Healthy Choices

Stroke survivor chorus sings praises of music therapy

Choir member Gary Barmore of Elk Grove, right, and others perform during the annual Christmas luncheon that brings together stroke support groups throughout greater Sacramento area to celebrate the holidays with survivors and caregivers at Plates Cafe on Saturday. Some people who lose their speech abilities due to stroke are still able to sing and participate in the survivor choir.
Choir member Gary Barmore of Elk Grove, right, and others perform during the annual Christmas luncheon that brings together stroke support groups throughout greater Sacramento area to celebrate the holidays with survivors and caregivers at Plates Cafe on Saturday. Some people who lose their speech abilities due to stroke are still able to sing and participate in the survivor choir. sacbeephotos@sacbee.com

The Miracle Minstrels choir doesn’t always know when to start singing. They don’t do much by way of harmonies, and some are a little foggy on the words. The goal for these performers, most of them stroke survivors, is just to make a joyful noise.

Sutter speech therapist Renee Garner and two-time stroke survivor Barbara LaPlaca formed the choir five years ago to provide a social outlet and form of therapy to people living with the effects of stroke. Many of its members have great difficulty forming sentences, but can chime right in on a familiar tune.

That’s because the right hemisphere, the part of the brain responsible for processing rhythm and melodies, often stays intact even when the stroke damages the left hemisphere, the part of the brain responsible for spoken and written language.

A stroke occurs when blood flow to a part of the brain is cut off, causing brain cells to die and inhibiting communication between the brain and body. For many of the 7 million stroke survivors in the U.S., the event results in a loss of speech, movement or cognitive function that can sometimes be regained with intensive therapy.

Patients with stroke damage to the left brain who suffer from aphasia, a communication disorder effecting the ability to speak, read, write and understand, can often access and produce melodic patterns stored in the right brain. Aphasia is often accompanied by apraxia, a motor speech disorder inhibiting the sufferer’s ability to send the correct sounds in the right order from the brain to the mouth.

“In their minds they form what they want to say, but the brain does not allow the planning to string together the sound to create the word,” Garner said. “With singing, they can form the word if it’s combined with a melody.”

James Conrad, an Elk Grove resident who holds several academic degrees and formerly played piano, could not speak for nearly six months after his stroke in 2011 and still has trouble forming answers to basic questions due to apraxia. One of the first accomplishments he made during his recovery was singing a tune from a Monkees song, said Deborah Conrad, his wife. He still doesn’t speak much, but he sings with the Miracle Minstrels by watching Garner’s mouth for motor planning cues.

“The choir brings back a lot of memories for him,” Deborah said. “The emotions are in his eyes, because his voice will never be the same. It’s just wonderful to see everybody doing whatever they can.”

Research has shown that melodic intonation therapy, in which patients associate common phrases with rhythmic pacing and simple tonal patterns, has helped some stroke victims improve their ability to speak over time. One of the first items stroke patients are given when they arrive at the hospital is a plastic “rhythm egg” that they are instructed to shake in a pattern to help get the brain back in motion, said Janet Masters, a registered nurse at Sutter General Hospital

“If they really want to recover, they have to work hard,” she said “You have to plug in. And it’s crucial for them to still use their voices.”

The number of minstrels fluctuates throughout the year, said choir director LaPlaca, but there were about 20 at the annual stroke support Christmas luncheon Saturday. The choir is primarily made up of survivors and caregivers from the stroke support group at the Sutter Neuroscience Institute, which meets biweekly. The luncheon brought together more than 100 survivors and loved ones from different support groups throughout the county, who gather only a few times a year.

For many stroke survivors who don’t get around as much as they used to, the choir is about camaraderie as much as it’s about therapy, LaPlaca said. Gary Barmore, a survivor and former helicopter pilot who now sings in the choir, called his stroke support network “closer than family.”

“It’s people who love each other, and have all suffered similar losses,” he said. “It’s a place where you can talk, or there are some people who can’t talk at all. And they’ll try to talk, and it’s fun to try to figure out what they’re trying to say.”

After his stroke in 1996, Barmore said he became almost catatonic and wanted to “just clam up and close in.” But joining the choir has helped him move forward.

“If you want to do something, go do it,” he said. “It’ll take you longer and it’ll be harder than you ever thought, but you can do it. You can heal.”

People of all abilities are accepted into the group, which practices twice a month and performs occasionally at hospital-related events. Teaching music happens slowly and with many modifications but always turns out all right, said LaPlaca, a former music teacher. She does everything a cappella so that she can look at the group and make sure no one falls behind. And she gives out music folders for everyone to hold, even if they can’t read it.

When not learning Christmas music, the singers are partial to John Denver and other ’70s classics.

“It’s very important for stroke people to feel included,” she said. “You see them and you know that for many of them, being in the choir and socializing is giving them hope to keep doing their therapy and keep going. People need that.”

“Strokes are devastating,” Garner said. “It impairs your functioning, and it impairs your ability to do what you do, in the way that you did it … Part of why we have the choir is to send the message of ‘share the gift,’ even though the gift may be broken or wounded.”

Call The Bee’s Sammy Caiola, (916) 321-1636.

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