Seven-foot wooden giraffes. Teacups big enough to sit in. Clown-suits, tutus, and heart-shaped headpieces.

Those are just some of the things 47-year-old Lisa Dube used to design and create in her Hudson home. Working for her oldest daughter, a high fashion photographer based in Philadelphia, Lisa would toil away on the costumes and scenery pieces when she wasn’t taking care of her three teenagers or working her part-time cashier’s job.

But this past spring and summer, Lisa’s creative ventures had to take a back seat to some far more tedious tasks – like learning how to stand and pivot to sit in a wheelchair or doing hand and leg strengthening exercises.

The change in Lisa’s physical abilities came in the wee hours of May 13th when she woke up with left-sided weakness and garbled speech. Diagnosed at Marlborough Hospital with a stroke, she was quickly transferred to UMass Medical Center, where a team of physicians had a history of treating Lisa for a pre-existing platelet disorder.

It was that platelet disorder that would soon be identified as the cause of a blood clot in Lisa’s neck, which led to her stroke.

Following a week at UMass, Lisa was transferred to Fairlawn Rehabilitation Hospital. Fortunately, the stroke had not significantly impacted her cognition, and her speech deficit was short-lived. However, Lisa’s impaired mobility required rigorous physical therapy. “When I left UMass, I needed two people to help me just stand and transfer to the wheelchair,” she recalled. “But in the first couple of days at Fairlawn, my physical therapist had me walking, and during that first week I got fitted for a leg brace and was doing stairs.”

Lisa credits the intense rehabilitation at Fairlawn for her progress. ““I was glad that my rehab was so intensive. My life is my kids and my husband, so I wanted as much therapy as possible so I could get home and take care of my family,” she said.

In occupational therapy Lisa had to work hard to regain the use of her hand. “By the time I left, I could open and close my hand, but I still needed to work on fine motor control,” she said.

So when Lisa transitioned to Fairlawn’s Outpatient Center in June, she worked on that, as well as improving her overall strength and endurance. Upon outpatient discharge in July, “I was walking perfectly fine on all terrains. I could snap my fingers and shuffle a deck of cards,” said Lisa, who also returned to driving this summer.

Although some residual weakness in her left hand has kept Lisa from taking out the power tools needed to create some of the big set pieces she used to make for her daughter, she is back to threading needles and wielding scissors to create fabric projects. “I made Halloween costumes this past October and right now I’m designing some new headpieces,” she said.

Although it will be a while before she’s back to making seven-foot wooden giraffes or teacups big enough to sit in, Lisa said she is thrilled to be back in her creative mode. “I’m sewing again – and I’m enjoying it.”

During her inpatient stay at Fairlawn, Lisa Dube worked on improving her standing, endurance, and hand strength by tending to the hospital’s vegetable garden.		Upon discharge from Fairlawn’s inpatient Stroke Rehabilitation Program, Lisa Dube continued to improve her strength and endurance at the hospital’s outpatient center.

 

No stranger to adversity - having coped with the unexpected loss of her father in a logging accident and her mother's recent struggle with a brain tumor - stroke survivor Tammy Jardine is now involved in her own crusade to raise $4,000 through the Train to End Stroke Program.

Six months ago, Tammy Jardine couldn't speak a word or walk a step. Today, the 36-year-old Hardwick resident is training to complete a half marathon. And she's doing it for one reason - so that what happened to her won't happen to others.
 
On March 14th, Jardine, a computer systems administrator, felt dizzy upon awakening to go to work. A few moments later, she collapsed on the bathroom floor. Home with only her dogs, Jardine managed to crawl to a telephone but could not remember any numbers - not even 911. Then, noticing her sister's number on caller ID, she tried three times before successfully dialing the digits. Upon hearing the garbeled speech on the other end of the receiver, her sister immediately called an ambulance.
 
At UMass Medical Center in Worcester, Jardine learned that the left side of her brain was encompassed by a blood clot. She had suffered a stroke.
 
During her 10-day stay at UMass, Jardine also learned that her stroke had been caused by an undetected congenital heart defect.
 
On March 24th, medically stable but still unable to move her right side or say anything more than yes and no, Jardine was transferred to Fairlawn Rehabilitation Hospital in Worcester. There, she underwent four weeks of intensive physical, occupational, and speech therapy.
 
"At first Tammy couldn't even stand to transfer from her bed to a wheelchair," said Lori Peltola, a physical therapist at Fairlawn. "But she was so motivated and worked so hard. And she made great gains."
 
Upon discharge from Fairlawn, those gains included being able to walk with a four-prong cane and move her left arm and hand. She had also made significant improvements in her speech but still needed continued therapy.
 
