Almost a year after a stroke, St. Anthony woman is still being denied rehab

Patsy Smith's husband, Tony Smith, isn't a physiotherapist, but his days are focused on helping his wife regain some movement in the limbs on the left side of her body.

The couple lives in St. Anthony, N.L., a small community on Newfoundland's northern tip. A number of months ago, a physiotherapist visiting the region gave Tony Smith tips to help with his wife's mobility that they've practised every day since.

"He's working on range of motion movements, core muscle strength and doing what he can," the couple's daughter, Tara Tucker, said.

It's the only rehabilitation Smith receives, after the family's applications for professional therapy from Newfoundland and Labrador Health Services were repeatedly denied.

"Dad has really been the one to step in and fill the void," Tucker said. "He's 73."

Stroke survivor

Smith suffered a hemorrhagic stroke on Dec. 30, 2023, and lost the ability to move her left side.

At 70, her initial prognosis was death. 

The community's hospital, Charles S. Curtis Memorial, doesn't have a stroke unit. Instead, the facility relies on medevacs to transfer patients to St. John's.

Tucker said a family doctor requested a medevac for Smith.

After the requests were denied, her mother was placed in palliative care. 

Days went by, and Smith didn't pass away. She improved.

"The bleed stopped, and because of that, very gradually and slowly, she didn't deteriorate as they suspected, but she actually started to gradually get better," Tucker said. 

Not equipped

Staff at the hospital in St. Anthony told Tucker they were not equipped to deal with her mother's condition.

"They indicated that they were in over their head," Tucker said.

She said the team encouraged her to advocate for her mother in the hope she could get under the care of a neurologist or a specialist in St. John's.

Over 10 months later, Tucker said, that still hasn't happened. 

Smith's recovery has been slow, but today, the stroke mainly affects her mobility due to decreased function of her left side.

"She's cognitively not exactly where she was before, but very close. She's made so many gains from where she was to where she is today," Tucker said. "She never lost her ability to speak.... She can eat independently."

These improvements took place without formal rehabilitation, she added.

Specialist recommendation

After six months in the hospital, Tucker said, her mother saw a specialist who visited St. Anthony.

In a letter, the doctor recommended that Tucker receive aggressive rehabilitation at the Miller Centre in St. John's or in Corner Brook.

The Miller Centre denied her application twice before the specialist's recommendation. 

Tucker said she was hopeful that, based on her mother's improvement and the doctor's recommendation, she would finally get care.

The doctor said that Smith was awake and alert during the examination. 

"She is sitting in a wheelchair. The speech is normal. The visual fields are full, eye movements are intact, and pupils are equal and symmetric both to light and accommodation," the specialist wrote.

They also said Smith's cranial nerve examination and the rest of her neurological examination were normal. 

Her motor examination revealed weakness on her left side, but the brain bleeding did not recur after her initial stroke.

"She is currently stable," the specialist wrote. "I agree she should have been having aggressive rehab physiotherapy."

Despite the recommendation, Smith's application was denied again. 

'We need to help mom'

Tucker said her mother will soon be discharged from hospital. Smith's primary caregiver is her husband, as Tucker lives in Paradise, on the other end of the island.

As her parents prepare for life at home, Tucker said she wants her mother to have a fair opportunity at independence.

"She hasn't been set up or equipped to go home to master life after a stroke," Tucker said. "We need to help mom become more independent so that they can both deal with this at home."

Tucker is frustrated, and says she's contacted the provincial government about her mother's situation to no avail.

"Politicians come back very quickly with the statement of, 'well, we can't intervene in medical decisions.' Fair, but then, who does?" she said.

NLHS doubles down

PC Leader Tony Wakeham brought Smith's situation to the floor of the House of Assembly last week.

"I ask the premier: Why is this mother being denied a chance?" asked Wakeham.

The premier responded he can't comment on specifics, but said Newfoundland and Labrador has some of the best-educated medical professionals in the entire world. 

Wakeham continued to press.

"Speaker, why is rehab in rural Newfoundland and Labrador being denied?"

Furey responded using his experience as a doctor in the province.

"I noticed that the member opposite initially said palliative care and then moved to rehab. That's a difficult dissonance to reconcile," he said. 

Minutes after question period, Wakeham told reporters that N.L. Health Services doubled down on their decision to keep Smith out of rehab.

"We had received an email at 2:21 p.m … from the health authority saying they've reviewed the situation, but they're not recommending that the lady be given any rehabilitation," Wakeham said.

Tucker feels stuck, and says residents of rural Newfoundland are being left behind in the health-care system. 

"Give her a month. Give her six weeks to shut us up. They won't even do that. They won't even give it a trial," she said. "Where do we go from here?

"They're digging their heels in so firmly and not wanting to give this woman a chance."

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