{"id":2227,"date":"2015-03-04T14:28:15","date_gmt":"2015-03-04T14:28:15","guid":{"rendered":"https:\/\/www.tmc.edu\/news\/key-recovery\/"},"modified":"2019-08-16T14:59:09","modified_gmt":"2019-08-16T14:59:09","slug":"key-recovery","status":"publish","type":"post","link":"https:\/\/www.tmc.edu\/news\/2015\/03\/key-recovery\/","title":{"rendered":"A Key to Recovery"},"content":{"rendered":"
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Spend ten minutes with Maegan Morrow and\u00a0you will see how much she truly loves helping people. It\u2019s not just in the way her face lights up when she talks about the work she has done over the past 15 years. It\u2019s also evident when patients stop her in the hallway for a hug, or offer updates on their at-home therapy sessions.<\/p>\n

Morrow is part of TIRR Memorial Hermann\u2019s team of music therapists\u2014all trained in utilizing neurologic music therapy techniques to help stimulate speech, increase mobility, and generally improve quality of life for patients struggling to overcome stroke or traumatic brain injury.<\/p>\n

It\u2019s a lesser-known form of therapy, but growing\u00a0in popularity thanks to the dedication of those in the field, and high-profile stories like that of Gabrielle (Gabby) Giffords, a former Arizona congresswoman who suffered severe trauma to the left side of her brain after she was shot at a local community event in 2011. Giffords was transferred to Memorial Hermann-Texas Medical Center, then TIRR Memorial Hermann, in the weeks following the shooting, and worked regularly with a team of speech, occupational, physical and music therapists, including Morrow and her colleague Amy Marroquin.<\/p>\n

While Giffords still struggles with aphasia\u2014trouble recalling and stringing together words\u2014she is quick\u00a0to sing along with some of her favorite songs from\u00a0the Broadway musical, \u201cAnnie.\u201d Monica Verduzco- Gutierrez, M.D., Medical Co-Director of the Outpatient Medical Clinic at TIRR Memorial Hermann, and Assistant Professor at The University of Texas Health Science Center at Houston (UTHealth) Medical School, explained how the brain processes language and music.<\/p>\n

\u201cOur brains are all very similar, and the language centers for almost everyone are going to be on the left side of our brain, in certain areas,\u201d she said. \u201cThere is an area that makes you come out with the word, there is an area that helps you comprehend the word…and for most people, those are on the left side of the brain.<\/p>\n

\u201cMusic is not just one side of the brain or the other. Music is everywhere in the brain, because music\u00a0can be so complicated and you have to be able to understand pitch, intonation, rhythm and the words that are coming through the music. So both sides of the brain process that. And we definitely think that music therapy helps for patients who have aphasia. Particularly for patients who have a musical background, because their brains are more developed towards music. So let\u2019s say someone has aphasia or is a little bit paralyzed in an arm, but they previously played the guitar and sang. They have really complex neurons laid down in their brain, and I think they would be more likely to get the movement and words back because of how complex their brain is from being a musician before and their ability to pull language from different areas of the brain through music.\u201d<\/p>\n

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Before a massive stroke last year robbed her\u00a0of speech and mobility, Cathy Flowers was always actively involved with her husband Billy\u2019s band\u2014 dancing and singing along during their shows and practice sessions. So when Billy was told early on that Cathy\u2019s outlook was so dismal that even if placed in a nursing home she would \u201conly be taking up space,\u201d he had a hard time accepting that he would never again enjoy those moments with his wife. So Billy jumped on the opportunity to have his wife transferred to TIRR Memorial Hermann. When she arrived, Cathy was unable to open her mouth and could not speak. Several weeks into her therapy at TIRR Memorial Hermann, Cathy was working with Morrow and Kelly Betts, a physical therapist, when Billy suggested they play a song by Johnny Cash.<\/p>\n

\u201cThey played the song, \u2018Walk the Line,\u2019 and they gave Cathy a fake microphone,\u201d recalled Billy. \u201cAnd she sat there with Kelly and Maegan and started mouthing the song. As the song went on, she was even singing along with the key chorus. And at the very end, Maegan cut the music off, but Cathy kept on going to sing \u2018because you\u2019re mine, I walk the line.\u2019\u201d<\/p>\n

