Transcription:
Life After Stroke Rehabilitation

Prakash Chandran:  Welcome to Picking Our Brain with Shepherd Center. I'm Prakash Chandran. A stroke can cause lasting brain damage and those who survive a stroke oftentimes need to relearn skills they lost because of that damage. Luckily, stroke rehabilitation is there to help stroke survivors become as independent as possible and to have the best possible quality of life.

Here to talk to us about life after stroke rehabilitation is Seth Dickinson, a former patient in Shepherd Center's Stroke Rehabilitation Program. First of all, Seth, it is great to have you here today. You experienced something that the majority of us can only imagine. So I'd love to start by you taking us back to when you first had the stroke. Talk to us a little bit about when you realized that you were having one and some of the symptoms that you experienced.

Seth Dickinson: Thank you. Much obliged to be here. First off about the experience, I don't recommend it. I was a freshman in college. I was at home on spring break. I was working out and got a headache. I thought I had maybe pushed myself too hard. I was working through trying to get some bulk, had gone a little bit hard that night. And then, I go upstairs to my room. My parents were at home as well. I was on the phone with a friend and she notices that my speech starts to slur. And I had the headache, but again, I'm thinking that it's just overexertion, I'm tired. It was still pretty late at night.

But on that phone call, I stopped being able to think, and she knew that I was speaking weird and I couldn't think anymore. I couldn't find words. She tells me to get off the phone and call my mother, who's a nurse. So I do that. But as I get off the phone with her and try to get my phone in my other hand to call my mom, I couldn't actually hit the buttons. I couldn't find the words.

Finally, I get my thumb over her contact and call and dropped the phone by my head. And my headache at this point is excruciating. And I get out two words, "Come here." She hears it, runs upstairs. And the rest is really history as I lose all capacity to think. I vomit. I knew something's wrong and I start fading in and out. And that's how I knew that disaster had hit.

Prakash Chandran: Oh, my gosh. That must've been so scary. How much time had passed between the time you left the gym and the time you started experiencing the symptoms at their worst?

Seth Dickinson: Ten minutes tops.

Prakash Chandran: Wow. Wow.

Seth Dickinson: One thing led to another. If I would not have gone from where I was working out to my room, I was going to get in the shower. I was told later I would have died in the shower had I not gotten that phone call from my friend. So there was less than 10 minutes, I would say.

Prakash Chandran: Wow. And one of the things that you mentioned is that your friend could tell that you had slurred speech. Is that something that you recognized in yourself as well?

Seth Dickinson: In a way, yes. It was hard for me to find words. I knew what I wanted to say, but it was almost as though there was a relay that was lost somewhere. I was trying to get things out. I couldn't tell it was slurred. I could tell there was something blocking it, but I didn't hear anything.

Prakash Chandran: So you were fading in and out. You were starting to vomit. What do you remember next?

Seth Dickinson: Everything. for me, the blessing and curse of brain injury was that I remember everything. I remember the sirens, the flashing, the sounds. I could hear throughout it all. I just couldn't communicate through it. I remember everything up until being intubated, put on life support. When they knocked me out, that's the last thing I remember.

Prakash Chandran: Wow. And so after you were knocked out and put on life support and you eventually came to, what do you remember about what the doctors said to you around your initial prognosis?

Seth Dickinson: Again, I could hear everything and I was taking it all in. When I came out and could think and process what my prognoses were, I was told, my family was told there's great chance that I may not walk. Talking would be a big issue for me. I could not go back to school in my beloved University of Mississippi and the prognosis was grim. And then that's when Shepherd came into the picture.

Prakash Chandran: Yeah. So let's talk a little bit more about what you understood about Shepherd Center and the role it would play in your rehabilitation.

Seth Dickinson: So for me, again, I was riding the wave. It was two weeks after the stroke. And I remember coming to on an airplane being flown from Memphis to Atlanta, and I could hear them say Shepherd Center. But to me, I was just thinking, this is another thing I have to live with. I couldn't communicate back to them. I couldn't do anything. I got checked in at Shepherd Center and realized, "All right, Seth, you got to do the thing."

Prakash Chandran: Yeah. So let's talk a little bit more about that. You're on an airplane. You hear Shepherd Center and you're being checked in. What do you understand about what's going to happen next by way of your rehabilitation process and what you have to do to start getting better?

Seth Dickinson: Generally nothing. My thought was, "All right. They're taking me somewhere to get better." What get better meant? I knew they were calling it a hospital. They were saying, “You can recover there." At this point in the injury, I didn't know what recovery meant. And I'm again, 18 years old. I'm ready to just get back to normal.

Prakash Chandran: Absolutely. So, when people were telling you that there might be a chance that you don't walk and that your speech might be changed forever, what was going through your mind? Like, what do you feel like the odds were that you were going to get better? What was your emotional state like?

Seth Dickinson: At that point, it was so raw. They were saying that, I didn't believe them. I was thinking, "No, I'm going to do this thing." I'm a naturally stubborn person anyways. I have a very strong faith and I knew, "Hey, I'm going to do this regardless."

