WORLD STROKE AWARENESS DAY is October 29th. In the United States, stroke causes one death every four minutes. When Melissa A. Rosati had a precognitive dream of an older woman in an intensive care unit, she did not consider the woman might be her mother. But her mother, an indomitable prima ballerina of dance instructors, was a ticking time bomb for a stroke. Each family member missed the symptoms. Days after the dream, Melissa's mother suffered a massive stroke. This mother and daughter relationship, by no means an easy one, faced the ultimate test of resourcefulness in the stroke’s aftermath of partial paralysis, speech impairment, and vision loss. Describing her mother's hospital room as a "hellfire pit of helplessness and loss," Melissa realizes her mother's best chance for survival is not in medical intervention alone. Her mother was a stroke patient by circumstances. She was a dancer in her heart and soul. In the United States, where 45 million adult caregivers provide care for someone over the age of fifty, there is growing interest in using creative arts in approaches to caregiving. In this presentation, Melissa shares how a hospital bed transformed into a dance studio, reclaiming her mother's identity, her will to live, and surprising her medical team.

1. A
STROKE
OF
INTUITION
A
Daughter’s
Perspective
on
Her
Mother’s
Stroke
Recovery
By
Melissa
A.
Rosati,
CPCC
October
29,
2014
|
#worldstrokeday

2. Key
Points
• Missed
symptoms
• The
Dixie
Cup
Test
• Intuition:
Focus
on
the
dancer
• Dancing
with
muscle
memories
• The
outcome
of
Mom’s
stroke
recovery
• Mom’s
return
to
dance
• Lessons
learned
• Resources
• About
the
Author

3. Missed
Symptom
#1:
The
Coffeemaker
It’s
early
morning.
Mom
is
standing
in
front
of
the
coffeemaker
and
cannot
make
the
mental
connection
required
to
insert
the
plug
into
the
wall
socket.
My
father
thinks
she’s
having
a
‘senior
moment’
and
plugs
it
in
for
her.
Leaving
the
house,
he
suggests
she
rests.
A
transient
ischemic
attack
(TIA)
is
an
event,
sometimes
called
a
mini-­‐stroke,
with
stroke
symptoms
that
last
less
than
24
hours
before
disappearing.—National
Stroke
Association

4. Missed
Symptom
#2:
TV
Remote
Control
At
11
pm.
on
the
following
evening,
Mom
calls
her
son
and
asks
for
help
turning
off
the
television.
She
can’t
remember
how
to
use
the
remote
control.
My
brother,
who
lives
close
by,
drives
to
the
house.
He
turns
off
the
television.
He
also
thinks
the
problem
is
her
memory.
He
bids
her
goodnight
and
returns
to
his
home.
Up
to
40
percent
of
all
people
who
have
experienced
a
TIA
will
go
on
to
have
an
actual
stroke.
Most
studies
show
that
nearly
half
of
all
strokes
occur
within
the
first
two
days
after
a
TIA.–
National
Stroke
Association

5. Day
3:
The
Big
Stroke
A
ballet
dance
instructor,
Mom
collapses
while
teaching
a
class.
Paramedics
rush
her
to
a
local
community
hospital.
After
the
initial
assessment,
she
is
airlifted
to
a
major
university
hospital
and
placed
in
ICU
(intensive
care
unit).

6. The
Big
Stroke’s
Impact
• Partial
paralysis
all
along
the
left
side
from
her
eye,
her
face,
side,
leg,
down
to
her
toes
• Difficulty
speaking
• Difficulty
swallowing
• Partial
blindness
in
the
left
eye
• Complete
shattering
of
her
sense
of
self

7. What
the
Doctor
Says
&
the
Backstory
He
Doesn’t
Know
Doctor’s
assessment
The
backstory
he
doesn’t
know
• Mom
has
high
blood
pressure.
• Mom
has
Arterial
Fibrillation
(A-­‐fib).
• If
she
does
not
take
her
high
blood
pressure
medicine
consistently
and
monitor
the
A-­‐fib,
she
will
most
likely
have
another
stroke
within
one
year.
• It
is
interesting
that
she
is
a
dancer,
but
she
is
69
years
old.
Recovery
is
tough;
she
needs
a
stomach
peg
tube.
It’s
unlikely
that
she’ll
return
to
teaching
dance.
Rehab
to
start
immediately
to
recover
basic
motor
skills.
Prepare
her
home
for
physical
accommodations.
• She’s
had
high
blood
pressure
for
years
and
did
nothing
about
it.
“I’m
in
great
shape.”
• Since
she
believed
her
strong
physical
conditioning
made
doctor
visits
unnecessary,
the
A-­‐fib
went
undetected.
• Mom
is
a
tough
competitor.
• She’s
dedicated
her
life
to
dance
education.
• By
implying
that
a
return
to
teaching
is
unlikely,
Mom
will
interpret
that
to
mean
she
has
no
reason
to
live.

