• Defining Moment

    Air Support

    Helping a patient get a running start on his life goals.

    Listen to 'Defining Moments'

    "I wish I could run again," Mike said. His tone was insistent, as if he'd just announced, "I plan to run." He sounded restless, too. What he really was telling me was, "Let's do this."

    As his outpatient physical therapist (PT), I knew to expect nothing less. Mike had spent his entire life overcoming obstacles.

    He'd been diagnosed shortly after birth with afibrinogenemia, a hemophilia-like blood disorder that to this day requires injections every 2 weeks to enhance clotting. Because he bruises easily, activities such as contact sports were off limits to him. But Mike never placed limits on his personal and professional horizons. That self-confidence didn't change even after he had a severe hemorrhagic stroke in May 2008, at age 18 and just 3 weeks from high school graduation. Mike had been recovering from mononucleosis, and his weakened state may have caused a bleed that was exacerbated by his disorder.

    The situation could not have been more dire. Physicians told his family, "Your son may not make it." A priest gave Mike last rites. But he did make it”through surgeries, a 2-week drug-induced coma, and 9 more weeks in the intensive care unit. Along the way, he was told that he might never walk again.

    While it's true that Mike retains some hearing loss in 1 ear from the stroke, in my experience, any hint of deafness he may have is selective and strategic. It typically coincides with a medical professional suggesting it's unlikely he'll be able to achieve something. (Similarly, Mike doesn't necessarily believe everything he hears”especially when the words are discouraging.)

    My evidence for Mike's ability to filter out bad news lies in everything he's done in the years since his stroke. Ventilator care in the ICU was followed by grueling inpatient therapy to relearn the simplest tasks in a day rehabilitation program. Then came rehabilitation for wheelchair mobility and gait training.

    I became Mike's PT in November 2011, when he was ready to start outpatient therapy. He immediately told me that he planned to finish high school and graduate from college. He would work extremely hard during and outside of our sessions, he said, to gain the highest possible degree of mobility and independence. He'd do everything I asked, Mike added”but he'd also feel free to up the ante as his goals evolved.

    A big goal emerged 6 weeks after he and I started working together. That was when Mike uttered those 6 aspirational yet defiant words: "I wish I could run again." At the time, we were working on gait training without use of a cane. Even that was a challenge, given Mike's ataxia and frequent falls. But he wanted to run. None of his existing issues mattered”not his decreased coordination, inefficient gait pattern, left hemiparesis, or poor balance. He wouldn't be satisfied until his goal was achieved.

    Nor would I. Now that I knew this was Mike's next mountain to climb, I had no other option, as his PT, than to be his guide as we climbed together toward the summit.

    So, we got to work. More gait training without an assistive device. Balance and gait activities with head motion and eyes closed to improve body awareness. Lower extremity muscle activation and power output exercises. Treadmill gait training without upper extremity support. Treadmill training in a ceiling harness to begin supported running. And, finally, running over ground with a gait belt.

    It wasn't pretty, but that didn't matter, as Mike accomplished his goal! He continued to make functional gains throughout our sessions together, and then he left for college.

    One of the proudest moments of my career was when Mike sent me an email from school with an attached video clip of him running independently across the football field. My purpose as a PT is to motivate patients to reach their highest potential. Determined patients like Mike inspire me to constantly stretch and expand my own abilities. What better and more rewarding job could there possibly be?

    Earlier this year, Mike, who's now 25, graduated from Illinois State University with a double major in international business and marketing. Having regained his ability to run, he now has set his sights higher”literally. He's looking for a job with international travel, so that he can experience different cultures. In other words, it's time for Mike to fly.

    My own spirits are soaring! Which stands to reason. I'm a PT. Uplift is what we do.

    Stacey Lane, PT, DPT, NCS, is a physical therapist at the Rehabilitation Institute of Chicago.

    Leave a comment: