Cadagan: Humor and tenacity after a stroke

Treatment for stroke has helped Cadagan thrive.

Most parents try to discourage their children from indulging in humor about bodily functions like burping. But for Daniel and Lori Hooley, a simple smirk in response to a belch was the sign they needed that their daughter, Cadagan, was going to be okay.

It was 2012 and 7-year-old Cadagan was asleep, tucked into bed for the night. Around 11 p.m., she suddenly awoke — but it wasn’t because of a nightmare or a late-night request for a glass of water. Instead, she seemed limp and couldn’t focus. Then she began throwing up. Born with an extremely rare genetic disorder called trisomy 12p, the little girl had already experienced her share of health challenges. But this was something different.

Cadagan is enjoying life after recovering from a stroke.

Fearing the worst

The Hooleys rushed their daughter to their local emergency room, which then transferred her to Boston Children’s Hospital when she remained minimally responsive. At first, clinicians believed she was having a seizure due to low sodium levels. But her mother Lori, a nurse herself, wasn’t convinced. “I knew it was something more,” says Lori. “I was concerned she’d had a stroke.”

Sure enough, Dr. Michael Rivkin of Boston Children’s Stroke and Cerebrovascular Center explained to the Hooleys that Cadagan had suffered a stroke on the left side of her brain. She was diagnosed with cerebral vasculitis — inflammation of the blood vessels in the brain — which is believed to have triggered the stroke. Lori feared the worst. “I instantly thought, ‘Oh no, this could be it,’” she remembers. “But Dr. Rivkin told us, ‘Never underestimate kids. They can do amazing things.’”

Cadagan visited with clowns at Boston Children's when she was recovering from a stroke.

An unconventional approach

Still, as Cadagan slept in the intensive care unit (ICU), her parents worried that she might not fully recover. The stroke had paralyzed her right arm and leg, and the right side of her face drooped. Then, while doctors and nurses swirled around them in the ICU, they heard a seemingly inconsequential noise, especially in a room full of children. Someone had burped.

And just like that, Cadagan opened her eyes. Her lip twitched ever so slightly, pulling up in as close to a smile as the paralysis would allow. She wanted to laugh, and she was trying the best she could to do it.

Inspired by the little girl’s humor and tenacity, Dr. Rivkin took an unconventional approach to getting her to truly chuckle: He installed a “burp app” on his smartphone that let out silly belching sounds at the push of a button. Soon, Cadagan was laughing in earnest, then giggling hysterically.

Tremendous progress

With time and effort, Cadagan slowly began to improve. When they brought her to physical therapy appointments, her parents were “floored” to see Dr. Rivkin there, watching Cadagan’s progress and even playing with her — even though it was the weekend. The family also worked with Dr. Cameron Trenor and Dr. Laura Lehman, who was a fellow at the time and who has since become the Center’s outpatient medical director. “It was a wonderful team approach,” says Lori.

Five years later, Cadagan has made tremendous progress. She’s regained much of the function lost after the stroke and only takes a daily baby aspirin. These days, she pushes herself in her wheelchair, loves listening to music, and playing with her cousins. “She’s Little Miss Social,” says Lori. “She has a complex condition, but she’s doing great.”

Learn more about the Stroke and Cerebrovascular Center.