June 1, 2018

PM&R Stroke Patient Featured in Michigan Health Post and Video

Four years after her stroke, PM&R patient Barbara Wiley works hard to strengthen her mind and body. She shares personal advice based on that journey.

After Relearning to Walk, Young Stroke Survivor Gets Active
Barbara Wiley had thought she was a healthy 41-year-old mother of two the day she had her stroke.

The morning of October 17, 2013, started with her usual vegetarian breakfast and her usual daily run. She saw her children off to school and later drove an hour south of her home in Canton, Michigan, to pick up a table she had found on Craigslist.

While loading the table into her car, Wiley began to feel nauseated. Sensing that something was wrong, the table’s seller suggested they call 911.

“I was adamant that I did not want to take an ambulance away from someone who really needed it,” recalls Wiley, agreeing instead to call her husband to come get her.

The seller, meanwhile, used her own phone to call 911, relaying questions from the 911 operator to Wiley and confirming her answers with Wiley’s husband.

“As that was happening I told them I felt a burst behind my eye,” Wiley recalls. “I wasn’t that worried until I heard her repeat it to the 911 operator. I remember thinking, ‘That doesn’t sound good.’”

Wiley was rushed to the nearby hospital in Tecumseh, Michigan, then airlifted by Michigan Medicine’s Survival Flight to Ann Arbor.

The diagnosis: a rare type of stroke.

Rare complication and major surgery

Wiley was told she had suffered a stroke caused by an arteriovenous malformation (AVM) in her brain. An AVM is a tangled cluster of vessels that form at a point where an artery and a vein come together.

Typically, a system of capillaries exists at that point. Without capillaries to regulate the speed and volume of circulating blood, however, blood flowing at very high pressure can rupture an AVM.

That was the sensation Wiley felt behind her eye.

Brain AVMs are rare, occurring in less than 1 percent of the population, and usually produce no symptoms until a serious complication such as stroke occurs.

Their cause is unknown, but doctors believe that a congenital defect was responsible for the AVM in Wiley’s brain.

Wiley’s AVM and a portion of her skull were removed during a 12-hour surgery.

She was hospitalized until December 2013 and was then transferred to a subacute rehabilitation facility until March 2014. A second procedure to restore the missing portion of her skull was scheduled for April but delayed until August of that year due to further complications.

A long rehabilitation journey

The stroke left Wiley with weakness and spasticity on her left side.

Soon after leaving the rehab facility, Michigan Medicine physical and occupational therapists began working with Wiley in her home. Later that year, she transitioned to outpatient therapy at Michigan Medicine’s Canton Health Center.

One constant in Wiley’s care has been her physical therapist, Hendrika Lietz, P.T., D.P.T., N.C.S.

“I’ve been with Barb since those early days in the ICU,” says Lietz, noting that early efforts to help the 90-pound Wiley stand up required four people to assist. “She was tremendously weak then and had virtually no muscle control. She’s made amazing progress since then.”

Read the rest of the story at Michigan Health>>