CLEVELAND, Ohio — Stroke Recovery Journey for Restaurant Owner

Tommy Fello, the owner of the well-known Tommy’s Restaurant in Cleveland Heights, faced a life-changing event when he suffered a stroke on Christmas Day 2023. For 19 years, he hadn’t missed a single day in the kitchen until that fateful day.

Despite undergoing physical therapy, he found himself struggling with stiffness and weakness in his left arm and leg, hindering his ability to return to his daily routine of preparing meals.

Amidst this challenging time, another stroke patient shared information about an innovative treatment—the first FDA-approved method for stroke recovery. This treatment involves an implant designed to stimulate the brain, aimed at forming new neurological pathways that boost muscle function.

In April, Fello became the inaugural patient at the Cleveland Clinic to receive the Vivistim System, a product developed by MicroTransponder, a Texas-based company. This system combines nerve stimulation with rigorous physical therapy, offering hope for restoring function in patients’ arms and hands, even years post-stroke.

At 73 years old, Fello has begun to reclaim some normalcy. He can now walk around his home in Novelty, prepare oatmeal, and even wash the bowl—small tasks that had previously seemed impossible.

“These may seem like minor accomplishments, but when you’ve had a stroke, they feel like monumental achievements,” Fello remarked. “I’m seeing progress, and I’m incredibly grateful for this opportunity.”

As of mid-August, Cleveland Clinic, one of the first hospitals in Ohio to provide the Vivistim device, has treated approximately eight patients. Dr. Mark Bain, a cerebrovascular neurosurgeon at the clinic, expressed excitement about the new option for patients who have plateaued in their recoveries. “This gives them a chance to regain some of their lost functionality,” he noted.

Breakthrough Treatment for Stroke

Fello experienced an ischemic stroke, which occurs when a blood clot obstructs blood flow to a part of the brain. While doctors can intervene quickly to remove such clots, once the acute phase is over, the primary treatment option has traditionally been physical therapy to address physical limitations.

The Vivistim System introduces a promising alternative by targeting the vagus nerve, crucial for various bodily functions, including heart rate and digestion.

By sending electrical impulses to the vagus nerve through a device implanted under the skin in the chest, the system aims to alter brain activity. A physical therapist activates the device during rehab sessions, but patients can also use it during everyday tasks. Fello described his experience, saying, “When I get home, I can activate it myself with a magnet, stimulating my arm muscles every 30 seconds.”

A clinical study from 2021 indicated that nearly half of the patients who underwent this procedure, combined with therapy, showed significant improvement, in contrast to a smaller improvement rate in the control group.

“Almost every patient I’ve worked with has experienced some level of improvement—some conditions have seen dramatic changes, while others may seem minor but still have a huge impact on daily life,” Bain shared.

Fello is one of about 700 patients in the United States to have received this vagus nerve stimulation implant. Launching the Vivistim program at the Clinic required coordination among a range of specialists, underscoring the complexity of the treatment.

“We have to ensure all the rehab elements are in place before implantation,” Bain explained, noting the necessity of an intensive rehabilitation therapy regime paired with the device. “If either component is missing, the benefits will not be fully realized.”

Current insurance practices typically cover shorter rehab sessions, but patients with an implant require longer, more frequent sessions for optimal results.

In the immediate aftermath of his stroke, Fello struggled with mobility, losing the ability to walk and move his left arm, which compounded the challenges of even using his right arm.

Now, Fello follows a busy routine of therapy sessions. He also incorporates stretching and dry needling, another approach for alleviating muscle pain.

Many stroke patients, like Fello, are hearing about the Vivistim device through personal networks and reaching out to the Clinic to explore their eligibility for the treatment.

Interestingly, one patient even found information through Instagram and decided to inquire further.

For candidates considered for the vagus nerve device, there’s a sweet spot in terms of mobility—too much or too little can disqualify potential users, Bain mentioned.

While research has centered on arm mobility, Bain believes the stimulation technique could be beneficial for other body areas affected by stroke, as well as for speech and language recovery, although these possibilities remain unexplored.

Bain, alongside his patients, is navigating the device’s capabilities and limitations. Will the enhanced arm function plateau at some point? And will it be safe to leave the implant in place?

“These are still open questions,” he acknowledged.

Bain feels encouraged by Fello’s progress. Meanwhile, staff and family members are keeping Tommy’s Restaurant operational during his recovery. Fello visits frequently, enjoying interactions with the team and customers. While he misses being present full-time, he maintains a hopeful outlook for the future.

“I’m aiming for a full recovery, but it’s hard to say. I see a lot of possibilities for contributing at the restaurant in different ways. Perhaps I could be the greeter. I really want to return, but it might look different than before,” he reflected.