For more information, visit.
Brain and Spinal Cord Injury Specialists

Unrivaled. Relentless. HERE.


Lydia Schieuer: Rising Above Stroke


If you were to be a fly on the wall for a day in Lydia Schieuer’s life, you would come to know a driven and passionate young woman. You would come to know a 20-year-old just two years away from earning her Bachelor’s degree in Elementary Education, a student and prospective teacher who dedicates each day to the educational growth of our community’s youth.

You might see her studying a curriculum for a class she’ll lead over the course of her teaching career. Or completing a class of her own to better understand federal educational initiatives. You might even see her nannying the children of a family friend, reading through books to foster their growing vocabulary and working through lesson plans to reinforce the moral of the story just finished.

In short, you would see normality. Yet that normality betrays a moment of tragedy for Lydia. And it ignores her inspiring path from tragedy to recovery.

On August 2nd, 2015, Lydia complained of a painful headache after having just returned home from a family vacation. Within minutes, her headache had induced vomiting. In incredible pain, Lydia couldn’t formulate accurate descriptive statements. Words were simply missing from her speech. When Rick and Jewel Schieuer, Lydia’s parents, tried to speak to her to determine what was wrong, they received confusing, almost unintelligible responses in return.

Rick and Jewel understood Lydia was experiencing no ordinary headache. Lydia was taken immediately to Omaha’s Methodist Hospital emergency center, and then to Nebraska Medicine, where it was clear she had suffered a temporo-parietal hemorrhage—effectively, a stroke—spurred by an extremely rare blood vessel malformation in Lydia’s brain.

The stroke was catastrophic, damaging Lydia’s vision and her ability to use and interpret language in even the most basic forms of verbal communication.

“She knew we were her parents,” Rick Schieuer said, “but she couldn’t say our names. She knew we were talking to her but there were times she couldn’t understand what we were saying.”

Lydia’s neurosurgery team gave the Schieuer family no guarantee that she would return to her level of function. They were told to prepare for a long road of recovery.

That long road took Lydia from the neurosurgery services of Nebraska Medicine to a brief stay at Lincoln, Nebraska’s Madonna Rehabilitation Hospital. Three weeks after her injury, Lydia transferred to QLI, where she began a program that would amplify her strengths, target her stroke-borne weaknesses, and define not only the following six months, but the foundations of Lydia’s life beyond injury.

Lydia’s team at QLI focused in large part on her vision and speech abilities, but targeted the more subtle issues affecting Lydia’s recovery as well.

During the day, Lydia often fatigued to the point of exhaustion, an exhaustion that directly impeded her progress in day to day therapy. And atop all of Lydia’s medical turmoil, she felt frustrated and emotionally strained, preventing her from being fully engaged in rigorous assessments and cognitive exercises.

To address these problems, the opening salvo of Lydia’s program targeted her sleep hygiene. Lydia frequently slept less than three hours a night, which directly contributed to much of the strain she experienced throughout the day. QLI established new routines to overcome her restless and shallow sleep patterns. Keeping Lydia consistently active and stimulated throughout the day improved the ease with which she fell to sleep in the evenings. And planning for waking episodes mid-sleep, such as limiting the energy she might use to get a snack after waking from a short overnight rest, helped Lydia develop longer, more restful sleep cycles.

“Addressing Lydia’s sleep was truly the first part of the puzzle for our clinical approach,” said Jennifer Pike, Lydia’s Speech-Language Therapist. “Once her sleep routines were carefully managed, the door was open for everything we wanted to accomplish functionally.”

Indeed, “functional” became Lydia’s key word.

Behind Jennifer Pike, Lydia’s speech therapy program focused on functional application—real world situations relevant to Lydia’s interests and goals where her use of language would be of the highest importance.

It was here that QLI began to incorporate Lydia’s great passion: education.

“Lydia would independently pursue formal workbook materials,” explained Pike, “because she was driven to ‘relearn,’ so to speak, all of the information she’d absorbed through elementary, junior high, and high school. As a parallel to that, we would work with Lydia on navigating computer programs, working our way up to reading and summarizing articles. Eventually, Lydia took on non-credit college courses online. Everything we put in front of Lydia related in some way to her interest in elementary education, so she was getting multiple enriching benefits: practicing her speech and comprehension while also energizing her knowledge and thought about teaching.”

Speech therapy sessions with Lydia often utilized pre-teaching, an element of QLI’s errorless learning practice, which helped Lydia anticipate the specific challenges she might face and establish successful routines she could rely on to be successful in varied situations. Together with a therapist, Lydia was frequently directed to pause pre-recorded seminars and lectures to speak about the themes and ideas being covered. The process challenged her verbalization abilities, as well as her ability to listen and understand important information. But Lydia quickly learned techniques to find accurate descriptive words, as well as strategies for how to best interpret statements she read or was meant to respond to.

