I would recommend Elizabeth to anyone who has had a stroke, she teaches you to take control of your learning and provides a caring environment and great tools for both you and your family to support your therapy.
My stroke happened on the 26th January. It was a Sunday morning, and I was at my friend’s house in Belfast. We had gone out the previous night for a friend’s 21st birthday party, and I decided to stay on their sofa like I had done so many times before. I woke up to the sound of my friends chatting in the kitchen. I didn’t feel like anything was wrong. I eventually got up and started walking around. My friends asked me if I was okay. I tried to respond but couldn’t. My lips were moving, but words weren’t coming out. I started to panic. None of us knew I was having a stroke, and why would we. I was reasonably fit, 21 years old at the time and had never had any problems before.
At this point, I could still walk but my speech had completely left me. I could think of the words to say, but nothing came out. My mouth didn’t feel right, some of my face felt numb. This wasn’t good. My friends told me to lie down in my cousin’s bedroom. I later learned this was because they could phone an ambulance without telling me. When the paramedics arrived, they were confused as to what was happening, same as us. I couldn’t respond to any of their questions, the only thing coming out of my mouth was gibberish. Several minutes later, they decided to take me to hospital. This is where things got really bad. As I was walking down the stairs, all feeling in my right side started to leave me. My right leg and right arm felt numb, like pins and needles only a lot more intense. I then had to start holding my right arm to support it. It didn’t even feel like my arm anymore. I had to be helped into the ambulance as I could no longer feel my right leg, leaving me unable to walk. This was bad.
The first couple of days were the toughest. My right leg and right arm still weren’t functional. I couldn’t even speak to my family or get out of bed to hug them. It took a couple of days for me to accept what had happened. My initial thoughts were that I was only going to be in hospital for a couple of days and that my disabilities would magically go away overnight. Obviously, this wasn’t the case.
I was very lucky, however. Within the first three days I started to get all feeling back into my legs and arms. I had to do regular movements to exercise them. They were still weak, but I could now stand with a bit of help. Within the first week I was walking by myself with no help. I soon got transferred to my own room which was relieving. I found the first ward hard because there was a lot of noise, so it was hard to sleep.
Even though I was getting my physical abilities back; the unfortunate thing was the fact that my speech wasn’t really coming back to me. I was told by the speech therapist that I would have to learn to speak again as I had severe apraxia. I couldn’t believe it. Something I had been doing all my life with ease, I had to learn again. The only word I could say at the start was ‘yes’. If a nurse or family member asked me a question, my reply would be the same thing every time - ‘yes’. Any other word seemed alien to me and my mouth. The only thing I could compare it to would be when parents tried to get their baby to say their first words. I felt helpless and the idea of learning to speak again made me very frustrated.
I got regular speech therapy in hospital. This was carried out every day for about 40 minutes apart from weekends. At the start I tried to learn some basic sounds which weren’t too bad, copying lip movements helped. This evolved into trying to say various short words and phrases, this was a lot trickier. As much as I enjoyed getting the speech therapy, it soon became the only thing keeping me in hospital. I had got all my physical abilities back and I was cleared by the physiotherapist and the occupational therapist. I soon became tired of being in hospital and really wanted to get back home. In total I was only in hospital for just under two weeks, but it felt like forever. The days were long, it wasn’t a nice environment to be in with so many people seriously ill and some close to death. I was told by doctor there was a two-month waiting list for speech therapy in my district, which was why they wanted me to stay a bit longer, so I could soak up all the therapy while I was still there.
The one thing I really enjoyed in Hospital was the visitors that came to see me. It put in a lot of time and it was nice to catch up with my friends and family. There was just this one recurring problem, I couldn’t talk. It’s hard to describe the frustration that comes with communication without using speech. My substitute was writing on paper, although even this was a challenge. I couldn’t put a full sentence together in my head. I had a lot of word finding problems and grammatical errors. The only thing I could compare it to, is getting up on stage in front of a crowd and freezing, unable to find the words to say because of nerves. That’s what I felt like when I was hovering over the paper with my pencil, nothing came out.
Most of the time I could convey my message across in some form or another. I think one of the most difficult things was not being able to join in with conversations. I remember my parents would be talking to my friends when they visited, there was so many occasions where I wanted to contribute to the conversation, to give my say on a matter, but simply couldn’t. You begin to realise that a lot of communication is all in the timing of it. If I tried to write something down and show people, immediately the focus is now on me and not the conversation. I could be saying something that relates to the last part of the conversation, but as I’m writing it, my parents say something else, my friends reply, I point to my page its already too late. It’s moved on, my notes are out of date and there’s no chance I can get them to understand it now. As the speech improved, this problem slowly got better. I could say people’s names and use simple phrases like ‘no, before that’ to help me in conversation. My messages were quite vague, so I was always going to have people misunderstanding my scribbles until I could talk again.
