Nicky's MS Rehabilitation Story
When Nicky Wolstencroft arrived at Circle Rehabilitation following a diagnosis of multiple sclerosis (MS), her mobility was extremely limited. She struggled to walk and her ability to engage in and complete day-to-day activities was severely affected. After 12 weeks of engaging with intensive rehabilitation, overseen by her Consultant in Rehabilitation Medicine, Nicky now is able to stand and walk short distances. She also has an increased understanding of how to manage her illness and the importance of looking after herself and knowing her limitations when fatigue begins to take its toll.
Nicky is a 46-year-old, friendly, chatty, positive woman from Bournville, Birmingham. Nicky loves her dog, Yosie, and horse, Tom. Being a very active person, Nicky’s passion in life is horse riding and running her dog walking business.
In February 2021, Nicky woke up and fell from standing. She was unable to move her right leg and arm. Her parents called the emergency services and she was taken via emergency ambulance to her nearest hospital. It was questioned if she had experienced a stroke.
Having had numerous tests including CT scan, MRI scan and lumbar puncture, Nicky was advised by doctors that she had multiple sclerosis (MS). With limited rehabilitation available at the hospital, due to COVID-19, she was transferred to Circle Rehabilitation for intense treatment to support her recovery.
Nicky received a bespoke 12 week rehabilitation treatment plan when arriving at Circle Rehabilitation. Our multidisciplinary team (which comprises doctors, nurses, physiotherapists, dietician, occupational therapists and clinical psychologists) worked together to establish a rehabilitation plan to meet Nicky’s specific rehabilitation needs.
Receiving a diagnosis like multiple sclerosis, can be hugely frightening and distressing, especially when you have little understanding of what the diagnosis means and how it is going to affect you and your life. Whilst there is often the follow-up with a specialist clinician to provide information, the shock at the time can mean it is very difficult to process and make sense of what has been shared. The information booklets, although a very beneficial resource, can be very scary and daunting, if a person is on their own trying to manage and cope as best they can. Unfortunately, the impact of Covid-19 has been that people in hospital are more isolated from their sources and networks of support, so find themselves even more alone.
When Nicky was referred to Circle Rehabilitation, Clinical Psychologist Dr Nicola Wheeler was concerned about her acceptance of her new diagnosis of multiple sclerosis (especially as she was a very active person who woke up one morning suddenly unable to walk and move her right arm) her mind-set and emotional response to this. Hence, psychology has played a large part in Nicky’s rehabilitation care. Together, Nicky and Dr Wheeler recognised that she needed space and time to talk through her diagnosis and how she was feeling, but also to make sense of the information she had been given so that it was no longer something to fear, but rather a useful resource to help her manage to live well with her multiple sclerosis (MS). Nicky found it helpful to refer to her MS as a 'monster at the bottom of the field', but the more they talked about MS, the less frightening this monster became and the closer it came towards her in the field, until finally Nicky started to see this monster as 'Sully' from Disney Pixar's film 'Monsters Inc'. Sometimes Sully can be frightening, which might be Nicky having a bad or more difficult day, or even a relapse in her MS, but most of the time, Sully is friendly and best mates with fellow monster, Mike. Nicky has come to see her MS as Sully who generally goes through life with her as her mate.
With support to put practicalities in place and to be organised about her care and support needs (Nicky now has a picture of Sully on her therapy folder), she feels much more in control of what is happening and how she can manage her MS rather than feeling her MS is taking control. This has included working with medical colleagues to ensure optimal medication management to support Nicky's emotional well-being. Nicky has been supported to share her knowledge and understanding about MS with her family, so that they know how to support her and what signs to look out for to help her manage her symptoms.
Therefore, through Nicky's psychological, and wider multi-disciplinary, care and rehabilitation, Dr Wheeler has employed the Recovery model's CHIME framework to support her recovery of well-being.
During Nicky’s 12 week stay as an inpatient at Circle Rehabilitation, she has received rehabilitation from Monday to Saturday. Physiotherapists Kieran and Katie have witnessed an increase in Nicky’s confidence through her determination and resilience.
Kieran: “During Nicky’s initial physiotherapy assessment, it became evident that she presented with additional injury concerns that could have an adverse impact on her overall rehabilitation journey. Taking full advantage of the unique service offered at Circle Rehabilitation, through a hybrid approach of combined neurological and musculoskeletal physiotherapy, Nicky has been able to regain an excellent level of function in her shoulder and ankle that will afford her the greatest opportunity to achieve her wider therapy goals."
Katie: '"On arrival at Circle Rehabilitation, Nicky received specialised neurological physiotherapy to support with her new diagnosis of MS. Her positive, hard-working approach to rehabilitation enabled her to progress to being able to walk and regain her independence. As a team, we provided a timetabled, individualised programme of therapy to enable her to build her confidence, strength, independence with activities of daily living and mobility. She set herself physical challenges/goals and with support of the multi-disciplinary was re-united with her horse, which we were thrilled to facilitate with the therapy team at Circle Rehabilitation."
Karishma: “Since her admission to Circle Rehabilitation Nicky has been working with Occupational Therapy to work on her goals of being able to manage completing daily tasks independently. Through self-determination, transference of skills and knowledge gained from sessions, Nicky is now able to complete a variety of tasks independently, including; washing and dressing, preparing hot drinks and using adapted cutlery, which is easier to hold. Also through a structured and guided upper limb programme, Nicky has regained strength, movement and activity in her right hand, enabling her to complete more tasks.”
Nicky’s inpatient stay with the team at Circle Rehabilitation was for a period of 12 weeks. Due to COVID-19 and the Government guidance surrounding patient safety, Nicky was initially unable to have her friends or family visit her. Every Saturday, her parents visited and brought Nicky’s dog, Yosie, to see her.
Nicky said: “Having these regular visits is very important as it is something to look forward to. It is also a great opportunity to show my family how well I am progressing and it gave them ‘a massive emotional boost!’ Yosie missed me greatly so we both got to enjoy some cuddles.”
Nicky’s passion is riding her beloved horse Tom. The team at Circle Rehabilitation set a recreational day for Nicky to leave the hospital and visit her horse. Nicky was involved in writing the risk assessment for the visit, which provided meaningful cognitive stimulation. The team supported Nicky in achieving her goal of visiting Tom.
Nicky has said: “Through the multi-disciplinary team all working together, I now feel I have ‘been put back together’ and I am now more in tune with my body, and I listen carefully to what my body is telling me it needs.” She now appreciates that good rest and sleep are important parts of recovery, and there is a need to pace yourself as over-doing things has negative consequences. Having a positive outlook and mentality has been essential so taking small, steady steps to reach her goals!
Nicky: “Thank you to all the staff at Circle Rehabilitation who have supported me with my recovery.”