It was her first year away from home. Sarah Jane Downton was a young student living in Wolfville, Nova Scotia, working hard to finish her degree in Nutrition and Dietetics. One morning, she awoke with a severe headache and walked to the doctor’s office, where she was prescribed migraine medication. The headache did not subside and when her roommate, Lorena, returned home, she noticed that Sarah Jane seemed delirious and wasn’t making any sense.
Luckily, Lorena acted fast and called an ambulance. An emergency MRI at a nearby hospital revealed blood clots and brain bleeding. Sarah Jane was immediately transported by ambulance to hospital in Halifax. While en route, she suffered a stroke.
According to the Heart and Stroke Foundation, a stroke happens when blood stops flowing to any part of your brain, damaging brain cells. The effects of a stroke depend on the part of the brain that’s damaged and the amount of damage done.
While stroke primarily affects those over the age of 65, it can affect any one of any age. In Sarah Jane’s case, she was only 20 years old.
“I recall the whole ride in the ambulance,” she recalls. “I was in so much pain, I couldn’t keep still.”
With a stroke, time is everything. When she arrived in Halifax, doctors whisked her into surgery to relieve pressure on her brain. Meanwhile, her parents rushed to St. John’s airport for the next flight. When they arrived by her bedside, she was already in an induced coma to help further relieve the pressure on her brain.
It was March 15, 2017. Her parents, her brother Michael, her sister Maria, her boyfriend Connor and her two roommates, Lorena and Michelle, alternately stayed by her side in Halifax for the next five months and were her biggest supports.
By March 31, her brother’s birthday, she was not improving and underwent another procedure to remove the blood clot. In early April, she was taken off her medications. Two weeks later, while still unconscious, she was finally showing signs of improvement.
At last, on April 23 – her 21st birthday – Sara Jane woke up.
“They told me afterwards that they did not know how cognitively well I would be. All I knew was that I was in a lot of pain. I’d lost muscle mass during my six weeks in coma and simply sitting in a chair for 15 minutes was excruciating.”
Sarah Jane had to learn to walk again. In addition, the damage to her brain had caused aphasia, a condition which impairs a person’s ability to use or understand words and made it difficult for her to turn thoughts into spoken – and written – language.
“I couldn’t read or write and when I began trying to speak, I’d say the wrong words or use words in the wrong order. One day, I tried to ask my mom to pass me a tissue, but all I could get out was ‘cheesecake.’ I know it seems odd, but sometimes I just couldn’t say the right word even though I knew what I really wanted.”
Following a period of rehabilitation in Halifax, and when she was well enough to travel, she returned home. Sarah Jane began therapy at the Dr. L.A. Miller Centre on August 15.
Determined to get well, she poured herself into her treatment. Because she needed help from specialists in several fields such as speech language pathology, psychology, social work, occupational therapy, physiotherapy and dietetics, she became a patient of the day hospital and received therapy for three hours a day, three to five days per week.
For the next five months, she worked hard to regain full use of her body – and to get her words back.
“The day hospital program enables us to focus on a team approach to therapy,” says speech language pathologist, Lori Greene. “The therapy can be intensive and we regularly meet as a team to discuss treatment plans and the patient’s progress.
“They had fun with me,” says Sarah Jane. “I was show and tell for the interns and I was okay with that. I knew what they learned about me, would help others. It’s important to me to give back any way I can and to show others who are in my shoes that they can get their lives back – even if it’s not the same life they had before.”
By December 17, 2017, Sarah Jane had progressed enough to become an outpatient.
Finding the right words…
Determined to finish her degree, Sarah Jane knew she still had a lot of work to do before she could, hopefully, go back to her old life. For her, speech language therapy was key to achieving that goal. She had therapy three times a week.
“When I first started therapy, I literally had to re-learn what the letter A was. And at first, it was all coming out in French. I guess the 13 years I spent in French immersion were ingrained in my brain. Oh, and I became really good at charades,” she laughs.
