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Betty Jo Starks is reading a sentence designed to trip her up.
"You must remember to eat sunscreen when you go outside to work in the garden," she says, reading the sentence aloud. Then the 83-year-old retired teacher looks up and wrinkles her brow. "That doesn't make sense," she says.
"Right. You're supposed to wear sunscreen, not eat it," says Michelle Bernat, a University of Central Florida graduate student who is teaching Starks, who suffered a stroke in 2008, how to coax words from her brain to her mouth.
For four hours a day, four days a week, Starks and a pair of UCF grad students sit in offices designed to look like a kitchen or a living room and practice memory and speech exercises. While sitting in the kitchen, for instance, Starks must look at pictures of apples, oranges and corn on the cob and try to name them.
The sessions may sound tedious, but they are part of an intensive, six-week therapy program designed to help Starks and other stroke victims regain their speech. And it seems to be working.
Although Starks once struggled to say a few words, now she can speak in complete sentences. "She's 50 percent better than she was when she started out here," said George Starks, her husband. "She's making very good progress."
Launched this summer, UCF's Aphasia House is one of only five intensive aphasia programs in the country. Aphasia is the medical term used to describe the loss of speech that results from a neurologic injury, such as a stroke.
Traditional stroke therapy consists of short therapy sessions over a long period of time, such as 30-minute sessions every day for months. But recent research suggests that patients may perform better with longer sessions over a shorter period of time.
UCF added a twist: Instead of seeing patients in what looks like a medical office, graduate students work with stroke victims in rooms that resemble a living room, a kitchen and even a garage. The house-like setting seems to spur patients' memories, said Dr. Janet Whiteside, director of UCF's Communications Disorders Clinic.
"In work with people with dementia, the home environment helps them reminisce," said Whiteside, who decided to test the concept with stroke patients.
The intensive program is small: Only four patients can participate at a time because of Medicare rules and clinical requirements. But as word about the new program has trickled out, people have begun calling from all over the Southeast.
"This is one of the best-kept secrets in Orlando," said Thomas Mullin, interim chair of UCF's department of communicative sciences and disorders.
The program, which is held six times a year, is not free. But Aphasia House accepts Medicare and staffers work with patients to fill out the required paperwork.
Begun as a pilot in 2008, the therapy program was launched full time this summer with the help of an anonymous $25,000 donation. While graduate students work with patients individually in separate rooms of "the house," Whiteside watches their therapy sessions through a one-way mirror or a video monitor.
The program provides intensive training not just for patients, but for graduate students — whose career path may include work with stroke victims.
"One of the great things about this program is that Dr. Whiteside's right here. We can ask her questions and get immediate feedback," said Bernat, 23.
Advertisement  And unlike in private practice, the 16 grad students who work in the clinic each semester have time to conduct extensive research on the types of therapy that might work for each of their patients. Sometimes, the grad students contact researchers at other universities, asking questions and getting to know the nuts and bolts of a new speech-therapy tool.
"For me, it's like having a team of 16 people to work on cases — instead of just one," Whiteside said.
Whether it's the home-like environment — or the frequent four-hour sessions — the patients are making progress.
After a massive stroke left Connie Cardin, a 79-year-old retired hairdresser, unable to speak, she went through speech therapy at a rehabilitation center. But even daily therapy sessions didn't help a lot.
For her daughter, Mo Cardin, it was sad to watch her mom, once vivacious and full of personality, withdraw because she couldn't talk.
Now, when Mo takes her mother shopping, Connie smiles and tries to talk. She also has learned to search her brain for the right word. And every night she sits down with her homework, looking at photos of everyday objects and trying to name them.
"One of the most important things is the confidence it has instilled in her to try to communicate and talk," Mo Cardin said. "Her personality is starting to break through."
Linda Shrieves can be reached at lshrieves@orlandosentinel.com or 407-420-5433.
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Posted: Sunday, August 29, 2010 12:15 am | Updated: 9:29 pm, Sat Aug 28, 2010.
By JESSICA COOLEY/The Lufkin Daily News
Having a stroke can be confusing, life-changing and sometimes even life-ending. The recently opened Stroke Center at Memorial Medical Center-Lufkin offers stroke patients a chance to go home healthy and educated, according to Memorial spokeswoman Yana Ogletree.
