This Is Why Cycle of Inspiration A young patient illustrates an enduring truth. By Susan Daugherty, PT, OCS | April 2013 Podcast: Listen to 'This Is Why' A couple of months ago I spotted a beautiful, young girl in our clinic's lobby, laughing and joking with her mom as they filled out her paperwork. She had a wonderful spirit that was impossible to miss. Joy seemed to radiate from her. As I read her prescription and entered her medical history into my evaluation, I was shocked to learn that this vivacious 18-year-old had a diagnosis of contractures due to juvenile arthritis. When she stood to greet me and walked back to our treatment area, I saw the braces on each wrist and noted that her gait was severely affected by painful contractures of her Achilles tendons and hip flexors. Kristen's symptoms first had appeared at age 8, when she developed huge nodules on her knees and hands that required surgery, ending her competitive gymnastics training and quashing her hope of one day reaching the Olympics. She had spent the next several years going from doctor to doctor and undergoing multiple tests. Her particular disease—polyarticular juvenile rheumatoid arthritis—is an autoimmune disease that manifests itself in painful flare-ups in her joints, nodules, contractures, altered gait and grip, and frequent bouts of illness. She described her previous physical therapy as having been limited to passive stretching that was painful. She asked, "Is there anything else we can do?" This determined young fighter added, "I will try anything to get better." I began to brainstorm. I knew right off the bat that our clinic's Alter G anti-gravity treadmill would be a great tool for improving Kristen's gait pattern once we reduced her contractures. I spoke with her pediatric rheumatologist, who was game for my trying some approaches that were a bit outside of the box. We began regular ASTYM™ treatments with Kristen, along with paraffin baths, passive range of motion, self stretches, core stability exercises, and gait training. She was a model patient, trying her hardest every day and never once complaining. Over the next few weeks I learned more about her struggles. She had undergone a regimen of painful weekly injections and monthly chemotherapy treatments that had further weakened her immune system. Her lack of endurance and compromised immune system meant she couldn't always attend school, but even when she did, she endured bullies who mocked her need for a special parking tag. Still, Kristen's spirit never wavered. Rather than becoming angry or sad, she pushed to raise awareness of her disease. She become a leading local face of the Arthritis Foundation, determined to spread the word that arthritis knows no age and that research money is badly needed. Kristin told us she'd been named the honoree of the city's annual Jingle Bell Run due to her activism with the sponsoring Arthritis Foundation, and that she'd be speaking at the event. She so inspired us that we formed our own team. We raised money, ran in the race, and performed free screenings onsite, wearing our Santa hats. After Christmas, Kristen had a few setbacks from illness, and a joint flare-up after a fever. We talked about how else we might help her, and we identified a brand of static progressive splints to fit to Kristen's wrists for better results and greater comfort. As physical therapists and physical therapist assistants, we all have patients like Kristen who show us that among our profession's great gifts is its positive, life-enhancing reciprocity. Just when we think we're the ones giving patients the will and strength to reach their goals and broaden their expectations of themselves, we realize that they—through their spirit and hard work—are having the exact same effect on us. I feel honored to be part of this cycle of inspiration—a wheel of progress that, with each one of us pitching in, keeps on turning, day in and day out, to the greater good of patients and providers alike. Susan Daugherty, PT, OCS, is employed by BenchMark Physical Therapy in Knoxville, Tennessee.