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Madison stroke victim keeps dancing as she works to regain speech, language skills

New Haven Register - 11/21/2021

Nov. 21—WALLINGFORD — The first day out of her bed at Gaylord Specialty Healthcare, stroke victim Paula Gallagher danced.

The 68-year-old retired hospice nurse couldn't utter a word, however, because the part of her brain centered on speech and language had been damaged.

"I danced from the minute I got up from my stroke," Gallagher said.

"Dance is my main creative outlet and thank God it is preserved," she said.

Almost a year later, she's regained much of her ability speak — with a long way to go — and the clinicians who have worked with Gallagher said the great progress is in part because she put the undamaged, creative side of her brain to work in developing strategies to cope and find words.

"The last time I saw Paula she was doing beautifully — making her wants, needs known significantly with friends and family," said Dr. Alyse Sicklick, a physical medicine and rehabilitation specialist, and medical director of inpatient rehabilitation.

Sicklick's field is known as physiatry.

"She was very, very creative before (the stroke) and very active," Sicklick said. "That has helped her."

Gallagher had an ischemic stroke, the most common type, and a massive one at that. Doctors don't know what caused it, as often is the case. Gallagher didn't have risk factors, as she was trim, exercised and had a healthful lifestyle.

She had the stroke Dec. 18, 2020, and was treated at Yale New Haven Hospital for five days before being transferred to Gaylord, where she was inpatient for four weeks. In the immediate aftermath of the stroke, Gallagher had mild right-side weakness, difficulty swallowing and the massive speech/language disorder.

Gallagher, an all-round spiritual person, was a professional dancer in the 1970s, performing modern dance in New York City and later as a professional belly dancer, and continued dancing for fun and spiritual reasons in the years that followed, most recently concentrating on sacred circle dance, on Zoom since the pandemic.

Sicklick said Gallagher was in "great" shape when she had the stroke and the cause is something Gallagher still grapples with. Sicklick said there's often no "reason," but those in good physical condition recover more easily than those who had lifestyle risk factors.

"I couldn't believe it happened to me because I was in perfect health," Gallagher said. "When I first had my stroke I couldn't talk at all, so I've done pretty good, but I still have a long way to go. Speech therapy is wonderful."

She even had to learn her ABCs all over again.

Gallagher is receiving outpatient services and is living at home in Madison now, with her loving and supportive husband, Bill Johnson, who said he does more for his wife than she wants him to, but he wants to help and can't do the direct work of making her speech better.

"I couldn't have done it without my husband," Gallagher said.

Gallagher receives outpatient speech therapy and other services, and adds her own creative techniques such as making collages from magazine photos to express the feelings she can't yet adequately express in words.

She also dances every day.

"Dancing is a good way to express yourself when you can't talk," Gallagher said.

Darielle Cooper, who was Gallagher's inpatient speech-language pathologist, said Gallagher has both aphasia — loss of ability to understand or express speech, including in written form — and apraxia of speech, meaning inconsistent articulation, difficulty sequencing and coordinating speech sounds.

"It's not uncommon to see both exist together depending on the location of the stroke," Cooper said.

Cooper said she evaluated Gallagher five days after her stroke when she came to Gaylord from Yale New Haven Hospital and she could only say a single consonant "m" and a few vowels.

"She was unable to count, say the days of the week or months of the year, and couldn't sing 'Happy Birthday,'" Cooper said.

"I knew I wanted to go to a chair over there, but couldn't express it," Gallagher said.

Now, although she struggles with articulation, she's easily understandable and although her speech doesn't flow quite as it once did, Gallagher can carry on a conversation and even sing "Happy Birthday."

Johnson said his wife "never lost her intuition or analytical sense," but has at times when expressing complex concepts had to use more basic words than she would have found ideal.

"Her progress is attributable to many factors — frequent and intensive speech therapy, both individual and group sessions immediately following the stroke, personal drive and determination, participating in a daily home exercise program (on computer devices), familial support, psychosocial support with counseling services, an insignificant prior medical history, her lifestyle habits (daily exercise, diet)," Cooper said.

Cooper said Gallagher has been an "inspiration" to her and "many others."

Clinicians said having a supportive partner like Johnson is a big positive in recovery.

Gallagher's team used activities to heal that involved music rhythm, as it helped her with rhythmic intonation, she said. Rhythm helped her "tap it out" to make the words flow and be less mechanical.

She also went to a psychotherapist, she said, because she was having anxiety about the stroke.

She used to keep journals and write poetry, but couldn't anymore because of her condition affecting language, so the psychotherapist suggested Gallagher go back to making collages to express her feelings.

Gallagher noted there are birds in every one of her new collages, to symbolize "the voice I can't let out."

One cut out from a magazine shows paint-stained hands around a large, cracked teacup, as if the person was about to lift it for a sip.

For Gallagher it's symbolic.

"There's a crack in everything. That's how the light gets in," she said. "And that's how I feel about my stroke. The crack is my stroke."

Another picture shows a man fishing on a boat, with bright bubbles of light in the water.

To Gallagher it represents "fishing for words in deep water."

"I had to pick my life up and start over. I don't know where to stop," she said. "Everything is a spiritual journey."

Sicklick said she's seen stroke victims make progress for years "through incredibly hard work."

"Your positivity and zest for wanting to get better will impact your ability to improve. ... The more you do, the better you'll recover," she said.

Gallagher said not many people know what aphasia is and she would like to raise awareness in the general public and with psychotherapists.

"It's an unseen disability," she said. "I'd like to say for the people who have aphasia, find something you love."

Johnson said he continues to be "blown away" by his wife's commitment and comeback, so much so that even though he knows nothing about carpentry, "I say I'm going to build a wooden boat."

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