Robert's story
Robert “Rob” Del Ross, a 54-year-old employee at Weise, USA, and a martial arts instructor and competitor from Mullica Township, New Jersey, checked into Virtua Our Lady of Lourdes Hospital for a scheduled elective heart surgery — a proactive step to prevent future cardiac issues. He spent most of his time after work teaching, training or with his wife and two adult children. He never imagined that he’d have a stroke during the procedure and that he’d have to relearn how to walk, talk and care for himself.
After he was medically stable, Rob and his wife Anastasia knew he needed specialized rehabilitation in order to return home. Anastasia researched hospitals and decided that Kessler Institute for Rehabilitation - Marlton was the best option, it wasn’t too far from home and had a good reputation for stroke rehabilitation. She’d also read a patient story about a man Rob’s age who had a stroke and a positive experience at Kessler Institute for Rehabilitation that made her feel hopeful.
Rob’s stroke caused hemiparesis — severe weakness on his right side, affecting his arm, leg and face. He needed help doing basic life tasks that many take for granted like walking and talking, and he relied on a feeding tube for nutrition. For a man who was a lifelong competitive athlete – Rob was a sixth-degree black belt in karate, fourth-degree black belt in arnis and first-degree black belt in jiu-jitsu – the sudden loss of independence was devastating.
At Kessler, “They got him up immediately and moving,” said Anastasia, who was relieved and grateful to see Rob out of bed. “That’s why we came here.”
Since Rob had a difficult time communicating, Anastasia helped with goal setting, which focused on helping him speak, walk and care for himself when he returned home. His physician-led team created a care plan that allowed him to reach these goals through physical, occupational and speech therapies.
Physical therapy helped Rob stand and walk. Rob’s treatment sessions began with exercises to help him acclimate to being in an upright position. After prolonged periods of immobility, the cardiovascular system can have trouble regulating blood pressure. This can cause dizziness and instability when changing positions. He was introduced to specialized compression socks and an abdominal binder to improve blood pressure regulation and a tilt-in-space wheelchair to position his body in a semi-reclined posture to build tolerance to being upright. He also used a standing frame to support him in a weight-bearing upright position. Initially, he needed maximum assistance to stand, but just a day after his first evaluation, his team helped him successfully take a few tentative steps.
To practice walking, Rob’s physical therapist positioned him at a left-handrail in the hallway which supported him as he practiced shifting weight from one foot to the other and taking steps. In days, he progressed from walking while holding onto the handrail to using a hemi walker, which is designed to provide support for single-handed users. This was vital for Rob since he was still working to regain strength on his right side. Just two days after that, he was able to use a cane that had four support points and was less cumbersome. His team also knew that Rob would have to navigate stairs at home, so they worked with him to climb up and down stairs.
By discharge, Rob could walk up to 132 feet with minimal assistance using his quad cane and climb stairs with assistance.
Rob’s occupational therapy sessions focused on regaining strength and function in his right arm while he relearned how to manage daily tasks. Therapists used an electric stimulation device to send mild electric impulses to muscles to increase blood flow and muscle contractions that cause movement. Regular electric stimulation treatments helped Rob to work on strengthening the muscles needed to grasp, reach, pull and push with his right arm and hand.
Adding a touch of fun to Rob’s therapy, his team wove in an array of kneeling and reaching exercises which are early moves that would be the building blocks of knee strikes and punches – martial arts skills that he knew and loved. By week two, Rob was practicing knee strikes and punches within the parallel bars for balance. He switched sides to engage his weaker arm and leg and his wife joined in by holding pads and executing slow punches that Rob blocked with his recovering right arm.
Anastasia was an essential part of Rob’s therapy. She attended nearly every session, learning how to assist with bathing, dressing and help him safely move between surfaces. Kessler Institute for Rehabilitation’s Care Partner Program provides education to help caregivers meet the challenges of caring for a loved one at home as they continue to recover.
