Bryan Caldwell was just 34 years old when he suffered a serious stroke. Caldwell, a type I diabetic since the age of six, was on a video call for a new job when he could tell something wasn't right.
"I thought my blood sugar was low so I was drinking a Snapple," said Caldwell. "Right as I passed out, I called out to my wife for help."
Caldwell's wife ran in to find him hunched over his desk and immediately called 911.
"I was really lucky that my wife was right there," said Caldwell. "I don't think I would have recovered as well if we hadn't got help right away."
Caldwell, who lives in Syracuse, Utah with his wife Britney and 6-year-old son Logan, was first taken to Davis Hospital in Layton, Utah—less than a mile from his home.
An initial assessment showed that Caldwell's kidneys weren't functioning as they should, and both his blood pressure and blood sugar levels were dangerously high. After consulting with a neurologist at University of Utah Health, Caldwell was transferred from Davis Hospital to University of Utah Hospital in Salt Lake City.
"By the time we got to the University Hospital, my blood pressure had come down a bit thanks to the medication they gave me at Davis Hospital," said Caldwell. "But things weren't good. I couldn't really talk and was slurring my speech."
Caldwell was intubated as soon as he was admitted into the Neuro Critical Care Unit at University Hospital. Initial scans and testing showed signs of a stroke. Some strokes are caused by blood clots in the brain (ischemic stroke), while others are caused by bleeding in the brain (hemorrhagic stroke). Caldwell had suffered a hemorrhagic stroke, and scans showed bleeding on the right side of his brainstem.
When a patient suffers a stroke in the brainstem, it typically causes weakness (which often develops into tight muscles) in the opposite side of the body as the stroke. Caldwell's left side was extremely weak.
Further testing showed his kidney function was at three percent of what it should have been, meaning he would have to start dialysis. Two days after his stroke, Caldwell was on dialysis every single night for more than two weeks.
Caldwell would spend the coming weeks at the University Hospital, in and out of the intensive care unit as he faced many challenges on his road to recovery.
Doctors discovered that Caldwell had thirteen ulcers in his small intestine and stomach, along with ten transient ischemic attacks (TIA), or mini strokes. Further testing showed the cause: extremely low blood pressure. At one point, the internal bleeding was so severe that Caldwell had three blood transfusions.
Luckily, Caldwell's exceptional care team had expertise in various fields of medicine including neurology, nephrology, gastroenterology, and internal medicine. And after two months at University Hospital, Caldwell was transferred to the Craig H. Neilsen Rehabilitation Hospital.
"Rehab was intense," said Caldwell. "I had to learn how I was going to function in the real world with only half of my body working like it did before the stroke."
Coco Corrigan, SLP, was the speech-language pathologist on Caldwell's care team at the rehabilitation hospital. Corrigan not only worked with Caldwell on his speech, but also helped with cognitive rehab—including memory strategies, attention, and problem-solving skills.
Corrigan has worked with many stroke patients throughout her career and has seen firsthand the unique challenges every patient faces after having a stroke.
"It's devastating, but there are a lot of resources available for rehab," said Corrigan. "Your life may look very different but there's still a way to have a fulfilling life after a stroke."
Katie Sell, an occupational therapist (OT), was another member of Caldwell's care team at the Neilsen Rehabilitation Hospital.
One rehabilitation tool that Sell used was simulation spaces. These spaces allow stroke patients to practice navigating tasks and spaces he would encounter after leaving the hospital. The Neilsen Rehabilitation Hospital has multiple home and public simulation spaces including a laundry room, airline seats, a restaurant booth, and a golf course.
"In occupational therapy, our biggest goal is to help patients return to meaningful daily activities," said Sell. "We look specifically at what kind of things you need to be able to do on your own and do all we can to help you get there. We have so many resources we are able to use to help our patients."
Even though Sell is busy working with many patients, she enjoys every single one. Caldwell was no exception.
"Bryan was really fun to work with—he has a wonderful sense of humor," said Sell. "He was also so motivated. We spent a lot of time working on the things that were important to him and made sure he was able to do those things that really mattered in his day-to-day life."
Director of Stroke Rehabilitation at U of U Health, Steven R. Edgley, MD, also helped care for Caldwell while he was at the Neilsen Rehabilitation Hospital. Because Edgley is a fellow stroke survivor, he is able to relate to each of his patients on a more personal level.
"I often tell my patients that when you are recovering from a stroke there are two sides to that recovery coin," said Edgley. "One side of the coin is 'spontaneous recovery,' and we work for as much of this as we can. The other side of the coin is the areas where we don't recover 100 percent to the way that we were. For those areas, we promote 'functional recovery,' meaning creating compensatory strategies for those deficits."
For Edgley and all of his patients, both sides of this recovery coin are critical.
"The overarching goal for every patient is for them to get back as much quality of life as they can," adds Edgley. "And a new normal does not have to decrease your quality of life."
For most stroke patients, the path to recovery starts with intensive inpatient care and rehabilitation, followed by outpatient care. Just as every patient is unique, so is their path to recovery. Some patients may receive outpatient care for many years, while others may not.
No matter the patient, no matter the path, there is hope. Caldwell is living proof of that.
After four weeks in the Neilsen Rehabilitation Hospital, Caldwell was sent home to be with his wife and son. Although there were a few bumps in the road after that, he is still home and thriving.
But there are still challenges.
Because of his kidney failure, Caldwell is on dialysis for ten and a half hours every single night. He has been on the waiting list for a kidney-pancreas transplant since October of last year.
However, Caldwell isn't letting any of this stop him. In August, he was cleared to drive again. He lifts weights nearly every day and takes walks with his wife and son. Last year, he raised more than $6,000 to help fellow stroke survivors who were struggling to pay for copays, prescriptions, and gas to get to and from appointments. And, when his sprinkler system broke last year, he put on his gloves, got out the shovel, and fixed it.
"If I put my mind to it, I can do pretty much anything I want," said Caldwell. "My perspective through this whole thing has completely changed, and I now approach it like it's a second chance at life. I know I still have so much to accomplish in my life, and I'm not going to give up now. I am making the most of every second."
Caldwell has some words of encouragement for others who may be grappling with their own stroke recovery.
"Don't compare yourself to other patients because your stroke is different from everyone else," said Caldwell. "Your expectation is what you make it. I've had lots of doctors tell me I wasn't going to be able to walk or do certain things. And when I was told those things, I put my middle fingers up into the sky."