Triumph of Therapy

Triumph of Therapy

Dr. George K. Chacko, Ph.D.
Dr. George K. Chacko, Ph.D.

Confounding Medical Consensus, 81 Year-Old Quasi-Quadriplegic Walks!

What follows is the rehabilitation story of Dr. George K. Chacko, Ph.D., Professor Emeritus, University of Southern California. It's an extraordinary story—told in his own words—and one that should provide inspiration to anyone determined to overcome daunting odds for recovery. 

“It’s a miracle!”

"You were like a piece of dead wood,” said my wonderful wife of 54 years. “You could do nothing without help. But look at you now! You're walking all by yourself with a walker 60–160 feet, with only one contact guard assistant. Many people say it's a miracle!"

“He will never walk again.”

On July 22, 2011, I underwent surgery for cervical stenosis. The surgery was successful, I walked the same day, and was discharged the next day. However, 36 hours later, grave and unexpected complications set in, requiring me to return to the hospital for a second surgery. There I remained for two weeks before being released to an acute rehab facility. I remained there for seven unproductive weeks before I was transferred to the Hebrew Home's Rakusin Rehabilitation Center. At that point, the medical consensus was: “He will never walk again.”

A change in discharge plans

Despite this disheartening prognosis for recovery, I had said from the beginning of my ordeal that my goal was to walk again, with the help of a walker or a cane. To achieve this, I needed to demonstrate functionalities beyond assisted transfers from one resting spot to another (e.g., bed to chair). While my original two-week therapy plan was modest, unbeknownst to me, two therapists at the Home had observed my positive response to efforts to acquire new functionalities and they felt strongly that given time, I could defy all odds and achieve significant new capabilities.

To my surprise, during my second week of rehabilitation, the first thing that occupational therapist Sanjita Bhandari said to physical therapist Sweta Diwan was: “Why don't we put him in the Hoyer Lift (a medical device used to move individuals with disabilities)? “ When they lifted me in my sling by cranking the mechanical lift, I stood erect and stretched my arms over the hand rest at the top of the machine. As my wife stood nearby and applauded, who should walk by at that very moment but Srilekha Palle, Executive Director of Therapy, who exclaimed: “He is standing!” It would have been impossible to schedule Mrs. Palle to witness this event because the two therapists themselves did not know if and when they would attempt to put me on the Hoyer Lift. It was now clear that I did have great potential for recovery and Mrs. Palle advocated for extending my stay. 

The rehab regimen

The basic rehab approach for me was: kneel, crawl, stand, walk. To learn how to crawl like a baby, you have to lie on your front and lift your neck up. While I could barely raise my head the first time, on the second attempt I could push myself up holding my arms straight with minimal help. Then I had to pull my back forward. I was given a huge ball and asked to crawl on top of it. When I did, I was told to crawl back, the back-and-forth crawl constituting one of ten exercise repetitions. 

To stand, using the Hoyer Lift, I had to push up on my legs, lift my torso, and stand erect. I was told to wave, and I waved my hands saying: “Look Ma, no hands!”

Moving from the Hoyer Lift to the Parallel Bars meant that my whole weight had to be supported by my two hands and knees, instead of the machine lifting me up. To train my legs to carry the weight, the therapist would lock his/her knees against mine, and I would have to walk forward lockstep with their knees, following their lead as they walked backwards. I graduated when I could walk forward holding on to the Parallel Bars with no assistance from the therapists.

In a process that I call "Journey of a Thousand Miles Beginning with Steps on a Walker," I worked on getting up from the bed or wheelchair, shifting my hands to the handles of a walker, and holding myself erect. I pushed the walker forward, put my weight on one leg, and moved the other forward; the process was repeated with the other leg.

“You’ll be walking out of here!”

In Week 16 of rehabilitation, my physician said after review of my weekly progress, “You'll be walking out of here!” Graduating from the walker, I practiced walking with a quad-cane (cane with four prongs), which demands considerable stability because my right hand and two knees essentially bear the whole weight of my body.

Fulfilling the faith of the two therapists

Had my stay at the Hebrew Home been terminated in Week 11 of my recovery, the medical consensus that I would never walk would have become a self-fulfilling prophecy. But there were two therapists who saw my response to their pushing my limits and the determined application of myself to their challenges. I am most grateful for the dramatic intervention in my behalf by the therapists and their director, Srilekha Palle.

What I am able to do today is the triumph of therapy—as much as the triumph of faith!

By Dr. George K. Chacko, Ph.D.

[Photo by David Khoo Heng Leong]

 

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