There’s a question many people would ask if they found themselves recovering from a stroke at the age of 31.
Keisha Spraggans refuses to ask it.
“Absolutely not,” she says.
Rather than look back or feel sorry for herself, she chooses to focus on the challenge ahead.
Spraggans was teaching fourth grade in the Philadelphia School District in 2009 when she found herself first with a "crazy headache" and, ultimately, drifting in and out of consciousness in her apartment. She is still not sure precisely what happened next, but an ambulance arrived and took her to a nearby hospital.
She spent the next two weeks in the hospital trying to comprehend her situation.
"I couldn't do anything," she says. "I could not speak, write, read, comprehend [what people were saying], had aphasia, cognitive issues. The only people that I recognized in my life were the family members and friends that were at the emergency room when I was brought in."
Physically, Spraggans was mostly unaffected with the exception of difficulty using her right arm.
Her biggest challenge was aphasia, a communication disorder that can affect speaking, reading, writing and understanding language.
The SCOR Program
When she was released from the hospital, Spraggans settled in with her mother in the Mt. Airy section of Philadelphia and joined the Stroke Comprehensive Outpatient Rehabilitation Program
(SCOR) at MossRehab.
Spraggans spent three months in the SCOR program, which is now based in Jenkintown, Pa., where she received physical, occupational and speech/language therapy. At the end of that time, she began intensive outpatient speech/language therapy with Pippa Siguenza, MS, CCC, SLP, a MossRehab speech/language therapist.
"She was severely aphasic," says Siguenza. "Keisha didn't understand a lot of what she was hearing, didn't understand a lot of what she was reading. She had word finding deficits. Writing was limited to single words, not phrases, not sentences, not memoirs or articles. She had been a prolific published writer. All four language modalities were impaired."
What followed was four years of hard work.
Some of the recovery came from Spraggans working on the symptoms of her aphasia with the same sort of drive she used to pursue acting, publish a book of poetry and become a teacher before her stroke.
"Keisha takes the strategies she learns in therapy and implements them," says Siguenza. "Not every patient that I work with takes their strategies home and posts them on the wall, but that's Keisha."
Back Into the World
Some of the recovery came from forcing herself back into the world—with urging from Siguenza.
"As she continued to progress, my job was to get her out into the real world to have her use her strategies in the community," says Siguenza. "She wasn't going out with her friends. She limited her socialization to her family."
"I didn't understand [other people]," Spraggans says. "And I didn't speak well enough for them to understand me. So I would just say to myself, 'Oh, never mind. I might as well just stay home and watch TV.'"
Siguenza and Spraggans kept working, though, and progress continued.
"Over the four and a half years there have been valleys," Spraggans says. "That's life. Stuff happens. You've got to keep going."
Did she ever feel overwhelmed by how far she had to go?
"No. I don't operate in that way," she says. "There have been challenges-and I think if I'm still breathing there will be more. But now, I am able to remember when I couldn't speak at all, when I couldn't read at all. Now, I notice that my progress has been pretty remarkable."
Today, Spraggans continues to receive outpatient speech/language therapy at MossRehab. She has participated in research around aphasia at the MossRehab Aphasia Center and local universities. She is part of the Health Mentors Program at Thomas Jefferson University. She serves as a mentor to other young people recovering from strokes.
"I'll call her and ask if she can stop by and talk to one of my new patients," says Siguenza. "I have quite a number of young people with aphasia in my case load, and it's encouraging to them to see someone who also has aphasia and has made excellent progress. She gives them hope."
The state-run Office of Vocational Rehab, which evaluates patients to determine when they are ready to return to work, told Spraggans it will take another year of therapy to get her back in the workforce.
She understands she still has work to do, but is also determined to move at her own pace and set her own goals.
"That's what they are saying," she says. "That's not what I'm saying. I'm OK with limitations because I know mine. I do. But I'm not going to allow someone else to define me, either. That's just not because of aphasia. That's just Keisha."
So, Spraggans continues with her therapy and has moved back into an apartment on her own. She is working on a second book of poetry, is considering a Web-based reality show and a return to acting, and is contemplating a role as a spokesperson for aphasia.
"No one knows what it is, unless they are in the speech pathology business," she says. "I know people are sympathetic, but they don't get it. Most of the time when people hear about stroke, they think of faces contorted and loss of memory. Everybody's different, and aphasia can be a huge part of one's stroke."
Spraggans carries a card given to her by Siguenza that explains aphasia to others who may not understand it. She has a message for others facing a similar situation.
"I would like to meet people, especially young people, and let them know that this is not the end of the road for them just because they had a stroke or they have aphasia," she says. "You have to find something that drives you. I'm all about passion and that's what drives me. To be better and do better."
So her journey continues.
"Will I be 100 percent healed in a year? No, I don't' think so. Maybe not even in two years. But I do know eventually I will be. I do believe I will be 100 percent back to the Keisha that I was a second before the stroke. I do believe that. It will just take time. It is supposed to take time."
This article was originally published in the Living Beyond Disabilities newsletter in May 2014.