8. The
Dixie
Cup
Test:
Failure
and
Fear
of
Death
• The
physical
therapist
instructs
Mom
to
pass
a
Dixie
cup
from
her
right
hand
to
her
left.
• It
slips
from
her
fingers
and
falls
dead
in
her
lap.
• Mom
unleashes
an
ear-­‐piercing
wail.
Her
face
is
beet
red.
She’s
drooling.
• The
hospital
room
is
now
a
hellfire
pit
of
helplessness
and
loss.
• The
young
physical
therapist
is
visibly
shaken.
I
ask
her
to
leave
us
alone
for
a
few
minutes.
• Mom
is
so
angry
and
frustrated
that
she
is
a
patient.
How
can
I
reach
her?
• Massaging
her
feet
to
soothe
her,
I
have
an
idea
to
try
something.

9. A
Stroke
of
Intuition
She
is
a
stroke
patient
by
circumstances.
She
is
a
dancer
in
her
heart
and
soul.
Holding
her
feet
in
my
hands,
I
choose
to
coach
the
dancer.
“Mom,
look
at
me,”
I
command.
Look-­‐at-­‐me.
Let’s
breathe.”
“No,
dy,
dy,
dying.”
Danseuse
en
Blanc,
1877.
Edgar
Degas

10. “Mom,
God’s
big
test
for
life
or
death
is
not
‘pass
the
Dixie
cup.’”
(Although,
the
family
fears
death
could
well
be
around
the
corner.)

11. We
start
with
leg
positions.
I
tell
her
to
put
her
feet
in
ballet’s
first
position.
Show
me.
As
if
she
is
on
stage
opening
Swan
Lake,
Mom
snaps
her
heels
into
place
—knees
straight,
legs
rotated
out
from
the
both
hip
sockets.
We
are
both
astounded.
No
longer
in
a
hospital
room,
we
are
in
a
dance
studio.
Her
bed
is
the
stage.
I
coach
her
on
through
the
next
four
positions
with
her
legs
and
feet.

12. Quip
per
Quo
“Not
bad,”
I
tease.
“
But,
I’ve
seen
you
do
better.”
(I
wish
I
had
a
dime
for
every
time
I
heard
that
one
growing
up.)
Now,
there
is
a
glint
of
a
smile
coming
from
her
right
eye:
“very
funny.”

13. Arms
&
Legs
Together
After
we
finish
the
leg
positions,
I
challenge
her
to
do
all
five
arm
positions.
While
the
partially-­‐paralyzed
left
arm
is
far
from
graceful,
her
range
of
motion
is
impressive.
Next,
I
challenge
her
to
do
arms
and
legs
together
in
all
five
positions.
She’s
100%
focused
on
her
body
as
an
instrument
and
does
each
position
on
my
command.
Drawings,
1870s.
Edgar
Degas

14. So,
why
can’t
she
pass
the
Dixie
Cup
from
one
hand
to
the
other?

15. The
answer
involves
muscle
memory.
Our
brains
record
and
store
all
of
our
repeated
actions.
With
this
procedural
memory,
we
become
very
good
(or
very
bad)
at
something
the
more
we
repeat
the
action.
Mom
had
unconscious
competence
and
excellence
for
dance
moments.
Passing
the
Dixie
cup,
on
the
other
hand,
was
asking
her
to
make
a
conscious
effort
to
complete
the
task.
Damaged
by
the
stroke,
her
brain
had
difficulty
processing
that
movement,
just
like
plugging
in
the
coffeemaker
and
turning
off
the
TV
remote.
Series:
Dancers
in
Green,
1870s.
Edgar
Degas

16. Dancing
with
muscle
memories
• Tapping
into
her
competitive
nature,
I
tell
her
the
doctor
doesn’t
think
she’ll
be
able
to
go
back
to
teaching.
“Shall
I
ask
him
to
come
see
what
you
can
do?”
• She
slurs
a
definitive
“yes.”
• I
lead
Mom
through
her
routine.
The
doctor
is
surprised.
She’s
still
in
serious
condition
but
she
is
transformed
in
her
demeanor.
• The
doctor
explains
her
muscle
memory
is
outstanding
for
ballet
movements,
and
perhaps
the
stroke
did
not
do
complete
damage
to
the
area
of
her
brain
that
controls
dance
movements.
• She
is
now
more
than
his
stroke
patient
who
needs
a
stomach
peg
tube.
She
is
a
dancer
who
wants
to
heal
after
suffering
from
a
severe
stroke.

17. Curtain
Call
Mom
has
now
regained
a
crucial
aspect
of
her
identity.
But
before
the
doctor
leaves,
I
place
the
Dixie
cup
on
the
tray
in
front
of
her.
“Focus
on
position
three
with
your
arms,”
I
tell
her.
“Now,
pass
the
cup
to
your
left
hand.”
Not
a
fluid
motion,
but
she’s
determined.
Very
slowly,
she
does
it.
Applause.
The
Star
of
the
Ballet,
1878.
Edgar
Degas

18. The
Following
Day…
• Mom
is
exhausted,
ashen,
and
looks
far
worse
than
the
day
before.
• The
physical
therapist
returns.
• Mom
does
pass
the
Dixie
cup
and
two
more
exercises
by
struggling
hard.
• Her
outlook
is
slipping
back
into
the
hellfire
pit.
• How
do
I
keep
the
dance
metaphor
alive
for
her?
•
Is
it
going
to
make
a
long-­‐term
difference?

