Using 21st-Century Innovations to Accelerate Rebuilding Life After Stroke
Stroke Onward co-founder Debra Meyerson interviews Rory Polera, who talks about how wearable technologies and smartphone applications helped him rebuild his strength, confidence and identity to recover from a devastating series of strokes. Rory is an engineer, husband, dad and stroke survivor. Rory’s passion for technology, coupled with his problem-solving mindset, encouraged him to develop a series of experiments resulting in small wins that enhanced his stroke recovery and journey to rebuild his life.
Debra: Thank you for being willing to share your stroke experience with us. Can you share a bit about your stroke experience and the challenges you faced afterward?
Rory: I was 36 when I had four ischemic strokes during two weeks in August 2022. The strokes left me nearly incapacitated. I was unable to stand, walk, swallow and see (from double vision) for the weeks and months to come. I had been on vacation in rural Idaho, planning my wedding when my life changed in an instant. After 31 days in hospitals and rehabilitation facilities, dozens of doctor appointments, and months of diligent outpatient therapy/recovery in four states, I accelerated my healing enough that I could walk down the aisle and marry my best friend 10 months after my strokes. And 17 months after my strokes, I was regularly waking up in the middle of the night to console my crying newborn son (which I’m still doing)!
Debra: Your experience must have been terribly challenging, both physically and emotionally. Technology, specifically wearable devices and various smartphone applications, have been helpful to you. Was there some event or turning point that put you on that path?
Rory: Particularly during the first 30 days of recovery, there was a lot of uncertainty around what caused the strokes. The dissection and aneurysm weren’t confirmed until 20 days after the first stroke. Not long after that, I became extremely overwhelmed by the anxiety of stroke recurrence, and I quickly realized that talk therapy and medication weren’t going to work in a vacuum. I realized I needed to make as many lifestyle changes as possible to reduce the risk of another stroke. Unfortunately, it’s more common than not, especially for young stroke survivors, to obsess over the risk of recurrence. In fact, stroke survivors of all ages have anywhere from a 5% to 50% chance of recurrence, so stroke prevention is crucial. Before the strokes, I was physically active and relatively health conscious. I had a smartwatch and tracked my activity levels. I ate reasonably well, socialized with friends regularly and enjoyed a social drink. I managed stress to the best of my ability, usually with exercise.
As I considered lifestyle changes, one of the first places I turned to was the same technology that I used before the strokes. As these health and wellness technologies have become more advanced, readily available and economically accessible, I found they were extremely useful tools for accelerating my stroke recovery, particularly during the outpatient phase.
Debra: What types of technology did you find most helpful, and how did they aid you in various aspects of your recovery?
Rory: I did my assessment of the technological landscape, and I found that using a combination of technologies helped accelerate my recovery. A wearable device was helpful to measure my steps, activity, heart rate and oxygen levels daily. I used the applications on my phone to translate the data from my wearable device into action: I used a sleep app to evaluate my sleep quality (I have a pretty severe case of sleep apnea as a byproduct of the strokes), a calorie-counting app to balance nutrition with weight loss and a fitness app to redefine my physical limits. These tools, combined with a series of tests and iterative goals, enabled me to lose over 30 pounds by walking over 5.5 million steps and cycling over 3,000 minutes in the past 22 months.
Debra: As you know, the work of Stroke Onward is centered on the critical aspect of rebuilding identity in recovery as a key factor in continuing to live a rewarding life. How has that been true for you? How did the use of wearable devices and apps help you reclaim your identity and discover new aspects of yourself after the stroke?
Rory: Fortunately, I had little to no cognitive deficits. I leaned into what I knew best: problem-solving with data. Throughout my career as an engineer, I have been fortunate to work on a variety of data-driven problems. Leaning into my pre-stroke identity and professional strengths helped me find a new sense of purpose and meaning in my life, except now, these strengths centered on my interpersonal life ‒ my family, my health and my future. Focusing on myself first is a big win, I think. It has been and will continue to be a challenging road ahead, but I try to be as optimistic as possible and celebrate the wins in whatever form they come.
Debra: In my book Identity Theft, one of the key themes we talk about is the importance of focusing on small wins. How did you use small wins in your recovery?
