Podcast: Listen to 'This Is Why'
In September 2008, 20-year-old Caleb was hiking in a national forest in Tennessee. He scaled an unmarked tower, seeking a better view. It was an electrical transmission line. Sixty-nine thousand volts shot through his body. He fell 20 feet, nearly died, underwent more than 20 surgeries, and spent 59 days in a burn unit before arriving at my rehabilitation hospital.
Caleb came to us with bilateral below-knee amputations and a brachial plexus injury that left 1 hand flaccid. I reviewed his chart, confident that my 5 years of experience in rehabilitation gave me the wisdom to accurately set goals and appropriately predict outcomes. I planned for slide board transfers until his residual limbs were ready for prosthetics. I projected him to discharge at a wheelchair level for community access. I foresaw that his walking would be limited to short distances in the home-if the residual limbs were able to heal and the grafts could tolerate the shearing of the prosthetics. I knew, too, that we'd be working on scar management at his axilla, where the electrical injury had demolished his brachial plexus and required extensive muscle flap and grafting surgery.
Caleb was a model patient. During the first couple of weeks of therapy we did slide board transfers, stretched and strengthened his legs on the therapy mat, then "stood" him up in tall kneeling. It was then-when he got his first taste of walking-that Caleb let me know he had his own goals and anticipated outcomes. They included mission trips, snowboarding, hiking, climbing, and medical school.
By his third week of therapy, his right residual limb was ready for prosthetic fitting and training. He was ecstatic.
We started taking steps in the parallel bars. He excelled at this. I next planned to use a walker equipped with a forearm platform for his left arm. But a walker, Caleb informed me, didn't fit in with the active lifestyle he had every intention of regaining. He wanted to try crutches.
I was skeptical. He only had 1 good fake leg, after all, and 1 hand that could grip. I didn't have a crutch that could accommodate a platform for his left forearm. I did, however, have a flexion mitt typically used with the upper body ergometer bike. We strapped his hand into the crutches and gave it a try. From there, there was no stopping him.
Caleb walked out of the hospital on crutches. Three months later, he took his flexion glove, crutches, and prosthetic leg all the way to India on a mission trip to help children. A month after that, his second residual limb had healed enough to be fitted for a prosthetic. Eleven days later, he was snowboarding down a mountain in Colorado.
Caleb hasn't slowed down in the years since. (That's him atop a mountain in the photo at left.) I love hearing about his continued adventures. For his own sake, of course, but also because of what they've taught me-about everything from the need to be innovative in adapting equipment to the huge role that a patient's determination, faith, and support system can play in his or her outcomes.
I've learned from Caleb personally, too. He continues to struggle with pain and leg infections, yet he goes to work and school, serves others, and writes motivational blog posts, Facebook messages, and articles. Caleb ran a 5K only a year after rehab, inspiring me to do the same. His ongoing commitment to the children of India has prompted me to become more deeply involved in community service.
"The care I received encouraged me to fight for my life, mobility, and freedom," Caleb has written. Knowing I played a role in that care energizes me to do my utmost, always, to help patients reach their potential-and to set high personal goals for myself.
Sara Bills, PT, DPT, GCS, is burn program leader at Madonna Rehabilitation Hospital in Lincoln, Nebraska.
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