James Daniel, 48, survivor of a hemorrhagic stroke, and his wife Tammie Brewer of Yukon, are very thankful for the excellent resources and level of skilled professionalism they found at the John W. Keys Speech and Hearing Center when help was desperately needed.

Speech therapy is often primarily associated with developmental needs of children and its value cannot be underestimated. Services are in demand, but clients who benefit span all age groups. In addition to therapies tailored for children, the John W. Keys Speech and Hearing Center, located in the University of Oklahoma College of Allied Health on the OU Health Sciences Center campus, offers comprehensive treatment for adults, often seen in connection with brain injuries or neurological disorders.

The day in September 2016 that changed James Daniel’s life began like most others. An avid mountain biker and road cyclist, Daniel made his usual loop around Lake Hefner; completed a regular workout routine; put in a full day of work at his job with a commercial fire and safety firm; and returned home to enjoy dinner with his wife.

Without warning, as the couple watched TV that evening, Daniel began to experience the “worst headache of his life.” Daniel resisted the idea of going to the hospital, but Brewer, a registered nurse, knew that immediate action was necessary. Later, they would learn that Daniel had experienced a massive stroke, the result of not one, but two brain aneurysms that ruptured. They now know the condition is hereditary, and that two other family members also have identified brain aneurysms and are monitoring them. “Even now, it’s frightening to think how it was just there, waiting to explode,” Brewer said.

An aneurysm is a bulging blood vessel that can leak, or as in Daniel’s case, rupture, releasing a rush of blood into the brain. This type of stroke occurs when blood fills space between the brain and thin, protective tissues covering the brain. Most aneurysms never rupture or create health problems, and are often detected as patients are screened for other conditions. However, if an aneurysm ruptures, it becomes a life-threatening event requiring immediate medical attention.

The aneurysm was located under the spinal artery at the back of Daniel’s head. The force of surging blood caused his brain to shift incrementally to the right of the skull. In one of many procedures that followed, Daniel’s carotid artery, dissected during the stroke, had to be surgically reopened. He remained in a coma for the first three to four weeks of what became a four-month hospitalization. Daniel underwent multiple surgeries during this time, including a brain flap to remove the large clot on the left side of the brain; placement of complex brain stents, a feeding tube and tracheostomy, followed by weeks of inpatient rehabilitation.

Pressure on the optic nerve resulted in visual deficiencies, mostly affecting peripheral vision. Daniel’s condition is monitored annually by Anil Patel, M.D., FRCSC, FACS, neuro-ophthalmology specialist at Dean McGee Eye Institute. While impaired peripheral vision is a concern, Patel believes Daniel is fortunate to be alive, with any remaining vision.

Among other long-term effects of the stroke, Daniel has aphasia, a language impairment that occurs when language areas of the brain are damaged. Because multiple areas of the brain are involved in language function, some regions may remain healthy and unaffected. Fifteen percent of people under age 65 who experience a stroke develop some form of aphasia. Types of aphasia vary according to the area of the brain that sustained injury.

Daniel has Broca’s aphasia, one of three common forms of aphasia, which prevents a person from forming intelligible words and sentences. Broca’s usually doesn’t impair the ability to understand others when they speak, but patients often have extreme difficulty retrieving learned language and formulating appropriate responses. Broca’s also may cause alexia (loss of ability to understand written or printed language) and agraphia (impaired ability to write or process written language). The affected area of the brain, the dominant frontal lobe, also houses vessels that deliver blood to movement centers. Paralysis, usually affecting the right side of the body, is another manifestation of Daniel’s stroke that presents challenges daily. He has limited use of his right hand.

Daniel has been in speech therapy for four years now. After discharge from the hospital, Brewer and Daniel explored and experienced a number of speech therapy options. One of these, a summer camp for people with aphasia, was led by Karen Copeland, M.S., CCC-SLP, who suggested the focused, adult-specific services provided at the John W. Keyes Hearing and Speech Center. It was their first awareness that such services were available.

As the first order of business before meeting with a speech pathologist at the Keys Center, Daniel took the Western Aphasia Battery, a diagnostic tool used to assess linguistic and certain nonlinguistic skills of adults with aphasia. The WAB provides information that can diagnose the specific type of aphasia by identifying the affected area of the brain causing aphasia. They were astounded by the thoroughness of this comprehensive diagnostic approach. Brewer remembers her husband repeatedly saying, “Wow!”