A Stroke Survivor’s Winning Perspective: ‘Anything Is Possible’
Many months after her brain “exploded,” as she describes it, Frances Galindez took her first step unaided at MossRehab in Elkins Park, Pa. Her physical therapist Janett Smith, PT, DPT, GCS, was by her side. Smith was the one who took Galindez’s walker out of her hands. “You don’t need this,” she told Galindez, who was skeptical and “petrified,” but wanted to walk so much she made her first tentative no-hands move.
It was a dramatic moment, but Galindez was so focused on putting one foot in front the other, the significance of doing something she wasn’t sure she’d ever do again didn’t hit her right away.
“Once I realized what was happening, I started crying,” she recalled one day in June before her regular biweekly physical therapy visit to MossRehab. Then, looking sheepish, she admitted, “The first thing I said was ‘Oh, wow, I’m walking!’” She laughed. She made her way out to the lobby where her husband was waiting for her. “He just looked at me and said, ‘Oh, my God!’”
It was a long journey to that walk.
In September 2016, a new school year, Galindez had just returned to the classroom at Archbishop Ryan High School where she taught history and Spanish when she found herself dogged for days by a crippling migraine. “I didn’t think anything of it because I get migraines,” she explains.
After school on Friday, she went back to the Mayfair home she shares with her husband and three children and immediately lay down, thinking a little rest might quell the pain. It didn’t. The next day, determined to visit her sister who had just had a baby, she pushed herself to get ready. She had just showered and dressed when it happened. “I felt an explosion in my head that knocked me off my feet,” she recalls. Her husband rushed to her side and called 911.
A stroke team was waiting for her at the Hospital of the University of Pennsylvania. “After the CT scan, they knew exactly what I had,” says Galindez. It was a brain aneurysm—a weakened, ballooning segment of a blood vessel that ruptured. The aneurysm was brought on by the other thing doctors found on the CT scan: a rare condition known as arteriovenous malformation, or AVM.
Usually present at birth, an AVM is an abnormal tangle of blood vessels connecting arteries and veins in the brain that alters the normal process of arteries transporting oxygen-rich blood from the heart to the brain and veins carrying oxygen-depleted blood back to the lungs and heart.
Usually, blood travels between the arteries and veins through tiny capillaries that keep the fast-flowing, arterial blood from overwhelming the smaller veins. In an AVM, high-pressure arterial blood flows directly into the low-pressure veins, bypassing the brake-like effect of capillaries and ultimately damaging and weakening the blood vessel. This can cause symptoms as varied as headaches and seizures, or the condition can remain silent until the pressure leads to periodic bleeding (which may be the cause of headaches) or a rupture that causes a hemorrhagic stroke. About 2 percent of hemorrhagic strokes are caused by an AVM. About half of people who have AVM will experience bleeding in the brain.
“My Whole Life Changed”
Galindez had a massive stroke on the right side of her brain which left her paralyzed on the left side, with visual field loss (she can’t see to the left), and, at the time, no control over intimate bodily functions. It also left her depressed, frustrated and angry. “I couldn’t believe what happened. My whole life changed,” she says. “I was discharged from the hospital in December 2016 and I could barely do anything.”
At first, her family had to do everything for her. She calls them—husband Fernando, daughters Mia, 14, and Arianna, 13, and son, Domenic, 7—“my pit crew.” They fed, dressed, and helped her in the shower and bathroom. Ironically, growing up in Ponce, Puerto Rico, and later, Philadelphia, Galindez had to perform some of those same tasks for her mother, who had multiple sclerosis. But her mother’s condition would not get better; her own could.
Still, there were times when the frustration and anger took over. “I once threatened to kick my first physical therapist,” she says. “He said it was okay as long as I used my left leg.” She burst out laughing.
Then, her husband suggested that she marshal that anger as energy to help herself.
“So now I use my anger to push myself,” says Galindez. “I use it to get things done.”
Twice a week her husband drives her to MossRehab at Elkins Park where she has occupational therapy at 10 a.m., followed by physical therapy at 11. On this day in June, her occupational therapist, Tori Snyder, OTR/L, was handing her off to Smith, with whom she conferred on what Galindez had accomplished in their morning session. But she also took some time to brag about their patient.
“Frances has taken every challenge we’ve given her and exceeded them,” Snyder says. “She’s our star pupil and she knows it.”
Galindez laughs. “Yes, I’m the example of why you should come to MossRehab,” she says.
Her therapists’ goals for Galindez is that she become “modified independent;” that is, able to go about her life with the help of one or more devices. One of those devices is the RELEAS splint, which she and Snyder had been working with that morning.
Galindez can grasp and hold items. This MossRehab innovation will allow Galindez, when she performs active relaxation, to open her fingers. Now she can grasp, hold and release. That will give her the ability to do everything from pulling up her own pants to folding laundry and picking up something as thin as a debit card. “It was invented by a MossRehab occupational therapist named Joe Padova,” says Snyder. It’s now available worldwide and there’s even a smaller model for children.
Snyder helps Galindez put the splint, which looks like a neoprene glove, on her left hand. It fits on the index finger, two long fingers and the thumb. Snyder hands her an ID card. Galindez grasps it between her thumb and fingers, then drops it.
During today’s PT visit, Smith and PT aide Yolanda Charris will be putting the finishing touches on a brace that Galindez will wear at night on her floppy left foot to prevent any shortening of her muscles and tendons. This will make it easier for her to walk with her brace.
Galindez walks to the PT room herself and, with a little help, climbs on to the table and lies back.
“I’m the Cool Girl at MossRehab”
Smith and Charris are engaging in some good-natured banter about who measured and cut the brace wrong. There’s far more laughing going on during the session than you might expect. One of those laughing is Galindez. “It’s all love, all love,” she assures a visitor. “The best part of my experience here is seeing how everyone works so well together,” she says. “Of course, they all fight sometimes to work with me. My husband says I’m the cool girl at MossRehab.”
She’s certainly a success story. “You’ve come a long way,” says Smith as she adjusts the freshly re-cut brace on Galindez’s leg. “When you got here you needed help getting out of your chair most of the time. What is it now?”
“Just with supervision,” Galindez responds.
“You couldn’t sit up when you first came here,” says Smith. “And didn’t it take two people to help you lay down?”
“Yes,” Galindez agrees. “Now I can do all of those things and more on my own.”
On her new bucket list is making her own coffee. “Sometimes she doesn’t get coffee in the morning if someone doesn’t make it,” says Snyder, who has popped into the PT room. “We’re going to work on that.”
But at the top of that “must-do” list is getting back in the classroom. “I work really well with targets and I really want to go back to teaching,” says Galindez. “I miss it so much. I get such beautiful messages from my students and my colleagues.”
Is it within the realm of possibility? “It’s been a process, a long process, but little by little I’m making progress,” says Galindez. “If there’s one thing I’ve learned here is that anything is possible. As long as I put my mind to it.”