“Our daughter and son also played a vital role in his recovery through their support and occasional participation in therapy sessions,” said Anastasia. “This was truly a team effort and it meant a lot to both of us that they were encouraged to join in.”
Speech therapy focused on rebuilding Rob’s ability to speak and eat. He participated in Response Elaboration Training where therapists encouraged him to expand upon short responses. They also wove in Verb Network Strengthening Training to help him to connect words. The therapist would present a verb challenging Rob to identify who performs the action and who the action is performed on. In addition, he looked at family photos and was asked to describe the scene and people. These exercises helped Rob to think of words.
Therapists also worked with Rob to strengthen his swallowing muscles and voice quality. He used an expiratory muscle training device; blowing into the handheld unit, which resembles an inhaler, improved the muscles used to breathe, cough and swallow. These treatments were accompanied by electric stimulation on Rob’s neck further activated and strengthened those muscles.
One of the joys of life is eating and Rob missed it. On admission, he was still getting nutrition through a feeding tube. In just a few days, he began to eat ice chips and a day later trialed iced tea, apple sauce and chicken salad. By discharge, Rob could eat a regular diet.
Throughout his rehabilitation, Rob’s humor and positive attitude became a source of inspiration for his care team. Whether practicing karate in therapy or joking with his therapists, Rob never lost sight of who he was — a husband, a father, a teacher and a fighter.
After seven weeks at Kessler Institute for Rehabilitation - Marlton, he was ready to discharge and continue therapy at home and as an outpatient.
Since then, Anastasia and Rob report that he continues to build upon the strength, endurance and the communication skills he first recovered at Kessler. When Rob first came home he primarily used a wheelchair for mobility. With two months of continued outpatient therapy, he is able to dress and groom independently and is walking with a single point cane.
“With his Kessler therapist’s encouragement, he continues to challenge himself to increase his step count each week,” said Anastasia.
While not yet back to training, Rob has attended martial arts classes, seminars and a tournament. He even clearly said a complete and well-articulated sentence regarding his skills: “I want my sidekick back!”
With Rob’s competitive nature and his lifelong love of the martial arts, Anastasia wasn’t surprised to hear it and believes that day will come.
After he was medically stable, Rob and his wife Anastasia knew he needed specialized rehabilitation in order to return home. Anastasia researched hospitals and decided that Kessler Institute for Rehabilitation - Marlton was the best option, it wasn’t too far from home and had a good reputation for stroke rehabilitation. She’d also read a patient story about a man Rob’s age who had a stroke and a positive experience at Kessler Institute for Rehabilitation that made her feel hopeful.
Rob’s stroke caused hemiparesis — severe weakness on his right side, affecting his arm, leg and face. He needed help doing basic life tasks that many take for granted like walking and talking, and he relied on a feeding tube for nutrition. For a man who was a lifelong competitive athlete – Rob was a sixth-degree black belt in karate, fourth-degree black belt in arnis and first-degree black belt in jiu-jitsu – the sudden loss of independence was devastating.
At Kessler, “They got him up immediately and moving,” said Anastasia, who was relieved and grateful to see Rob out of bed. “That’s why we came here.”
Since Rob had a difficult time communicating, Anastasia helped with goal setting, which focused on helping him speak, walk and care for himself when he returned home. His physician-led team created a care plan that allowed him to reach these goals through physical, occupational and speech therapies.
Physical therapy helped Rob stand and walk. Rob’s treatment sessions began with exercises to help him acclimate to being in an upright position. After prolonged periods of immobility, the cardiovascular system can have trouble regulating blood pressure. This can cause dizziness and instability when changing positions. He was introduced to specialized compression socks and an abdominal binder to improve blood pressure regulation and a tilt-in-space wheelchair to position his body in a semi-reclined posture to build tolerance to being upright. He also used a standing frame to support him in a weight-bearing upright position. Initially, he needed maximum assistance to stand, but just a day after his first evaluation, his team helped him successfully take a few tentative steps.
