tell us a little bit about your childhood?

- Well, I was born and raised in California, working class father, wonderful mother, got good childhood.

I definitely got a good work ethic from my father, which I think helped me in my stroke recovery.

High school, I was a student leader.

I was student body president of my class, my senior year.

That kind of laid the groundwork for my future.

And then, the early 90s, I went to film school in San Francisco, and then it became, you know, basically, a serious hobby up until the 2000s.

I met a gentleman named Todd Stanley, who's the... or a producer of "Deadliest Catch", and he and I created a TV travel show, which sort of sparked my career interest in going into full-time production.

- What moment did you realize you wanted to do cooking for your career?

- That sort of started around 2010 slowly.

My apprentice is... as a chef in Sacramento and ended up going to work for Bon Apptit Management Company.

That career path led me to Maryland, where I took a job as a chef in Maryland for Bon Apptit Management, and it was in Maryland where I had my stroke and pretty much brought my life to a screeching halt.

I was driving out from work, and my speech started to slur.

I called my daughter, talked to her real quick.

I didn't tell her what was going on, but I sensed something was happening.

And, it was a short drive from home.

I got home, I laid down, and within half an hour, the right side of my body went numb.

I remember trying to get up to go to the bathroom and just stumbling, ended up on the floor.

- People get cholesterol plaque buildup here in their carotid arteries, which are the two main arteries feeding the brain, and under certain circumstances, pieces of those can break off, and then they basically block off blood supply to an artery, and that causes a stroke.

- I had an ischemic stroke, so I wasn't getting oxygen in that part of the brain, and basically, that part of the brain died.

When you face adversity and face a life-changing health event, you know, you have two choices, and that's, you know, give up or fight.

And, you know, when you've been affected by something like a stroke, you know, it's not what happens to you, but it's how you react to that.

- So, I think what's so impressive about Jaime is that he was reaching out to people pretty early on, as soon as he could.

Jaime could have just gone quietly away and thought, "You know what, I don't know what the future's gonna hold," but he reached out, and he was letting people know what had happened to him, where he was at, what his hopes were for the future, what he hoped to do and accomplish.

The outpouring of energy from him matched the support that was given to him.

- He is an individual that is highly motivated following his stroke, and initially, when he had his stroke, he did have his physical therapy, and it helped for the recovery from his stroke, which affected, actually, the left side of his brain, but when you see him, the right side is affected, so he has a flaccid right arm, and he has muscle strength issues with the right leg, as well.

Good.

And then, lift up that left leg.

Good.

And back in.

Good.

And, again, keep a little bend in it.

Head up.

When we look at function, there's crossover for motor function, so if the left side of your brain is affected, you'll see issues occurring on the right side of your body.

And, with Jaime, he has issues with his right arm and his right leg.

One of the gait deficits he has, which is a very common gait deficit, is called "foot drop", and that means his foot or his ankle does not pull up and especially when he's walking, so it's a very high risk for falling and tripping.

The muscle that pulls your foot up is either not working at all, or the timing when the brain tells it to turn on is not appropriate anymore.

- So, a lot of the recovery has been around rebuilding neuroplasticity.

Like I said, if you knew me at the beginning versus now, it's nothing short of a miracle that I can talk.

- The stroke is an initial injury.

It doesn't progress.

It's static.

It stays there.

So, the only thing that will progress is you getting better or motivating, helping someone to look at their potential and to keep moving and fighting for that.

We found out over the last 15, 20 years that the brain does have what we call "neuroplasticity", so it has the ability to learn and to be able to take on more function even though he's had prior injury to his brain.

- The feature of stroke recovery really lies in the body's ability to rebuild nerve signals from the brain to the outer extremities.

In the meantime, you really have to focus on proper eating and taking the right supplements and exercise and mindfulness and breathing and different techniques to basically build... rebuild your neural networks.

- This is normal, and you're at normal, you have a stroke, and you drop down to baseline.

Within the first six months, you might come up to here, but that doesn't mean you're finished in recovery.

Recovery can be a lifelong recovery.

This next part here is where we're talking about getting up to here, is the neuroplasticity and the motor control, where we want to make new circuits in the brain to be able to get that movement or that activity occurring, because where the brain has been insulted by the stroke, that part of the brain is now dead, but we have lots of circuitry in the brain to take over those components.

