Pamela “Pam” Petri, 65, had just retired after a career as a social worker. Her husband, John, also retired around the same time and they were looking forward to spending their retirement years doing things outdoors that they love such as riding motorcycles, camping, hiking, kayaking and sitting outside on the deck.
Pam and John had recently returned from their first motorcycle road trip when she became ill. Pam spent a week in bed, thinking she just had the flu. One evening, as she got up to put dinner in the oven, Pam temporarily lost consciousness and fell to the floor. John was in the basement watching a hockey game when he heard her calling out for him. When unable to lift Pam from the floor, John called 911 and an ambulance rushed her to the local emergency room.
At the hospital, Pam underwent a battery of tests, including an MRI, CT scan and bloodwork to determine what was wrong. She was found to have low sodium and required medication to stabilize her electrolytes. After Pam was moved to the ICU, a neurologist ordered even more tests and additional MRIs. These tests showed Pam was suffering from central cord syndrome (CCS), an injury to the central part of the cervical spinal cord in the neck. CCS blocks the communication of the nerves between the brain and the parts of the body below the injury, leaving Pam suffering from quadriparesis, a condition in which a person experiences muscle weakness in all four limbs.
A week and a half after she lost consciousness in her kitchen, Pam underwent a laminectomy and spinal fusion surgery, a procedure that decompresses and stabilizes the cervical spine. Five days later, at her neurosurgeon’s recommendation, Pam arrived at SSM Health Rehabilitation Hospital – Bridgeton to begin intensive rehabilitation.
Upon admission, Pam required nearly complete assistance to transfer positions and perform her self-care. She had limited strength, coordination and range of motion in her upper body, which greatly limited participation with her activities of daily living. Pam was only able to walk a short distance with the assistance of two therapists and propel her wheelchair 15 feet with assistance. Her goals were to regain her independence so she could go on trips and resume an active retirement with John. "I wanted to be as self-sufficient as possible,” Pam said. “I wanted to be able to walk, to groom and to bathe. The less my husband has to do for me, the better."
Pam’s physician-led team of nurses, physical therapists and occupational therapists created a comprehensive care plan to help Pam reach her goals. In occupational therapy, the initial focus was to educate Pam on different techniques and use of adaptive equipment to increase independence with self-care tasks. Specifically, therapists worked with Pam on using a device called a universal cuff on her hand, which helped to hold utensils and assist her impaired grasp and finger coordination, while also teaching Pam how to use adaptive equipment to get dressed. Occupational therapists also focused on improving Pam’s core stability and strength to improve sitting balance and posture. To help Pam improve her grasp and finger dexterity, they guided her in coordination exercises and used electrical stimulation to increase hand function so she could hold and manipulate items for self-care. Therapists also worked on pain management strategies so Pam could better participate in therapy.
In physical therapy, Pam was fitted for custom ankle/foot orthotics to provide additional support as she walked. When she arrived at SSM Health Rehabilitation Hospital – Bridgeton, Pam was struggling with post-surgical pain, so her care team collaborated to reduce her pain using a combination of medicine, positioning, relaxation and moist heat, which improved her ability to tolerate the therapy. Despite her pain, Pam was always motivated to move forward, asking for exercises that she could do on her own. Physical therapists utilized the LiteGait, a body-weight supported harness system, to support Pam while she practiced walking. They also used electrical stimulation in the form of a functional electrical stimulation bicycle to improve leg strength and function. Pam said there were several key turning points during her stay. “Being able to walk again was amazing. I was thrilled when I was able to feed myself using my right side again. Everyone in my life being there for me and pushing me forward was huge,” Pam said. “Every single staff member made such a difference in my life.”
John was also very supportive of Pam and participated in several hands-on family training sessions to learn how to better help her once she returned home. John visited Pam every day, sometimes bringing their dog, Uriah, along. He also helped prepare the house for Pam’s discharge, making modifications to the bathroom and installing a ramp to enter the house.
During Pam’s 32-day stay at SSM Health Rehabilitation Hospital – Bridgeton, her therapy team arranged for her to use a power wheelchair when she returned home. However, Pam progressed so quickly that she ended up not needing it. At discharge, she was able to manually propel a wheelchair, a big achievement. Pam was also able to complete all eating, grooming, dressing, toileting and bathing tasks with minimal assistance. Additionally, she was able to walk 300 to 400 feet using a rolling walker and go up and down 12 steps with the assistance of one person. Pam had high praise for her care team, sharing “Everyone was so great and so supportive. The therapists, nurses, aides and housekeeping staff were so friendly and kind. I received excellent care. I could not ask for more. They were top-notch. We were so impressed.”
Pam looked forward to returning home and spending time sitting on her deck with John and Uriah. She continues to make progress every day and plans to continue rebuilding strength at the SSM Health Day Institute. Pam offers this insight for others who are facing rehabilitation: “It’s a marathon, not a sprint. Listen to your therapists and doctors and communicate with them. They have your best interest in mind. Advocate for yourself and listen to others.”