When Richard was admitted to The Dean Neurological Centre after a very challenging stay in hospital, the odds were stacked against him. This is the story of his remarkable rehabilitation and determination to regain his independence.
Neurological injury and respiratory failure
Richard was initially admitted to Hereford County Hospital with hematemesis and showed signs of hepatic encephalopathy. He contracted C-Difficile whilst in hospital which led to many complications including type 1 and 2 respiratory failure, causing Richard to need a tracheostomy. He was also diagnosed with Central Pontine Myelinolysis and Polyneuropathy.
When Richard arrived at The Dean, he was unable to mobilise and required the assistance of a team member to transfer into a wheelchair, although he could self-propel and do some aspects of his care himself. Richard began a rehabilitation treatment plan working with our specialised nursing and therapy team, with a rehab goal of living an independent life back in his home environment.
Richard inspired the whole team with his determination and dedication to integrating rehab into every aspect of his daily life. He would often complete exercises in his room, outside of his physiotherapy sessions, and this helped Richard to progress quickly.
We spoke with Richard after he had been at The Dean for six months and he shared his story with us.
Hi Richard, thanks for talking to us today, can you tell us how you became to be a patient at The Dean.
“I went to hospital for mental health issues. I was suffering with depression and anxiety and was self-medicating with alcohol, I wasn’t in good shape. Three days after I was admitted, I contracted C-Difficile, which is a common hospital bug. My colon swelled and was crushing my lungs. I was sent for life-saving surgery with 80% chance of dying during the operation. The C-Difficile had infected my lungs and I required a tracheostomy. My body could no longer absorb vitamins and nutrients, which combined with the level of alcohol intake, caused a brain injury.
“After a stay in hospital recovering, I was then moved to The Dean, and by this point some of my mobility had returned but I could barely walk and I was very shaky. They have something here called the Bergs Balance test. It is scored out of 56; I scored nine.”
Could you explain more about your rehab experience at The Dean?
“I received support from physiotherapists. At first I would practise with the frame and strengthen my legs, now I’m walking again without the frame. I cannot thank all the physios enough! I have now scored 49 out of 56 on the Bergs Balance test.
“I also had some input from occupational therapy, sometimes it would be in the kitchen. I baked salted caramel shortbread the other day; it was quite nice actually. Great British Bake Off here I come!
“To help me with my talking, I have also had speech and language therapy. Although I know the words, I struggle pronouncing them. The SLTs are helping me and it is working, so again, thank you all.”
How do you feel about the progress you are making?
“They say a drowning man clutches at straws and that is futile, but that is not true. You grab one or two straws; you are still drowning. You get to a hundred, then a million, and suddenly you are floating. I am that drowning man and I am clutching at straws. I haven’t got to a million yet, but I’m working on it and it all started with just one straw!”
After we spoke with Richard at his six month point at The Dean, he continued to make great progress with his rehab.
Physiotherapy
The physiotherapy team worked with Richard on an intensive physiotherapy programme, practising walking with a frame and strengthening his legs.
As soon as Richard was able to mobilise with a wheeled frame, the nursing team would ensure they took the time to walk Richard to go and get his breakfast and out into the lounge for mealtimes to help him progress his walking.
Richard was very competitive with himself and was determined to score highly on the Berg Balance Scale. By the time Richard left, he was 1 score away from achieving full marks on his Berg and always promised the team that he would aim for full marks and be able to stand on one leg in the future!
Speech and Language Therapy (SLT)
Richard was Nil by Mouth upon arrival to The Dean, so the SLT completed oral trials and began an intensive rehab programme, which included voice function exercises and oromotor exercises. The SLT and nursing team worked closely together, supporting Richard at mealtimes and he eventually progressed to a normal diet which was a huge success. SLT and the physiotherapy team worked jointly on breath control helping to improve his lung function and cardiovascular fitness.
Occupational Therapists
Occupational Therapists and the nursing team focused on enabling Richard to be fully independent with daily tasks and Richard regained a lot of independence in his own care.
Richard is a shining example of what can be achieved with strong determination and drive to achieve goals. Having arrived at The Dean in a wheelchair, Richard was discharged able to walk out through the door on his own without any walking aids. We caught up with Richard post discharge to see how he was managing with daily activities and if he was continuing to make good progress.
What is life like for you since discharge?
“I was discharged four weeks ago and it is wonderful to be back home. I can’t tell you how elated I am to catch up with old friends, go out for coffee or go to the pub for a lime soda! I actually went with a friend to Wagamama the other night, I had a teriyaki soba with sirloin steak. These are normal things for everyone else, but they are a huge achievement for me!
“I even venture into town on my own, my balance isn’t perfect though so I’m super careful. I guess I’ve just re-learnt how to walk so it will come with time. In my mind I could remember how to walk, of course, put one foot in front of the other, but it felt like my body had actually forgotten how to walk. Guess all them nerve connections had to be remade.
“It’s the same with talking, in my mind I know the words, but my body has forgot how to say them. It’s loads better though; I’ve even got my northern accent back which is kind of apt as my nickname is Geordie!”
Where are you living now?
“I have my own flat, which I’ve had great fun furnishing. It’s assisted living, so there are carers on hand if I need them. Occasionally I need a little bit of help as I’m partially sighted – sometimes I can’t see small print in documents or I miss small areas when cleaning. I’m trying to be as independent as possible, and I’m loving it, even the little things, like washing up! I mean who loves washing up?! But I do.
“All in all, life’s good! The world is full of opportunities, and I intend on taking them, all of them!”
How do you feel about what you’ve achieved
“It’s wonderful to be here at this point in my rehab. There was always a glimmer of hope that I held on to, but it was two very difficult years, fighting back from paralysis and in three different hospitals.
“Belief has got me through this experience, even in the face of true adversity, I never gave up!”
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