Rory: Small wins have and continue to play a huge role in my stroke recovery. Coming from a scientific background, I treated my stroke recovery like one big engineering problem. I had a hypothesis, collected data and analyzed that data in real time, adjusting course as necessary. Some weeks were certainly better than others, but I used each experiment to maximize my performance and recovery outcome. Experiments were as simple as increasing step counts week over week to introducing higher-intensity workouts like jogging, weight training and cycling. When doing higher-intensity workouts, I tracked my heart rate and took frequent breaks, so I didn’t overdo it. At times it didn’t feel like I was making any progress, but it was those moments that I would look back at the data and video recordings to see the amount of progress made. It was beyond motivational to see how far I’d come and to continue testing my newfound limits.
Debra: One of the things I’ve experienced is that the same activities I do to help regain capabilities also help me rebuild my identity – my sense of self ‒ as an academic, mother, partner and more – and all of this supports my broader emotional well-being because I can own my answer to the question, “Who do I want to be now?” Has that been true for you too?
Rory: Besides being an engineer, being an athlete was also a big part of my pre-stroke identity. Doing repetitive tasks was part of my DNA. It was in this training process and my desire to reclaim my identity that I found a tremendous amount of purpose and fulfillment when I needed it most. It helped me avoid the depression and emotional crises that often arise with stroke. It certainly was not easy. I leaned heavily on social and emotional resources such as my care team, caregivers, family and friends.
I’m now jogging one mile in nine minutes just 22 months after the strokes. The best part about this is I share this experience with my son while using the stroller for extra balance support. It’s in moments like this that I realize the importance of being active, holding myself accountable, finding a sense of identity, purpose and fulfillment so that I can enjoy these firsts with my growing family.
All that said, I firmly believe you do not have to be an engineer, scientist or athlete to replicate this kind of outcome. You need the willingness to investigate what technologies are available to you that will aid you in your physical, psychological and interpersonal recovery.
Debra: Our health care system doesn’t always make it easy to access the whole person care we need – both finding it and paying for it. Your approach offers a clear example of how to own and self-manage some of your recovery. What advice or recommendations would you give to other stroke survivors who might be considering incorporating these technologies into their recovery journey?
Rory: I realized early on that I needed to make the most of what I had to work with. This was in line with what a psychologist once said to me, “I’m not going to fix your problems for you. You have to want to fix them yourself. I’m just going to give you some tools to help you.” It was during my second inpatient rehab stay that I realized I needed to invest in myself beyond what care was available. The care team and insurance benefits were only going to get me so far. (I understand that this might not be the case for other stroke survivors.) So I decided to bring whatever tools I could home with me. This included buying aids like foam boards, rope ladders and a stationary bike to work on balance, cardio and agility. Once I started spending money, whether it was $10 or hundreds of dollars, I was much more inclined to stick with it. There are plenty of technologies in the marketplace. I would recommend finding what works for you (given your constraints) and staying diligent. It took me a long time to learn how to be patient, listen to my body and trust the healing process. I’m 22 months in and still have a long way to go!
Rory, thank you for sharing your experience with us. You can hear more from Rory in a recent interview on the Know Stroke podcast.
Thinking beyond Rory's experience, the use of wearable devices, smartphone apps and other accessible technologies has the potential to help a many people recovering from strokes and other health challenges. These tools are becoming more available and affordable. Some may even be covered by health insurance. These aids and assistive technologies don't require an engineering background like Rory has, just a willingness to experiment and find what data inputs are most meaningful for one's personal situation.
Study finds people who need wearable health devices the most use them the least
For younger stroke survivors, gamification and social sharing aspects of many health apps may be a draw. Older adults and those with more significant disabilities from their stroke could leverage voice interfaces and accessibility features to more easily interact with the technologies. Fundamentally, the approach of using accessible technology to support recovery goals and using data-driven accountability can empower individuals from all walks of life to take an active role in regaining capabilities, redefining their sense of self and rebuilding overall well-being after stroke. Assistive and adaptive technologies including AI are now a part of Stroke Onward’s strategic agenda, and we look forward to sharing resources and helping to ensure that devices get into the hands of those who need them most.
Stroke survivor Debra Meyerson and Steve Zuckerman, her husband and “carepartner” after stroke, founded the nonprofit Stroke Onward to help survivors, families and caregivers navigate the emotional journey to rebuild their identities and rewarding lives. As guest writers, they share their experiences and insights in their post-stroke journey.
