July 1, 2013 Columns

E-lumination: A 'Can-do' Attitude

After suffering his third brain bleed, Andrew Bloom found the resilience to recover speech and swallowing with the help of his creative speech-language pathologist.

I made many plans and took many roads I thought would lead me to my future, only to find that my plans had been changed and I was on a new and unexpected path. This was never truer than on August 20, 2011. I was tired and had a headache, so I spent the next few days in bed, watching a lot of television and thinking I was just fighting a bad virus. I had had two previous bleeds in the pontine part of my brain due to a malformation, but I had surgery in Arizona and believed another bleed was not possible. As the days went by, my wife noticed my speech was deteriorating, the weakness on my right side was worsening, and my appetite was shrinking. After the kids left for school that morning, we decided it was time to call 911. At the time we were concerned, sure, but we never thought we were going to hear what we were about to.

Once I arrived at the hospital, the doctors immediately ordered a CT scan and MRI. After reviewing the results, the neurosurgeon informed me another bleed had taken place. No way! I told him about my surgery and the prior bleeds. By this time, the hospital staff was concerned and the neurosurgeon was confident in his diagnosis. He said this was a fresh bleed and, although I'd had surgery, it didn't guarantee that another bleed would not occur. He told me that the surgery only guaranteed that the malformation would not bleed again because it was removed; the possibility of another still existed.

This bleed was in the same area and was smaller than the two previous ones, so we thought I would have a quicker recovery. However, even this caused a long hospital stay, rehabilitation and long-term deficits. My disappointment and frustration were apparent; everyone who saw me knew that I was knocked down, beat up and back at square one. I felt and looked exhausted and overwhelmed. I kept wondering why—why I'd been tasked with a long recovery and uphill battle for a third time. But I'd been through this before and I knew I could do it again.

Unlike the two previous two, this bleed affected my speech and swallowing. It also limited my ability to open my mouth. Saliva and secretions were constantly accumulating in my mouth, throat and chest. I relied heavily on a Yankauer suction device (something like the ones dentists use) to remove secretions accumulating in my throat. As the days passed, I could not speak, eat, open my mouth or swallow. Lack of nutrition became an issue and they placed a feeding tube in me as a short-term solution.

I was transferred to Cornell Rehabilitation and assigned to Sharon, a great speech-language pathologist who worked every day with me for three weeks. We started using tongue depressors to create an opening in my mouth. Each day or two days we would add sticks to gradually create an opening. First it was two, then 10, then 20. We also spent hours going over and repeating words, phrases or even songs. Over time, these exercises helped with pronunciation, syllables and communicating.

Then came our biggest challenge—swallowing. Sharon knew of a treatment protocol and felt I would benefit from it. It was an external electrical stimulation therapy that aids people who have difficulty swallowing. I used it for an hour per day. I would try to swallow flavor packets, water, juice or jello. In the beginning, I would start to choke or cough, but we stayed the course and over time it got better. Then after a few days, we tried pudding, soup or ice cream. After a few weeks, we noticed considerable improvement. I would wear this device as I did my therapy, and we believe it sped up my recovery. Time and patience were important attributes that helped us get through the monotony and boring—but required—repetitions. We joked around and laughed when we could, which, looking back, made our sessions more pleasurable. I enjoyed our time together, and I think she understood how frustrated I was. I also noticed she went out of her way to speak with my wife, my mom, and even my children, often.

I strongly believe that my positive attitude and having an SLP who is creative and wants her patients to make the best recovery possible make all the difference. I still keep in touch with Sharon, and always go out of my way to thank speech-language pathologists, audiologists, nurses, and other health professionals. The important rehabilitation they offer every day is priceless. 

Andrew Bloom, lives in West Palm Beach, Fla.

cite as: Bloom, A. (2013, July 01). E-lumination: A 'Can-do' Attitude. The ASHA Leader.

  

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