Rehabilitation helps St. Charles physician find the right words following a stroke

WHEATON, Ill. -   Just days after surviving a stroke, Eric Werner, MD, walked out of Northwestern Medicine Central DuPage Hospital unassisted. However, while he appeared to be doing well physically, the 62-year-old was facing an invisible impact of stroke: aphasia. The language disorder, most often caused by strokes, affects the ability to communicate. 

In June 2022, Dr. Werner, an anesthesiologist, was at his St. Charles, Ill., home alone when he dropped to the ground. He was too weak to stand, and he couldn’t reach his phone. As he fell in and out of consciousness, he couldn’t comprehend exactly what was happening.

About two hours later, Dr. Werner’s wife returned home and immediately called 911. He received advanced treatment in the Northwestern Medicine Mobile Stroke Unit, a state-of-the-art ambulance equipped with a 16-slice CT scanner and stroke medications. He was rushed to Northwestern Medicine Central DuPage Hospital’s Interventional Lab to remove a 4.5-millimeter blood clot in his brain.

“With the Mobile Stroke Unit, we can take the hospital to the patient and provide treatment right away in the field,” said Harish Shownkeen, MD, medical director of the Stroke and Neurointerventional Surgery Programs at Northwestern Medicine Central DuPage Hospital. “This early intervention leads to better outcomes, as every second counts when you are treating a stroke.”

Dr. Werner was out of his hospital bed and walking the next day. Within a week, he was discharged to home.

“It felt like a miraculous recovery. The same day I got home, I cut down a small branch of a tree just to see what I was capable of,” said Dr. Werner. 

However, while he felt great physically, Dr. Werner was having trouble verbally expressing what he was thinking, as well as not always clearly distinguishing what he was hearing. For example, certain letter combinations, such as a “th” and “sh,” would get mixed up, making it difficult to understand some words. He was diagnosed with aphasia.

“Aphasia results from damage to the language center of the brain. Intellectual skills are perfectly intact, but there is a disruption in the ability to communicate,” said Michelle Armour, MS, CCC-SLP, founder and program lead clinician of the Northwestern Medicine Aphasia Center at Marianjoy Rehabilitation Hospital. “It may impact listening, speaking, reading and writing. Every individual is different, however, so not everyone experiences changes in all of these areas.”

To improve functional communication and language, Dr. Werner attended outpatient skilled speech-language therapy at Northwestern Medicine Marianjoy Rehabilitation Hospital. Therapy targets both receptive and expressive language skills with education, retraining and implementing compensatory strategies.

“With Dr. Werner, we specifically focused on verbal expression, thought organization, auditory processing and motor speech skills,” said Amy Nourie, MA, CCC-SLP, speech-language pathologist at Marianjoy Rehabilitation Hospital. “Dr. Werner demonstrated exceptional effort and follow-through of completion of home exercise programs, which positively affected his recovery.”

The goal is stimulation of the brain’s language center to engage aspects of neuroplasticity, the ability of the brain to find new pathways. Patients also learn new methods of communication, such as gestures, pictures or use of electronic devices.

“At first, the recovery is remarkable, but then it slows down, and over the next year, there is a gradual improvement,” said Dr. Werner. “I’m a type-A personality, and I’ve faced this like a mountain to climb. If I feel like I’m hitting a wall, I try something new. Recovery has become a full-time job.”

In addition to outpatient therapy, Dr. Werner attended an eight-week session at the Northwestern Medicine Aphasia Center at Marianjoy. In a small group setting, participants practice communication through real-life activities, including conversation, games, math, writing, music, technology and book clubs. Each session focuses on improving language functioning, socialization, independence and quality of life. 

Dr. Werner made new friends at the Aphasia Center and feels one of the biggest advantages of the group setting is the social interaction.

“People with stroke tend to self-isolate,” said Dr. Werner. “I’ve made a big effort to not do that with my friends. The more opportunities I have to speak with others, the better. People are very supportive and understanding.”

When speaking with Dr. Werner today, the aphasia is rarely apparent to others. But he is very aware of the extra work he must do, especially during fast-paced conversations. With enthusiasm and optimism, he continues to look forward and is dedicated to working on his speech several hours a day.

“For some patients, aphasia may never completely go away, but they can make amazing progress as they learn new skills and keep practicing,” said Armour.