Darleta's story
After retiring early from a career in IT project management to care for her mother, Darleta Darnell, 63, kept busy with interior design and gardening. She was enjoying a full, independent life with her dog and lots of good friends.
Things changed suddenly for Darleta when she began to experience stomach cramping and pain at home. She thought the pain would pass, but when it didn’t, a friend drove her to the local emergency room. Tests indicated it was her gallbladder and she would need immediate surgery to have it removed.
The surgery seemed to go well, but afterwards it was determined that Darleta had a bile leak, a rare but serious complication that can occur after gallbladder surgery. The leak occurs when a bile duct, which carries bile between digestive system organs, is damaged during surgery, allowing bile to leak into the abdominal cavity. Bile, a fluid made by the liver, contains acids that help break down fats and proteins during digestion. These acids are damaging to organs that aren’t designed to carry them.
Darleta spent four days in severe pain before doctors did a CT scan and learned that she had a bile leak and needed to undergo an endoscopic retrograde cholangiopancreatography (ERCP), a procedure that uses an endoscope (a medical device with a light attached) and X-rays to examine and treat the bile and pancreatic duct. While Darleta was waiting to be transferred to another hospital equipped to do the procedure, a nurse came to check on Darleta and noticed she was declining cognitively. She was found to be in septic shock, which is when an infection causes organ failure and dangerously low blood pressure.
Darleta was transferred to the intensive care unit, where she went into cardiac arrest twice while the doctors were trying to intubate her, requiring the staff to do CPR. She also needed a feeding tube and had to go on dialysis temporarily due to kidney failure. Once she was stabilized, Darleta was finally transferred to have the ERCP performed.
Darleta would spend the nearly three weeks in the hospital. Her illness and surgeries left her weakened and on supplemental oxygen. Once she was ready for the next step, her physician recommended inpatient rehabilitation. Darleta chose SSM Health Rehabilitation Hospital – Bridgeton because her friend, who had been treated at the hospital previously, recommended it.
Upon admission, Darleta needed assistance with walking due to increased fatigue, poor endurance and struggles with balance. She arrived at the hospital using a wheelchair because her legs might give out upon standing. Darleta also required assistance for basic self-care activities such as dressing and using the bathroom. Additionally, she was struggling with swallowing and at risk for aspirating, which is when food or liquid accidentally enters the airway and lungs.
Darleta’s goals were to become independent again so that she could “go home by myself and take care of myself, the house and my garden.” Her physician-led care team of nurses and physical, occupational and speech therapists worked with Darleta to devise a treatment plan that would help her reach her goals.
Initially, Darleta required hands-on assistance from her physical therapists while walking. She felt as though her legs would give out, so a therapist would follow her closely as she walked in case she needed to sit down. As the days passed and Darleta’s strength and endurance gradually improved, she progressed to walking increased distances with a walker. Physical therapists also worked with Darleta extensively on improving her balance, having her navigate low hurdles, practice stepping around cones and practicing going up and down steps. Therapists also had her step on and off a foam balance cushion; the dense yet soft foam added a low level of instability to help her improve her balance.
“Walking on uneven surfaces helped,” Darleta admitted. “I did not like walking on uneven surfaces because it was unsteady, but I did it fairly well. None of it is pleasant, but I tried to do all of the exercises to gain my strength back.” Darleta said that the turning point in her recovery came when she was able to walk all the way down the hall.
In occupational therapy, Darleta’s sessions focused on building her endurance with functional tasks including moving around in the kitchen, retrieving items and simple household activities like folding and hanging laundry. Therapists also worked with Darleta on how to safely transfer in and out of bed and navigate transfers in the bathroom in order to stay safe. Meanwhile, speech therapists worked to teach Darleta safe swallowing strategies, including taking small bites and sips, chewing carefully, alternating food and liquid, and avoiding distractions.
After 13 days at SSM Health Rehabilitation Hospital – Bridgeton, Darleta made great progress. She was discharged home using a walker and was able to perform her personal care independently. Her swallowing function also improved and she required only minimum assistance when eating. Darleta was also able to discontinue use of supplemental oxygen.
“Darleta was a very hard worker, motivated and always willing to try whatever I threw at her,” her physical therapist noted. “She always gave it her best even if it seemed challenging or if it was a new activity. I truly enjoyed working with her and seeing the progress she made.” Darleta planned to continue her rehabilitation with outpatient therapy.
Of her time in the hospital, Darleta said, “It has been good and very helpful. I have been able to gain strength back. I am meeting my goals and getting to the place where I can do things on my own.” She is looking forward to returning home, cooking her own meals and sleeping in her own bed.
Her advice for others going through a difficult recovery? “Keep the end goal in mind, work hard, even when not in therapy and work on strengthening your body,” she said, adding that the support of family and friends made a big difference for her.