I found this clip via Instapundit, who linked the blog of an old friend of the man being profiled, Mark Stephan.
Stephan is a successful businessman who also ran marathons and participated in triathlons. He became quadriplegic due to injuries from a bicycling accident on Aug. 11, 2007. NBC is playing the “inspiration” angle.
Actually, what Stephan’s success in overcoming quadriplegia reveals is the scandalous way paralyzed people are abandoned in our healthcare system and what we can do to ensure better outcomes and even regained abilities by using his successful rehabilitation program as a model.
(Background for any new gentle readers: my late life partner of over 20 years had multiple sclerosis and we met when she could still limp two blocks. She was quadriplegic due to the MS the last 10 years of her life and paralyzed from the chest down for two more years before that. So I participated in the full range of rehab care for people with mobility impairments and I know what it is like to live with quadriplegia since I was the one providing her care and lifting and transferring her. We were lucky enough for her to receive care at the National Rehabilitation Hospital in Washington, D.C., and the therapists there trained me, so I do know what passes for top care in the U.S.)
The biggest scandal and most heinous atrocity about paralyzing injuries or illnesses in the United States is that the patients are so neglected during their acute care hospitalizations that their muscles and tendons contract and harden irreversibly. It only takes a few days of failure to provide proper range-of-motion exercises for their hands to look like they were wax and got too close to a flame and their fingers are melting and for their feet to be pulled into a permanent point. This means that when they are transferred to a rehabilitation hospital, the neglect during acute care is actually responsible for a significant percentage of their disability AND IT DID NOT HAVE TO HAPPEN!!!!!
I did range-of-motion exercises for Margaret at least once a day, and usually more, for about 16 years. It did help that after she became paralyzed, she was prescribed Baclofen, which reduces contractures. I worked so hard on this because it made Margaret more comfortable, it kept her ankles and calves flexible — so her feet would rest flat on the floor instead of rigidly pointing down — so I could transfer her (from bed to wheelchair, wheelchair to car, car to wheelchair) by pulling her into a standing position and pivoting. Range-0f-motion exercises also ensured her knees and hip joints stayed flexible enough so she could continue to receive gynecological exams.
So, what Mark Stephan has done is not inspirational, IT IS FREAKING MEDICAL HISTORY because he has shown what works to rehabilitate some paralyzing injuries. AND HE HAS SHOWN WHAT CAN BE ACCOMPLISHED WHEN REHAB STARTS IMMEDIATELY and acute care neglect is not allowed to create new, irreversible injuries due to contractures.
Update, 12/11/09, Sat.: Welcome, Instapundit readers, and thank you, Prof. Reynolds, for the link. I just want to emphasize there are two important points to this story. First, we could save a LOT more abilities for people with paralyzing injuries or illnesses with the knowledge that physiatrists, physical therapists and occupational therapists have RIGHT NOW but the current system has too great a division between acute care and rehab care, including the fact that they are applied sequentially instead of simultaneously because often they are at different physical locations.
That is, the paralyzed person gets treated for their injury/illness in the acute care hospital, but little or nothing is done to preserve range-of-motion and the flexibility of muscles and tendons. Contractures can become irreversible in just a few days, or require surgery that could have been avoided with proper and immediate range-of-motion therapy (and sometimes splinting). So when the patient is transferred to the rehab hospital with permanent contractures from neglect in the acute care hospital, there may be little or nothing the physical therapist and occupational therapists can do to help them recover the abilities that were lost DURING THEIR ACUTE CARE.
Second, the program that Mark Stephan put together to recover his independence and walking was successful and should be used as a model and studied to find out why it worked.
Determined people ARE able to make breakthroughs like this. It was not doctors who created the field of physical therapy and physiatry (rehab medicine) — it was a nurse in the outback of Australia using her own common sense to fight epidemics of polio and restore the ability of polio survivors to walk again. Her name was Sister Elizabeth Kinney (the British call nurses “Sister” — there is a wonderful biopic called “Sister Kenny,” with Rosalind Russell playing the title role). And what was it do you suppose that resulted in permanent loss of the ability to walk, which she learned how to prevent or even reverse so that many of HER patients regained the ability to walk?
In cases of brain injury or atrophy, talk to the doctors about heterotopic ossification. Range-of-motion exercises do not prevent this condition.