Aphasia Awareness for the EMS Provider

This allowed him to work as an emergency medical technician and paramedic in many different and exciting capacities: critical care paramedic, certified flight paramedic, rescue technician, in the allied roles of firefighter, hazmat operations, and weapons of mass destruction technician, and as a paramedic with Magen David Adom in Israel. Life was good.

In early June 2007, at 33 years of age, Avi was admitted to Columbia Hospital, in New York, for surgery repair on a mitral valve prolapse (MVP) that was discovered near the aortic valve in his heart. Like many people who go to the hospital for serious but routine surgeries, Avi thought he’d be out and recovering in short order. However, that was not to be. During the surgery, Avi experienced a stroke on the left side of his brain, leaving him with right-sided paralysis and profound aphasia, which proceeded to wreak havoc on his life.

Avi remained in Columbia Hospital for two months and then was moved to a rehab hospital in the North Shore - Long Island Jewish Health System for two more months of intensive in-patient rehabilitation. By early October, he was discharged and began outpatient therapy at home (which he still receives for his arm and leg). During his stroke rehabilitation, Avi received “traditional” physical, occupational and speech therapies, but he also utilized a rich mix of non-traditional therapies that included acupuncture, massage, tai chi, yoga, constraint therapy, water therapy, computer games and special speech software. Avi also tried using a Neuromove™ device on his right side.

Avi still has balance problems and weakness on the right side of his body, but it’s his Expressive Aphasia that frustrates and confounds him more than any of his other post-stroke residuals. Avi can understand what people are saying to him and he can still read quite well.  However, he continues to have a lot of trouble speaking and writing, both of these being reflect problems with expressing himself. This can be devastating for any friendly and outgoing person, let alone a certified paramedic who needs to communicate accurately and effectively to do his job.

Avi refuses to let aphasia get in his way. He still works (and volunteers his time) as a paramedic and, more importantly, he’s embarked on a new mission of “aphasia advocacy,” educating others about aphasia and how it impacts a stroke survivor’s day-to-day life.

To make this new goal a reality, Avi has been involved in a lot of aphasia-related projects:

• Since November 2008, he’s been an active contributor to the “Aphasia Awareness Training for Emergency Responders Project,” for the National Aphasia Association.
• Assisted with outreach efforts to police, firefighters and EMTs in New York, New Jersey, Pennsylvania, Connecticut, Ohio, Illinois, California, Israel, and more by participating in their training sessions and creating curriculum and materials used in their training programs.
• An article published about him for the August 13, 2010 edition of the “Jewish Standard” newspaper. The article, entitled “Got _______? Aphasia: At a Loss or Words,” was the featured cover story.
• Every year since August 2009, Avi has played a lead role in the Adler Aphasia Center’s drama club before an audience of 500 people at the Adler Aphasia Center in Maywood, NJ.
• Served as an Aphasia Consultant on two plays: 1) From May through June, 2009, for the production of “Night Sky,” in New York City, and 2) In September, 2010, for the production of “Wings.”

Since 2009, has volunteered his time at the Adler Aphasia Center, where he participates in the educational training for medical residents, medical students and other healthcare professionals.

Avi says that his stroke hasn’t fundamentally changed him. He’s still the same sociable, affable, and compassionate person that he was before his stroke. He is eager to help others in need and devoted to his job as a paramedic. He has even more projects in mind for the future. For one thing, he would like to expand on his aphasia awareness efforts by becoming a “motivational speaker” to hospitalized patients in the North Shore – Long Island Jewish Hospital system. “I tell them anything is possible,” he said. That philosophy might help explain how — after suffering a stroke during a medical procedure some 9 years ago—he was able to graduate from wheelchair to cane to unassisted walking.

As for English, “I can understand everything but I can’t get the words out,” he wrote in the PowerPoint presentation he has prepared to help him explain aphasia. He noted that a review of his EMT manual showed that aphasia is only mentioned once—not nearly enough, he said.

Mr. Golden also is engaged in volunteer work, assisting paramedics at two New York hospitals and visiting stroke patients at North Shore Hospital and Long Island Jewish Hospital. He said that after someone has a stroke, he or she may be tempted to retreat. “I tell them not to give up,” he said.