[Upbeat music] Marshall.

Caring, connecting, elevating.

www.marshallmedical.org [Background noise] - My name is Jaime Tafoya.

And in 2017, I had a stroke.

[Acoustic guitar music] - Having a stroke or having any traumatic life event is a disrupter in your life.

- You're kinda like a deer in the headlights.

They say over a third of people who experienced a stroke, did not get adequate rehabilitation.

- There's not a lot of areas that America and its people, sco-, score the highest in, but when it comes to, uh, health disparities, it, it-, we're almost number one [Inaudible] that, you know, uh, in every category.

- The modern lifestyle, the modern diet, the stress of daily living got us where we are today with the risk factors of stroke, diabetes, hypertension, cardiovascular disease.

- Stress can be a major trigger for, uh, for any type of stroke or cardiac event.

So I was-, I had just started a new job and, uh, I just broken up with my girlfriend like two days before.

These are-, all these things are like crashing down around me and I was just like a, a time bomb waiting to go off.

[Acoustic guitar music] [Background noise] [Birds chirping] - I'm Jennifer Whitney Tucker and I'm a psychotherapist, uh, licensed marriage and family therapist.

I've known Jaime for years and have been aware of his journey through this stroke and his recovery.

And, uh, there are so many different aspects to something like that.

- Jaime first came to me as a patient, post-stroke, um, with also as being both Native American and leaning towards diabetes.

- Following a stroke, a lot of people take care of the person with kid gloves and protect them and keep them safe and not push them.

And that's the worst thing to do.

The best thing to do is, keep motivating them, push them, push their boundaries, let them look to what they might be able to accomplish and just go for it.

[Orchestral music] - So Jaime, I really want everyone to get to know who you are and as a person and like your background.

So could you tell us a little bit about your childhood?

- Well, I was born and raised in California.

Working class father, wonderful mother.

Got good childhood.

I definitely got a good work ethic from my father, which I think helped me in my stroke recovery.

- High School, I was, uh, a student leader.

I was student vice president of my class, of my s-, senior year.

That kinda la-, l-laid the groundwork for my future.

And then the early 90s, I went to film School in San Francisco and, um, then it became, you know, basically a serious hobby up until the 2000s.

I met a gentleman named Todd Stanley who's the or a producer of, "Deadliest Catch", and he and I created a TV travel show which sort of sparked my career interest in going into full-time production.

[Melodious music] - What moment did you realize you wanted to do cooking for your career?

- Um, that sort of started around 2010, slowly.

Uh, my apprentice is as a chef in Sacramento and ended up going to work for Bon Appétit Management Company.

That career path led me to Maryland where I took a job as a chef in Maryland for Bon Appétit Management and, uh, it was i-in Maryland where I had my stroke and, uh, pretty much brought my life to a stre-, screeching halt.

I was driving home from work and my speech started to slur.

I called my daughter, talked to her real quick.

I didn't tell her what was going on, but I sensed something was happening and I was a short drive from home.

I got home, I laid down and within half an hour, the right side of my body went numb.

Then I remember, trying to get up to go to the bathroom and just stumbling, ending up up on the floor.

[Suspense music] - People get cholesterol plaque build up here and their carotid arteries, which are the two main arteries feeding the brain and under certain circumstances pieces of those can break off and then they basically block off blood supply to an artery and that causes a stroke.

- I had an ischemic stroke.

So I wasn't getting oxygen in that part of the brain and basically that part of the brain died.

When you face adv-, adversity and face a life-changing health event, uh, you know, you have two choices and that's, you know, give up or fight and, uh, you know, when you've been affected by something like a stroke, you know, it's not what happens to you but it's how you react to that.

- So, I think what's so impressive about Jaime is that he was reaching out to people, pretty early on as soon as he could.

Jaime could have just gone quietly away and thought, you know what, I don't know how-, what the future is gonna hold but he reached out and he was letting people know what was-, had happened to him, where he was at, what his hopes were for the future, what he hoped to do and accomplish.

The outpouring of energy from him match the support that was given to him.

[Background noise] - Ready?

He is an individual that is motivated, um, following his stroke.

And initially, when he had his stroke, he did have his physical therapy and it helped for the recovery from his stroke, which affected actually the left side of his brain.

But when you see him, the right side is affected, so he has a flaccid right arm and he has muscle strength issues with the right leg as well.

Good, and then lift up that left leg, good.

And back there.

Good.

And again, keep a little bend in that [Inaudible] When we look at function, there's crossover for motor function.

So if the left side of your brain is affected, you'll see issues occurring on the right side of your body and what Jaime, he has issues with his right arm and his right leg.

One of the gait deficits he has, which is a very common gait deficit, is called foot drop.

And that means his foot or his ankle does not pull up wh-, and especially when he's walking.

So it's a very high risk for falling and tripping.

The muscle that pulls your foot up is either not working at all or the timing, when the brain tells it to turn on, is not appropriate anymore.

So a lot of the recovery's been, been around, uh, rebuilding neuroplasticity, uh, like I said, if, if you knew me at the beginning versus now, it's nothing short of a miracle that I can talk.

