A Man of Courage Makes His Way Back from Stroke
The seven bass guitars hanging on a wall in his apartment serve as reminder of Vincent Heath's past as an award-winning gospel musician as well as inspiration for his future.
He hasn't played any of those bass guitars since June 15, 2010-the morning he suffered a massive stroke that crippled the left side of his body.
But thanks to modern medicine and computers, he has relearned to play the bass-on an iPad. He has even occasionally rejoined his fellow musicians at St. John CME Church in Winston-Salem to play his beloved gospel music, with his iPad wired to amplifiers.
Heath is an acknowledged workaholic, something that may have led to the high blood pressure that caused his stroke. His powerful motivation and work ethic, however, now help him in recovery, as have clinical trial injections of botulinium toxin, or Botox®.
The Botox injections were given through the spasticity clinic of Wake Forest Baptist Health, and they allowed Heath to begin a regular exercise regimen that has slowly helped him regain strength in his left arm and leg.
"Having a stroke, you have to be able to teach yourself all over again,'' Heath says. "It's like being a baby. You have to train your new cells to move your arm and walk and talk. And this is what I'm doing right now.''
'The Carpet Was Soaking Wet'
In June 2010, Heath, 52, had a busy, satisfying life. He was the optical lab manager for Industries for the Blind, supervising 80 employees. He'd go in early, work a full day and then head home for a brief break. Then he'd go right back to work because he owned Vinco Services, a janitorial business with a contract to clean two state Department of Transportation buildings. Heath worked right alongside his cleaning crew.
Then there was his small business designing embroidered shirts and doing screen printing. And there was his music; he played for St. John CME and Galilee Missionary Baptist Church. Heath says he averaged about six hours of sleep.
That didn't bother him. At 6-foot-3 and 216, he was fit (he liked to play pickup basketball) and never had any obvious medical issues.
But the morning of June 15, as he got out of bed, he felt wobbly. On his second attempt to stand, he fell to the floor and couldn't get back up. He started sweating profusely.
"I remember the carpet was soaking wet. They told me later that I had two blood clots in the right side of my brain with no place to go, which made my pressure rise, which is what caused me to sweat so much.''
While on the floor, his boss and a friend called, and eventually firefighters rammed in the front door of his apartment. Heath woke up in the hospital, where he would remain for nine weeks, receiving medications to break up the clots and starting rehabilitation. He did not require surgery.
A friend saw a TV advertisement for the Botox trial and told Heath about it. He began to receive injections in January 2011, continuing them for a year while beginning a rigorous, three-times-a-week post-stroke exercise program called the Millennium Team at the YMCA.
Relaxing the muscles
Allison Brashear, MD, is chair of the Department of Neurology with Wake Forest Baptist Health. She treated Heath for his post-stroke spasticity.
"Vincent had a very tight fist and elbow, which is the usual posture after somebody has a stroke or brain injury. After brain damage, the arm and wrist typically flex and become difficult to move,'' Brashear says. "So what we did was give an appropriate dose of botulinum toxin to loosen his muscles. Vincent was aggressive in physical and occupational therapy and he has improved a lot.''
The drug is far better known for its use in removing wrinkles from the skin. Brashear smiled about the misconception.
"It actually started to be used in the U.S. in the late '80s for neck and facial injections for overactive muscles,'' she says. "In the '90s, we began to use it for celebral palsy or stroke or damage to the brain, such as trauma or multiple sclerosis (MS).''
It was Brashear's research, first published in the New England Journal of Medicine in 2002, that demonstrated the effectiveness of injections of botulinum toxin after a stroke to treat spasticity.
Despite her years of research, Brashear knows that botulinum toxin is no miracle cure.
"What we've learned (with botulinium toxin) is that it's more about dosing, and it depends on the individual patient,'' Brashear says. The most important thing for a person who's had a stroke, Brashear stressed, "is they need to prevent a second stroke.''
So besides treatment and rehabilitation, patients such as Heath need to control their blood pressure and weight, basically just taking good care of themselves, Brashear says. The other important thing? "Be as active as possible, exercise that limb as much as possible. You may continue to need medications and injections and you may not.''
'Glad to be alive'
Heath has spent months learning to use his right hand to "play'' the notes on the neck of the bass shown on his iPad via the Garage Band program and another bass app. As a righthanded person, normally he would use his left hand on the neck of his guitar.
Dorothy Barnhill, administrative assistant to the pastor at St. John CME, says Heath's commitment to recovery has been inspiring. His fellow congregants have watched as he went from using a crutch, to a cane, to walking freely. And now they see him moving the fingers of his left hand.
"He had to take baby steps to get back to where he is,'' she says. "So he's taken the baby steps and now he's running."
So far, the treatment and his commitment have allowed Heath to uncurl his left hand enough to hold the neck of the bass guitar, but not yet pluck. Three years after the stroke that changed his life, Heath is patient.
"I'm just glad to be alive,'' he says.