To practice walking, Rob’s physical therapist positioned him at a left-handrail in the hallway which supported him as he practiced shifting weight from one foot to the other and taking steps. In days, he progressed from walking while holding onto the handrail to using a hemi walker, which is designed to provide support for single-handed users. This was vital for Rob since he was still working to regain strength on his right side. Just two days after that, he was able to use a cane that had four support points and was less cumbersome. His team also knew that Rob would have to navigate stairs at home, so they worked with him to climb up and down stairs.
By discharge, Rob could walk up to 132 feet with minimal assistance using his quad cane and climb stairs with assistance.
Rob’s occupational therapy sessions focused on regaining strength and function in his right arm while he relearned how to manage daily tasks. Therapists used an electric stimulation device to send mild electric impulses to muscles to increase blood flow and muscle contractions that cause movement. Regular electric stimulation treatments helped Rob to work on strengthening the muscles needed to grasp, reach, pull and push with his right arm and hand.
Adding a touch of fun to Rob’s therapy, his team wove in an array of kneeling and reaching exercises which are early moves that would be the building blocks of knee strikes and punches – martial arts skills that he knew and loved. By week two, Rob was practicing knee strikes and punches within the parallel bars for balance. He switched sides to engage his weaker arm and leg and his wife joined in by holding pads and executing slow punches that Rob blocked with his recovering right arm.
Anastasia was an essential part of Rob’s therapy. She attended nearly every session, learning how to assist with bathing, dressing and help him safely move between surfaces. Kessler Institute for Rehabilitation’s Care Partner Program provides education to help caregivers meet the challenges of caring for a loved one at home as they continue to recover.
“Our daughter and son also played a vital role in his recovery through their support and occasional participation in therapy sessions,” said Anastasia. “This was truly a team effort and it meant a lot to both of us that they were encouraged to join in.”
Speech therapy focused on rebuilding Rob’s ability to speak and eat. He participated in Response Elaboration Training where therapists encouraged him to expand upon short responses. They also wove in Verb Network Strengthening Training to help him to connect words. The therapist would present a verb challenging Rob to identify who performs the action and who the action is performed on. In addition, he looked at family photos and was asked to describe the scene and people. These exercises helped Rob to think of words.
Therapists also worked with Rob to strengthen his swallowing muscles and voice quality. He used an expiratory muscle training device; blowing into the handheld unit, which resembles an inhaler, improved the muscles used to breathe, cough and swallow. These treatments were accompanied by electric stimulation on Rob’s neck further activated and strengthened those muscles.
One of the joys of life is eating and Rob missed it. On admission, he was still getting nutrition through a feeding tube. In just a few days, he began to eat ice chips and a day later trialed iced tea, apple sauce and chicken salad. By discharge, Rob could eat a regular diet.
Throughout his rehabilitation, Rob’s humor and positive attitude became a source of inspiration for his care team. Whether practicing karate in therapy or joking with his therapists, Rob never lost sight of who he was — a husband, a father, a teacher and a fighter.
After seven weeks at Kessler Institute for Rehabilitation - Marlton, he was ready to discharge and continue therapy at home and as an outpatient.
Since then, Anastasia and Rob report that he continues to build upon the strength, endurance and the communication skills he first recovered at Kessler. When Rob first came home he primarily used a wheelchair for mobility. With two months of continued outpatient therapy, he is able to dress and groom independently and is walking with a single point cane.
“With his Kessler therapist’s encouragement, he continues to challenge himself to increase his step count each week,” said Anastasia.
While not yet back to training, Rob has attended martial arts classes, seminars and a tournament. He even clearly said a complete and well-articulated sentence regarding his skills: “I want my sidekick back!”
With Rob’s competitive nature and his lifelong love of the martial arts, Anastasia wasn’t surprised to hear it and believes that day will come.