VNS Health’s Speech-Language Pathologists Share Some of Their Most Memorable Cases
May is Better Hearing and Speech Month, and May 18 is National Speech-Language Pathologist (SLP) Appreciation Day. These recognitions are an opportunity to highlight the life-altering care provided by SLPs at VNS Health and other health care organizations nationwide. Whether it’s assisting an aphasia patient to find the words that are eluding them, treating a swallowing disorder in someone recovering from a stroke, or training a laryngectomy patient to use a voice prosthesis, these skilled therapists help their clients regain the ability to eat, speak and communicate every day.
To get an inside look at the important work they do, we asked several VNS Health speech-language pathologists to share some of their most memorable professional moments.
“Because we get involved with our patients’ lives on a more personal level, we become aware of issues they hadn’t been able to communicate.”
Charlene Cano, Senior Speech-Language Pathologist, Queens
“A few years ago, I had a stroke patient who had been diagnosed with primary progressive aphasia [difficulty understanding or expressing oneself through language]. He was a veteran who lived alone, and he was very difficult to understand. He’d been communicating with pencil and paper but even that was challenging, because the stroke had affected his right hand. Since this was during the pandemic, he was trapped in the house and had nowhere to go. It was almost impossible for him to communicate his needs, which was extremely frustrating for him.
“After I involved his nurse-practitioner at the Veterans Administration, she started to make home visits to him, I also connected with VNS Health’s Veterans Home Care program, which led to him getting a computer communication device. A big part of our job is to enable basic functional communication, whether it’s talking, pointing, writing or using a device. We have to kind of sift through the options and see what works. Just by being with this particular patient, I knew his potential and could see that he needed a device in order to communicate, since he couldn’t do it verbally. I can recall a moment when he used the device to convey some essential detail to his home health aide—maybe he’d fallen, or his hand hurt. It was a big deal, because that was something he wouldn’t have been able to do before.
“As speech-language pathologists, our work is all about communication. Often we end up helping patients with issues that go beyond our job description, like identifying and linking them with the resources they need. Because we get involved with our patients’ lives on a more personal level, we become aware of issues they hadn’t been able to communicate. In some instances, we can even clear up a misdiagnosis—for example, a doctor might wrongly assume that a patient has dementia or some other cognitive deficit just because they’re unable to express themselves.”
“It was so rewarding to see something positive come out of what is really a devastating diagnosis—it was like opening another world for her and her family.”
Katie Gildea, Speech-Language Pathologist, Manhattan
“I had a patient who was homebound with ALS. She was in her 70s and had been a CEO—a very capable and motivated woman. When I started working with her, she could still manage to do some eating, and could still get out a few words at that point, like yes or no. But ALS is a progressive disease and she was going to transition to a feeding tube soon. She had already obtained an augmentative and alternative communication (AAC) system known as an eye-gaze enabled speech generating device, so she could communicate with her family every day and text her grandchildren. She was known for her strong opinions and she needed a way to convey them.
“One of my primary tasks was training her how to use the eye-gaze system. Technology has really advanced and it’s a great option, but it’s not for everybody—there’s a lot of trial and error involved, and it’s a tedious and time-consuming process. She was incredibly focused and motivated. It was fascinating for me to see a patient progress so quickly. By the time I left, she was able to send very short messages by text or email through her eye-gaze device. ALS is like a locked-in syndrome—she was completely intact cognitively and just wanted to be able to communicate the way a grandmother ordinarily would with her grandchildren. It was so rewarding to see something positive come out of what is really a devastating diagnosis—it was like opening another world for her and her family.”
“It’s moments like these that make me so grateful I chose the career I did. It makes me happy just talking about it!”
Jennifer Hansen, Speech-Language Pathologist, Staten Island
“One of my clients had just had his larynx surgically removed as part of his cancer treatment. He was in his early 60s. He had been a police officer and 9/11 first responder, which is how he got the cancer. When I was at his home doing my initial evaluation, I could see how frustrated he was at having to scribble everything down. He already been prescribed an electrolarynx, which is a battery-operated machine that produces sound that patients can shape to create a ‘voice’—so I said, ‘Wouldn’t it be nice if your electrolarynx was delivered while I was here?’ Within 20 minutes, the doorbell rang and it was delivered! So we were off to a good start.
“The electrolarynx was actually a temporary solution. Eventually he was going to be using his tracheoesophageal puncture [TEP] implant, a voice prosthesis that was already in place, but he wasn’t ready for that yet because of postsurgical swelling. That’s a little simpler to use because it’s implanted—you just press the button in your throat and speak. But the electrolarynx was a way to help him communicate in the meantime. So we worked on finding the sweet spot on his throat where the device works best, and then we practiced articulating the sounds with his mouth when he held the electrolarynx on that sweet spot. There’s a learning curve to using it, but by the time I left I was able to understand about 75 percent of what he said. He was talking up a storm! He was ecstatic, and I was ecstatic! It made my whole week. He gave me a huge hug on my way out. It’s moments like these that make me so grateful I chose the career I did. It makes me happy just talking about it!”
“I was thrilled to learn that in fact he had decided to go into the medical field instead, because this had been such a life-changing experience for him.”
Sherri Hughes, Speech-Language Pathologist, Nassau
“All of my patients are important to me, but three really stick in my mind. Last year, I had an 18-year-old who’d had a seizure in college due to a brain aneurysm. He survived the aneurysm but had aphasia, which involves issues with finding words. Language processing, forming sentences, memory, sequencing, the ability to attend to a task—all of that was affected. We worked on all of those things, and he got everything back except for his ability to do math. That’s not one of my strong points, so I told his mom to set him up with a math tutor. That was about a year ago. I recently learned that he no longer wanted to go back to his school, where he’d been studying computer programming. I initially thought it was because of the math issue. But then I was thrilled to learn that in fact he had decided to go into the medical field instead, because this had been such a life-changing experience for him.”
“Another memorable patient was a man in his 50s who’d had a brain-stem stroke at work. Many people don’t survive those, but he quickly Googled his symptoms and had his coworkers call an ambulance. That quick thinking saved his life. He came home from the hospital with a feeding tube, and was incredibly motivated to get off of it by regaining his ability to swallow. He diligently did all the home exercises—it might not sound like much, but dry swallowing all day is grueling work! He followed through, however, and we gradually moved through all the textures—from liquids to thicker liquids to purees. We celebrated his discharge with pizza!”
“Then there’s Mr. Jelly Cake, this wonderful elderly patient from the South with dementia. He always has a smile on his face and has never said an unkind word about anything or anybody in my presence. It’s the warmest house I’ve ever been in. When we were getting to know each other, I asked him about his past. One of the passions we share is baking. He kept talking about jelly cake, which I hadn’t heard about. I learned that it was a Southern cake that used apple jelly—made from apple peels—instead of frosting. That’s what he calls me—“Jelly Cake”! He came down with COVID a while ago and returned a changed man: He was barely awake or attentive. So I went in there and worked on keeping him awake, making him keep his eyes open and answer basic questions, and gradually his spark came back. He’s in a wheelchair and his dementia is progressing, but it’s so great to see him close to his old self again. And fortunately, he doesn’t have any swallowing issues. In fact, I’m planning on baking a jelly cake and bringing it to him one of these visits.”