The opportunity soon came for me to think about going home. The problem was still the long wait for speech therapy. Two months wasn’t going to cut it. I needed speech therapy right away or else it could have seriously hindered my recovery. My parents began looking for options, going private seem to be the way to go. Thankfully, they found out one of my old school friends’ mother - Elizabeth McBarnet, was a speech therapist whose focus was on Stroke patients. The best part was she only lived only 5 minutes away, it seemed it was meant to be. A couple of phone calls later, Elizabeth kindly agreed to give me six sessions within the couple of weeks of me being discharged from hospital. This meant my parents and I, could feel comfortable going home knowing I was going to get the therapy I needed.
I went to Elizabeth the following day to get my first session, this was a 2-hour session to assess my speech and language and to start a plan for my recovery. At this point, I had lost all confidence in my speech, during hospital I had improved on saying short words, but any more was a challenge. I was nervous at first going in but soon felt relaxed. Elizabeth was really friendly, and her workspace environment was nice and quiet, unlike the hospital. I found this first meeting to be very motivating as I learned things I didn’t think I was going to learn. This involved all about how sounds are made, the way the mouth, lips and tongue work in unison with the brain when people speak. I learned more about my condition and what it takes to fully recover. I recorded some words that would later be used to identify the progress I had made.
Elizabeth recommended to us that we buy an iPad that would be used coherently in her sessions and home as well. This turned out to be one of the best things for my recovery. In the first session she showed me different apps I could download and use at home with my family. These apps were very useful and involved several features that would help with my speech, language and typing. One of the best apps involved lots of long words and phrases accompanied by a human mouth that would repeat the lips movements slowly for me to copy.
As I said before, I had 6 sessions within the two weeks with Elizabeth and it was during this time I made remarkable progress. The key thing was breaking down words into their different sounds, allowing me to repeat each sound slowly until I got it right. The apps were a great help. All the work I did with Elizabeth I took home to practice again with my family. My mum and sister took a particular liking in participating in the sessions. They became my very own home speech therapists and enjoyed helping me at home.
Before the stroke, speaking was second nature, but now I had to take control of my lips, mouth and tongue and understand every single movement when I was saying a word. If a word didn’t sound right, it was because I did something wrong with my mouth. Repeated repetition was the solution and soon it started to give me the muscle memory I needed to talk more clearly.
When someone has a stroke, the recovery tends to be much more rapid at the start. This was coming clear with my recovery. Within the first few sessions, I had already gained a lot more confidence with my speech. I could now say short words and sentences with little error. Longer Polysyllabic words and sentences still were tough, but I was getting there. That was the main thing. There is nothing more motivating than hearing the difference in voice recordings recorded a couple of days apart and seeing the improvement. When I was at home, I was still getting a lot of visitors. Some of my more regular visitors told me they could hear a big difference in my voice each time they visited. One clear identifier of my progress was actually the decreasing need to use paper to write down words. At the start, paper was making up probably half of my communication. Especially when friends visited, as I felt embarrassed not being able to say something. I found much easier to write it down. This soon was turning into only writing down difficult words which I couldn’t get on the second or third tries.
As my speech and language improved, my therapy and practice shifted to be more challenging. A lot of my practice now was day to day conversations. I decided it was time to go out and order different things like a coffee from a cafe, or phoning in a take-away order. I felt comfortable chatting to friends, and began using my PlayStation again, where I was speaking over online voice chat to multiple people at the one time. I even booted up my laptop and began looking at my university work to start the challenge of me getting back. Life slowly felt like it was getting back to normality again. Elizabeth and I decided to space out our remaining sessions as my speech was improving rapidly and it was looking like I wouldn’t need many more sessions.
There was a 3-week period where I didn’t have any speech therapy, and instead was working every day at home with my mum and sister. My progress was beginning to slow up a bit, but there was still a big change in my voice recordings from week to week. I got to the stage where I thought to myself, that in a normal conversation it would be hard for someone to notice my speech difficulties. At the beginning, this was the end goal I wanted to achieve for myself.
Due to Covid-19 the rest of my sessions with Elizabeth were held over Zoom. This didn’t turn out to be a bad thing. I still found great benefit from the sessions and they didn’t feel much different to the face to face ones. In our last session, I got to hear the audio recording of my first session. The difference was breath-taking, it was like a different person talking. At this stage I was talking a lot more fluently and clearly and with more expression and intonation. In the recording I was getting several words wrong, whereas now I was getting every word right except for the odd one.
It was hard to believe that was my time up with Elizabeth, the progress I made was remarkable.