Ability To Communicate
Not missing a beat, Jardine immediately began outpatient treatment at HealthSouth Rehabilitation Hospital in Ludlow. There, along with working to further improve her mobility and the fine motor control in her right hand, she intently focused on regaining her ability to communicate.
 
"Tammy's language was not gone - she couldn't access it. She knew what she wanted to say but could not find the words," explained Margot Greenwald, a speech-language pathologist at HealthSouth. "She also had trouble putting the words together to form sentences and had significant difficulties with writing."
 
Tears come quickly when Jardine, who now speaks clearly and confidently, talks about her struggle to regain her use of language. "I could handle the problems with my walking and my hand, but not being able to speak really took its toll on me," she said, occasionally pausing to find the words needed to express her thoughts. "It was the worst thing to go through - understanding what people were saying and knowing what I wanted to say but not being able to talk."
 
These days Tammy Jardine is not only talking and even writing about her stroke, she is also participating in the American Stroke Association's Train to End Stroke Program. Come January 7th, Jardine will walk a half marathon in Orlando, Florida. Funds raised through the event will go to support stroke research and education.
 
Greenwald, who says "Tammy pushed herself very hard with the goal of resuming her life just as it had been before her stroke," is thrilled but not shocked by her former patient's efforts. Nor is Peltola, who said, "Given Tammy's motivation and personality, I am not at all surprised that she is participating in the marathon event."
 
Having just recently returned to work part-time, Jardine trains four times a week with a team of coaches and other local program participants, some of whom will walk or run a full marathon. "I want to help people realize that if they can do things to avoid a stroke, they should do it now rather than later. I also want to raise awareness and money for research to prevent strokes like mine," said Jardine, who recently underwent surgery at Mass General to correct her heart defect. "If you've had a stroke, you don't ever want to do it again."
 

One Man's Story
Family Support - An "Unquantifiable Edge" in Stroke Rehabilitation
 
By MARY HERMAN-CAPPOLI
 

John Hallen's family played a significant role in his stroke rehabilitation at Fairlawn Rehabilitation Hospital. John (left) is shown here with his wife Eleanor and (former) Fairlawn rehab tech Steve Evora.

For John Hallen, a healthy, successful businessman, stroke was an unexpected visitor that made its presence known on a snowy New England night. It left John, then 58, with right side paralysis and verbal apraxia, a motor-speech disorder that would make it difficult for him to verbalize his thoughts.
 
On that night, John's wife Eleanor and five of their seven adult children battled treacherous driving conditions to be with him at St. Vincent Hospital in Worcester. Meanwhile, a family friend stayed with John and Eleanor's two mentally disabled sons, Hal and Paul, who live with their parents in nearby Leicester, MA.
 
Although he has no recall of his three-week stay at St Vincent's, John Hallen vividly remembers his first thoughts on that winter night as he lay immobilized on his living room floor. Struggling to find the right words to express those thoughts, he said, "My main concern was what would happen to Hal and Paul if something were to happen to me."
 
That came as no surprise to Rosemary Hallen, one of John and Eleanor's daughters. "My father has always been devoted to all of us, but he shares a special closeness with Hal and Paul," she said. "He is very protective of them and is constantly thinking of their well-being."
 
During the next three months, while John was a patient at Fairlawn Rehabilitation Hospital, his family did the same for him. "When my father was at Fairlawn, it wasn't unusual for two, three, or even four of us to be present during his daily physical, occupational, or speech therapy sessions," said Rosemary.
 
According to Dr. Roger Giordano, Fairlawn's Chief of Physical Medicine and Rehabilitation, that kind of family support can have a significant impact on a patient's outlook and recovery. "We in rehabilitation determine our success based on our patients' successful discharge back to the community. The crucial role of family and other social supports in this is the unquantifiable edge," he said. "As rehab professionals, we must all remember that we are a stop in our patient's journey to recovery, and it is the family who will make that journey with them,"
 
During the rehab stage of his journey, John graduated from using a wheelchair to walking with a cane. His speech improved considerably, and he regained partial use of his right arm and hand.
 
When John's formal therapy ended, his family helped to maintain his progress in subtle yet significant ways. Combining patience with persistence, Eleanor urged him to answer the telephone and use his right hand to open the car door. Likewise, on the first Christmas following their father's stroke, the Hallen children urged him to assume his annual duty of handing out gifts. "Because of his speech difficulties, he was reluctant to do it, but we insisted," said Rosemary. "He stumbled over some names, but we were all so happy that he was with us and that he did such a great job. Christmas wouldn't have been the same if he hadn't."
 
While his communication skills and mobility continued to improve, adjusting to his speech difficulties remained a formidable challenge for John. Having once played a leadership role in several community organizations, he missed the days when his quick wit and facility with language made it easy to share a joke, mingle with friends, or serve as master of ceremonies at group functions. "Throughout my recovery, I have experienced many frustrations, but not being able to express myself like I used to has been most difficult," he said. "I know what I want to say … the thoughts are in my head … it just takes a while for me to express them."
 
