On the wall outside room L65 in The Alexis Verzal Children’s Rehabilitation Unit (AVCRU) stands a huge construction paper crown with glittery letters proclaiming, “Princess Savannah.” It’s the ideal nameplate for a 3-year-old who loves princesses and anything pink. But unlike fairy tale princesses, Savannah Wubbels is a stroke survivor. Doctors are baffled as to why the beautiful preschooler from Hallam, Neb., with long red hair and sky-blue eyes, has suffered numerous strokes.
Savannah’s symptoms began on St. Valentine’s Day morning 2011 when she claimed the room was spinning. By March 11, Savannah had endured a few more vertigo episodes, was running a fever, vomiting and couldn’t get her balance.
Doctors at Crete Area Medical Center performed a CT scan and sent Savannah and her parents, Aaron and Heidi, to Children’s Hospital in Omaha. An MRI revealed Savannah had suffered several small strokes. On March 17, armed with a daily baby aspirin prescription to counteract future strokes, Savannah transferred to Madonna for rehabilitation. “I was excited to hear that there are only four pediatric inpatient rehab facilities in the country and one is right out my back door,” said Heidi.
Savannah completed 18 days of inpatient therapy, including speech, physical and occupational therapy sessions before transitioning to the outpatient Rehabilitation Day Program. Then, on Mother’s Day, May 8, Savannah restroked in the car on the way to her grandmother’s house. Savannah’s brothers, Austin, Tanner and Wyatt, were shocked to see their sister struggling.
Aaron and Heidi rushed their youngest child back to Children’s Hospital where another MRI confirmed strokes had attacked both sides of Savannah’s cerebellum and a tiny area in her brainstem. Previous strokes had only affected the right side of her cerebellum. “As an adult, there is a history or something that puts them at risk for stroke,” said Heidi. “Savannah had no family history of stroke – we had no idea what was causing it.” A neurologist and a hematologist monitored Savannah, who started twice daily injections of Lovenox® (an anti-coagulant).
On May 23, Savannah was back at The AVCRH where her pediatric therapy team devised an intensive rehabilitation program for the youngster.”Every cell in Savannah’s body is programmed for ‘go, go, go!’” explained physical therapist Kilee Oetjen. “We definitely used that to our advantage in her rehab.”
In a wheelchair, with her left leg braced to prevent hyperextension, Savannah made baby-steps toward her main goal to walk independently. She learned to sit up on her own, crawl and finally, walk. Savannah initially had a slow, labored journey of 15 to 20 feet with a therapist providing maximum assistance for balance, trunk control and advancing her legs. The three-year-old progressed to walking sessions on the pediatric Lokomat®, a gait retraining technology that is only available in the Midwest at Madonna
Play time became therapy time for Savannah. Her love for babies and ‘mommy tasks’ were incorporated into her therapy.
“We’ve practiced carrying and putting away groceries to address dynamic balance and walking skills,” said Kilee. Savannah pushed babies in a weighted stroller to increase her core and pelvic stability. Occupational Therapist Kelly Myers introduced many homemaking tasks that strengthened Savannah’s left arm. Under Kelly’s guidance, Savannah pretended to carry baskets of laundry, wash windows or sweep floors. One of Savannah’s favorite activities was aqua therapy. Water toys and games bolstered her affected left side. “This was all play time; she didn’t realize how hard she was working,” said Heidi.
Speech therapists worked with Savannah to refine her pitch and word flow. “Savannah’s vocabulary is amazing for her age,” said Teresa Springer, speech-language pathologist. “Her ability to describe complex situations is well beyond her peers.” The youngster experienced dysarthria (speech-motor weakness) impacting her intelligibility of speech. Tongue-twisters, familiar nursery rhymes and songs helped increase Savannah’s rate of speech, while maintaining “clear speech.”
Therapists introduced Savannah to children at Madonna’s Child Development Center (CDC), so she could interact with her peer group and rehearse the strategies from her individual sessions. Savannah made remarkable gains in her ability to speak clearly. “This impacted her confidence to initiate conversations with children at the CDC and keep up with her brothers,” said Teresa.
Madonna Rehabilitation Hospital’s on-site housing proved to be a lifesaver for the Wubbels. “My husband and the boys were just a parking lot away from me,” said Heidi, who home schools the children. “I could cook, do laundry and still be a mom.”
Savannah had a setback on July 6 when she suffered a mini stroke, known as a transient ischemic attack or TIA. After a battery of tests, she returned to The AVCRH. So far, doctors have not been able to diagnose the cause of Savanna’s strokes. “We don’t take any day for granted,” said Heidi.
On July 22, Savannah returned home with her family, but will return for outpatient therapy in the Rehab Day Program. She walks independently, bolstered by a tiny brace on her left leg. She smiles and waves – just like a real princess.