Nick Espiritu's Story
Nick Espiritu, 39, enjoys an active life in Las Vegas—working full time, hitting the gym and spending time with family and friends. He also practices yoga as a way to manage stress and stay fit.
One day, while driving to get a smoothie before yoga class, Nick experienced numbness on the left side of his face and in his left hand. The sensation gradually subsided, and he proceeded to attend the hot yoga class. However, during lunch afterward, Nick’s vision became blurry, he felt dizzy and collapsed. Following this episode, he reported to the Emergency Department where doctors diagnosed him with high blood sugar and a panic attack.
While driving to a friend’s house the next day, Nick experienced vertigo and pulled over. He felt hot and vomited. After returning home, Nick became very dizzy and vomited again. When he developed difficulty swallowing, his alarmed friend rushed Nick to Dignity Health St. Rose Dominican Hospital – San Martin campus, where physicians determined he had suffered a stroke. After stabilizing, Nick struggled with swallowing, and a gastric tube was placed for feeding. Additionally, he experienced difficulty with physical balance and coordination.
“My left side was harder to move, and I had a loss of sensation in my mouth and slurred speech,” Nick recalled.
He required additional time and expert care for recovery, so he chose Dignity Health Rehabilitation Hospital. Upon admission, Nick met with his physician-led multi-disciplinary team, which included nursing as well as physical, occupational and speech therapy. Nick outlined his recovery goals: “To swallow, stand and use the bathroom by myself, and to be able to do things at my house without having someone watch over me.”
The nursing team collaborated with Nick’s dietitian to ensure he received proper nutrition through his feeding tube to support his recovery. They also educated Nick and his family on feeding tube care and monitored and addressed his low blood pressure, administering prescribed medication as needed. These steps helped Nick overcome bouts of dizziness, enabling him to process in physical, occupational and speech therapy.
In physical therapy, Nick worked on balance exercises on the mat table in the therapy gym. With direction and encouragement from the therapist, Nick moved through lying, sitting and kneeling. He even worked up to modified planks to strengthen his mind-body processing skills affected by the stroke. Additionally, Nick spent time on the Bioness Integrated Therapy System (BITS), a large touch screen digital display with programmed exercises designed to improve the physical, visual and cognitive abilities of patients. The physical exercises in combination with the advanced technology of the BITS helped Nick through the balance and perception challenges he was experiencing as a result of his stroke.
In occupational therapy, Nick focused on the activities of daily living (ADL) tasks he would need to live independently when returning home. He worked with his therapists in the kitchen of the ADL suite. Designed with all the same appliances as a home kitchen, this space allowed Nick’s therapist to provide real-world, hands-on training to refine his motor skills. They worked together on typical everyday tasks such as cutting an apple and prepping ingredients for cooking. Nick even baked brownies for his biggest supporter, his mom, who regularly visited to cheer on his progress.
Although Nick’s physical skills were improving and he was gaining confidence in making meals, he couldn’t eat the food he was preparing as he was still dependent on his feeding tube for hydration and nutrition. This was the next big hurdle to tackle.
Nick’s speech-language pathologist placed electrodes under his chin and neck to deliver electrical stimulation to his weakened swallowing muscles. As the muscles became stronger through the stimulation, oral exercises were added to progress his swallowing and speaking skills. After two weeks of therapy, Nick was overjoyed when he progressed to swallowing a pureed diet by mouth rather than relying on the feeding tube.
After 18 days at Dignity Rehabilitation Hospital, Nick was ready to return home. He was now independent with all his physical and everyday living skills in a good place. Nick most looked forward to, “being at home, relaxing and eventually, eating food again.”
As he was leaving, Nick expressed his gratitude to his rehabilitation team who helped him recover saying, “I learned a lot here. Everyone was great. The entire staff was really nice, and they helped me understand what was happening and how to get better.”