Relearning To Speak in a Pandemic

By: Jade Waddy

Daran Landry was determined to work hard during his therapy sessions at TIRR Memorial Hermann Outpatient Rehabilitation – Greater Heights  and then in an instant the world came to a stop due to the rapid spread of COVID-19 and Landry thought he might have to postpone his treatments.

“Initially pausing therapy sessions was a thought but once I found out I could do exercises at home and eventually safely continue to come in, I said there was no way that I was going to stop,” said Landry.

Two days before Thanksgiving 2019, and five months prior to the start of the global pandemic, Landry, 48, a private equity banker, suffered an ischemic stroke. A relative living with Landry noticed he was slurring his speech and quickly called the paramedics who rushed him to the hospital.

“I was out eating with friends when I received the call that he was being taken to the hospital,” said Dawn, Landry’s wife. “I don’t remember anything about the drive, I just know that I beat the ambulance.”

Landry was taken to Memorial Hermann Memorial City Medical Center where doctors administered tissue plasminogen activator, called tPA for short. It is the intravenous clot-busting drug that is a first line agent to treat ischemic-type strokes within the first four hours and 30 minutes.  After undergoing an emergent CTA, a specialized CAT scan to best see blood vessels, Landry was told that his left left carotid artery was 100% blocked and an additional blockage was found along the intracranial branches of this vessel.

“This combination of occlusions is typically unresponsive to just tPA, suggesting this would have evolved into a massive stroke,” said Dr. Gary Spiegel, a neuro Interventional surgeon affiliated with Memorial Hermann Memorial City Medical Center and Landry’s physician. Spiegel is also Director of Endovascular and Interventional Neurology at McGovern Medical School at UTHealth.

Landry was brought to the angiographic suite where Spiegel navigated across his occluded carotid artery using catheters to reach the blocked brain vessel.

“The clot ‘corking’ the vessel shut was ‘vacuumed’ out completely restoring flow through this critical vessel,” Spiegel added. “The occlusion of the carotid artery was then rectified by placing two overlapping stents, propping open its lumen. These treatments restored near normal flow to his brain.”

After the surgery, Landry was paralyzed on his right side, he could not open his right eye and he could not speak. After five days in the intensive care unit, he was transferred to inpatient rehabilitation at Memorial Hermann-Katy Rehabilitation Hospital (Katy Rehab).

“Unfortunately after about a week, he developed a bad ulcer which we believe was a bad reaction to medication,” said Landry’s wife, Dawn. “He was taken to Memorial Hermann Katy Hospital and spent approximately a week in the intensive care unit.”

After being discharged, Landry returned to Katy Rehab to undergo additional inpatient rehabilitation. At Katy Rehab he spent extensive time in physical, occupational and speech therapy where he re-learned how to walk and regained some of his strength he lost due to the stroke. In total, he spent 24 days throughout December in the hospital. He finished at Katy Rehab just in time to celebrate Christmas with his family.

Shortly after finishing Katy Rehab, he began outpatient physical, occupational and speech therapy at TIRR Memorial Hermann Greater Heights. By the time he started outpatient rehabilitation, he had made tremendous progress in regaining his strength and movement on his right side. He completed occupational and physical therapy in March and speech therapy became the focus.

At Greater Heights, he worked with Speech Therapist Lindsey Duckworth. Just a few sessions into his journey, the global COVID-19 pandemic began and he had to postpone therapy sessions for a short time.

Duckworth provided Landry with exercises he could do at home during the brief COVID-19 break, and then began to work with him two to three times a week when protocols were put into place and it was safe for him to return to in-person therapy.

“Mr. Landry was a highly motivated patient who had a history of overcoming medical obstacles, so he allowed me to significantly challenge him each session in spite of it being difficult,” said Duckworth.

Landry experienced aphasia, which is when an individual has difficulty understanding and expressing language. Using research-based activities, Duckworth worked to stimulate the parts of the brain that are responsible for speaking, understanding, reading, and writing.

“Mr. Landry’s vocation is highly dependent on his ability to build rapport with clients, explain complex details, and then communicate to others an efficient plan,” said Duckworth. “His language returning was imperative for a successful return to work, but more importantly, to a life where he is a leader in communication.  He is determined and inspiring; a patient I will never forget!”

In July, Daran wrapped speech therapy with Duckworth and stepped out into a new normal. He regained his ability to speak and swallow and looks forward to returning to work into a new normal for everyone. 

“Despite the world feeling as if it had stopped on the outside, Lindsey continued to give me the best care and work hard with me every session,” said Landry. “I’m extremely grateful for her hard work and efforts with me.”

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