At the Bedside: Stroke care at UTHealth Houston helps woman regain independence

Venessa Johnson, 68, has found positivity and resilience after suffering a stroke in April 2024. (Photo by Venessa Johnson)

Venessa Johnson, 68, has always valued her independence. 

As a former social worker at UTHealth Houston, Venessa had a routine: She arrived at the office early, she exercised every day —whether it was spending her mornings on the elliptical or riding bikes with her five grandchildren — and she was a fierce advocate for her patients. 

So when she had a stroke on April 25, 2024, at the age of 67, Venessa was scared that the incident would completely upend her lifestyle. 

That morning, she arrived at the Texas Medical Center ready to meet one of her patients when she unexpectedly struggled to sign into her computer. She asked one of her colleagues, a nurse, for help. 

“When I was in there talking to her, she looked at me and said, ‘Venessa, are you having a stroke?’ I said, ‘No, I'm not having a stroke,’ and she said, ‘I think you are.’” 

Venessa was rushed to the emergency room, where it was determined that she had suffered a hemorrhagic stroke, a life-threatening condition that occurs when a blood vessel breaks in the brain. 

Hemorrhagic strokes are commonly caused by high blood pressure, which Venessa had been taking medication to treat for several years. 

Because Venessa’s hemorrhage was relatively small, she didn’t require surgery. After spending three days in the intensive care unit to ensure she wasn’t bleeding, Venessa was referred to Anjail Z. Sharrief, MD, MPH, professor of neurology at McGovern Medical School at UTHealth Houston and director of the Stroke Transitions Education and Prevention (STEP) Clinic at UTHealth Houston. 

Sharrief’s priority for Venessa was getting her blood pressure under control, an aspect of post-stroke care that Sharreif said is commonly overlooked. 

“A patient with stroke may first come into the ICU, then will be managed by members of the stroke neurology team before discharge. They may then either go on to rehabilitation in the inpatient setting or be discharged home with a plan for outpatient rehabilitation,” Sharrief said. “In our program, they are also referred to our outpatient stroke team for further care. Our outpatient team has a different focus, which includes preventing a second stroke and addressing other complications and needs after a stroke.”

Blood pressure control, for example, presents one major gap in post-stroke care, Sharrief said. 

“Some individuals may have their blood pressure controlled in the hospital, but more than 50% of patients with stroke will not have their blood pressure controlled in the long term,” she said. 

To close the gap for Venessa, Sharrief enrolled her in the REACH-ICH study at UTHealth Houston, an NIH-funded study for which Sharrief is lead investigator. The study aims to help stroke survivors maintain healthy blood pressure in the long term. Participants are monitored for one year; they’re coached and educated about blood pressure and stroke risk. 

“They receive feedback on their blood pressure numbers and if blood pressure is elevated. They have a coach who works with them on trying to address barriers to blood pressure control. Participants get text message reminders and motivational messaging,” Sharreif said. “The study is looking at how nonmedical factors affect blood pressure.”

Venessa said the study helped her identify factors that could raise her blood pressure, including her osteoarthritis. She has been very in tune with her health since her stroke, in part because of her experiences in physical and occupational rehabilitation at TIRR Memorial Hermann. 

While she initially resisted the idea that she needed more therapy, Venessa said she eventually had to accept that the stroke had impacted her mental and physical abilities. She struggled to get in and out of a chair, type at her normal speed, or speak normally, as the stroke had weakened the muscles in the left side of her face. 

She grew to enjoy the activities TIRR offered. She even bought some of the games she played during her 10-week rehabilitation, including Blockus, so that she could continue playing at home with her grandchildren. 

“The best part about it was being challenged in my neuropsychology,” Venessa said. “They taught me exercises to get that back, to get those muscles back, which I really appreciated.” 

On Feb. 22, 10 months after her stroke, Venessa faced another setback: She suffered a seizure while taking a bath at home. She was once again rushed to the emergency room. 

“It's like, ‘Oh wow. I'm back to where I started again,’” she said. 

Up to 2 in 10 people, or 10-15%, experience a seizure after a stroke. People who have hemorrhagic strokes are more likely to have a seizure in the days or months after the initial incident. 

Venessa followed up with Sharrief and an epilepsy specialist. She was prescribed antiseizure medication.

“There are some people who will have seizures early after their stroke, and then there are some people who will have seizures at some later point following the stroke,” Sharrief said. “People who have seizures later after stroke are more likely to continue to have seizures in the long term.” 

Venessa’s future seizure risk depends on multiple factors that must be monitored long term, including the amount of scarring left on Venessa’s brain, Sharrief said. 

But Venessa is determined not to let her stroke hold her back. Her mother had a stroke when she was young, and Venessa saw how her mother’s physical and mental health deteriorated. 

Though Venessa had to retire from her job at UTHealth Houston, she’s spent the last year in recovery studying for the Licensed Clinical Social Worker Exam, with the hope that she will go back to working part time this summer. She takes classes in business and finance at Lone Star Community College to keep her mind stimulated. She exercises regularly, from walking laps in her backyard to listening to jazz while riding a stationary bike or using a rowing machine. 

“What this experience did was empower me. It showed me that it is possible. You can still do things,” Venessa said. 

Venessa said that adjusting to life after her stroke has reminded her of the advice she gave her patients while working at UTHealth Houston. 

“I would tell my patients, ‘This is a new lifestyle, so you have to rewrite your life and how you want to live it,’” she said. “This may be a new lifestyle, but I'm going to go back and still live my life. Change is good sometimes.”