Life after stroke

Therapy, family and a strong spirit help woman recover speech and mobility

Shannon Barsam © UC Regents
Intensive speech, physical and occupational therapies helped Shannon Barsam recover from a stroke at age 44. Today, she facilitates a support group for stroke patients.

Posted Sept. 7, 2011

It was a Friday morning and 44-year-old Shannon Barsam was driving home in Rancho Murieta after running errands. But something was different that October day: Her right arm felt numb. As she pulled into her driveway, she felt strangely disoriented. The engine was running, but she couldn’t figure out how to turn it off. She spotted her cell phone, but how to operate it? Heart thumping, Barsam slipped out of her seatbelt, propelled herself out of the car window and half-crawled to a neighbor’s house.

Strokes increasing among younger adults

In her confused state, Barsam recalled that her father had passed away at age 49 from stroke. While advanced age is a risk factor, research shows that a growing number of younger Americans are vulnerable. Among people ages 35 to 44, the number of hospitalizations due to acute ischemic stroke, the most common type, increased by 47 percent in men and 36 percent in women, between 1994 and 2007, according to the U.S. Centers for Disease Control and Prevention. Experts have attributed this to the prevalence of obesity and high blood pressure, which are common risks.

Know the risks and the signs

Strokes can affect anyone. However, there are risk factors that increase the chances of stroke, including advanced age, family history, high blood pressure, diabetes and obesity. Often thought of as a man’s disease, stroke today affects more women than men, and women have unique risk factors, including:

  • Migraines
  • Birth-control pills
  • Hormone-replacement therapy
  • Autoimmune diseases such as diabetes or lupus
  • Clotting disorders

Everyone should be aware of stroke symptoms, which require immediate attention. Call
9-1-1 if you experience any of the following

  • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination
  • Sudden, severe headache with no known cause

Dr. Piero VerroOur mission is to provide comprehensive, attentive care to the patient from the emergency room to discharge and beyond.”
— Piero Verro

Realizing that Barsam was unable to speak, her neighbor called 9-1-1 for paramedics, who took Barsam to UC Davis Medical Center. The slender, athletic, relatively young patient did not appear to be in immediate danger. She had no history of high blood pressure and no facial sagging or weakness, which are characteristics of stroke. But a CT scan and MRI confirmed that Barsam had suffered an ischemic stroke, caused by a disruption in the blood supply to the brain due to a clot or narrowed arteries.

The clock was ticking. Because parts of the brain begin to die when stroke cuts off its blood flow, administering a drug called tissue plasminogen activator (tPA) is critical. The drug, which dissolves clots and restores blood flow, is given within hours following the onset of stroke symptoms. Piero Verro, UC Davis Stroke Program director and professor of neurology, gave Barsam the tPA, confident it would improve her recovery.

Barsam spent two weeks in intensive care at UC Davis, followed by weeks in the medical center’s acute and rehabilitation units, where she underwent intensive speech, physical and occupational therapies to compensate for the damage to her brain that caused right-side paralysis, along with difficulties with speech and calculations.

“Our mission is to provide comprehensive, attentive care to the patient from the emergency room to discharge and beyond,” said Verro.

Barsam remembers her fear and regret that first night where she lay mute and partly paralyzed. Her husband and teen children, Kelly and Cody, then 15 and 17, were at her bedside.

“The morning of my stroke, I didn’t get a chance to tell Cody and Kelly that I loved them. It was something that we did every morning. And now I was in the ER and couldn’t communicate with them,” she says.

Regaining skills, facing losses

Nearly two years after her stroke, Barsam can speak coherently, has relearned to drive, walks with a brace and manages to write with her left hand – even using that hand to apply eye makeup. Her experience has cemented her relationships with her family. Of her husband, Dennis, she says: “He is one in a million. He stayed in the hospital 24/7 and said things I wanted to say but couldn’t.” Daughter Kelly became a second caregiver, her go-to girl when she wanted her hair done, her shoelaces tied or help with speech-therapy “homework.” Son Cody became a companion, asking about her day, making sure she spoke in complete sentences and always saying “I love you.”

About the UC Davis Stroke Program

The UC Davis Stroke Program features acute inpatient care as well as outpatient management of cerebrovascular disease. Patients receive aggressive medical care and treatment that includes:

  • Thrombolytic therapy
  • Interventional neuroradiologic techniques
  • New medications under clinical investigation

A dedicated stroke unit provides intense monitoring and rehabilitation for patients. After they are discharged, patients can receive follow-up services through a weekly outpatient clinic.

The stroke program is certified as a primary stroke center by the Joint Commission and received a 2011 Get With The Guidelines–Stroke Gold Plus Quality Achievement Award from the American Heart Association/American Stroke Association for its commitment to and success in implementing excellent care for stroke patients.

But she has faced losses, too.

“I can’t work because of problems with reading and math, and I miss my fifth-graders,” says the former elementary school teacher. Also on her “miss list” is her mobility. A one-time runner, her walking is now stiff and labored. She cannot wear the high heels she once rocked, and she tires more easily than her peers.

To Verro, Barsam’s experience presents a wake-up call to hospitals, paramedics and patients themselves, who may think of stroke as just an older person’s disease.

Barsam family © UC Regents
Barsam's experiences have strengthened her connections with family: (left to right) son Cody, husband Dennis and daughter Kelly.

“Strokes can occur at any age, as Ms. Barsam’s case demonstrates,” he says.

Barsam’s speech-language pathologist, Christine Davis, credits her patient’s perseverance with her remarkable metamorphosis from intensive care unit patient to vibrant volunteer (Barsam facilitates a support group for stroke patients led by Davis and a colleague).

Davis used to work with Barsam every weekday. Now she’s down to one weekly session, which she anticipates will further her patient’s progress.

“I’ve always had very high hopes for Shannon,” says Davis. “She is proof that you can’t always gauge outcome by the level of brain damage. The human spirit can triumph over tremendous adversity.”