Van Lindahl's Cancer Patient Story

Pushing Back on Cancer and Celebrating "The Best Father's Day Ever"

For Van Lindahl, 59, the past year's joys and challenges have been about restoring his communication skills, rebuilding his strength and regaining a firm hold of his family and career — both affected as a result of a brain tumor and aggressive cancer treatments.

Lindahl hasn't let the effects of his tumor or cancer treatments infringe on his life. He triumphed over the diagnosis to unite his family, become a more involved dad and learn the value of reading a goodnight story to his sons. He also returned to his unique talent and passion for hand-rendered architectural designs, a unique and specialized talent.

Lindahl, described as a highly intelligent man with a deep knowledge of history, architecture, music, politics and sports, had been bothered for nearly a year by an ironic difficulty finding simple words, phrases and common-knowledge facts such as "the street that runs along the lake" (Lake Shore Drive) or "things you wear on your cuff" (cuff links), recalled his wife.

On a spring day in 2008, he suffered a series of seizures and was rushed to Northwestern Memorial Hospital and stabilized in the emergency room. Then, he was diagnosed with an anaplastic astrocytoma level 3 glioma tumor, an aggressive form of brain cancer. The location of the tumor within the brain close to several critical areas makes it inoperable without risking his quality of life. While surgeons may one day need to resort to surgery, Lindahl chose to try aggressive cancer treatment to shrink the tumor. The tumor's location in the brain is such that it affects memory, speech, expression and other cognitive functions.

In November, bad dizzy spells led him to the Rehabilitation Institute of Chicago and Gail Gamble, M.D., medical director of the cancer rehabilitation program and a specialist in physical medicine and rehabilitation. "We knew right away we liked her, and she has continued to be a Godsend," says Lindahl's wife, Kim. "She spent three hours with us and was determined to help Van improve."

Innovative Cancer Care

Dr. Gamble prescribed intensive speech, physical and occupational therapy through RIC's day rehabilitation program, a unique rehabilitation setting specifically geared for patients like Lindahl who are medically stable but need multiple, intensive coordinated therapies — from three to six hours a day for up to five days a week. "Van had marked cognition problems, language difficulties, balance problems and lethargy, and he was physically de-conditioned," says Dr. Gamble. "With impairment in several areas, he was best suited to day rehabilitation."

The Lindahls chose RIC's DayRehabCenter in Ravenswood, conveniently located near their home in Uptown, for his therapy. RIC DayRehabCenters also are located in Chicago's River North neighborhood and the suburbs of Elk Grove Village, Homewood, Northbrook, Wheeling and Willowbrook to serve people throughout the Chicagoland area.

After a thorough assessment by a rehabilitation team including Dr. Gamble, nurses, clinical social workers, psychologists, occupational and physical therapists, speech and language pathologists, and other specialists, an overall plan was developed to help Lindahl reach his main goals: To regain the ability to communicate with his wife and family, to be able to spend quality time with them and continue to be an involved father.

His speech and language pathologist, Jennifer Gorokhovsky, describes his condition at the beginning of their work together as "complicated."

"It was hard for him to get his point across," she says. "He had difficulty thinking of words and putting sentences together. He also had cognitive challenges with organization, problem-solving, reading comprehension and attention. All of this made his aphasia word retrieval problems worse."

The term "speech therapy" is in some ways a misnomer; the work involves much more than just speech and is not about vocalizing, but rather about cognition — mental processes — related to language. (Vocal therapy, a branch of speech therapy, deals specifically with producing sounds.) Lindahl's rehabilitation involved working on puzzles, worksheets and other exercises to practice skills such as problem-solving, sequencing, deductive reasoning, finding specific words and following directions. "Practicing these skills helps the brain reorganize and find new connections," explains Gorokhovsky. She also taught him specific strategies for working around abilities that had been compromised, such as highlighting important words in texts and talking about a word as a way to unblock the actual word.

Meanwhile, Lindahl was working with physical and occupational therapists on upper body strength and function, balance, coordination, endurance, safety, independence and activities of daily living.

Lindahl's course of rehabilitation was extended beyond the initial plan because he continued to make such great progress. This was largely due to his positive attitude toward the process. "He understood what we were doing and why, and if he didn't understand, he did it anyway. He put his trust in us," says Gorokhovsky.

Beyond the physical and cognitive, day rehabilitation addresses emotional needs as well. Patients tend to become close and form informal support groups, which can be therapeutic in and of itself — progress is enhanced by sharing experiences with those facing similar challenges and seeing the success of others further along the road to recovery. The Lindahls also took advantage of psychological counseling available through RIC and worked with Leigh Chethik, Ph.D., in adjusting to changing family roles and other stresses from dealing with cancer.

Lindahl underwent several months of chemotherapy and radiation treatments with his oncologists that shrunk his tumor 40-60%. This, in combination with his cancer rehabilitation treatment at RIC, has brought about positive overall results.

The day rehabilitation program focuses not only on regaining functional ability, but also on adjusting to new challenges and re-entry to home and community. Lindahl, his therapists and other patients went on walks, trips to Target and visits to a neighborhood coffee shop to help re-assimilate to community living and learning to manage daily activities. Each evening, he returned home to begin putting his new skills into practice with his wife and kids.

The Best Father's Day Ever

Lindahl has now graduated from day rehabilitation and is going to outpatient therapy a couple times a week to continue to maintain his restored function. "I am light years from where I was when I started," he says, an extraordinary statement from someone who a few months ago could not put together a sentence.

"He has made remarkable gains," agrees Dr. Gamble. "He has insight and humor, which are very advanced cognitive abilities."

From being unable to complete a task as simple as circling an animal and underlining a piece of furniture in a group of pictures, he is back to hand-rendering drawings — a rare skill even among architects — and recently completed a rendering of a building he designed in Moscow. At one point, Lindahl's hands were so shaky that his lines were wavy and his signature had become nearly unrecognizable. As an assignment from his RIC vocational rehabilitation specialist, Lindahl regained the ability to draw.

But perhaps the most remarkable healing has occurred within his family relationships, a result, he says, of coming face-to-face with his own mortality. Lindahl has reorganized his priorities for family and discovered the importance of his relationships with family.

The Lindahls' son Luke, 5, had never met his big brother from Lindahl's previous marriage, Oscar, 11. They had a joyful introduction and are now enjoying spending time together as a family and getting to know each other. They will be attending the same school in the fall, which both boys — and their father — are very excited about.

He made several trips to his native Tennessee to visit his family with whom he hadn't had contact in several years, a visit that his RIC therapists encouraged as an important part of his healing process.

For the first time ever, Lindahl had all his children together on Father's Day 2008, including his daughter Liv and her son Everett. Lindahl thanked his wife, ex-wife and children for the "best Father's Days of my life."

"We're taking it one day at a time," said Lindahl. I'm blessed to have the restored ability of communication and better overall function. It's amazing to see how far I've come."

"We feel profoundly blessed, loved and rewarded. We are especially grateful to all of those involved in Van's care," said Kim. "We feel that Dr. Gamble and the RIC therapists made a marked and significant difference in the quality of our lives and the well being and healing of our relationship with family and friends."

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