Shaunt's Story
It was supposed to be a romantic date night for Shaunt Beavers-Hickerson, 45, and her husband, Brandon. They’d made dinner reservations at a nice restaurant and even booked a hotel for the evening.
It was a short reprieve from their busy lives as the parents of two young children, one of whom was an infant. Shaunt, a Cleveland native, worked two jobs – at a group home and as a teaching assistant – and loved spending time with her family and playing with her kids.
After dinner, Shaunt and Brandon planned to see a movie, but Shaunt was tired so they headed back to the hotel so she could rest. That’s when the night changed in a moment.
Back at the hotel, Shaunt fell and became unable to communicate. Brandon called 911and was rushed by ambulance to Cleveland Clinic Main Campus. Imaging at the hospital showed Shaunt had suffered strokes in two of the arteries in the left side of her brain, leaving her unable to move the right side of her body.
While an overwhelming diagnosis for anyone, this was especially challenging for Shaunt because she is hearing impaired and relies on sign language to communicate. Without the ability to use her dominant right hand, she had no way to express her needs.
When swelling in Shaunt’s brain didn’t improve after several days, she underwent a decompressive hemicraniectomy, a procedure that involves removing a large section of the skull on one side of the head to relieve pressure on the brain. Over the next several weeks, Shaunt would need to undergo a tracheostomy, a surgical procedure that creates an opening (stoma) in the trachea (windpipe) to allow air to enter and exit the lungs, and have a breathing tube placed. Shaunt also had to receive a feeding tube into her stomach for nourishment.
Shaunt would remain hospitalized for four weeks before she was medically stable enough for the next step in her recovery – an intensive inpatient rehabilitation program that would help guide as much progress as possible. Brandon, who works at Cleveland Clinic, chose Cleveland Clinic Rehabilitation Hospital, Beachwood for his wife’s recovery after a colleague recommended the hospital.
Being transferred to the rehabilitation hospital was both scary and exciting, Shaunt recalls. She was apprehensive about not having a way to communicate with others and was worried about her children at home. She had no idea how much she’d be able to do in therapy, or what to expect on the road ahead. Shaunt’s goals were to improve her ability to sign, walk and get dressed with as little help as possible. Her physician-led team of clinicians, including nurses and physical, occupational, speech, respiratory and recreational therapists, created a plan that would help Shaunt restore independence.
Upon arrival, Shaunt was still receiving nutrition through a feeding tube and oxygen through a tracheostomy mask. She was experiencing cognitive challenges that were making it difficult for her to follow directions or communicate her needs. Shaunt also had mobility challenges requiring the assistance of two people to sit at the edge of the bed and stand within the parallel bars. She also needed a mechanical lift to be transferred from bed into a wheelchair and personal care tasks also required assistance.
Shaunt’s nurses worked to manage her pain with proper positioning and medications while also monitoring the healing of the incisions on her scalp. Nurses also ensured that her stoma and feeding tube were clean and administered all of her medications and nutrition through the tube.
Occupational therapists focused on helping Shaunt gain as much independence as possible so that she’d be able to care for herself and her children. Because she uses her hands to communicate, therapists had Shaunt use a specialized stationary bike that sent low level electrical impulses to her right arm to improve blood circulation and help stimulate her weakened muscles. With time, Shaunt’s right arm improved to the point where she could begin to use it in other aspects of therapy, including getting dressed and using the bathroom. Occupational therapists also worked with Shaunt on her standing balance while practicing household tasks in the activities of daily living suite, which mimics a home environment with a bed, bathroom, kitchen and washer/dryer.
In physical therapy, Shaunt and her therapists worked to improve her balance and ability to walk on her weakened right leg. She practiced walking and stepping up while using a mobile rehabilitation system that secured Shaunt in a harness. This provided bodyweight support in a safe, secure setting. Therapists further challenged her right-sided balance by having her complete a variety of exercises, including standing at a ledge and getting in and out of a car.
Initially, speech therapists and respiratory therapists worked together to begin the process of liberating Shaunt from her tracheostomy mask using a tracheostomy cap, which is a cover that blocks the opening the tube, forcing a patient to breathe through their nose and mouth. As Shaunt was able to breath more independently, speech and respiratory therapists were able to remove her breathing tube and slowly transition her diet. Speech therapists focused on swallowing exercises to improve Shaunt’s swallowing strength to ensure that she could drink and eat safely. Her team also helped Shaunt improve her reading comprehension and handwriting using a specialized app that helped her understand and communicate more easily.
For the first week of her rehab stay, Shaunt and her team relied on a virtual sign language interpreter, who translated the directions of therapists to Shaunt using a screen. When her therapists recognized that it was difficult for Shaunt to follow directions through the virtual interpreter, the hospital arranged for an in-person sign language interpreter to attend Shaunt’s therapy sessions to help translate instructions. This significantly improved Shaunt’s understanding and made her more comfortable and confident, helping to ensure that she was getting the most out of her therapy sessions. The interpreter also spent time with Shaunt to practice signing with both her weakened right hard and her non-dominant left hand.
Recreational therapists helped keep Shaunt’s spirits up by finding activities for her to do in her spare time, including painting a canvas with her infant son’s name to display in his nursery. Shaunt says that some of her favorite memories were with her recreational therapist playing Wii bowling and air hockey.
Shaunt admits that there were many highs and lows throughout her rehabilitation. A highlight was any time her children came to visit as her spirits were immediately lifted knowing she had her family’s support. It gave her the motivation to participate fully in therapy every day. Other highlights were the first time she was able to walk, being upgraded to a normal diet and being freed from her breathing tube. Shaunt says that every milestone made her feel like her hard work was worth it.
Both Brandon and Shaunt’s mother participated in family training so they’d know how to safely move Shaunt and transfer her to different positions. Brandon appreciated learning more about strokes and what to expect for Shaunt in the future. He admits that it was all very scary at first, but the hands-on family training at the hospital made him comfortable and confident in taking Shaunt home.
After nearly two months at Cleveland Clinic Rehabilitation Hospital, Beachwood, Shaunt was ready to go home. She’d made significant progress, including being able to walk 75 feet with a cane and go up two steps with the assistance of two people. She could also propel her wheelchair over 150 feet with supervision. While Shaunt still required some assistance to get dressed, she was able to comprehend and communicate her needs using her left hand to sign. With these skills, Shaunt has the foundation to return to using her phone and social media to communicate with friends and loved ones.
As Shaunt prepared for discharge, the staff arranged a special “clap out” lining the hallway and cheering her on as she headed out. Rather than using hands to clap, staff used sign language to do the sign for applause – waving their open hands in the air and twisting them at the wrists. Shaunt will continue her recovery with home health care and looked forward to being Brandon and her children again.
Shaunt says she feels stronger now and knows she can accomplish even more. “Set goals and work hard to accomplish them,” Shaunt advises others who may be facing a difficult recovery. “You can do it!”