Bruce Roberts was especially excited about the anticipated arrival of his grandson. He and his wife Rose live in walking distance from their son and daughter-in-law’s house. After a particularly icy winter storm, Bruce was helping to sand their driveway when he fell suddenly. The impact from his fall caused a C4 spinal cord injury. This is considered the most severe type of injury because it damages the topmost portion of the spinal cord that is in the neck and upper shoulders. At the hospital, Bruce had emergency surgery that included a C4-5 laminectomy and C2-T1 fusion. The doctors were able to stabilize his neck and relieve the pressure on his spinal cord but his path to recovery was uncertain.
Choosing Northeast Rehabilitation Hospital
Bruce had to wear a cervical collar after the stabilization surgery. This neck brace supported his neck 24/7. He was able to talk, breathe on his own, and eat with assistance. However, in the days following his surgery, he had shown minimal signs of movement in his arms and feet. To realize his full potential, Bruce needed additional care at an acute rehabilitation hospital. This specialty care environment provides more physical, occupational and when needed, speech therapy, than any alternative level of care.
“I live in ME and was at a hospital in MA,” explained Bruce. “We discussed my options with the care team. I hadn’t considered needing rehab before the fall, so I had never explored my options. I read Northeast Rehab’s reviews and they were all good.” Bruce and his wife chose Northeast Rehabilitation Hospital in Portsmouth, NH, and he was transferred there two weeks after his accident.
His wife Rose shared that she was hesitant to send him outside of Boston. “I tell you; it didn’t take long for me to realize he was where he needed to be. He progressed so quickly. I was setting the house up for one situation and it kept changing because he was constantly improving. Bruce had the best care and made the best relationships with people.”
At Northeast Rehab Bruce would have access to a clinical care team specialty trained in spinal cord injury rehabilitation – a hospitalist, physiatrist, and specialty physicians; certified rehab registered nurses (CRRNs); therapists and dedicated case management. Daily check-ins with a physiatrist or hospitalist allowed for ongoing assessment of his medical condition while also providing the appropriate specialty care, including pain management.
Getting Settled and Setting Goals
“At that time, I was pretty much laying on my back, not able to move much. The outcome wasn’t looking good. I wasn’t sure I’d walk again,” said Bruce.
When he arrived at NRH he had limited movement and sensation in all four limbs. He was suffering from orthostatic hypotension which prohibited him from maintaining an upright position without his blood pressure significantly dropping. Bruce was also unable to roll in bed or access a call bell. Environmental controls enabled him to access help when he needed within his capabilities while also supporting his independence and progress towards his goals.
So much was going on and being at rehab was another stage of his journey. He does remember the white board in his room. On this board, one of the LNA’s wrote a goal, ‘To walk out.’
At this point, Bruce was relying on people to do everything for him. “I was used to doing everything by myself and on my own. I even had to be fed. I tried to be nice to everyone. I didn’t know what to expect and was cautious,” said Bruce. Everybody was so nice to me, I mean everyone. They all treated me with respect. If I had a concern, they listened to me. I can’t say enough about how wonderful everyone was, they all treated me the way I wanted to be treated.”
One Moment and One Movement at a Time
At his initial Occupational Therapy (OT) evaluation, Bruce began to wiggle his finger on his left hand. This subtle movement provided hope. Bruce was also experiencing extreme pain with any movement at his right hip and left shoulder. Once his blood pressure was controlled, sitting upright was still difficult due to the extreme pain.
Bruce’s care team understood his physical and emotional needs. Daily check-ins with a physiatrist or hospitalist allowed for an ongoing assessment of his medical condition while also providing the appropriate specialty care, including pain management, to make sure that he could realize his full potential.
“When I first arrived, I had therapy five days a week, three hours a day. I hated it at first. As time went on, I looked forward to it and with the progress I wanted to do more,” said Bruce. The three hours of therapy were divided into am and pm sessions and included physical and occupational therapy. “I told the therapists I’d try whatever they wanted me to do. I did and it seemed to work.”
A turning point for Bruce was when he could stand up for the first time in the standing frame, then quickly progressing to the parallel bars; when just days prior he was unable to sit up at the edge of the bed.
Finding Motivation, Tackling Milestones
Bruce’s grandson was born while he was in the hospital. “Whenever it got hard, I kept saying his name to move on. He was my inspiration. When everything started to hurt, I just kept saying his name.”
Through his care, Bruce progress from…
- Walking with a harness systems to a platform walker to a wheeled walker and eventually no adaptive device
- Using adaptive utensils for self-feeding to eating independently
- Requiring a roll-in shower chair for trunk stability while bathing to getting in and out of a tub shower
- Requiring assistance for dressing to being able to dress himself with little assistance
“It happened so fast,” said Bruce. “It seemed like we were talking about getting me a powered wheelchair, then a regular wheelchair and then a walker. I went from doing therapy with the LiteGait to them helping me to be independent.”
Preparing to Return Home
Bruce was ready to return home but before he did, a few therapists joined him on a house visit to make sure that everything was ready for him. While there, his son and daughter-in-law came by so he could meet his grandson. Before he returned home for good, “A couple of the doctors brought in a baby carrier for me. I was so afraid I wouldn’t be able to carry my grandson. They believed in me, and I was able to use it! They really made everything special.”
When Bruce left the hospital, he was moving independently with a walker. Since then, has progressed to using a cane. He took a moment to reflect on his journey at Northeast Rehab, “I put my faith and trust in the therapists and did what they asked. Zoe and Melissa, they are the gold standard. Was I scared, absolutely, but I tried everything they wanted me to do. I didn’t know what would happen and knew that if I just laid there I wasn’t going to go anywhere.”
“It wasn’t like a family. It was a family,” said Bruce. And Rose added, “Yes, they were your family.”