The Alleged Two-Year Limit On Recovery

The reason why I am writing this article is to express my understanding of this concept.  Hopefully it may clear up some of the misunderstandings.  I am also attempting to clear up any potential stress about it.  Please be advised, as many of you know, I am an attorney by trade.  As such, I do not have any medical training.  The following is my interpretation and my understanding about the above-captioned concept.  It’s fairly typical of a lawyer to start out by throwing a disclaimer on you.  I just want to explain to you my hopefully well reasoned take on the matter and avoid any possible confusion about it.  While it is a lay person’s opinion, it is based on numerous discussions with doctors and assorted medical personnel.  This does include a neurosurgeon, a neurologist, a physiatrist and several therapists.  As such, it is an opinion based on some facts on the subject.  A medical professional may disagree with parts of it.  Perhaps it’s just wishful thinking because it’s been more than two years since my injury?  However, my opinion is one that is thoughtful.  You can decide if it’s a well-reasoned one.

You will often hear people in the medical field refer to what can sound like there’s a two year time frame for recovery.  I think these discussions may be curt, last only a few sentences, and can leave a patient with the impression that there is a two year limit or cap on their recovery.  There are instances where this couldn’t be further from the truth when you ask to have this rule explained more thoroughly.  Rather it is more a rule of general application or a guideline of sorts.  There are instances where this rule is impossible to apply on an individual basis.
It certainly is something that can’t be applied to every situation.  For example, I suffered a very serious brain stem stroke in early November of 2014.  As such, I am several months over this suggested time frame of two years.  It was explained to me that my stroke was so severe that I am very fortunate to have survived it.  Many people with a similar injury unfortunately don’t survive.  Due to its severity, the typical two year window on recovery may not apply and it may be more like five years.  

That’s not to say that a recovery past two years for a variety of types of injuries is not possible.  In fact, my neurosurgeon and therapists state that they routinely see people making significant gains well past the two-year mark regardless of the injury.  In fact, I can attest to this because I am fortunately still making gains.  I certainly feel like I have more substantial gains to make.  Even if progress has slowed down after two years (of which it may do), as many people know seemingly small improvement can have a fairly significant impact on daily life.  For example, I have very recently been able to stand in the shower.  I previously needed to shower in a shower chair.  I have grab bars to assist me but don’t use a shower mat or traction stickers on the shower floor.  The small improvements in my balance have enabled me to stand and no longer use a shower chair, being more independent well beyond the two-year mark.  While it may seem trivial to someone who just stands and showers every day, being able to stand while I bathe is actually a rather big step for me and a welcomed return to normalcy.  It seems like just the other day that I was in inpatient rehabilitation and my occupational therapist had to assist me in transferring into the shower.  Happily, that is something I am doing completely independently today.  Back then it would take a moderate amount of effort to assist me in transferring to a shower chair.  In therapist speak I was probably a “mod.”  That means I required a moderate amount of assistance.  It’s probably clear I am someone who has undergone an extensive amount of therapy.  It’s something that I continue to engage in to this day.  This is an example of seemingly small improvements leading to fairly large functional gains.

My neurosurgeon feels that a large portion of my recovery fits into this general two-year guideline.  He seems to suggest that it only means the most recovery will take place in two years.  That’s not to say all recovery has to take place within two years.  For example, I was able to speak within two years.  It took me about eight months to do so.  Probably the longest eight months of my life.  I was able to walk within two years.  As such, I have been able to do the very big things in the two year time frame.  He thinks I can certainly make improvements to the clarity and volume of my speech and walk faster with less assistance in the future if it’s something I continue to work on.  However, he maintains that I did make the lion share of my recovery within two years.

