When Life Changes in a Split Second: Touro Rehab Patient Shares Her Story

Guest Author – Taylor Tycer

My life could not have been better in the fall of 2017. All in the same month, I’d met someone and received an offer for a job that I had worked tirelessly to land. One night, in November, a friend and I were celebrating at an engagement party. It went until the wee hours of the morning, and I fell asleep as soon as I got in the passenger seat. When I woke up I wasn’t at home, but in a hospital room. I don’t remember what happened next, actually I don’t remember the next six weeks.

I was told that our car crashed on the interstate. I had several injuries, a few  serious: a broken tibia/fibula/femur, 3rd cranial nerve damage of the right eye, and Atlanto-occipital dislocation of C1-C3. I learned a few months later that the kind of dislocation I had was just a fancy word for internal decapitation. However, none of these compared to what my family were told. My parents were taken into a private room where a doctor told them that I was a quadriplegic and that I would need respiratory assistance for the rest of my life. By some miracle, my toes responded to a stimulation test.

 

Although my spinal cord wasn’t severed, it was severely injured and caused central cord syndrome. This meant that I lost all function in my body from the neck down, but would eventually gain it back. After several surgeries and a stay at a nearby LTAC, I was finally able to start Inpatient Rehab at the Touro Infirmary. Three hours a day of physical, occupational, and speech therapy were tough but doing it while in a cervical halo was even tougher. Luckily, I had three incredibly patient, genuine, and dedicated therapists. 

My speech therapist, Maggie, worked with me each day to strengthen my throat muscles. So, I could have the mint chocolate chip ice cream that I had been dreaming of. Until I passed the swallow test, I was fed through a peg tube and only allowed a few ice chips. It took about 2-3 weeks, but I finally passed the test and celebrated with all the ice cream I could handle. Because of Maggie I can eat all of my favorite foods again. 

 

Even though I was slowly regaining function of various body parts, my brain didn’t know how to use my body parts anymore; because of this I needed occupational therapy. My OT, Erin, taught me how to feed myself the ice cream that I wanted. She also taught me how to dress myself and brush my teeth. One of our rehab sessions was spent entirely on practicing applying makeup. She took the time to make sure I felt like a person again instead of a patient. Erin helped me feel like myself. 

 

I was incredibly weak, but I still had to participate in physical therapy to learn how to walk and among other things. Josh pushed me to my limits every single day but it’s what I needed. I went from taking 6 steps, to walking back to my room, to walking to a nearby restaurant for lunch. Some days, I felt like giving up, but Josh was there to push me to increase my stamina. He is the reason why I can walk a few miles at a time today. 

 

After 6 weeks, it was finally time to leave. On my last day, Maggie came to visit me and bring me coffee before I was discharged. Later that day, I was surprised by Josh and Erin as well. They brought me a “Certificate of Completion” along with a graduation cap and gown to wear on my walk out. Erin played the graduation song as I walked out of the hospital

while my family cried tears of happiness. I haven’t looked back since. 

Because of the fantastic care I received at Touro Inpatient Rehab, it was an easy decision to continue my care at Touro Outpatient Rehab. My nurses, doctors, techs, and therapists all made me feel like they were taking care of a friend instead of a patient. I get the same care at outpatient rehab as I did in inpatient rehab. I consider my therapists to be my friends as well. 

 

Today, I continue with speech, occupatinal and physical therapy a few days a week. I’m up to walking at least 2 miles at a time. Most importantly, I’m getting back to my old self. I’m thankful that throughout all of the trauma and tears, I never lost the person I was before. In fact, I feel as though I’m the same Taylor just with a pretty incredible story. 

New Strides for a Young Mom

Ke’erra Williams was diagnosed with a rare neurological disorder called Wernicke encephalopathy while pregnant with her son. Today, she continues to regain strength and function at Touro’s Neuro Rehabilitation Center.

Ke’erra Williams was ecstatic to hear the news about her pregnancy. Williams’ pregnancy began with morning sickness, like it does for many women. She thought the nausea was normal. Her mother, Kenya Fortenberry, began to think otherwise when her daughter’s morning sickness became a daily battle. Williams began to experience weak, numb legs. Six months into the pregnancy, her health continued to deteriorate, and she lost a significant amount of weight.

Mysterious Symptoms

During the last three months of her pregnancy, Williams was in and out of the hospital constantly. Her symptoms perplexed physicians. She experienced temporary blindness, and at one point fell into a coma state. At seven months pregnant, Williams developed tremors, and her memory started to fade.

