Cathy's Story: Stroke Rehabilitation

When Cathy Flowers overslept one morning – which was out of character for her – her husband, Billy, knew something was wrong. She was lethargic, and her symptoms worsened as the day progressed. So, they went to a nearby emergency room in Sulphur, Louisiana. After being diagnosed with having had a stroke, Cathy was transferred to a hospital in Lake Charles, LA where she was rushed into surgery to remove a large portion of her skull to allow for brain swelling. After the surgery, her prognosis was grim and Billy was told to prepare to lose her.

“She was nonresponsive and on a ventilator, the physicians recommended we remove the vent and let her go if she couldn’t breathe on her own,” said Billy. “I coaxed her for two days to place her hand on mine, and she did! Because she followed that command, they were willing to put her back on the vent if its removal caused her distress. She struggled a bit, but was able to breathe with help from the machine. I had taken videos of her putting her hand on mine and sent them to a rehabilitation center in nearby New Orleans, and to TIRR Memorial Hermann. Ultimately, TIRR Memorial Hermann admitted her. I never heard back from the other facility.”

Once accepted into TIRR Memorial Hermann, Cathy was immediately transported to Houston where they were introduced to their team of physicians, nurses, therapists, and other staff who were prepared to work with Cathy.

“I come from a musical background,” said Billy. “I’m a musician and Cathy became a back-up singer in my band. I believe that music therapy was key in Cathy’s recovery.”

During one of her music therapy sessions, the therapist played Johnny Cash’s “Walk the Line.” She handed Cathy a pretend microphone, and Cathy finished a lyric to the song. It was the first time she’d spoken in weeks!

“I had done research in music speech stimulation and melodic intonation therapy and used those protocols when working with Cathy,” said music therapist Maegan Morrow, MT-BC, NMT Fellow. “By beginning to sing a familiar song but fading out the end, the patient’s brain wants to complete the lyric. This method shows results.”

In the gym, Cathy was able to utilize the Vector system (an advanced overground gait and body weight-support system that allows patients to practice intensive physical therapy early in their rehabilitation).

“Combining physical and music therapy in one session helped with her walking because the music provided a cadence for Cathy to move to,” said Kelly Horstmann, PT, DPT, NCS. 

“Her initial injuries were so severe, they seemed like they may be impossible to overcome,” said Dr. Monica Verduzco-Gutierrez, medical director of the Brain Injury and Stroke Program at TIRR Memorial Hermann. “But Cathy worked so hard and did everything with a positive attitude.”

After several weeks at TIRR Memorial Hermann, Cathy was discharged to go home and continue with outpatient therapy. Two months later, she had surgery to replace the portion of her skull that was previously removed with a man-made piece. That was followed by a second, brief stay at TIRR Memorial Hermann to ensure her recovery after the surgery went smoothly.

“One of the tools she left TIRR Memorial Hermann with was an Alternative Augmented Communication device,” said Chloe Brivic, speech therapist. “I customized it for her and she uses it to communicate via her iPad. It has common phrases that she can simply tap with her fingers and her device says the phrase out loud. It is helpful and used in conjunction with continued speech therapy.”  

Now, Billy and Cathy have settled into their new normal. Cathy gets around their home relatively unassisted with a cane, communicates with those around her, and enjoys a good laugh. They visit Dr. Verduzco-Gutierrez in TIRR Memorial Hermann’s outpatient clinic quarterly so that Cathy can have Botox injections. While back at TIRR Memorial Hermann they always visit the TIRR Memorial Hermann staff they credit with Cathy’s recovery.

“The injections help with her spasticity management,” said Dr. Verduzco-Gutierrez. “She continues her physical therapy at home in Louisiana, so we need to ensure her body stays limber. Even a few years after her stroke, she continues to make improvements. Her hard work has yielded results!”