That day marked a huge milestone in Cathy\u2019s recovery. It was so monumental that Billy had shirts made featuring a line from the song\u2019s lyrics, \u201cbecause you\u2019re mine, I walk the line.\u201d For Billy, seeing his wife\u2019s personality and smile return in the seven months since her stroke has been nothing short of incredible. Morrow feels fortunate to be able to help patients reach those milestones.<\/p>\n

\u201cIn patients like Gabby and Cathy, who were dealing with aphasia, where they can\u2019t get the words out when you ask them a question, spontaneous speech might come out,\u201d she said. \u201cBut when I work with them, I use a technique called music\/speech stimulation. And it basically looks like I\u2019m just singing with them, but I am actually stimulating speech from their brain. So I am accessing a different part of their brain to retrieve words. I\u2019m retrieving lyrics instead of proper semantic speech.\u201d<\/p>\n

Music therapy has also found a home in Children\u2019s Memorial Hermann Hospital, where services range from helping children in their pediatric trauma center work through severe burns or brain injury, to facilitating socialization and parent\/infant bonding.<\/p>\n

\u201cThere is almost never a \u2018typical\u2019 day for us here,\u201d said Jessica Jarvis, a music therapist at Children\u2019s Memorial Hermann Hospital. \u201cAnd I love it because that means I get to use music in a variety of ways for emotional, physical, cognitive, communicative, and\/ or social goals. Music is used psycho-emotionally, writing a song to process a death or a traumatic accident. It can be used during the beginning stages of neuro-rehabilitation for patients with brain injuries to increase awareness and purposeful responses, or, in later stages, in the recovery of motor, communicative, or cognitive skills\u2014like the work done by the music therapists at TIRR Memorial Hermann. Music is also used for pain management, whether it\u2019s pain due to the diagnosis, a procedure, or during rehabilitation exercises. The Gate Control Theory of Pain explains how using music, such as playing a drum or singing, creates a type of engagement that lowers the patient\u2019s perception of pain.<\/p>\n

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\u201cAn over-simplified explanation of the gate control theory of pain with music therapy is that when we are going through something painful the brain kind of opens up a pathway to perceive and feel that pain,\u201d she added. \u201cAnd in the brain music is a \u2018large fiber\u2019 stimulation that demands our brain\u2019s attention as well. Because the brain cannot focus on two things at once it essentially \u2018shuts the gate\u2019 on the pain pathway and lowers the patient\u2019s perceived pain. And that works for babies all the way up to adults. So with a therapist engaging the patient in music, the patient can engage in their treatment longer, they can stretch farther, and they may potentially need less pain medication.\u201d<\/p>\n

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“For us, music was like a key that unlocked the doors inside her head that might otherwise have stayed shut or taken longer to open. Music therapy has unlocked her potential.” — Billy Flowers, Husband of TIRR Memorial Hermann patient Cathy Flowers<\/p><\/blockquote>\n<\/div>\n<\/div>\n<\/div>\n

The three music therapists at Children\u2019s Memorial Hermann Hospital also lead group sessions for infants, school-age children and teens. They work in group activities, through song and instrument play, to provide an outlet for self-expression, develop coping skills, and give young patients some sense of control over their circumstances\u2014control they don\u2019t often feel when it comes to their treatment.<\/p>\n

\u201cWe have a group, Musical Monday, with school-age patients. The main focus is on social interaction for the kids, through interventions that allow for self-expression and opportunities to be successful,\u201d said Jarvis. \u201cSo they\u2019re working on things like turn-taking with each other and following the leader, and getting to assert their own independence with what they want to play and how they want to play it, fast or slow, loud or soft.\u201d<\/p>\n

\u201cAnd those do seem, on the surface, like elementary things,\u201d added Alyson Ryall, a music therapist and child life specialist at Children\u2019s Memorial Hermann Hospital, \u201cbut really they go such a long way because these are things that kids don\u2019t get to do in the hospital. Jessica is talking about making choices and asserting their independence and expressing themselves. Whereas in the hospital rooms, to take care of their medical needs, they need to be poked and have different medical tests and things, and they don\u2019t get to be in charge of that. So these groups are really important.\u201d<\/p>\n

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Memorial Hermann was an early adopter of music therapy, having implemented their program more than 15 years ago to support physical, occupational and speech therapies. However, many patients struggle\u00a0to find access to music therapists once they leave the hospital, or they face insurers unwilling to cover music therapy sessions.<\/p>\n