Williams’ OB/GYN ordered an MRI and blood tests to determine the problem. The results showed that Williams was suffering from severe vitamin B deficiency, which can cause a condition known as Wernicke encephalopathy (WE). WE is a serious, often long-term neurological disorder that can be significantly disabling and potentially fatal. While the news of her condition concerned her, Williams was determined to deliver a healthy baby. She pushed herself to participate in outpatient physical therapy until her delivery.

Road to Recovery

After Williams gave birth to her beautiful son, Makhi, her WE became worse. Her tremors were uncontrollable, and the terrible nausea continued. “Her shakes were so bad that I had to feed her and take care of everything for her,” said Fortenberry. Williams was told that she would never be able to walk again and that her condition was permanent. She remained determined to prove otherwise.

A month after her son was born, Williams continued outpatient rehabilitation at Touro’s Neuro Rehabilitation Center. Her physical therapist, Dana Segraves, is supporting Williams’ goal to walk again. Williams has been receiving physical therapy at Touro for almost two years and has seen tremendous improvement. Her tremors have slightly subsided, and she can now stand up for a few minutes without support. “She has gone from being wheelchair bound to walking with a rolling walker. We are now working on walking with a cane,” said Segraves.

Building Confidence

Williams is using the Aretech ZeroG suspended track at Touro’s Neuro Rehabilitation Center to help her learn to walk again. The track is mounted to the ceiling and allows the patient to move in many directions. A harness is attached to the patient to build confidence and ensure safety. It provides support during an array of physical therapy activities, such as sit-to-stand, walking, balance and climbing stairs. “She doesn’t have to depend on me to correct her, and she can figure it out on her own,” said Segraves. “I can really challenge her because she feels safer.”

The fear of falling is eliminated, and the best part of the suspended track for Williams is that she can practice holding and carrying her son for the first time.

Grateful and Motivated

Williams is motivated to make a full recovery. “My goalis to do things on my own without any help at all,” shesaid. She also wants to help her mother by caring forher son independently. Williams and Fortenberry are extremely grateful for the care she has received and to Segraves for helping her recover. “Ke’erra really went through a lot during this pregnancy. She really did, and I want to see her walk again,” said Fortenberry.

REHAB THAT’S RIGHT FOR YOU

The Neuro Rehabilitation Center at Touro specializes in the treatment of patients with
brain injury, strokes, spinal cord injuries or other neurological injuries or illnesses, using a community-integrated approach.

Learn more about our Neuro Rehabilitation program online at www.touro.com/rehab-neuro or call 504-897-8157.

Written by Kristin Fletcher Lotten

Life after Cancer Treatment: How Cancer Rehab Can Help!

Arielle Crist, LOTR and Lillian M. O’Cain, LOTR

According to the National Cancer Institute, there are currently over 14.5 million people living with cancer in the United States and over 1.5 million people newly diagnosed each year. With advancements in diagnostic capabilities and treatment options, more individuals are living longer. Despite better outcomes, survivors may be left facing physical, cognitive, emotional, or psychosocial issues. The question becomes “where do patients go after finishing cancer treatment to address these issues?”

What is Cancer Rehabilitation?

www.eye-creative.com Frank L Aymami III

Surprisingly, cancer rehabilitation is relatively new in the healthcare system. So much focus has always been on removing or decreasing cancer in the body but issues such as endurance, balance, emotional well-being, and social participation can be overlooked. Cancer treatment can lead to impairments that impact everyday quality of life during or after treatment, which for some could have been completed months or years earlier. These issues can severely limit an individual from living a healthy and productive life. Therefore, cancer rehabilitation is now becoming an essential component of cancer care.

Cancer rehabilitation was created to fill a gap in the continuum of cancer care. After treatment such as surgery, chemotherapy, or radiation therapy is completed, many individuals need follow-up care to address new deficits. Common deficits include cognitive and sensory changes, decreased range of motion, lymphedema, difficulty swallowing, incontinence, decreased strength and endurance, fatigue, and pain. These can prevent survivors from returning to their regular lifestyle and participating in their home, work, and community.