- So, very important to start physical activity immediately because your brain has to have time to rewire.

I can remember going out in a walker into the hallway with their assistance and holding me up and me, walking down the hall, holding the railing to get that physical activity started.

- I mean, obviously, there are days when you just want to go, "Forget it.

I'm out today.

I'm in bed," and you have to give yourself that, too.

You have to be able to do that.

But, the other days where if you can just will yourself up and out to do the activities that are prescribed for you or that you need to do, whatever, maybe it's just to come down and get breakfast or something, it can be anything, it doesn't have to be elaborate, just to try to gain your daily routine, pieces of it back, anything that you can do to keep yourself active, because when you're active physically, you're going to be active mentally, and that's the key.

- A typical mindfulness session will look so different for anybody and everybody.

It's two people or more participating in the energy that they each bring.

I'm listening to them and giving... just holding space for them to express what they're going through and not so much giving them answers, but prompting them to find the answers within themselves.

The activities can be breathwork, holotropic, it could be guided meditations, it could be questions.

There is no, like, one set answer.

It's always fluid to the energy between me and another person.

And, when I'm mentoring or coaching somebody, my job is to meet them where they're at.

- Two of the things that I recommend to my clients who are experiencing trauma, whether it be physical or mental, is to practice meditation and to practice breathing.

So, breathing practices can make a huge difference in calming your central nervous system and rewiring your brain.

- You know, we talk about wellness in the physical, emotional, you know, but there's a spiritual component of wellness, too, and when you have two people, or even a team of people working collaboratively together to find a way for a person to improve their life, well, that's sacred.

That's a sacred process.

No matter where they come from or what they represent, all of those things disappear, and then when you have a team like that that's working all to help one person, then it's going to happen.

- We are not our diagnosis.

We are not our disease.

We are a whole body mind with everyday trials and tribulations.

Typically, all of us have some type of traumas in our lives, and the unraveling of that is also how we heal ourselves to better understand ourselves as part of the healing process.

[uplifting music] - The individual really needs to be self-motivated and learn that they're going to have to keep pushing themselves and training themselves for a lifetime, going forward, from that stroke to be able to obtain that highest level of function.

- You're coming to grips with a new life of disability, and it's a word I don't like to use, but, you know, I have to.

You know, I am disabled.

I'm... you know, I can't go out and run a quarter mile anymore.

I exercise three days a week, eat right, but coming to terms with that takes time, and you have to make adjustments, and those adjustments become second nature after a while.

- Not only you're having all these issues that occur to you, now, you have all these people bombarding you with information on how to get better and what to do, and it could be huge overload in your system at times, especially after a new stroke, it's a catastrophic event, may need a lot of psychosocial support to get you through it.

- The circle of healing, the fact that you have the physical, mental, emotional, and spiritual, and until you work on all aspects, you can't completely heal.

- So, I love the circle of healing concept.

So, I'm Lakota and Dakota, and so, you know, in our... to our people, we say, "[indigenous language]" which is the sacred hoop, basically symbolically represents that secular circle of care that you're talking about.

We place you in the middle, and we place all of the providers in a circle around you.

Everyone's working inward.

It's all collaborative, it's all interconnected, and it's focused towards you.

- It was really my Native American network that caught me in their net, you know, was the talking circles, the mental health services I was receiving from the Native American Health Center that really slowly turned the ship around.

And, connecting with the right people, you know, the universe conspires to connect you with different people, and if you're open, all these people fill a different niche, you know, that fit your plan.

I did go to several healthcare providers and it was... once again, you know, a lot of this has to do with insurance issues, so there were only so many places I could go.

I remember insurance-wise, I couldn't get in, so that's why I ended up at the Sacramento Native American Health Center, because they would accept my insurance, And so, I knew I was aware of them, and then I became established there, and within the first year, Sage LaPena started her program, and I was referred to her.

- I am the principal herbalist here at Sacramento Native American Health Center with the Healing Ways program.

I consider herbalism, herbal medicine, to be traditional medicine.

Western medicine is a baby.

Western medicine has only been around for a very short period of time in the greater scheme of things, and plants have always been medicinal and our greatest teachers when it comes to health and wellness.

