Joshua's story
On an otherwise normal evening, Joshua “Josh” Hinchey started to exhibit concerning symptoms. His long-time girlfriend, Mary, noticed that he was slurring words and having trouble moving around. Although he thought he was fine, Mary knew otherwise and called for an ambulance.
Mary’s instincts were right: Josh was having a stroke. In fact, over the preceding two weeks, Josh was experiencing symptoms because of a dissected carotid artery, which supplies oxygen to the brain.
The 51-year-old tattoo artist was rushed to AltlantiCare Regional Medical Center where imaging confirmed her suspicions. Josh was immediately given clot-busting medication and underwent angioplasty and stenting in his carotid artery.
Unfortunately, three days later, further testing showed swelling was causing a midline shift (where tissue is displaced past the midline of the brain)and Joshua needed a hemi-craniectomy, a procedure to remove part of the skull to relieve pressure on the brain.
After the stroke and surgery, Josh experienced severe physical and cognitive issues and was in need of continued care to regain his strength and relearn the skills that he lost. When he was medically stable, he chose to go to Kessler Institute for Rehabilitation (KIR) - Marlton to continue recovering.
Upon admission to KIR – Marlton, Josh had a significant need for assistance in daily activities. He exhibited deficits in mobility, cognition and suffered from severe left neglect, meaning that he had trouble recognize and interact with stimuli in his left side of his body.
His physician-led team of therapists created a treatment plan that would help Josh relearn all the things that he could no longer do. With intensive therapy, including high intensity training occupational and physical therapies, aquatic sessions, and yoga and meditation, Josh exhibited steady improvement.
“Whatever I was told to do, I just tried to do it,” he explained. “If I noticed I was getting super fatigued, I just had this mantra in my head ‘don’t stop when you’re tired, stop when you’re done.’”
Josh’s occupational therapy sessions focused on improving his independence in activities of daily living. From requiring total assistance, Josh progressed to completing tasks with supervision and demonstrating enhanced insight and awareness into his condition.
Similarly, physical therapy played a vital role in Josh's recovery. He progressed from not being able to walk more than a few feet on his own to covering significant distances. High-intensity sessions, coupled with determination and a good attitude, helped strengthen his body.
“I thought I was going to be in the hospital permanently,” said Josh. Thankfully, that wasn’t the case and he was able to build upon his successes, no matter how small they might seem. “The first step was just standing, then standing up straight,” he said.
Speech therapy addressed Josh's difficulty swallowing and speech impairments. Through targeted interventions, including expiratory muscle strength training, Josh showed marked improvement in swallowing function and vocal quality. His cognitive communication skills also saw significant enhancement, allowing him to engage in meaningful conversations and improve his overall quality of life.
Mary, his girlfriend of 15 years, was also instrumental in his recovery. She was a positive presence and cheerleader for Josh and attended educational training to prepare for his return home.
Reflecting on his progress, Josh emphasized the importance of positive internal dialogue. Stroke recovery is a tough journey and a lot of hard work physically and mentally, he admitted.
However, he said, “It got easier and easier to the point I didn’t have to think about what I was doing."
Throughout his rehabilitation journey, Josh's resilience remained steady. He embraced each therapy session with determination, echoing his mantra of "don't stop when you're tired, stop when you're done."
After discharge, Josh had a few weeks of home therapy followed by outpatient at Kessler Rehabilitation Center and he continues to do well.