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For more information on stroke rehab, go to www.handmentor.com
By Jonathan Bassett
There's a Duke Ellington quote posted on the door to David Nabb's office in the music department at the University of Nebraska in Kearney.
"Life has two rules. Rule one: never quit. Rule two: see rule one."
For Dr. Nabb's students, it's a message to persevere in the face of hardship and drastic life changes. But for Nabb, PhD, associate professor of music and an accomplished woodwinds performer, it holds even deeper significance.
Six years ago, Dr. Nabb suffered a severe stroke at the age of 37, which left him with drastic functional limitations, including the inability to play his beloved instruments-especially the saxophone. Music wasn't just the way he made a living, but as he puts it, "the very way I expressed myself to the world."
In a quest to recapture his life, Dr. Nabb embarked on a circuitous course of rehabilitation that would span 6 years and 2 continents, and take him on trips to some of the most noteworthy rehab centers in the world.
Depending on how you view it, Dr. Nabb's odyssey is either a tale of triumph or an exposé of the progress yet to be made in stroke rehab. As he would discover, taking advantage of the latest in stroke rehab techniques requires a judicious blend of ingenuity, financial resources, die-hard perseverance and more than a little good fortune.
'The Forgotten Survivors'
Stroke is a mystifying condition to rehabilitate. Part physical, part cognitive, part emotional, its effects cascade through the body and strike down functional systems as diverse as gait, speech, bladder efficiency and memory.
As a result, stroke is in a class of its own. While rehab is a proven way to recapture essential abilities, it lacks the established treatment parameters of more predictable patient populations. Estimating an accurate number of treatment visits, setting up timetables and determining expected improvement levels borders on impossible. What works brilliantly for one patient might barely register a small uptick in another.
Because of these clinical uncertainties, patients often receive incomplete and conflicting information from health care providers. A recent survey by the National Stroke Association conveys the sobering news: Almost 40 percent of stroke survivors said they lack key information pertaining to their rehab and recovery.
"Stroke survivors are on a lifelong journey," says James Baranski, executive director and CEO of the National Stroke Association (NSA). "But the majority of survivors are not getting the latest information about their rehabilitation needs and options. They've become the forgotten stroke survivor."
Dr. Nabb could have been one of those cases, if not for serendipitous life circumstances-if his wife hadn't been such an unrelenting advocate for his care, if he hadn't been watching CNN one night in 2001, if he hadn't pursued and qualified for key trials run by the National Institutes of Health (NIH), or if his father-in-law hadn't been a prominent physician in Germany.
"On one occasion we were told that a doctor was on vacation and unavailable," recalled Dr. Nabb. "But when we called back the next day and mentioned that my father-in-law is a physician, suddenly the story changed."
Dr. Nabb has nothing but the highest regard for therapists who build their careers around this challenging and unpredictable patient population. But he doesn't mince words when describing the less-than-stellar aspects of his care. "Many of my therapists figured I'd never get better," Dr. Nabb says. "Those people never helped me. As a patient, you can sense what your therapists believe about your condition. If they feel there's a limit to how much you can improve, you're going to adopt that belief yourself."
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