Once again, John's family rallied to help him find a way to return to the social arena he loved so much. Several months after his discharge from Fairlawn, upon his family's urging, he began volunteering at the hospital. "While John was a patient at Fairlawn, we noticed a number of volunteers were physically disabled, and we found out they were former patients," explained Eleanor. "The children and I thought it would be good for John to have that extra experience of being out with people again, so we contacted Fairlawn's Volunteer Department."
 
The family's instincts were right. "Volunteering at Fairlawn brought him out of his shell and back into the community. It really strengthened his self-confidence," said Rosemary.
 
Today, although unable to drive Hal and Paul to their many social-recreational activities, John remains an active supporter of the Worcester Area Association for Retarded Citizens. Even though he cannot tend to many of the household maintenance tasks he used to do, he now gets up at the crack of dawn to get Hal and Paul get ready for their day at a nearby occupational training center.
 
Meanwhile, Eleanor and the children all pitch in to do many of the things John once did without a moment's hesitation. "We've always been a close-knit family. If someone needs help, we're right there for them," said Rosemary. "But this whole experience led us all to greater appreciation of the countless things Dad has done for each and every one of us."
 
John Hallen has his own thoughts on that subject. "If there's one thing I've learned since my stroke, it is the importance of family. My family has always been important to me, but now I am even more aware of how wonderful they are and how lucky I am to have them all."
 

 
Unique Therapy Helps Firefighter Regain Independence
 
By MARY HERMAN-CAPPOLI
 
"More than anything, I want to go back to being a firefighter. I see what's
going on in the country now, and I feel so strongly that I have to get back.
I just have to."
- David Layte
September 2001
 

Using constraint induced therapy to improve function in his right arm and hand, David Layte works with occupational therapy assistant Dori Walsh in the therapeutic kitchen at Fairlawn Rehabilitation Hospital's Outpatient Center.

Since last spring, when a stroke left him unable to speak or move his right side, 46 year-old David Layte has longed to return to his role as an Oxford firefighter and EMT.
 
That goal has been the motivating force behind David's six-month struggle to walk, regain use of his right hand, and to once again put thoughts into words.
 
David's struggle began in the early morning hours of May 16th when he awoke with a "strange feeling" on his right side and "a problem" with his speech. Sliding out of bed and onto the floor, his garbled calls for help somehow rousted his daughter from sleep.
 
When two of his fellow EMT's arrived, David lay silently immobilized on his bedroom floor. "I couldn't speak, but I made eye contact with them," said David, speaking slowly and deliberately in a recent interview. "I was part of their family … so I knew I had connected with them."
 
Following two days at Worcester's Medical Center, where he learned that a blood clot had caused his stroke, David was transferred to Fairlawn Rehabilitation Hospital in Worcester. There he would spend three weeks in intensive physical, occupational and speech therapy.
 
Gradually moving from a wheelchair to a walker and regaining some use of his upper right side, David moved on to the hospital's outpatient center where he would continue to work on his speech and fine motor skills.
 
Unique Therapy
 
That work has included a unique form of therapy in which David's fully functional left arm is placed in a sling, forcing him to use his impaired right arm and hand.
 
"The theory behind constraint induced therapy is that after a stroke you want to try to rewire the brain where the neurons were lost from the stroke," explained Dori Walsh, occupational therapy assistant. "By constraining the functional arm and making the one that's affected do all the work, you start the process of rewiring, which leads to improvement in the impaired side."
 
That is exactly what has happened for David. "I've noticed a big change. Things I couldn't do just a week ago, I can do now," he said. "I can use my right hand to pick up a coffee cup and drink from it. I can use my fingers to push down a light switch."
 
According to Walsh, David's perseverance has played an integral role in his recovery. "In order for constraint induced therapy to be really effective, a person has to wear the sling for at least six hours a day. We can give patients the tools and show them what to do in therapy, but they have to follow through at home. David has done that. He is so motivated," said Walsh.
 
Often wearing the sling for up to 10 hours a day, David is now using his right hand for nearly all activities, including shaving, eating, and writing. He is also making marked improvement in speech.
 
David's hard work has been augmented by tremendous emotional support. "My wife, my daughters, and my friends have been behind me all the way," he said. "Without them I wouldn't be able to reach my goals of taking control of my life again or returning to the fire department."
 
According to his therapists, David's goals are now well within his reach.
 
"I feel so strongly about getting back to being a firefighter. It's the best way I can help people," he said. "I am going to come back from this thing 100 percent. If I have to, I'll settle for 90, but I'm going for 100 percent."
 

 
Patient Satisfaction • Success Stories