I love to swim. A lifelong musician, I’ve developed my own system for counting laps. If I’m on lap five, Beethoven’s Fifth resounds through my head; for the 10th lap, zero becomes “0,” so I launch a Rossini overture. The music adds to my enjoyment, and I never lose count.

Which is why I was surprised one morning a year ago when I reached the end of my swim and glanced up at the bright-red numbers on the pool’s digital clock. My time was 12 minutes longer than I expected it to be.

Barbara Silverstein says a sense of humor is essential to stroke recovery.
handout
Barbara Silverstein says a sense of humor is essential to stroke recovery.

Getting out of the pool was no problem, but when a lifeguard passed me on my way to the locker room, he looked, well, odd. It wasn’t until I had trouble locating my locker that I realized that I was out of kilter. It never occurred to me to call 911. Instead, I called a friend, and she called her doctor. When I couldn’t answer his questions, he told my friend to get me to an emergency room – now. He knew what the hospital doctors would soon confirm: I had had a stroke.

I recall the first time the hospital doctor tested my vision. That’s when I realized I could see almost nothing to my left. I was so stunned I couldn’t follow his explanation. Two or three days later, I awoke to discover that much of my vision had returned. The improvement was so startling that the neurosurgeon ran his “how many fingers?” test three times before he was convinced. Four days later I was discharged, prescriptions and referrals for in-home therapy visits in hand. At their assessment visits, the therapists determined that sight was better, but still needed work. Physical therapy wasn’t needed. But my speech and cognitive functions needed even more work.

After several weeks, I could travel to a rehab center. My occupational therapist provided me with take-home exercises specifically targeting the weaknesses in my vision. We both noticed small but regular improvements at nearly every visit, which was almost as therapeutic for me as the exercises. My speech therapist was challenging me at the same time to rebuild my cognitive skills. Before long, she introduced me to a mobile cognitive and speech therapy app that I still use today called Constant Therapy. I can access it anytime on my tablet, tackling personalized tasks that challenge my reading comprehension, analytical skills, and memory.

As I improved, I felt emboldened to return to other aspects of my life. I had to bring music back – but I was terrified. How much was left? Could I recover the rest? It was time to sit down and play my piano. My first attempt was a fumbling mess. The fingers of my right hand seemed unacquainted with their counterparts on the left, let alone with the keyboard. Pieces I had played for most of my life sounded terrible. I stopped and sat at the keyboard, unwilling to prolong the carnage.

The next day, I considered the progress I had made so far. Each exercise I did had started at the first or second level of difficulty and went from there, gradually rebuilding my skills. This process worked. I just needed to adapt it to my playing. So I tried again. I chose a slow movement of a sonata I had performed often, stumbled, slowed down even more, and persevered. Not good, but better than the previous day. By the third day, my fingers started to pay attention to each other, and my hands rediscovered their way around the keyboard.

I still falter occasionally. One morning, as I poured milk onto my cereal and fruit, I looked down and saw that my breakfast was laced with chicken broth. I do not recommend it. In the past I would have raged at such a stupid mistake. Now I laugh. First rule of thumb for recovering from a stroke: Keep your sense of humor ready. You’ll need it.

Second rule: If family or friends want to help, welcome them. You will get better, but you’re going to need a lot of help at first. You’d do the same if the situation were reversed.

Third, expect to be worried at the outset, a lot. I was. What if I banged my head getting into a car, or tripped on a carpet and fell? Would I instantly relapse?

Life isn’t all wonderful now. At the outset, my doctors said they thought that swimming caused, or at least contributed, to my stroke. They said those quick head turns back and forth may have damaged the right occipital artery, which could have led to the stroke. I’m now cleared to swim but have hesitated to restart. If and when I do enter the water, I’ll begin with just a few laps, and build from there.

Coming back from a medical shock that has disrupted your brain and body takes time and effort. But it will happen. You will feel like yourself again. And maybe even better for the experience. I know I am.

Barbara Silverstein was artistic director and conductor of the Pennsylvania Opera Theater for 17 years. She created English translations of operas in Italian, French, and German. In 2011, she was artistic producer of the Philadelphia International Festival of the Arts in its inaugural season. Since her retirement, Barbara has continued writing, playing music, and training her dogs.