And her sister always knew what Sarah Jane was trying to say. “She’s four years younger than me, but she’s my best friend. When the doctors would come to my room, she would translate my hand gestures.”
Some of Sarah Jane’s lessons involved identifying common words and putting them into writing. Other lessons included finding the missing words in a sentence or reading novels and answering questions about what she had read to test her knowledge retention. She watched TED Talks and even wrote essays.
“When you read a book, there’s more to it than what the words mean. There can be inferences, or hidden meanings,” says Lori. “Would Sarah Jane be able to grasp that at a university level? We wondered if her desire to go back to school was realistic. But she wouldn’t quit. And she never said no to any challenge we gave her.”
And Sarah Jane was creating her own challenges. She took online distance courses though Memorial University and in May 2018, just a year after her stroke, travelled to Halifax for a four-week rigorous language therapy program at Dalhousie University that would recreate the intensity of a university setting, so she would be prepared to resume her degree in Nutrition and Dietetics.
“She was bound and determined,” says Lori. “I saw a positive difference in her when she returned. Her speech was more fluent and she could think on her feet. It was amazing to see her take the things we taught her and use them as a springboard to search out other things that would help her recovery.”
But Sarah Jane wasn’t done yet. She intended to return to school in the fall. And to prepare for that, she decided she needed to get a job in her field of study – dietetics.
In June, she began working as a food service worker at Eastern Health. Her job was to interact with patients by taking their food orders and delivering their trays via the Steamplicity® food system.
“I worked 12 – hour shifts and got to do some meal co-ordination for a few days on fill in basis. The only challenge for me was that I was reluctant to bring meals to the stroke unit as my own experience was still fresh in my mind. People could tell I still had some limitations, but they were so accepting, so great. Some days were harder than others, but I really enjoyed my work.”
This past September, Sarah Jane’s determination, hard work and grit got her where she wanted to be – back at school.
Back in the driver’s seat
But her recovery was not without its challenges, challenges she’s faced head-on.
The damage to her brain caused seizures, a fact she discovered on a trip to Toronto to see the play, Come from Away and an Ed Sheeran concert.
“I got ringing in my ears and the next thing I knew, I was in hospital. New medications now help control that issue. Fortunately, with much help from the superb staff at St. Michael’s Hospital in Toronto, I was able to see both shows!”
Due to scarring, she now has a smaller trachea, which has changed her voice and makes walking up hills more difficult. So she got two dogs: Jack, a 9-year-old poodle-terrier’, and a one – year old goldendoodle, Sadie. Their need for daily exercise pushes Sarah Jane to get the exercise she needs when she’s at home. “Having these two wonderful dogs in my life has made my ‘new normal’ a little better and has provided me with a lot of happiness,” says Sarah Jane.”
And school? She finished her first semester with an A average, is in her final semester and will finish her degree this spring. “I am in the process of applying for Dietetic Internships throughout the Atlantic region. I think I have a lot to offer in terms of my experience in the health-care system as both an employee and a patient.”
Her support network was a huge part of her success.
“My family was my rock through this whole journey,” says Sarah Jane. “And I can’t say enough about my health-care teams at Eastern Health in St. John’s and the Nova Scotia Health Authority in Halifax. They did such an incredible job. They believed in me and knew I would push through. Without the hard work and collaboration among the many health disciplines in both provinces, I would not have been able to get back to school – and back to my life.”
And while her life has been impacted by those who were there for her from the beginning, she’s touched lives as well.
“Sarah Jane personifies the power of motivation, positive thinking, never giving up – and accepting yourself as you are,” says Lori. “She guided us. She led the charge. We’re all so proud of what she’s been able to accomplish.”
Sara Jane’s story is an example of how serious the effects of stroke can be. If you think you or someone around you is having a stroke, it’s critical to act FAST:
To learn more about stroke, visit the Heart and Stroke Foundation website. ■
This story was written by Robyn Lush, a communications specialist with Eastern Health.