New Orleans Photographer Frank Aymami

Cancer rehabilitation teams consist of many healthcare professionals including but not limited to: oncologists, physiatrists, nurses, navigators, occupational therapists, physical therapists, speech-language pathologists, recreational therapists, dietitians, psychologists, and case managers. Examples of how each profession fits into the team include:

  • A survivor may discuss difficulties with everyday tasks with the treating oncologist or radiation oncologist.
  • A referral to physical therapist may be indicated for the survivor experiencing difficulty climbing stairs, poor balance, falls, diminished core strength, or chemo-induced peripheral neuropathy in the feet.
  • An occupational therapist may be needed for the survivor who cannot perform basic self-care, prepare a meal, complete home management tasks, or care for a family member due to deficits such as decreased strength or energy conservation.
  • A survivor of head or neck cancer may have difficulty swallowing or with voice production. A speech therapist can assess the survivor’s abilities and provide exercises or a diet to manage and improve these deficits.
  • Survivors experiencing incontinence or pelvic pain can be referred to a physical therapist with specific training of the pelvic floor.
  • Survivors diagnosed with breast cancer or gynecological cancer may experience lymphedema, or swelling of an extremity due to removal of lymph nodes, and can be referred to a lymphedema therapist to learn ways to manage swelling.

What is Prehabilitation?

Prehabilitation is a familiar term for those preparing for a joint replacement with the goal of improving the outcome and having a faster recovery from elective surgery. This concept is entering the cancer rehabilitation field for head and neck, prostate, lung, and breast cancer patients. A better informed patient who has the knowledge of what to do and what to look for can advocate for intervention sooner and typically have better outcomes. Knowledge is power.

Rehabilitation is commonly associated with strokes, spinal cord injuries, brain injuries, joint replacements, or the weekend warrior. Now cancer survivors have the benefit to improve quality of life for themselves and not settle for the sequela of the medically necessary treatments. Each profession provides a piece of cancer care needed to help individuals heal.

Touro Infirmary’s Cancer Rehabilitation Program

Through cancer rehabilitation, survivors are able to increase their function and independence for better quality of life. Touro‘s Cancer Rehabilitation program is the third in the nation to receive CARF accreditation. We provide cancer survivors with several options for rehabilitation, depending on their needs and conditions. Click here to learn more.  

Arielle Crist, LOTR is from Mandeville, Louisiana. She is a recent graduate of  Louisiana State University Health Science. She is an Occupational Therapist for Touro Infirmary’s Cancer Rehabilitation Program.

OCain, LilLillian O’Cain, LOTR, CAPS has over 25 years of experience as an Occupational Therapist at Touro Infirmary and in 2013 was promoted to Program Manager for Touro’s Cancer Rehabilitation Program. Lil received a bachelor of science in Occupational Therapy from Louisiana State University School of Allied Health Professions in 1986. She has developed a passion in the field of study for both fall prevention and Aging in Place and regularly volunteers her time to offer innovative programming and opportunities to educate seniors, caregivers, physicians and Touro staff.

Statistic reference https://www.cancer.gov/about-cancer/understanding/statistics

Ballerina – Stroke Survivor – Mother

Sarah Abrusley, Touro patient

Too many times one allows herself to be defined by what one does rather than what her spirit holds dear.  I look at the above facets of my life and feel such great accomplishment that I am proud to be identified in such a fashion!

I studied ballet, tap, and jazz dance with Ellen Hardeman for 15 years, and attended New Orleans Center for Creative Arts briefly before my matriculation at Boston University in 1995.  After studying with Boston Ballet and at The Gorny Institute in St. Petersburg, Russia, I graduated from Boston University with a B.A. in Russian and Eastern EuropeanSarah Abrusley, Touro patient, with husband and newborn Studies in 1999.  I returned to New Orleans and began a career in the Hotel and Tourism Industry, as well as a dancer with Loyola Ballet, Komenka Ethnic Dance and Music Ensemble, Ballet Hysell, Lula Elzy Dance Theatre, Jefferson Performing Arts Society, and the New Orleans Opera Association.  I have taught ballet at Boston University, Loyola University, Ellen Hardeman Dance Academy, New Orleans School of Ballet, and The Schramel Conservatory of Dance. I’ve performed all over the world as a dancer, in countries as varied as France (2 tours), Italy, Bulgaria (2 tours), and Poland.

Shortly after returning from touring Italy and Bulgaria with Komenka  Ethnic  Dance and Music Ensemble,  I suffered a massive hemorrhage in the right frontal lobe of my brain due to a cavernous  malformation,  at age 29.  My life was saved by the incredibly skilled hands of West Jefferson Medical Center’s renowned Dr. Frank Culicchia, who performed an emergency craniotomy.

Thankfully, when I suffered my stroke on September 7, 2007, I had already enjoyed a beautiful 26 years of dancing and had achieved so much as a ballerina and international character dancer.  I have translated my talents as a performer into a vocation as an inspirational speaker and spokes model, or as I call myself, “strokes model” for The American Heart and Stroke Association and as the Ambassador for Loyola Ballet, as well as an actor, appearing frequently with Moscow Nights US.

