Stroke Recovery and the Power of Team and Coach

Article originally published on Know-Stroke.org


There is power in being one team working together. Mike and I have witnessed this first hand while building Team EnableUs! The power of the group becomes one.


We dive into this topic in the current episode of the Know Stroke Podcast. This was a real impactful episode for my co-host Mike and I as we convened late this past Sunday evening to interview board certified vascular and general neurologist, Lester Leung, MD, MSc of Tufts MC. For myself (co-host David Dansereau), this episode was also very personal as I was able to thank Lester for the critical role he played in my own stroke recovery both as my neurologist and as a friend and coach and for being the one who showed he cared in a critical time I needed it later in my stroke recovery.

Listen to This Podcast Now!




 

Lester's Bio:

Lester Y. Leung, MD, MSc Tufts Medical Center

Accomplishments:

  • Board certified vascular & general neurologist

  • Assistant Professor of Neurology

  • Director, Comprehensive Stroke Center at Tufts Medical Center

  • Director and Founder, Stroke and Young Adults (SAYA) Program

  • Principal Investigator, Tufts Vascular Neurology Research Group

  • Director, Stroke Service at MetroWest Medical Center

  • Co-Chair, American Heart Association-American Stroke Association Massachusetts Stroke Systems of Care

Background:

Lester grew up in New Orleans, LA and after coming to Boston to attend college he returned home to New Orleans for medical school and found himself on a mission to help rebuild New Orleans post Hurricane Katrina. From this early advocacy, rebuilding homes and riding with EMS to help Katrina victims “where they were” he was moved and impacted by the fractured healthcare system and all the challenges it presented for victims during an emergency like Katrina. Lester credits these early lessons learned as well as having really dynamic mentors along the way, in particular New Orleans based stroke neurologist Sheryl Martin-Schild, MD,PhD for enlightening him on how people with stroke are suffering and have multifaceted unmet needs. This early career experience solidified Dr. Leung’s dedication to neurology and when he later moved back to Boston to begin his career you’ll learn how these early lessons sparked his passion to do more for the stroke community, with a special interest in the needs of young stroke.


This was indeed a moving and enlightening discussion and together, Lester, Mike and I unpacked these and many more stroke topics including:


  • Exploring and studying screening of late complications after stroke among stroke survivors, esp. young stroke survivors

  • Dr Leung’s advocacy to spearhead a statewide/regional/(global)* PSA on the need to seek emergency care for stroke despite the pandemic surge. * Mike revealed he even viewed and heard Lester’s PSA used across the Atlantic as a model to use as a stroke awareness call to action while in Dublin!

  • Treating patients at Tufts in later time windows after stroke (late presenter thrombolysis)

  • Understanding disparities and stroke recovery outcome, including novel factors like neighborhood income inequality, (and often blunted recovery trajectory after discharge) as community investment in stroke rehab resources and investment are often influenced most by zip code. The research around social determinants of health (SDOH ) with Dr Leung and his team is fascinating and eye opening and can be found in the resources links in this episode.

  • Use of high technology and technology investment in stroke recovery vs high touch longitudinal coaching and education models and how both involve following the reimbursement dollars for care delivery and addressing recovery plateaus

  • The Comprehensive Stroke Center at Tufts, including its first in the Nation SAYA Program (Stroke And Young Adult) an outpatient longitudinal care model founded by Dr. Leung. SAYA model is aligned with medical and surgical specialists throughout Tufts Medical Center, and the Stroke Neurology team aims to help young adults with stroke uncover the causes of their strokes which are more varied and numerous than in older adults. Additionally, Lester spoke to how he and his team help assess and manage unrelated conditions that may increase risk for future stroke and other health problems. Dr. Leung discussed how within the SAYA model, the team helps you understand how your stroke has affected you, how it may have lingering impact, and how they can work together to minimize that impact and help your measure meaningful changes in your recovery and “move that rock” that may be there in your way.

  • Lester has a great acronym for the strengths and the core pillars of this longitudinal program model to focus in on recovery outcomes, he referred to this in the interview as ENDURE.


ENDURE:

E “Etiology”

N “Next Stroke”

D “Deficits/disability”

U “Unexpected complications”

R “Rehabilitation and Recovery”

E “Education”


In addition, Mike and I were pleased to hear his feedback on where our mission driven efforts at EnableUs fit in this model. Listen in here for details!


Watch this Episode on YouTube:



What's next on our podcast?


We’ll be taking an even deeper dive into the SAYA model next episode when we are excited to welcome Katelyn Skeels, MSN, FNP-C Stroke Advanced Practice Nurse Tufts MC. In fact, when we asked Dr Leung our “magic wand question” he answered with a strong emphasis that the future of stroke recovery best outcomes will include a strong MD-NP partnership in the leadership space in the clinic and one which expands outside the clinic walls to include a holistic coaching approach. Dr Leung, as well as Mike and I believe this model of care will enable a key bridge to the gap between healthcare and community support services.

We’ll dive into this topic in much more detail with Kate in the next episode and with future upcoming guests who are moving the needle in this area of medical / wellness coaching.


Podcast Episode Resources:

For more about Dr. Leung and Tufts MC:

http://lesterleung.com

http://youngadultstroke.org

https://www.tuftsmedicalcenter.org/physiciandirectory/lester-leung



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