Through its partnership with Methodist Hospital in Houston, Memorial became a nationally recognized stroke center this week by the Joint Commission Accredited Hospital Organization, Ogletree said.
On Thursday morning, I had a “mock” stroke to learn what a stroke patient would go through and how big of a role response time plays on the outcome. After being coached on what signs and symptoms a stroke patient would have, I was ready to go.
Thursday morning started out like any other. E-mail, coffee and chatting with co-workers about my day, but at 8:55 a.m. I began to notice weakness on my right side.
“Are you OK?” my publisher, Greg Shrader, asked.
I wanted to say “no,” but I struggled to find the words. Recognizing the signs of stroke after going through a stroke seminar given by Memorial earlier in the week, Greg called 911 at 9 a.m.
Two minutes later, three paramedics from Lufkin Fire arrived at my office to take me to the hospital. My co-workers and passersby watched with curiosity as I was loaded into the ambulance.
Minutes later I was greeted at the ER doors by stroke program coordinator Kim Deaton. I was immediately taken to the radiology department for a CT scan so my doctors could see how my brain was being affected.
“Jessica, do you know where you are?” Deaton asked me with a concerned look on her face.
I nodded, but felt a little confused.
“OK, we’re going to take you to a room now so we can assess you,” she said.
“You may feel a little overwhelmed because of how many people will be working on you, but it’s all part of the process,” one of my nurses told me.
I then went through a series of assessments where my strength was tested on both sides of my body, I was asked simple reasoning questions and my vision was tested.
The stroke I had was given a value of 13 on the National Institute of Health (NIH) stroke scale, an acute one I would likely recover from, Dr. Cherry Matthew explained. The blockage was coming from the left side of my brain, causing weakness in my right side.
The next step would be for my care staff to give me Tissue Plasminogen Activator (t-PA) intravenously. t-PA is a clot-busting drug that must be given within three hours of the onset of a stroke, Matthew explained. I had to be weighed so my care staff would know how much of the drug to give me. Matthew told me I was a candidate for t-PA because of the mildness of my stroke and how quickly my stroke symptoms were recognized. Patients with an NIH stroke assessment above 22 are typically not candidates for t-PA, Deaton explained.
Fifty percent of patients are eligible for t-PA if they are treated within a three-hour window, Suzanne Monsour, a project coordinator with Methodist Hospital said. Ideal treatment time is 60 to 90 minutes.
“A lot of people don’t get here in time because they don’t recognize the symptoms,” Monsour said.
Because t-PA thins the blood, I would spend the next day in ICU and would be monitored heavily by nurses, Deaton said.
After spending a “day” in ICU, my condition approved. I went from a 13 on the NIH scale to a 1 and was “stepped down” to post-stroke unit.
At that point, I met Amber Loggins, Memorial’s community stroke educator. She explained to me the aftercare involved with stroke patients. From her I learned that stroke is the number one reason for nursing home admission, a sad fact I did not know.
“It can be very overwhelming for the stroke patient and their families,” Loggins said. “We try to send them home knowing what to expect.”
At 11 a.m. I was walking out of the hospital, feeling a little overwhelmed, but having a thorough understanding of what a stroke patient would go through.
While I hope that no one I care about has to go through something like this, it is nice to know having a stroke does not mean the end.
Jessica Cooley’s e-mail address is jcooley@lufkindailynews.com.
Stroke symptoms
Sudden numbness or weakness of the face, arms, legs, especially on one side of the body
Sudden confusion, trouble speaking or understanding
Sudden trouble seeing in one or both eyes
Sudden trouble walking, dizziness, loss of balance or coordination
Sudden severe headache with no known cause
Stroke facts
Stroke is the second leading cause of death worldwide
Less than one in five people can identify stroke signs
An American dies of a stroke every 3.1 minutes
Women can have unique stroke symptoms including hiccups, nausea, chest pain, face and limb pain, shortness of breath and heart palpitations
Out of nearly 6 million stroke survivors alive today, two thirds of them are disabled
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