- The ways that we view alternative care in the Western world has been a little biased.

You know, it's just... you know, we want to, kind of, leave that piece out and, kind of, turn a blind eye to those options, and, you know, I think now, we're starting to see a change in healthcare delivery where, especially for communities of color, where we say, like, we're up against some pretty, you know, specific types of barriers in our communities, and it's not... there's no confusion about how those barriers were established and introduced and integrated into communities of color.

You know, it's very strategic, and so we can also be very strategic about undoing and, you know, really decolonizing health care services and even how our communities perceive health care and what it should be.

The system of health care cannot be cookie cuttered to our communities, and it doesn't have to be, because typically, if we're going to practice traditional care in these systems and in these buildings and facilities, it's going to be always something that can be easily accommodated.

It's not only more beneficial, but it's also oftentimes culturally appropriate in some situations.

- So, what I offer is another way of looking at and thinking about what it is they've been diagnosed with.

We can utilize herbs to help some of the other medications to work better.

- Most importantly, we're not teaching how to heal a sickness, we're teaching how to live a better life, and so those two components, they kind of run counter to each other.

You know, it's like where you're sick, and you do X, Y, and Z to feel better.

Well, these other teachings, they will not only teach you how to feel better, but they'll teach you how to live better, too.

And, that's the biggest component and responsibility from a traditional perspective that we have in this life is that we understand that this, our body, our robe is a borrowed one.

It's gonna... you know, we're gonna... we pick it up, and we come in, and we put it down when we leave, and just, you know, our spirit continues.

Finding ways to get the word out to our own communities about the importance of integrated alternative care is equally, if not greater or more important, than informing the system itself, because hospitals and systems of care are typically driven by the patient, you know, demand or patient, you know, feedback, so, you know, if we educate our own relatives about what the options are, what they look like, where they live, how to integrate them into their care, I'm sure they would be more than happy to explore those options.

- Integrative medicine is an important part in recovery because it enhances the medical services that you're already getting.

If you Google "integrative medicine", you'll find that they have integrative medicine programs that include things like nutrition, herbs and supplements, body work, mindfulness, massage, acupuncture, things like that, so those are more holistic services that you can deploy to improve your recovery journey.

- In the Healing Ways program, I feel as setting precedents for other clinics, certainly IHS clinics across the nation.

I do utilize SOAP notes.

I write them a little bit differently.

We do practice all of your HIPAA laws, so I can see my... who I'm working with's blood work, of course, and other diagnoses, medications, and again, part of that is really a safety issue.

I want to make sure that I am not causing harm by suggesting certain herbs be utilized by that patient.

- So, the challenge for me has been getting to a certain level of recovery services, and that's really been... that's been a five-year process of building a team around me that's efficient and effective and that works for me.

I've had to fight tooth and nail for every service I get, and, you know, now, I can confidently say I've got a really good team around me that includes my cardiologists, my physical therapist, my primary care doctor, my Healing Ways practitioner, my mental health providers.

My mental All those provide a complete circle of integrative health services that really effectively address my issues, post-stroke.

- Not only are we in need of connection, we are also in need of purpose.

So, every time you come back to a depressed state or an anxious state, it helps to be able to define what your purpose is, because that can make the difference.

That can give you the little boost that you need to get up and go do the next thing.

- That's something that people have, the people, post-stroke, have to come to grips with, is that, you know, you need extra help, but what meaning does your life have after that?

And, that's having a purpose and connecting with friends.

You know, I have lots of friends, that helps a lot, and I have goals and ambitions, and that keeps me going.

- What is a message of hope for people who go through something like this?

I would say expect change.

If you put the effort into connecting with others, doing the work that you need to do physically, realigning with your values and your purpose that there will be improvement, your brain is on your side.

- My message to stroke survivors is to keep going.

Don't stop.

Look at what your goals are, your ambitions, and you just aim for them and keep moving towards them, because someday, you'll turn around and you'll say, "Hey, I did it.

I accomplished it."

- It's a major, major deal, like I said.

Six and a half million survivors in the US alone, 800,000 people every year having strokes, we really have to fight for the rights of stroke survivors and make sure they're getting adequate recovery services.

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