\u201cUnfortunately, they don\u2019t offer music therapy where we are going [after leaving TIRR],\u201d said Billy Flowers. \u201cIt seems like music therapy is not a profitable therapy, and so not a lot of folks offer it. I would never wish this on anyone, to have a personal family member go through what Cathy has been through, but if they could see firsthand, they would understand the magnitude of how good this therapy can be.<\/p>\n

\u201cFor us, music was like a key that unlocked the doors inside her head that might otherwise have stayed shut or taken longer to open,\u201d he said. \u201cMusic therapy has unlocked her potential.\u201d<\/p>\n

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To help better understand the science behind the techniques\u2014which include musical speech stimulation, melodic intonation therapy, oral motor and respiratory exercises, and rhythmic auditory stimulation, among others\u2014and provide some much-needed visibility and support for the field of music therapy\u2014 TIRR Memorial Hermann Chief Medical Officer Gerard Francisco, M.D., is overseeing several research projects. TIRR Memorial Hermann has also partnered with Michael Thaut, Ph.D., director of the Center<\/p>\n

for Biomedical Research in Music at Colorado State University, to bring a music therapist training course to Houston. These are all exciting and promising steps forward for the music therapists who see the results every day.<\/p>\n

\u201cWe do have a large base of research for music therapy, but we are a new field. That\u2019s what I have gone back to school to do,\u201d said Jarvis. \u201cI am getting my Ph.D. in rehabilitation sciences, so I can learn more about how we can produce the kinds of research that will be generalizable and that we can disseminate so that people can start to take music therapy as a standard part of care.<\/p>\n

\u201cIt\u2019s almost a selfish job, because I love seeing the results with these kids. To see the joy in a mom\u2019s eyes when her child gets up and walks for the first time because it\u2019s easier with music as a stimulation and motivation…I see music therapy making a real difference in my patients. And I just think that\u2019s awesome.\u201d<\/p>\n

GATHERING OF FRIENDS<\/strong><\/p>\n

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Late last year, the Institute for Spirituality and Health (ISH) partnered with TIRR Memorial Hermann to host their annual \u201cGathering of Friends\u201d fundraiser. Former TIRR Memorial Hermann patient and Arizona Congresswoman Gabby Giffords attended the event with her husband, Mark Kelly, and was there to cheer on her TIRR Memorial Hermann therapy team as they received the Caring Heart Award.<\/p>\n

The event was capped with a performance of the Annie song, \u201cTomorrow,\u201d by Cantor Daniel Mutlu of Congregation Beth Israel. The song is one of particular importance to Giffords, as her mother would sing it to her often throughout her recovery.<\/p>\n

\u201cFor almost 60 years now, the mission of the Institute for Spirituality and Health has been\u00a0\u2018to increase awareness of the role spirituality plays in health and healing,\u201d said John Graham, M.D., president and chief executive officer of the ISH. \u201cOur Gathering of Friends Luncheon was
\na beautiful reflection of out mission. Our time together gave us the opportunity to reflect on the impact of the devastating injury Congresswoman Gabrielle \u2018Gabby\u2019 Giffords sustained and to\u00a0learn more about the compassionate care she received at TIRR Memorial Hermann was touching. Especially, learning of the role music therapy played in her recovery.<\/p>\n<\/div>\n

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\u201cIt was amazing to see Gabby sing the entire song along with the Cantor. That was a spiritual experience for us all. We call them \u2018sacred moments\u2019 where we connect with one another in a deep and profound way.\u201d<\/p>\n

Also during the ceremony, Kelly offered remarks on Giffords\u2019 journey, and the support that helped carry her through. He thanked her team
\nof therapists and caregivers from TIRR Memorial Hermann for their role in helping her to never give up.<\/p>\n

\u201cWhile Gabby would certainly trade her own life to bring back any of those six individuals who died that day, she is incredibly thankful for her life, and her friends, family and caregivers,\u201d said Kelly. \u201cToo many to name. People that brought Gabby from that bottom and into the light […] The power of the human spirit is an incredible thing. To watch how hard people fight to survive, and the fight to come back. I got to see that up close.<\/p>\n

\u201cStill today when Gabby goes off to do something, like physical therapy, when she gets in the car, the last thing she will say to me is \u2018Fight, fight, fight,\u2019\u201d he added. \u201cAnd I think she learned that from some of you in this room. And she reminds me each day to deny the acceptance of failure.\u201d<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Spend ten minutes with Maegan Morrow and\u00a0you will see how much she truly loves helping people. It\u2019s not just in the way her face lights up when she talks about the work she has done over the past 15 years. 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