Prakash Chandran: Yeah. I can only imagine that having that mindset and that faith going into something like this, into your rehabilitation, was paramount in getting to where you are today, wouldn't you say?

Seth Dickinson: Oh, yes. It's a mindset. So brain injury, it's literally all in your head as I've realized it's getting past that mental obstacle of I can. It's not "What I want to do," it's that "I can do this." And for me, as soon as I realized, "Oh my gosh, I'm going to do it," things began to get done.

Prakash Chandran: So let's talk about the rehabilitation program itself. What is the first thing that you remember going into it?

Seth Dickinson: The food. I remember being able to sit up, have soups and stuff again. And I remember them waking me up very early in the morning, having a nurse give me a shower. And I was thinking "This is life." And then going to those first few hours of physical therapy, it was my first day there.

They were trying to stand me up and I realized to me mentally that showed, "Look, if they're going to give me a chance, I'm going to take it and do what I can with it."

Prakash Chandran: And talk us through like a day in the life of rehabilitation. You mentioned the food was amazing, but talk us through some of the things that you did at Shepherd.

Seth Dickinson: So you go through a full repertoire of physical therapy, occupational therapy, speech therapy, and my favorite rec therapy, having fun. You wake up in the morning, shower, dress, groom. You go eat. They have it blocked out, for when my mother would come and get my schedule off the board, she would find my name and say, "All right, Seth. First, you have physical therapy, then speech therapy, then occupational therapy." And every day, it would change. And you get very close with your therapist because you see them several times a day. They know who you are. They invest in you and you in them. It's a lot like going to school again. It's having a schedule. It's actually having homework at night when you go back to the room but these things, they tailor it to you.

And what I appreciated most is they asked me on that first day when I could communicate, what are your interests? And I would tell them, "My interests are going back to school, getting back to college, playing golf," stuff like that. And they tailored my experience into getting me back to where I wanted to be.

Prakash Chandran: Got it. And one thing that I'd love to have a better understanding of is you were unable to communicate right in the beginning, right? Everything was in your head, you were taking it all in, but the communication was tough. And so at what point were you able to communicate these goals of yours, like you wanted to go back to college and you wanted to play golf?

Seth Dickinson: It would've been three weeks after the stroke once the brain fog had lifted and I could think. Again, I could hear throughout this entire thing, so people could talk to me, but as soon as I really got into speech therapy and could communicate and process, the emotional storm had quietened down, it was not long thereafter where I was letting people know this is what I want to do.

Prakash Chandran: Okay. So in terms of timeline, two weeks in, you were taken to Shepherd. About a week after that, you were slowly able to communicate with the people around you, talk about the goals that you had after rehabilitation was over. Then after that, how long did it take in rehabilitation until you could leave?

Seth Dickinson: I left inpatient Shepherd to go back to get my skull flap put in in May. So I was there for about two months roughly. Went back to Memphis. I got my skull flap put back in and then had one week off, my one week brain vacation. And then I started at Shepherd Pathways, the outpatient or day program, at the end of June. And then I was completely checked out of Shepard in July. So from March to July, that was my shepherd experience, then to go back home and do outpatient therapy while taking online classes.

Prakash Chandran: And for those of us that don't know, can you talk just a little bit about what a skull flap is?

Seth Dickinson: Yes. Your skull flap is where when they have to get access to your brain. They remove a section of your school and store it somewhere. I don't know if I want to know where. And that's to alleviate the pressure and then allow doctors to get access to whatever part of your brain the bleed is, and then it's removed. And then after your brain stabilizes and you progress in your recovery enough, they go back and they put the skull flap back in.

Prakash Chandran: Okay. And that's lot because the brain swells and, in order to alleviate some of that pressure, that's kind of why they do that, right?

Seth Dickinson: Yes.

Prakash Chandran: So, let's talk a little bit about what your life and accomplishments look like now. So from March to July, you were inpatient at Shepherd, then you went outpatient and online classes. Talk a little bit about your journey, where you are today and what's happened.

Seth Dickinson: I knew it would be very difficult for a lawyer not to be able to talk. And it would be very difficult for a college student not to be able to walk around campus. So in January of 2016, less than a year after my brain injury, after the stroke, I went back to the University of Mississippi, back to campus, finished out at Ole Miss in 2018, started law school the next fall. And I actually have just graduated law school in April. I'm now a lawyer, working on becoming an attorney, taking the Mississippi bar exam at the end of July. And I will start at the state supreme court in August.

Prakash Chandran: That is so incredible to hear. I mean, it's amazing to hear everything that you've overcome to get there. I want to just ask you quite candidly, law school is not easy, do you feel like after having gone through a stroke, that things were just a little bit harder? Like what can people who have been through rehabilitation expect as they go out to pursue something as difficult as law school?

Seth Dickinson: I think the most important thing to understand is perspective matters. Things were more difficult, maybe physically. Every brain injury is different. I cannot attest to anybody else's difficulties or abilities, but my understanding and what got me through was that having a brain injury, being a disabled American, that gave me a spark.