19. Visualization:
Powerful
Medicine
What
Mom
and
I
create
together
in
her
hospital
room
heals
our
difficult
relationship.
No
regrets.
However,
I
recognize
the
difference
between
strength
and
stamina.
She
cannot
do
her
dance
movements
every
day.
But
she
could
dance
entire
ballets
in
her
imagination!
I
bought
for
her
a
CD-­‐Player
with
large
buttons
and
headphones,
Swan
Lake
and
Sleeping
Beauty.

20. The
Rehabilitation
Process
• The
CD
player
did
the
trick.
Mom
loves
listening
to
music.
Her
feet
and
hands
sway
in
time.
She
begins
to
imagine
going
back
to
her
studio.
• I
talk
to
the
physical
therapist
and
suggest
to
her
to
put
Mom’s
exercises
into
a
dance
context.
Explain
what
she
wants
Mom
to
do.
Then,
ask
her
to
perform
it.
• When
she
is
transferred
from
the
hospital
to
a
rehabilitation
facility,
Mom
doesn’t
like
it.
By
being
uncooperative,
she
thinks
she
can
force
the
doctor’s
hand
to
send
her
straight
home.
• Drawing
comparisons
between
rehabilitation
and
rehearsals,
I
help
her
see
that
rehabilitation
is
a
series
of
steps
leading
up
to
going
home.
• Six
weeks
later,
she’s
passed
all
of
her
physical
and
occupational
therapy
assignments
and
is
released
to
return
home.

21. Mom’s
Return
to
Dance
Sitting
in
a
chair,
Mom
directs
her
class
with
help
from
the
advanced
students.
She
has
the
stamina
for
one,
sometimes
two
classes
each
week.
One
year
after
the
stroke,
she
teaches
several
classes
almost
every
day.
Two
years
later,
she
retires
and
takes
up
gardening.
Seven
years
later,
she’s
still
gardening
and
teaching
the
occasional
private
lesson.
Rehearsal
of
the
Scenes,
1872.
Edgar
Degas

22. Lessons
from
this
experience
• Mom
learns
to
accept
help
and
that
her
medical
team
is
on
her
side.
She
follows
their
instructions
for
medication,
sticks
to
her
check-­‐up
schedule,
and
asks
for
help
when
she
needs
it.
• The
family
learned
the
FAST
formula
for
signs
of
a
stroke.
• A
diagnosis
is
not
a
definition
of
who
the
patient
is
as
a
human
being.
• Tapping
into
a
patient’s
passion
for
life
can
open
the
channel
for
regaining
identity,
self-­‐respect,
and
motivation
for
going
forward.
• Visualization
is
an
empowering
practice
for
helping
a
patient
construct
her/his
future.

23. Resources
The
personal
essay
provides
the
full
story
and
twenty-­‐two
links.
For
World
Stroke
Awareness
Day,
it
is
FREE.
October
29,
2014.
Click
on
the
image.
Selected
highlights
include
the
following.
1. Know
the
Signs
of
Stroke
2. Remember
Who
I
Am
3. Narrative
Medicine:
Honoring
the
Stories
of
Illness
by
Dr.
Rita
Charon
4. Dance
Therapy
Using
Video
Technology
5. The
Science
of
Dreaming
Note:
This
presentation
and
personal
essay
are
intended
for
general
information
only.
For
health
concerns,
always
consult
a
medical
professional.

24. About
Melissa
A.
Rosati,
CPCC
Melissa
A.
Rosati
writes
about
hopes,
fears,
and
the
mysteries
of
Awe
in
everyday
life.
She
is
the
Founder
&
President
of
Melissa’s
Coaching
Studio,
LLC.
Working
with
clients,
Melissa
puts
‘who
you
are’
first.
Then,
she
helps
her
clients
bring
‘what
you
do’
and
‘how
you
do
it’
into
balance.
Learning,
sharing
knowledge,
and
finding
relationship
pathways
through
writing
and
the
arts
are
the
cornerstones
of
her
coaching
practice.
A
frequent
speaker
and
workshop
director,
Melissa
has
presented
at
writing,
wellness,
and
creativity
conferences
held
at
Memorial
Sloan
Kettering
Cancer
Center,
Montefiore
Medical
Center,
the
Leukemia
&
Lymphoma
Society
in
New
York
City,
Yale
University,
Skidmore
College,
the
University
of
Maryland,
and
the
Geneva
Writers’
Group,
in
Geneva,
Switzerland.
Melissa
is
a
graduate
of
The
Coaches
Training
Institute,
San
Rafael,
CA.
She
lives
in
New
York
City
with
her
husband
and
their
cat,
Social
Media
Max.
P:
917-­‐628-­‐4547
|
E:
melissarosati@me.com
|
T:
@melissarosati
|
L:
/in/melissarosati