- The stroke is an initial injury.

It doesn't progress.

It's static, it stays there.

So, the only thing that will progress is you getting better or motivating, helping someone to look at their potential and to keep moving and fighting for that.

We found out over the last 15-20 years that the brain does have what we call neuroplasticity.

So, it has the ability to learn and to be able to take on more function, even though he's had prior injury to his brain.

- And the feature of stroke recovery, uh, really lies in the body's ability to rebuild nerve signals from brain to the outer extremities.

In the meantime, you really have to focus on, uh, proper eating and taking the right supplements and exercise and mindfulness and breathing and different techniques to basically build-, rebuild your neuro networks.

- This is normal and you're at normal, you have a stroke and you drop down to baseline.

Within the first six months, you might come up to here but that doesn't mean you're finished in recovery.

Recovery can be a lifelong recovery.

This next part here is where we're talking about getting up to here, is the neuroplasticity in the motor control, where we want to make new circuits in the brain, to be able to get that movement or that activity occurring.

Because where the brain has been insulted by the stroke.

That part of the brain is now dead.

But we have lots of circuitry in the brain to take over those components.

So, very important to start physical activity immediately because your brain has to have time to rewire.

I can remember going out on a walker into the hallway with, with their assistance and holding me up and, um, me walking down the hall, holding the railing to get that physical activity started.

[Background noise] I mean, obviously there are days when you just wanna go forget it.

I'm out today, I'm in bed and you get-, have to give yourself that to, you have to be able to, to do that.

But the other days where if you can just will yourself up and out to do the activities that are prescribed for you or that you need to do whatever, maybe it's just to come down and get breakfast or something, i-it can be anything, it doesn't have to be elaborate, just to try to gain your daily routine pieces of it back.

Anything that you can do to keep yourself active because when you're active physically, you're gonna be active mentally and that's the key.

[Background noise] - Typical mindfulness session will look so different for anybody and everybody, it's like two people or more participating in the energy that they each bring.

I'm listening to them and giving-, just holding the space for them to express what they're going through and not so much giving them answers but prompting them to find the answers within them self.

The activities can be breath work, uh, holotropic.

It could be guided meditations.

It could be questions.

Um, there is no like one set answer.

Uh, it's always fluid to the energy between me and another person.

And when I am mentoring or coaching somebody, my job is to meet them where they're at.

- Two of the things that I recommend to my clients who are experiencing trauma, whether it be physical or mental is to, um, practice meditation and to practice breathing.

So, breathing practices can make a huge difference in calming your central nervous system and rewiring your brain.

You know, we talked about wellness in the, in the physical, emotional, you know?

But there's a spiritual component of wellness too.

And when you have two people or even a team of people working collaboratively together to find a way for a person to improve their life or that sacred, that's a sacred process.

No matter where they come from or, or what they represent, all of those things disappear and then when you have a team like that, that's working all for-, to help one person then it's gonna happen.

- We are not our diagnosis.

We are not our disease.

We are a whole body, mind, with everyday trials and tribulations.

Typically, all of us have some type of traumas in our lives and the unraveling of that is also how we heal ourselves.

To better understand ourselves is part of the healing process.

[Melodious music] [Birds chirping] - The individual really needs to be self-motivated and learn that they're going to have to keep pushing themselves and training themselves for a lifetime going forward from that stroke to be able to obtain that highest level of function.

- You're coming to grips with a new life of disability a-and it's word I don't like to use, but, you know, I have to, you know, I am disabled.

I'm, you know, I can't go out and run, run a quarter-mile anymore.

Um, I exercise three days a week, eat right.

Um, but coming to terms with that takes time and you have to make adjustments and those adjustments ce-, become second nature, uh, after a while.

- Not only you're having all these issues that occur to you, now you have all these people bombarding you with information on how to get better and what to do and it, it could be huge overload and your system at times, especially after a new stroke, it's a catastrophic event, may need a lot of psychosocial support to get you through it.

The circle of healing, the fact that you have the physical, mental, emotional and spiritual and until you work on all aspects, you can't completely heal.

- So I love the circle of healing concept.

- So I'm Lakota and Dakota and so, you know, in our-, to our people, we would say, um, [Speaking foreign language] which is the sacred hoop.

Basically, symbolically represents that secular circle of care that you're talking about.

We place you in the middle and we place all of their providers in a circle around you.

Um, everyone's working in word.

It's all collaborative, it's all interconnected and it's, and it's focused towards you.

- It was really my Native American Network that caught me in their net, you know, was the, the talking circles, the, uh, mental health services I, I was receiving from the Native American Health Center, that really, slowly turned the ship around.

And connecting with the right people, you know, the universe conspires, it connect you with different people and if you're open, all these people fill a different niche, you know, that your, your plan.

I did go to several healthcare providers and it was, once again, you know, a lot of this has to do with insurance issues, so there were only so many places I could go, I reme-, remember, insurance-wise, I couldn't get in.

