After stroke, former MTI president says ‘I’ve never been one for self-pity’

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Chris Paustian and his physical therapist, Steve Van Genderen, work on a marching exercise recently at Dakota Physical Therapy in Mitchell. The exercise helps Paustian strengthen his legs and improve his balance after his Aug.1 stroke. (Chris Huber/Republic Photo)

Talk about it

Chris Paustian considers himself a lucky guy.

Two months after a stroke numbed his left side, he’s already up and moving.

Paustian, 68, retired in June 2008 after serving nearly 24 years as president of Mitchell Technical Institute. Mitchell Superintendent of Schools Joe Graves dubbed Paustian “Mr. MTI” for his dedication and tireless leadership.

Trips to doctors’ offices and physical therapy were not how Paustian envisioned spending his retirement.

“I would prefer that this didn’t happen to me, but I’ve never been one for self-pity,” he said in a recent interview at his home. “But my feelings are, ‘Let’s deal with it and move on.’ ”

The stroke left him with left-side numbness, a form of hemiplegia in which the muscles on one side of the body are either weakened or paralyzed.

He can still use his computer, but his control of his left hand isn’t what it was. In therapy, he’s working to get control of the ring and pinky fingers of the affected hand. In the meantime, he uses a right-handed keyboard.

Paustian feels fortunate that the stroke did not affect his speech or cognitive abilities. He suffered a right-brain bleed, or a cerebrovascular accident (CVA).

During therapy sessions in Sioux Falls, Paustian met other stroke patients who were much worse off, including one quadriplegic young man in his 20s who was paralyzed in a diving accident.

Type A doesn’t quite describe Paustian’s personality. Lively, chatty and involved, he’s had difficulty accepting his temporary confinement to the lower level of his home.

Emergency

Paustian received little warning that his life was about to change forever. He remembers that he was home sitting at his desk Aug. 1 when he felt an odd, tingling sensation in his left leg.

“I tried to get up and I couldn’t,” he said.

As the strange sensations increased, he slid off his chair to the carpet to prevent injury in case of a fall. Once on the floor, he tried to sit up but couldn’t. His wife, Sandi, was in another part of their home, but he couldn’t reach the intercom on the wall to call her for help.

He dragged himself to the hall, where Sandi heard his yells for aid and quickly dialed 911. After a CAT scan at Avera Queen of Peace Hospital, doctors decided to send him by helicopter to Avera McKennan Hospital in Sioux Falls.

Paustian had been on anticlotting medication for other health issues. After the stroke emergency, physicians administered plasma to stop the brain’s bleeding. It apparently worked. Doctors at McKennan were relieved to see there was little difference between their CAT scan and the earlier scan taken in Mitchell.

After weeks in the hospital to stabilize his condition, Paustian began his long rounds of therapy and worked with his doctors to control blood pressure that was stubbornly high before and after his stroke.

Humor intact

Paustian’s well-known sense of humor has remained intact throughout his ordeal.

He says he has become a student of his illness and laughs that he’ll bore anyone who will listen with the details of his stroke. He’s already thinking about driving again, but he realizes that’s literally and figuratively down the road a bit.

He even managed to find the humor in his situation while being airlifted to Sioux Falls.

“I remember laying on my side in the chopper,” he said, “but I didn’t know where my hand was. When I asked the nurse, she said it was on her thigh.”

Paustian remembers the pilot joking, “You can’t use that line again.”

The incident left Paustian with a new favorite word: “proprioception,” the ability to sense the position, location, orientation and movement of the body and its parts.

In Paustian’s case, the limbs on his left side are not always doing what he thinks they’re doing; hence, the humorous helicopter episode.

Proprioception is a problem when he walks. When a healthy person decides to make a left turn, his left foot automatically moves in that direction and into a position to receive the body’s weight.

Paustian’s walking has become more deliberate since his illness because his nervous system’s feedback loop was dulled by the stroke. If he wants to make a left turn, he must do so deliberately and first check his foot’s location before making any sudden moves. Failure to do so could mean a fall.

He also wears a brace on his lower left leg to keeps his toes up when he walks. Without it, his foot would drop and he might trip.

Paustian has a strong grip with his left hand, but it’s difficult for him, without deliberate effort, to gauge the amount of pressure he’s exerting.

The best description he can give is that his entire left side, from his left ear to his left foot, feels “muted.”

The stroke’s effects can be oddly capricious. While his left side is dead to most pain, “I can still feel my arthritic knee and I can scratch an itch and get relief,” he said. His appetite is also dulled, but not his love of ice cream.

Therapy

“Do you know the difference between a therapist and terrorist?” Paustian asks. No. “You can negotiate with a terrorist.” The joke draws a laugh from Steve Van Genderen, Paustian’s physical therapist at Dakota Physical Therapy, but there’s some truth to it. You’ve got to be tough to make progress.

“We make him work,” said Van Genderen, “but Chris’ upbeat attitude about therapy makes a huge difference.

“Successful therapy depends on motivation. Chris has a lot of motivation, and that makes my job a lot easier.”

Paustian takes physical therapy three times a week to build strength, balance and gross motor skills, and the same amount of occupational therapy to develop fine motor skills. It helps to improve strength and balance and to rebuild nerve and muscle connections.

Other therapies help him to develop his sense of touch. One exercise calls for him to use his left hand to find objects in a bowl of rice. When he began, he had difficulty finding a toothbrush. Now he can find paper clips and safety pins, but he can’t distinguish between the two — not yet, anyway. His sense of humor helps keep him optimistic.

“You’ve got to have fun with this,” he said, his “I won the Norwegian Lottery” T-shirt making his point. The shirt shows the unfortunate lottery winner up to his neck in lutefisk.

‘Hand you’ve been dealt’

Paustian is pleased, but impatient, with his progress. His next goal is to get to the point where he can discard his walker and use a four-point cane. His major concern is a repeat brain bleed.

He remains fully involved as congregation president at the First Lutheran Church of Mitchell, and he maintains his involvement with Rotary International. The experience has dented, but has not destroyed, his strong sense of self-reliance.

“You don’t understand what it means to be laying in bed and asking for everything,” he said. “Everybody who goes into the health-care professions needs to lay on their backs for 24 hours in a hospital bed and depend on others for their most basic needs.”

In another sense, his illness has opened a path for others, giving friends an opportunity to demonstrate their caring and friendship. They have done just that, from washing his cars to delivering cooked meals to his home.

He also believes his experience would have been tougher to contend with were he not a man of faith.

“I’m not going to let the ifs, maybes and perhapses control my life,” he said. “I don’t live in that world. In the end, this is the hand you’ve been dealt, and you go with it.”

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