Iluminado Ruiz's story
Iluminado (Lumi) Ruiz, 75, worked as a machine operator for 25 years. Now that he’s retired, he enjoys spending time with his large family – including wife, Aramita, two sons, 10 brothers and sisters on his side and nine brothers and sisters on Aramita’s side, plus countless nieces and nephews. Lumi also enjoys camping and playing guitar for his church and family.
One day while camping, Lumi began experiencing double vision. Aramita suggested they pack up and go home, but they decided to follow through with plans to meet friends for breakfast. While Aramita finished eating, Lumi walked back to the camper by himself to take his medications. When Aramita returned to the camper, Lumi was vomiting and his blood pressure was high. When he complained of an excruciating headache, Aramita took him to the nearest hospital where doctors performed an MRI and determined he had a stroke.
Lumi was then transferred to Cleveland Clinic Main Campus for additional treatment. Doctors were able to stop the bleeding in his brain, but as he continued to decline the decision was made to put him on a ventilator. Aramita recalls this difficult time saying, “He kept getting worse and the doctor told us we needed to decide if we wanted to take him off the ventilator or not. We decided to wait one month. He started making little improvements every day and we knew it would be okay,” she continued. Once he began showing signs of improvement, Lumi was transferred to Regency Hospital – Cleveland West where his recovery continued.
Respiratory therapists immediately began working to liberate Lumi from the ventilator. Guided by a pulmonologist, the team stepped him through a series of lung-strengthening exercises. They also used monitored bursts of time off the ventilator, allowing his lungs to take on more work.
Successful, Lumi’s tracheostomy was fitted with a special valve that permitted more normal speech.
As the mental fog lifted, Lumi’s ability to participate in physical therapy improved. He met a major milestone when, working with his speech therapist -- he could speak loud enough to hear his own voice. Therapists continued lung-strengthening exercises until he was strong enough to have the airway support removed.
From there, Lumi began working extensively with his physical, occupational and speech therapy team to regain the ability to care for his daily needs. Through balance, coordination and strength-building exercises, physical therapists helped Lumi’s brain and body reconnect. Over time, he could take side-steps and move his left leg while sitting at the bed’s edge.
Occupational therapists led rounds of cognitive exercises to improve memory and object recognition. They also worked on activities of daily living. Initially, Lumi could not complete any self-care tasks, but soon was able to brush his own teeth, among other activities. Lumi’s ability to remember objects and people also started to improve.
After a month of steady progress, Lumi was ready for the next phase of recovery.
He transitioned to the Cleveland Clinic Rehabilitation Hospital, Avon. Upon admission, Lumi had left-sided weakness, impaired motor coordination, speech challenges and balance issues. His goals included regaining movement on this left side, becoming more independent with everyday tasks and going home.
Due to decreased trunk strength, Lumi leaned to the left when seated. Physical therapists began by working with him on safely transferring from one surface to another. He started using a transfer board from a seated position, but still required two people to complete the task safely. Once his strength improved, therapists were able to work on standing transfers with a walker. Initially, Lumi required the assistance of two people but with increased practice he was able to accomplish it with one.
Aramita and their sons came to multiple therapy sessions to learn how to assist Lumi with transfers so they would be able to assist him when returning home.
Next, Lumi’s therapy team they tackled walking. First, they focused on increasing muscle strength in his leg and left ankle which included electrical stimulation to retrain his brain to use the muscles needed for walking.
In occupational therapy, Lumi focused on regaining his independence when performing everyday activities. Therapists applied electrical stimulation to his left arm while he performed reaching tasks to stimulate muscle movement and promote left-sided body awareness. One of Lumi’s biggest challenges was left-sided spatial neglect, a condition that prevents many stroke survivors from sensing or “seeing” things on the affected side of their body. It isn’t a vision issue, but rather a deficit in perception and attention that Lumi was able to improve through prism adaptation therapy.
Speech therapists worked to strengthen the muscles in Lumi’s mouth and throat by performing swallowing exercises to improve independence with eating. Nursing worked on decreasing his tube feed and provided education to his family on how to manage this aspect at home.
Recreational therapists worked with Lumi on getting back to playing the guitar and other musical instruments. Meanwhile, case management facilitated ordering and providing education on needed equipment such as wheelchair, hospital bed, commode, shower chair and walker.
Aramita was thankful for the care provided to her husband. “Everyone worked so hard to help him do everything at the beginning and then teach him the safest way to do it himself.” She also expressed her gratitude to family and friends for their support during the difficult journey. “We received so many prayers, cards and flowers. Family came in from all over, and they called us all the time to check up on Lumi.”
After three weeks, Lumi could successfully transfer with a board, walk with walker and complete activities of daily living, all with minimal assistance. He discharged home and looked forward to working around the house, playing guitar and enjoying his Sunday dinners with family again. “My granddaughter said she wanted to have everyone back and Lumi to play music like he used to,” said Aramita. The team as Cleveland Clinic Rehabilitation, Avon helped to make that happen.