A native of St. Louis, self-employed entrepreneur Nick Damato, 66, is known throughout the United States for his controllers used in light displays. He also supervises a team that installs holiday light displays. One of nine children, Nick is married to Hope and is a proud father of two daughters and grandfather of six, all of whom live nearby.
Nick was attending a St. Patrick’s Day parade at the Lake of the Ozarks when his life took an unforeseen turn. “I was talking to a security guy and I noticed that my speech was not making sense,” Nick recalls. According to his wife, Nick walked a quarter of a mile to get to his car and proceeded to get on the highway. Soon after, Nick forgot where he was going, stopping the car in the middle of the highway. He got out of the car and stood in the middle of the road. His wife happened to call while this dangerous incident was happening. “I could tell something was wrong with his speech, but Nick didn’t know where he was,” Hope said. Nick managed to get back in his car and drove fifteen miles to the hospital.
Once he arrived at the Lake of the Ozarks hospital Nick was tested to determine what was wrong. Following a CAT scan, it was determined that he had suffered a hemorrhagic stroke caused by the rupture of a blood vessel that led to bleeding in the brain vessel. Physicians worked to stabilize him, but by the next morning, Nick was completely paralyzed and unable to speak or understand commands.
Nick was then transferred to University of Missouri Hospital where a second CAT scan showed that the bleeding in his brain had increased. After physicians determined that Nick was a good candidate for surgery to remove the blood clot, he underwent the procedure. The surgery was a success; however, while Nick could move his left leg, he had no feeling on the right side of his body and was unable to move his right arm or leg.
Hope, an SSM Health employee, was familiar with SSM Health’s rehabilitation network. When a physician recommended inpatient rehabilitation at SSM Health Rehabilitation Hospital – Bridgeton to help Nick recover, the decision was an easy one.
Upon arrival at Bridgeton, Nick faced many challenges. His care team noted he struggled with swallowing and communication, necessitating the use of a modified diet and gestures to express himself. Nick's mobility was also significantly impaired, requiring the assistance of two people to walk and the use of a wheelchair. The lack of movement in his right arm meant that Nick required maximum assistance for his self-care tasks and transfers. The stroke had also left Nick with impaired vision and spatial neglect on his right side, which is when a person loses the ability to pay attention to their surroundings and body parts on the affected side.
Nick's initial goals were to be able to speak, use his right hand, walk with a walker and use the bathroom independently. His physician-led multidisciplinary team of therapists at SSM Health Rehabilitation Hospital – Bridgeton began an intensive and comprehensive rehabilitation program tailored to his unique needs.
The speech therapy team focused on restoring Nick's ability to swallow and communicate. Therapists took him through trials of different food and liquid textures to determine what he could safely swallow. They also worked on targeting Nick’s automatic speech by having him practice reciting numbers, days of the week and months of the year as well as repeating familiar sentences and participating in social conversation.
In physical therapy, Nick and his therapists initially focused on exercises to improve his standing balance and chair transfers. “Nick was motivated and ready to work every day,” his therapists noted. Once his standing balance improved, therapists worked with Nick on going from sitting to standing and walking with the assistance of two people. He quickly progressed to walking with one person while being assisted by a walker or a cane.
Occupational therapy also played a vital role in Nick's recovery, with therapy sessions focusing on helping him become more independent with his self-care tasks like toileting, dressing and feeding. Occupational therapists utilized several pieces of leading-edge rehabilitation technology in his sessions, including the Bioness Integrated Therapy System (BITS), which is an interactive touchscreen device to improve hand-eye coordination, reaction time, depth perception and working memory. To help Nick regain use of his right arm, therapists used the Hocoma ArmeoSpring, an ergonomic and adjustable exoskeleton that features built-in sensors that record active movements and all joint angles during the session. They also addressed Nick’s spatial neglect, which required friendly reminders for him to look to the right and a vision clinic visit with a neuro-optometrist.
His family was a constant presence during his time in rehab, with someone visiting every day, working with Nick on exercises for his right hand like throwing and catching a ball. One of Nick’s sisters had students from her school send him “get well” cards and his family read letters to him every night. The therapy team also educated his family on how to provide assistance so that he could return home safely. His therapists completed a home evaluation to help his wife and daughter practice getting Nick in and out of the house as well as how to help him transfer to the shower, bed and toilet.
During his 21-day stay at SSM Health Rehabilitation Hospital – Bridgeton, Nick made incredible strides toward his recovery including his exhilarating first walk down the hospital hallway with his physical therapist. Prior to his discharge, he was able to resume a normal diet and was having simple conversations with family and staff; he particularly enjoyed telling stories about his traveling experiences and his Christmas light displays. Nick was able to stand and walk using a walker and could complete his personal care with just stand-by assistance for balance. He also had progressed to having full range of motion in his right arm and could even use his right hand to tie his shoes.
Everyone agreed that Nick and his family were a delight, and his laugh and smile were contagious. His occupational therapist was particularly complementary about Nick, saying, “I absolutely loved working with Nick. He was one of the hardest working patients I have ever worked with. He always had a huge smile on his face and was genuinely happy to come to therapy each day.”
Nick was looking forward to returning home to the simple joys of sleeping in his own bed and reconnecting with friends who dropped by for visits. He plans to continue his recovery with outpatient therapy at the SSM Health Kirkwood Day Institute.
Reflecting on his transformative experience, Nick has the following advice for others facing a challenging recovery: "Try to do everything you can as often as you can in therapy. Keep pushing to get the most out of yourself.”