So that's why I ended up at the Sacramento Native American Health Center because they would accept my insurance and so I, I knew, I was aware of them and then, I became established there and within the first year, Sage Lapena started her program and I was referred to her.

I am the principal herbalist here at Sacramento Native American Health Center with the healing ways program.

I consider herbalism-, herbal medicine to be traditional medicine.

Western medicine is a baby.

Western medicine has only been around for a very short period of time in the greater scheme of things and plants have always been medicinal and our greatest teachers, when it comes to health and wellness.

- The, the ways that we view, uh, alternative care in the [Clears throat] Western world has been, um, a little biased, you know, it's just, you know, we want to-, kinda leave that piece out and, and, um, and kind of turn a blind eye to those options.

And, and, you know, I think now we're starting to see a, a, a, a change in, in healthcare delivery, where, um, especially for communities of color where we say like, we're up against some pretty, um, you know, like specific types of barriers in our communities.

And it's not, uh, there's no, um, confusion about how those barriers were established and, and, uh, introduced and integrated into communities of color, you know, it is very strategic.

And so, um, we can also be very strategic about undoing and, you know, really decolonizing healthcare services and even how our communities perceive healthcare and what it should be.

The system of healthcare cannot be cookie-cutter to our communities and it doesn't have to 'cause typically if we're gonna practice traditional care in these systems and in these buildings and facilities, it's gonna be, uh, always something that, that can be easily accommodated.

Uh, it's not only more beneficial but it's also, um, oftentimes culturally appropriate in some situations.

- So what I offer is another way of looking at and thinking about what it is they've been diagnosed with.

We can utilize herbs to help some of the other medications to work better.

- Most importantly, we're not teaching how to heal, uh, sickness, we're teaching how to live a better life and so those two components, [Drum beats] um, they kind of run counter to each other, you know, it's like where you're sick and you do XYZ to feel better.

[Cultural music] Well, these other teachings, they will not only teach you how to feel better but they'll teach you how to live better too.

And that's the biggest, that's the biggest component and responsibilities, uh, from a traditional perspective that we have in this life is that, we understand that this our, our body and our robe is, is, is a borrowed one.

It's gonna, you know, we're gonna-, we pick it up and we come in and we put it down when we leave and just, you know, our spirit continues.

[Drum beats] [Cultural music] Finding ways to get the word out to our own communities about the importance of integrated alternative care is equally if not greater or more important than informing the, the system itself because hospitals and, and systems and care are typically driven by the patient, you know, demand or patient feedback, so, you know, if we educate our own relatives about what the options are, what they look like, where they live, how to integrate them into, into their care, I'm sure they would be more than happy to, to explore those options.

- Integrative medicine is an important part of my recovery because it enhances the medical, uh, services you're already getting.

If you go to UC Davis or Sutter Health, and google, integrative medicine, you'll find that they have integrative medicine programs that include things like nutrition, uh, herbs and supplements, bodywork, mindfulness, uh, massage, acupuncture, things like that.

So those are more holistic services they can deploy to improve your recovery journey - In the healing ways program, I feel as setting precedents for other clinics, certainly IHS clinics across the Nation.

Um, I do utilize SOAP notes, I write them a little bit differently.

We do practice all of your HIPAA laws, so I can see my, um, who I'm working with, blood work, of course, and other diagnosis medications.

And again, part of that is really a safety issue, I want to make sure that I am not causing harm by suggesting certain herbs be utilized by that patient.

- So the challenge for me has been getting to a certain level of recovery services.

And that's really been that's been a five-year process of building a team around me that's efficient and effective and that, that works for me.

I've had to fight tooth and nail for every service I get and, um, you know, now, I can confidently say I've got a really good team around me that includes my cardiologist, my physical therapist, my primary care doctor, my healing ways, practitioner, my mental health, uh, providers.

Um, all those provide a complete circle of, of, uh, Integrative Health Services that really effectively address my issues post-stroke.

- Not only are we in need of connection, we are also in need of purpose.

So, every time you come back to a depressed state or an anxious state, it helps to be able to define what your purpose is because that can make the difference.

That can give you the little boost that you need to get up and go do the next thing.

- That's something that people have to-, people post-stroke have to come to grips with is that, you know, you're-, you need extra help but what meaning does your life have after that?

And that's having a purpose and connecting with friends, you know, I have lots of friends that helps a lot and I have goals and ambitions and that, that keeps me going.

[Soft music] - What is a message of hope for people who go through something like this?

I would say, expect change.

If you put the effort into connecting with others, doing the work that you need to do physically, realigning with your values and your purpose, that-, there will be improvement.

Your brain is on your side.

- My message to stroke survivors is to keep going.

Don't stop.

Look at what your goals are, your ambitions and you just aim for them and keep moving towards them because someday you'll turn around and you'll say, "Hey, I did it, I accomplished it."

- It's a major, major deal.

Like I said, six and a half million survivors in the US alone.

800,000 people every year having strokes.

We really have to fight for the rights of stroke survivors and make sure they're getting adequate recovery services.

[Melodious music] [Melodious music] [Melodious music] [Melodious music] [Upbeat music]