BRAIN INJURY AND STROKE:
Scott Chan's Story
A Second Chance at Life
When 16-year-old Scott Chan was wheeled through the Rehabilitation Institute of Chicago’s (RIC) doors on a stretcher in March 2007, he was unable to move, eat or speak on his own.
Chan experienced a hemorrhage of an arteriovenous malformation, or an abnormal collection of blood vessels in the brain, that resulted in a brain injury and a subsequent stroke.
“You need to call your priest and family members because it doesn’t look like he's going to make it,” emergency room doctors told his mother.
Surgery to stop the bleeding had saved his life, but had also resulted in a stroke for Chan. When he first came to RIC, Chan was paralyzed on his left side, had little physical ability and had to be fed through a tube in his stomach. His family was terrified for the future of their bright, young son who was a gifted student at Notre Dame High School, a prestigious Chicago preparatory school for young men.
Chan initially began his rehabilitation in the Pediatrics Rehabilitation Program, which cares for patients younger than 18 years old. His care team worked tirelessly with Chan to help him toward recovery.
He was not able to hold his head up alone, so physical therapists first focused on head control, allowing him to interact with his team. They then pushed him on sitting balance, bed mobility and maintaining upright positioning. Soon enough, Chan was able to regain enough strength and control that he was able to sit up by himself.
Without the use of his left hand, he had to learn to do the basics like dressing, brushing his teeth and toileting using his right hand only. Chan’s occupational therapist worked with him to teach him these basic daily activities. “He had to relearn everything starting from the beginning," said Scott's mother, Hilba Chan.
Speech therapy was not just aimed at improving his speech, but also focused on how to eat and drink. Daily exercises focused on opening and closing his mouth and flexing and moving his tongue inside his mouth.
Chan was able to use his right hand to scribble thoughts in a notebook. One of his first messages to Hilba revealed his priorities. “I want meat ravioli from Martino’s,” it read, referring to his favorite Italian restaurant.
Each new day brought remarkable progress. Around 8:30 p.m. on Easter Sunday, Hilba was sitting next to her son's bed when she heard someone softly say, “Mom.” She turned and looked at Scott, realizing in amazement that he had spoken the word. She couldn’t believe her ears. Hilba could not control her tears and hugged Scott as hard as she could.
Chan’s speech continued to improve. A week later, on the 5th floor, prompted by his speech therapists, Chan said “Hey doc, what’s up?” to a small group of doctors walking down the hallway. Chan slowly repeated the question. It was his first full sentence since the stroke.
Physical therapists used sensory stimulation to increase movement on his left side and stimulate physical functioning. Once Chan was able to sit up by himself, therapists worked with him on standing and eventually walking with a cane.
Chan also remembers one of the first times he actually stood using a seated device that slowly lifted him up into a standing position. Chan recalled that one of his therapists shouted, “Scott, you’re standing!”
“Oh, my God, I really am standing,” Chan responded, unable to believe it.
By the end of April, Chan’s feeding tube had been removed, and he was eating solid food again. One night, Hilba surprised him with a plate of meat ravioli from Martino’s.
“We saw ongoing progress each day with Scott,” said Katelyn Adams, PT, MSPT, Chan’s physical therapist. “Scott is an extraordinary young man and has the determination of a lion.”
As Chan prepared to leave RIC’s Pediatric Inpatient Rehabilitation Program in May, Adams presented him with a book titled, “Believe in Yourself.”
“I wanted this book to remind him of all the hard work he had done and accomplished during inpatient rehabilitation and all the hard work he will continue to do,” said Adams. “The title of the book just fit him and I wanted to remind him that if he believes in himself, the sky is the limit!”
Touched and newly motivated, Chan was grateful. “Thank you so much for everything you’ve done for me,” he said, giving her a hug.
Continuum of Care
Though Chan had made tremendous gains as an inpatient, his team believed he had the potential to achieve more independence and referred him to RIC’s Day Rehabilitation Program at RIC’s River North location in Chicago. The unique program provides multiple coordinated therapies, delivered simultaneously on an outpatient basis to help patients transition from inpatient care to the independence of living at home.
Resuming his therapy there, Chan's occupational therapists helped him relearn math, which had been his favorite subject at Notre Dame High School. Prior to the stroke, he was taking an advanced Algebra/Trigonometry class. Now therapists were helping him to relearn how to do basic math.
Chan received therapy to enhance his memory retrieval by participating in group exercises such as reading a newspaper article and then reciting its basic facts to other patients in the group. Everyone had to take notes on each other’s reports and then quiz each other to see which facts they could remember.
This therapy complemented the work he had been doing at Stephen Tyng Mather High School, where Chan was working with teachers and aides to repeat his junior year of studies.
“His therapists were knowledgeable, professional and compassionate,” Hilba says. “They made him comfortable, and he responded to everything they did. He became very attached to them.”
After completing day rehabilitation, Chan entered a gait research study in the Neural-Locomotion Lab at RIC’s Searle Rehabilitation Research Center, the largest rehabilitation research effort of its kind.
Chan participated in a treadmill training study three-times each week for a month. The study challenged Chan to walk as fast as he could at his target heart rate for 45 minutes. Once he completed the trial, the data found that he increased his average daily walking in the community (outside of the research trial or therapy) by 72% and had an increased gait efficiency of 64%, meaning he was using less energy for the distance traveled.
“Chan showed improved walking speed, endurance and confidence in balance,” said Jennifer Moore, MPT, a researcher in the RIC Neural Locomotion Lab. “He also used less energy and was able to attain higher walking speeds than his initial trial. He did great in this study!”
Advancing To the Next Level
Chan continues to fine tune his physical endurance, balance and strength through outpatient therapy at RIC’s flagship hospital. He is set to start his last year of classes at Notre Dame High School this coming August and looks forward to getting back to class.
"Going back to Notre Dame High School means a lot," Chan said. "I'll be able to start taking regular classes again and graduate from the school where I started. That has always been my goal."
Now, Chan is able to walk, talk, eat and maintain his independence in most everything he does.
Hilba never imagined this day would come. “RIC has given him the potential to continue a normal life,” she said. “Here was a kid who less than two years ago was hooked up to five machines and couldn’t even move. Now to see him back in school and preparing for college is a miracle. We are truly blessed."