Wednesday 17 April 2024
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Nottingham

Nottingham woman with golf ball-sized brain tumour learns to speak again

A Nottingham woman who had a golf ball-sized brain tumour removed from the centre of her brain and had to learn to talk again has thanked the therapy teams at Nottingham University Hospital NHS Trust who helped her to regain her independence.

Nora Flynn, 29, from Carlton, had been experiencing extreme fatigue and dizzy spells for a year but it had been chalked up to stress as blood tests continued to come back clear.

But on 10 June, 2023, Nora collapsed as she got off a bus and was taken by ambulance to Queen’s Medical Centre where CT and MRI scans revealed that she had a large but benign brain tumour.

Four days later Nora underwent brain surgery to remove the mass, but due to its location it had damaged the area of her brain which control her motor functions so she had a long road of rehabilitation ahead of her.

Nora, originally from Bulgaria, said: “My last memories before waking up on the D10 ward were from May, so I’ve lost a couple of weeks before I collapsed.

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“The consultant explained that given the rate of how slowly these tumours grow, it had probably been there for 25 years, if not all my life.

“To begin with, I could open my eyes but couldn’t move my face or make any expressions, and I could only just move my arms and legs.

“Then I could only give a thumbs up or down, and eventually I progressed to be able to write on a whiteboard, but I still couldn’t talk as I could only just open my mouth.

“A friend of mine joked that every time he visited, I had a different method of communicating.

“It was very frustrating and I was jealous of people who could talk. All my thoughts were coherent but I couldn’t express them.”

Nora was transferred to the Linden Lodge rehabilitation unit at City Hospital where she worked with a whole team of therapists to regain her speech, her mobility and her independence.

The Speech and Language Therapists worked closely with Nora to help her to start using her vocal chords again and making noises – although of course it was all in her second language, English.

Nora said: “We started with the basic vowel sounds, and general noises. Then we were playing a game where the therapist was counting and I had to try to say the next number.

“She counted one, but I couldn’t do two or three. And then she counted three and I managed to say ‘four’. So that was my first word.

“My voice was very stilted and robotic with no inflections to begin with, because I hadn’t used it in a month.”

Emma Dent, a Speech and Language Therapist who specialises in neuro rehab, supported Nora whilst she was at Linden Lodge and was pleased to see her make such rapid progress.

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She said: “It’s rare for us to see patients who aren’t able to speak at all recover so quickly, so I was particularly surprised when Nora said her first words and was able to speak normally quite soon after that, the therapy we were doing with her seemed to unlock something in her brain.

 

“It’s a great feeling when you are helping to give someone back their ability to communicate, which is so important to each of us because it’s what allows us to have relationships with other people.

 

“First we looked at her oro-motor movements – so the movement of her lips and tongue – to determine whether she had any problems with the nerves there, and then I got her to copy sounds which she could do.

 

“After that, we focussed on automatic speech tasks, things that are coded in the brain and are more spontaneous such as counting or singing ‘Happy Birthday’, before then working on picture naming.”

 

Emma explained that there are a variety of different patients who she sees when they come to Linden Lodge, including people with traumatic, acquired or hypoxic brain injuries, or tumours.

 

Speech and Language Therapists also support patients with swallowing and eating, functions which are often affected by the illnesses or injuries they have experienced.

 

This can include assessing patients at their bedside or observing their eating and drinking while having an x-ray, and then recommending changes to their food or drink and helping them with swallowing exercises.

 

Emma said: “Eating and drinking are important as it’s not just eating, it’s all the social aspects that go with it, like having dinner with your family, or being able to go to the pub with friends for a drink.”

 

Regaining her speech was just one of the challenges Nora had to overcome in her recovery. Physiotherapists worked with Nora to enable her to use a wheelchair before progressing to standing, and then taking small steps, and soon Nora was walking backwards and sideways to test her abilities.

 

She said: “The whole team were really sweet and supportive. They had to keep coming up with different exercises and tests for me as I kept acing them.

 

“Then being able to walk to the bathroom and take showers by myself was amazing.”

 

Psychologists were part of Nora’s therapy team, who carried out cognitive assessments to understand the impact the tumour and subsequent surgery had had, and as she moved towards being able to go home.

 

The Occupational Therapists worked closely with Nora to enable her to carry out actions independently. This included going to the shops to buy items, using planning and budgeting skills, and then cooking a simple pasta meal.

 

As a result, and as her mum had travelled from Bulgaria to support her, Nora was able to return home to her flat in Carlton at the end of July.

 

She said: “Rehabilitation provides a very important bridge from when you are ready to be discharged from the QMC, but not able yet to return to normality and independence.

 

“I am very lucky to have recovered so quickly, partly because I’m so young and determined, but also because of the staff on D10 and Linden Lodge, including the custodial staff.

 

“They were all absolutely amazing, and I didn’t have a single negative experience.”

 

Nora added that she looks forward to seeing the opening of the National Rehabilitation Centre near Loughborough as hopefully it will enable patients even more progress and independence throughout their recovery.

 

Nora is now able to live fully independently again, recently celebrated her 30th birthday, and this week returned to her career in IT.

 

Additional information on Speech and Language Therapy at Linden Lodge

 

Our speech and language therapists provide support to patients with speech, language, communication and swallowing difficulties.

 

This includes difficulties such as aphasia, dysarthria, cognitive communication difficulties and apraxia.

 

Aphasia is where the patient struggles to understand speech and/ or express themselves. Our therapists may help with communication aids such as apps on an iPad or communications books where the patient can point to a picture of what they are trying to say. They may also work with the individual patient to improve their expression and comprehension. Working closely with the patient’s family is important to help them communicate together.

 

Patients with dysarthria experience slurred speech due to muscle weakness.  Therapists can help to develop clearer speech by promoting strategies such as slowing down and over-articulating their words.

 

Patients with cognitive communication difficulties may have changes to their social understanding, attention and memory which impacts their ability to communicate day to day.

 

Patients with apraxia cannot coordinate the muscles that form speech and therapists use a variety of different techniques depending on their specific needs.

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