Pushing the Boundaries
A Personal Account of Recovery from Stroke

Rita after stroke rehabilitation at Noordhoek Bay
March 2013 and recovery achieved. Looking north along the Atlantic coast of the Cape Peninsula, above Kommetjie village

This website is complementary to the book ‘Pushing the Boundaries’.
Its purpose is to help the progress of stroke rehabilitation therapy through:

discussions - answering questions - news about stroke rehabilitation - maybe thinking outside the box

Pushing the Boundaries, a personal account of stroke rehabilitation and recovery

About the Book

In the UK 100,000 strokes occur each year. Many survivors are left severely disabled. But why is this - when it is well known that some can and do make excellent recoveries?

Thanks to the expertise of a team of neuro-surgeons, Rita survived a life-threatening stroke, but was left with physical and cognitive disabilities needing full-time care. With no training and knowing nothing about stroke, Rita’s husband David took on the job of main carer. He had no idea what he was letting himself in for, made many mistakes and got into several disagreements with medical and care authorities.

This reluctant carer had the determination to make sure his wife would overcome her disabilities and lead a normal life again - if that was ever possible. A change of environment was needed. Why not South Africa during the English winter? When they arrived in Fish Hoek, near Cape Town, Rita remained wheel chair bound, incontinent and could not make a cup of tea without help. It looked like a long, hard struggle for them both.

Rita in a wheelchair after her stroke, first visit to Fish Hoek, February 2010
February 2010, First visit to Fish Hoek

Yet Rita did climb her mountain to recovery. How was this possible?

And how did a small team of therapists and carers succeed where UK health authorities had failed?

What reasons did David identify to explain Rita’s unexpected recovery?

Is it really necessary to travel all the way to South Africa to find a rehabilitation therapy that works?

March 2012, at home in Noordhoek during Rita's stroke rehabilitation programme
March 2012, at home in Noordhoek

David comments that although this book is an anecdotal story of the recovery from stroke of just one person, his wife Rita, it contains several irrefutable facts:

April 2008
Rita was left with severe disabilities following a major stroke.
June 2010
Eight health and care staff assessed Rita as having no capacity for recovery, this negative prognosis was confirmed again in September.
September 2010
David took Rita to Cape Town to escape the UK winter and give Rita a warm sunny environment.
October 2010
Rita began a daily stroke rehabilitation programme set up and managed by a nurse and two therapists.
By April 2013
Rita had been cured of all disabilities except for a poor short-term memory.

The cost paid by David and Rita for all the stroke therapy and care provided in South Africa between October 2010 and April 2013 amounted to £9,500 (paid in Rands of course). If the same therapy could have been set up in the UK, the cost would probably have been very roughly £20,000.

There are several reasons why Pushing the Boundaries was written:

  • 1

    Following the negative prognosis for Rita’s recovery in 2010, one reason was to describe how a straightforward, easily managed and effective rehabilitation programme was then organised near Cape Town and achieved its aims.

  • 2

    A second was to explain the reasons that David believe contributed to Rita’s successful recovery and to justify – easily – the financial cost of 18 months of daily therapy.

  • 3

    To provide (in Appendix D) a list of information about stroke that David wished he had known, or been told about, when Rita first fell ill. That would have helped him avoid the many mistakes he made. As it was, it took between 9 and 18 months for David to find most of it.

  • 4

    To suggest where we should head from where we are now, to improve the rehabilitation prospects for severely disabled stroke survivors.

If you would like to know how the answers to the following questions can be explained...

Rita’s recovery from a severe stroke was unusual – a negative prognosis was followed by an excellent recovery. Can this be explained? (Yes).

Should Rita be considered unique in her ability to get better? (No).

Why should stroke rehabilitation in the UK be too often seen as inadequate by service users? (The answer to this is self-evident).

One purpose for the book is to take forward the suggestion that many more badly disabled stroke survivors should be capable of significant recovery than presently manage it. How might this be achieved?

...then look in Pushing the Boundaries