I am incredibly grateful to have suffered my stroke in 2007, as opposed to even 10 years earlier.  As scientists look back at all the discoveries made in the 1990’s, the so-called Decade of the Brain, one finding stands out as the most startling and, for many scientists, the most difficult to accept: people are not necessarily born with all the brain cells they will ever have.

In fact, from birth through late adolescence, the brain appears to add billions of new cells, literally constructing its circuits out of freshly made neurons as children and teenagers interact with their environments. In adulthood, the process of adding new cells slows down but does not stop. Mature circuits appear to be maintained by new cell growth well into old age. For decades, it was axiomatic that people were born with all the brain cells they would ever have. Unlike the bones, the skin, the blood vessels and other body parts, where cells divide throughout life to give rise to new cells, it was believed that the brain did not renew itself.

Although the Congressionally mandated ”Decade” produced many other discoveries, from ways to obtain images of fleeting thoughts inside a person’s head to new drugs for a wide variety of mental disorders, the finding that the brain develops and maintains itself by adding new cells is the most revolutionary.  As such, rehabilitation methods offered to stroke survivors are very different now than in 1997, for example. I work now on forming new connections from my brain to my left arm and leg, as opposed to solely strengthening my right side, which is an example of the old rehab philosophy.

Sarah Abrusley with son AlexiI always imagined that I would one day have children, but life as a performer and now stroke survivor had delayed my plans for a family, as had living in a perfectly located yet small apartment.  I began to feel a strong pull to mother hood in early 2011. At 33 years of age with so much of my stroke recovery achieved, purchasing a house and having a baby became my focus.  Who could expect that my incredible husband’s tendency to over-plan and be overly cautious would get in my way!  Never one to run from a challenge, I finally convinced my husband to buy a house in Lakeview in July 2012.  At the same time, I began to focus my efforts in occupational therapy with the incomparable Francine Bienvenu at Touro, on the essentials of caring for a baby. Working with a doll weighted and sized to simulate a real baby, I learned to change, clothe, feed and carry with one very strong right arm while relying on support from my weaker left arm.  Through these therapy efforts, I proved to Damien that physically, I was prepared to care for a child.

Damien remained fearful that he would shoulder much of the burden of caring for a baby until he and I spoke in early 2013 to an occupational therapy class devoted to parenting with physical challenges at LSU Health Sciences Center. The incredible stories of perseverance as parents that the other speakers shared finally convinced Damien that we were ready to become parents.    But now I was preparing to perform the role of the Fairy Godmother in Moscow Nights’ production of “Zolushka”, the Russian version of Cinderella with Moscow Nights US.  The show closed on April 9, 2013 and I became pregnant on May 6.

Damien and I were invited to speak on the same panel at LSU Health Sciences for the third time on January 21, 2014. In an extraordinary twist of fate, we could not appear because I was delivering Alexei, our son during the class!  We are going to speak again in September and will introduce the newest, handsomest member of “Team Abrusley” to a whole new class of Occupational Therapy Students!

This incredible journey from world-traveling dancer to half-paralyzed stroke survivor, to mother has been a stunning triumph.  It would not have been possible without my incredible support system as well as my own refusal to be limited in any fashion from living the life that I choose.  I promise to instill these values into my son Alexei Lanaux Abrusley.  He will learn from me, his mother, to always be a survivor and never a victim!  A great hope of mine is that Alexei will one day write an essay about me.

I am constantly amazed that caring for Alexei is much easier than I anticipated, even as my physical challenges continue to improve.  I compare these constant adjustments and transitions to weathering a winter in the Northeast.  As a Boston University alumna (College of Arts and Sciences ’99), I speak from experience when I say that it’s much easier to transition from chilly fall temperatures into a frigid winter because it happens so gradually.  I compare this to being the mother of a 1 year old baby.  He has grown so beautifully and naturally that caring for Alexei has been much easier than I ever could have imagined!  Thankfully, I’m very creative and thoughtful about my way of moving.  I use the right side of my body, particularly my hip more to support Alexei.  I am now able to hold my 23-ish lbs. 31-inch baby with both arms, thanks to the incredible efforts of Dr. Laborde of Orthopaedic Associates, and, of course my ongoing work at Touro’s Neuro Rehab Center.  Because I just turned 37, I hope to get pregnant again in May.  My husband Damien is also on board for a second child, although he remains true to his cautious nature and would like to wait a few months longer.  I know that we’ll find the way that is best for our family, and I look forward to my continuing adventure!