One thing has become very clear to me.  This alleged guideline is unable to account for one variable.  That is the strength and motivation of the human spirit.  Improvements are progress no matter how small they seem.  As long a person tries to push to make improvements they will eventually materialize.  Even if it appears an individual reached a plateau sometimes that is exactly when breakthroughs can happen.   Small seemingly insignificant improvements can add up to significant gains.  That’s why they are to be celebrated and it’s so important to keep striving to make any gain.  I think it’s relatively much harder to act with motivation and grace when circumstances are very difficult.  On the other hand, it’s relatively easy to act this way when things are seemingly going well.   I believe that how a person reacts to adversity can truly define them as a person.  It’s even probably more important to try harder when improvements can slow after time.  Even if a setback hasn’t occurred and no injury is suffered there are always things that can be improved in one’s life.  Every person owes it to themselves to continue to try and improve.

by John Carbonara

8 comments

  1. friends on Facebook post your messages and I am so glad that I get to follow what you’re up to! You’re so right about the human spirit! So happy you’re making such great progress.

  2. You have amazed Mike and I but I always knew you would get better everyday because you are a fighter and you have a greater purpose here
    Showing other people anything is possible you are a Superman
    Your wife and family are right there with you
    We are to , we just don’t get to see you to encourage you everyday but we hope you know we are still here for you .
    Katie keeps us informed ❤️
    Love the article
    You should give inspirational tours

  3. John, as a coworker and friend I watched your struggle. I cheered for every gain that you mad. I recently was advised that I have a serious medical condition. When I was given my prognosis, you were one of the first people that I thought about. All along, all of us at work, and Carla, have felt that you we’re going to be exemplary in your recovery.We all knew that you had the spirit and determination to rebound. You are an inspiration.

  4. Hello John,
    I am happy that Saj tagged me on Instagram to come and read your post today. I am also a brain stem stroke survivor (July 2014 at age 50) and am blessed to be here on earth still. Reading your post was like looking at my own recovery and many parts were completely different. That is what people do not realize. We as survivors can share so many similarities and so many differences.

    First, let me say I am so glad you are here still and fighting the fight. I remember the chairs, the assistance, etc. and never thought I would be where I am today as well nearly 3 years in. But, like you I imagine you have days where your brain is really lost and the motor skills and speech go. There are so many things in our world (and govt) that need to be changed in aiding survivors. I wish we were given more time to heal and get strength back. I don’t know about you but I am lucky to sleep more then 4 hours straight each night and my body (stroke effected side) is in pain constantly. I am in the USA so not sure what country you reside in.

    Yesterday, my world crashed yet again when I learned I have to cash a small 401k out in order to have Medicaid. Medicare kicked in January 2017 and has been taking out a large chunk of my disability. No one told me I could not be on both and have a 401k, I learned this on my own. Another fault in our system. I will be without full healthcare until these funds are gone and I can apply again (I don’t even know how long that will be) and I was supposed to see specialists and get fitted for a new AFO in June.

    But, I need to be grateful. Grateful because I am still here and even if they take everything away from me and I must live in a cardboard box I am still here!
    Grateful that we as survivors were given a second chance. After this happens, you realize how material things do not matter.

    I am sorry for my long rant today. Your post came at a time where I needed to be reminded how far so many of us as survivors have come and no matter what they take away from me…I still have my LIFE!

    Bless you and may your recovery continue to improve!

  5. Thank you everybody for your strong words of encouragement. This post was was inspired by a woman I know named Joyce and a person I follow on Instagram named @jenzylorraine. They both expressed some concern over this so called two year recovery limit. I just wanted to let them know I didn’t see it that way. Personally knowing Joyce, her commitment to therapy and improvement is something that I find very inspiring.

  6. Nancy Maxwell James,

    No matter what please try to keep up the good fight. It sounds like from your post that’s what you’re prepared to do. I also live in the USA and I know how difficult and dysfunctional health care can be. Just never give up!

    Regards,
    John

  7. I am a firm believer that if you continue to work hard at your recovery ( whatever that is for you and your particular stroke) you will see gains after the “2year mark”…. I am just over my 3 year mark and I still feel like I am making improvements with my gate and with things like sensitivity to sound… small improvements but still improvements! I’ve been told by some open minded doctors that I can expect to continue to see recovery 10 years down the line! I think the biggest recovery happens within the first two years – it is important to not give up after that as improvement is still so possible. Stay positive and focused and anything is truly possible! I am happy to have provided some inspiration for this post… please continue to inspire others yourself John! All the best!

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