Toni's Story
As a registered nurse, Toni Diaz, 67, was well versed in the signs of a stroke, but she never expected to see those symptoms in herself. The morning after a busy 12-hour shift, Toni noticed weakness in her right hand. Later, she noticed her right leg dragging. While Toni excelled in helping patients, she was less stringent with her own medical care and had a hard time asking for help.
She finally told her partner, Pete, almost 24 hours after the onset of her symptoms. When he got home to take her to the hospital, she could barely make it into his truck. Tests confirmed her nurse’s intuition: she had experienced a stroke in the left side of her brain. Toni’s speech, swallowing and the right side of her body were all impacted.
She remained at Medical City Denton for two days where physical therapists said Toni lacked coordination and balance which meant she needed help for all activities, including standing.
Toni and Pete knew she would need rehabilitation in order to return home and to work. For that, Toni chose Select Rehabilitation Hospital of Denton.
By the time Toni arrived at Select Rehabilitation Hospital of Denton, she had yet to take a single step. That changed when her physical therapist evaluated her and provided Toni with assistance needed to walk ten feet. Her therapy also included Andago gait training technology, a free-standing mobile frame which supported Toni while she practiced walking. She gained strength and mobility each day and within two weeks, Toni was walking 150 feet independently with a rolling walker for support and under a therapist’s supervision.
Toni also needed assistance with her right hand, which she called “useless.” Her goal was to play the air guitar. Occupational therapy focused on increasing Toni’s arm strength and hand dexterity by facilitating active range of motion exercises as well as neuromuscular electrical stimulation to help with wrist movement and to regain control of her hand for playing guitar. To further help with arm movement, her therapists also used a device called the Armeo (a spring training device) where Toni would place her arm in a sling and the machine would facilitate neuromuscular feedback for the upper extremity to maximize functional use of her arm, training it to be ready to perform functional tasks. Within about three weeks, Toni was strumming her air guitar to a variety of tunes.
Regaining her fine motor skills gave Toni her biggest thrills and her most memorable “a-ha” moments. Simple movements lifted her spirits -- straightening her right hand, pulling up her pants and waving at therapists in the hallway.
During her stay, also Toni started speech therapy with an altered diet and some voice difficulties due mild weakness that resulted from her stroke. Speech therapists practiced compensatory strategies for clear communication with her in various tasks to where she felt comfortable using them in conversation. Toni also noticed some coughing and was concerned food and/or liquid was possibly going down the wrong way. Accordingly, speech therapists also performed a modified barium swallow study to evaluate her swallowing function. Toni was grateful to learn that the swallow study showed only mild difficulty. Her therapists then trained her to use swallow strategies to help close her airway and safely swallow all food and liquids. Within two weeks she was able to enjoy all her favorite foods and drinks, and Pete let her know that her voice and ability to communicate clearly had returned to a normal level as well.
Within four weeks, Toni was walking and managing her self-care needs independently. She was excited and ready to return home with Pete, where she plans to resume her salsa dancing.