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Kyrgyzstan-bound; Stroke victim to return home after rehab.

Byline: Karen Nugent

WORCESTER - Ludmila Hwan was observing a high school classroom near Gill in May when she suddenly collapsed. The 36-year-old native of Kyrgyzstan, whose only neurological problems until then had been the occasional headache, had suffered an acute cerebral hemorrhage - a stroke.

All alone except for a colleague who would soon return to Kyrgyzstan, Ms. Hwan had surgery at UMass Memorial Medical Center - University Campus to alleviate escalating pressure on her brain and was in a medically induced coma for three weeks. She stayed at UMass for seven weeks before she was transferred in late August to the Fairlawn Rehabilitation Hospital on May Street.

Tomorrow, Ms. Hwan, an assistant professor at the American University of Central Asia in Bishkek, Kyrgyzstan, will fly home to her anxiously waiting parents, two sisters and 17-year-old brother. Rather than the glimpse into the U.S. education system she expected to get during her trip, she had an up-close-and-personal look at American health care.

During an interview yesterday at Fairlawn, Ms. Hwan wondered what would have happened if she had the stroke at home. There is no medical insurance or government-funded health care there, she said with a firm shake of her head. Doctors and hospitals expect cash up front, often from family members.

"Only cash can be paid to doctors. You won't be treated if your relatives don't have the money. It's sad. A doctor can refuse to take patients because they have no money. It's very sad," Ms. Hwan said.

"There is a big difference," she said. "The U.S. is, of course, much better. If this had happened in Kyrgyzstan, things would be very, very different for me. There are no such things as rehabilitation hospitals there. It was much better for me that it happened here, rather than in my country."

Ms. Hwan, who teaches languages at American University and speaks English, Russian and Kyrgyz, began her U.S. visit in May at Columbia University in New York. In June, she moved on to Western Massachusetts to observe classes at Northfield Mount Hermon School, which is where she had the stroke.

Ms. Hwan has no memory of the stroke or of most of her stay at UMass. She had no idea where she was or what had happened.

"I was frustrated, not frightened," she said.

Experiencing dizziness after she came out of the coma, she could not stand up for a while, but Dr. Angela Wang, a doctor who treated Ms. Hwan at Fairlawn, said her patient has made remarkable improvement. Since her transfer to Fairlawn, Ms. Hwan has progressed to walking with a walker and doing most daily activities with some help. She has trouble with balance but was able to walk up and down corridors and negotiate stairs with the help of physical therapist Sarah R. Chanler.

Throughout Ms. Hwan's recovery, several organizations have contributed funds for her care and return home, including American University, which contacted the Open Society Foundations. That organization, established in 1984 to help countries making the transition from communism, has paid for most of Ms. Hwan's healthcare.

The organization helped arrange for her 11-hour flight from New York to Moscow tomorrow, along with the second leg to Bishkek and finally to her hometown of Kant, a small village where her parents do farm work.

Jacqueline Grady, director of marketing services at Fairlawn, said American University is providing Ms. Hwan with a companion from the college who will accompany her from Fairlawn

back to Kyrgyzstan. Open Society helps international students who become ill, get in accidents or suffer trauma, Ms. Grady said.

There is some concern about Ms. Hwan's follow-up care, which is crucial for brain injury patients. She is hoping that a doctor one of her sisters contacted will provide treatment.

Dr. Wang is optimistic.

"She already has had rehab and is in very good shape now. I think with the family help in mobility and activities of daily living, she will continue to improve," Dr. Wang said.

She said it is difficult to predict if Ms. Hwan will make a complete recovery.

"She still needs some supervision, but I think she will do well. She has made such a swift recovery from six weeks ago when she could not even stand up," she said.Kyrgyzstan, officially called the Kyrgyz Republic, is a landlocked country in Central Asia and was annexed by the Russian Empire in 1876. It became independent in 1991, but recently has been plagued with corruption, terrorism and drug trafficking, according to the CIA World Fact Book. Ms. Hwan's parents are thrilled she is coming home, even though her mother was concerned that she was not eating properly at the hospitals.

"I said, `Mum, it's like a restaurant.' I told her I like the idea of selecting my food," Ms. Hwan said with a smile.

She will live with her parents when she gets home, but plans to finish her doctoral dissertation.

"I picked up some stuff at Columbia in the five weeks I was there - I was really enjoying it," Ms. Hwan said. "I started it, and I must finish it."


CUTLINE: Physical therapist Sarah R. Chanler works on developing the balance of Ludmila Hwan at Fairlawn Rehabilitation Hospital in Worcester.

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Title Annotation:LOCAL NEWS
Publication:Telegram & Gazette (Worcester, MA)
Date:Sep 19, 2010
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