In effect, QLI had simulated the college experience for Lydia, even enrolling her into an English Composition course through a local community college. In doing so, her therapists pushed her language abilities without overwhelming her. The work became a source of empowerment, as Lydia, across several months in rehab, began to see the rewards for her commitment. By October, Lydia could provide appropriate responses to verbal communication over 85% of the time in assessment situations. And she was beginning to succeed in natural situations.

QLI’s approach to addressing Lydia’s hampered vision assumed a similar structure, leveraging functional tasks and strategies to maximize her independence.

Lydia suffered from a right field cut as a result of her stroke, a condition that affected her ability to perceive the rightmost field of vision in both of her eyes. As a result, Lydia’s Occupational Therapy team challenged her with formal vision tasks, but also built a program around utilizing compensation techniques within functional environments. Whether by complex cooking and meal preparation, by identifying items in grocery stores, by practicing computer use, or even through simple, therapist-initiated driving drills performed at QLI with a cart, Lydia learned practical ways to overcome her vision shortcomings. In turn, Lydia’s compensatory techniques bolstered her safety and capability in everyday tasks.

As the rehabilitation program evolved, QLI made it a priority to simulate nannying, another important element of Lydia’s identity, into her therapy, knowing full well both the emotional and functional benefits of the activity.

“Lydia’s approach to nannying was more than simple babysitting,” said Pike. “Before her injury she created lesson plans, prepped snacks, prepared activities and crafts, had books ready to read to the children. Her level of preparedness and organization was staggering.”

Coordinating an on-campus visit from the family Lydia had nannied for pre-injury, QLI set the stage for Lydia to simulate familiar caregiving responsibilities in a controlled environment. Soon, she was nannying the family’s children once again—at first in weekly therapist-accompanied sessions, and then in real-world spaces such as public libraries and, eventually, the family’s home itself.

“Her clinical team really drove the nannying at the outset, mostly to boost Lydia’s confidence and get her acclimated to the activity level again,” Pike explained. “It didn’t take long before she took on more responsibility, performed more complex tasks, and became more reliable and independent in her supervision of the kids.”

Nannying became key. Challenging Lydia’s cognitive flexibility made her more successful in a wider range of unpredictable real-world situations, and made her more comfortable in her own skin. Being successful—and feeling normal—in meaningful activities gave Lydia not just a rehabilitative boost, but an emotional one as well.

The veritable snowball rolled downhill, picking up momentum and energy in its descent.

By November, she was recovering cognitively and physically on her own terms—both on QLI’s campus and amongst her peers in the fitness center of the University of Nebraska-Omaha. But she was also giving back to others in ways large and small.

She and Ruby, the Schieuers’ family poodle—a dog that Lydia herself had helped adopt during her time at QLI—joined other rehabilitation clients on campus for dog therapy. Often working during these sessions with other individuals who were non-verbal as a result of their injuries, Lydia honed her communication skills by providing commands to Ruby. And she managed to help her fellow wayfarers on the path to recovery along the way.

“She’s so motivated by being able to help others,” her mother Jewel said. “One time Lydia and Ruby were working with a gentleman at QLI who was noncommunicative. We were all under the impression he couldn’t speak. But there with Lydia and Ruby, and this gentleman spoke for the first time. It was really an amazing moment.”

That gratifying drive to see others succeed continues to be Lydia’s rocket fuel as she jettisons beyond rehabilitation into the next stage of her life. In August, Lydia’s future was an open question, her life on hold without guarantee. She couldn’t speak, and she faced an uncertain future.

In November, she graduated from QLI’s inpatient services to return home with her parents in Omaha. And in January, at the completion of an additional day program at QLI, she confidently welcomed life’s new challenges with open arms and an indomitable ambition.

Just six months after a life-changing stroke, Lydia spends her time rock climbing and working out. She volunteers at QLI to provide dog therapy to other clients in their rehabilitations programs. And she looks forward to returning to school to complete her education degree in Lincoln, Nebraska, having already begun officially credited course work once again through the University of Nebraska-Omaha.

Lydia pushes herself to excel against all obstacles, and she leads others with the same vigor.

If you were to be a fly on the wall for a day in Lydia Schieuer’s life, you would see normality for a driven, passionate young woman. If you were to be a fly on the wall for her entire story, you would be inspired by so much more.

 

 

 

 

 

Don't forget to register with Team QLI by filling out the Count Me In form.