I remembered how it was to not have a voice. And I remember what it was like, not be able to communicate or I felt beat down in the healthcare system. That was my passion throughout law school, is to give people their voice, whether they've lost it because of brain injury or bad decisions or factors, they can't control.

My perspective was that this happened to me, but I'm back for a reason. It's not because I'm so special. It's because I've been supported because of a great family, a healthcare system that had benefited me, a lot of faith and stubbornness. I understand very clearly that I am not where I am because of Seth Dickinson. I'm here because of those that supported me and poured into me and I feel like I owe it to the world to do the same.

Prakash Chandran: Wow, Seth, that is an incredible perspective. And one thing that I think it's important that people take away from this conversation, especially people that are stroke survivors, is that whatever power you believe in, that power has given you a second chance. And I think to have the perspective and the mindset to understand and seize that opportunity to do something is so important because you are an inspiration to others that will go through the same thing. I mean, wouldn't you say that's true, Seth?

Seth Dickinson: Yes. I think I remember looking at the bus at the Shepherd Center and seeing their motto, restoring hope and rebuilding lives, and I think as soon as you have your hope restored and realize you're here for a reason, regardless of your limitations, regardless of where you are, you can get better. You can adapt. It's always going to be worse for somebody else. So while you're rebuilding your life, I think that as survivors, we owe it to rebuild others' lives too.

Prakash Chandran: Seth, what has been the hardest part about your rehabilitation?

Seth Dickinson: I'm not very patient. I have been the hardest part of my rehabilitation, of being frustrated that I wasn't recovering on the timeline I wanted to. The hardest part for me is myself, is that I'm never satisfied with where I am. My perspective sometimes needs some realigning. I should be looking when I get frustrated about how far I've come and not looking at how far I still have to go. Again, the mentality has been the hardest part to still adjust to almost seven years later.

Prakash Chandran: Yeah. And do you feel now that you are hindered in any way as you go through on your journey to become an attorney? Like how do you view your post-stroke rehabilitation life and what obstacles still remain to be jumped?

Seth Dickinson: Hindered, no. I've been slowed down, but there is not a hurdle too high to leap, I understand. And with the mentality of the hurdles in the way, bear right through it. I still have physical weakness on my left side, but I've learned to adapt. The biggest obstacle that I see in my way of becoming an attorney, aside from the bar exam, is just making sure that I have the mental wherewithal and fortitude to apply myself of not getting discouraged of remembering "Seth, seven years ago, you were nothing" to now understanding I'm on the cusp of my life goal.

Prakash Chandran: Absolutely. Seth, after everything that you've been through, what's a lesson that you might want to leave the audience with today?

Seth Dickinson: I would say know the signs. I was 18 years old when this happened. I had no reason to think, "Okay. A stroke's possible." Again, I thought it was a headache. Looking back, now that I've been educated more, I realized the face droop, all the signs were there, but I didn't know them. And my mother, thankfully, who was a nurse, she could tell these are stroke symptoms, this is bad, where if it would have been just me at 18 years old without the knowledge, or really what I thought was the need to have that knowledge, I very easily could have died. So I think knowing the signs of a stroke, no matter how old you are, no matter how healthy you think you are, know the signs of what could happen to you at any given time, because there's a chance it may.

Prakash Chandran: So let's get into the details of what those signs are. Can you maybe talk a little bit about how you like to think about them?

Seth Dickinson: So for me, it's listening to your body, of understanding how your extremities feel, your face, how your speech is going. Because a stroke is something you don't ever think you're going to have to deal with. So be aware of the things that you hear on TV, the FAST signs, the face, the arms, the tingling, the speech, and then T, time. And then when you realize, "Hey, I have all of these signs," get yourself care. Don't just think it will pass. Regardless of age, understand that it can happen to you too.

Prakash Chandran: Yeah. And you mentioned that acronym FAST, and that is F for face, A for arm, S for speech and then T for time. And the T is a very important piece, because as you mentioned, it only took 10 minutes from the time that you left the gym to the time that you started experiencing these severe symptoms. So for the audience that's listening, if you start experiencing any of this, it's very important to get help, to call 911 so you can minimize the damage to your brain as quickly as possible.

Seth, I really appreciate you sharing your story here today. Is there anything else that you would like to leave with our audience just regarding your post rehabilitation life or anything at all that you want people to know?

Seth Dickinson: Keep the faith. Stay strong. Restore your hope and your life will be rebuilt. For me, if there's anything I can share to myself seven years ago, it would be, "Seth, keep the fight going."

Prakash Chandran: Well, Seth, you certainly have. And congratulations on your graduation from law school. I mean, truly incredible. And I also really appreciate your time today. So thank you so much.

Seth Dickinson: Much obliged.

Prakash Chandran: That's Seth Dickinson, a former patient in Shepherd Center's Stroke Rehabilitation Program. For more information about Shepherd Center, please visit shepherd.org.

If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. This is Picking Our Brain with Shepherd Center. My name is Prakash Chandran. Thank you so much, and we'll talk next time.