- Eibar Coa
Lenny Olsen: Stroke Patient's Recovery
Moise Brutus: Victory Over Trauma
Freeman Burks: Making a Connection
Anthony Dorto, MD: Physician Becomes Patient
Memorial Guides Jockey on Ride of His Life
By age 40, Eibar Coa was one of the top jockeys in America. He won 4,080 races and purses in excess of $129 million. He was weeks away from piloting Florida sensation Mucho Macho Man in the Kentucky Derby in pursuit of horseracing's celebrated Triple Crown.
Then, on a sunny Friday afternoon February 18, 2011, Eibar's horse was unable to avoid a mishap and tossed him hard to the Gulfstream Park turf.
"I attempted to get up, but nothing moved," he says.
Rushed to Memorial Regional Hospital, the native Venezuelan had fractured the C-4 vertebrae in his spine along with his wrist and shoulder. With no feeling below his neck, he was diagnosed a complete quadriplegic and told he would probably never walk again.
"I was conscious in the Trauma Center, and I was very scared," says Eibar. "Speaking with the surgeons and staff gave me a lot of confidence. As an athlete, I can tell right away when everyone is on the same team. I knew Memorial was the place I needed to be."
Eibar's fracture was severe, requiring surgical repair in two procedures over two weeks – first to the front of the spine, and then to support the back. As he awoke from his second surgery, doctors were amazed to notice slight movement in his arms.
By the time he was moved to Memorial Rehabilitation Institute at Memorial Regional Hospital South, Eibar could move his arms a little. "The first thing he said to me was that he would walk out of here," says Sherri Magcalas, Coa's first physical therapist. "He couldn't even sit up or support his head at that point. It was inspiring to see his determination, and I knew we were in for a journey."
Starting with the essential functions like support and balance, Eibar's team worked slowly with him, as with any patient. But soon they became aware that his tenacity and relentless work habits were fueling their own energies, challenging them to new heights. "It's seldom you have a patient who wants to go on through the pain, through the exhaustion," says Magcalas. "He never wanted to quit. It's exciting and motivating for all of us."
"Rehabilitation of the mind, body and spirit is an emotional as well as physical journey that we share with each patient," says Denise Maillet, Director of Rehabilitation Services at Memorial Rehabilitation Institute. "We have to adapt to what brings out their best. Some days we tell jokes, the next day, we might be stern. Because some of our physical therapists are marathon runners, they identified with Eibar as athletes and competitors. They were as determined as he was. Soon they were trying to keep up with him."
Eibar's progress shocked everyone but himself. "Every day is a project," he says. "First I worked to sit, then to stand, then to take steps. I forced my mind to send signals to my body. My body was like an old car. It only needed good mechanics to get it rolling again. I had many good mechanics here."
On April 14, less than two months after the accident, Eibar took slow but steady steps with his wife, Rebeca, as they left the hospital.
"My recovery was a team activity," says Coa, now in outpatient rehabilitation at Memorial Hospital West. "My whole life was spent in a very physical, competitive environment where I had to depend on myself. In a single second, all of that was gone. I had to depend on my wife to physically carry me. I had to depend on my therapists at Memorial to teach me to move again. My injury taught me to depend on the team – my team at Memorial."
Memorial Helps Put Young Stroke Patient Back in the Running
Active, athletic and adventurous, Joanie considered herself the picture of good health. A runner and scuba diver, she was in the midst of preparing to compete in a marathon, when life took an unexpected course.
"Thankfully, my husband was home unusually early from work," says Joanie. "I told him I felt like I was having a stroke. I was only 48 years old. I couldn't believe this was happening to me."
Her husband took her immediately to Memorial Regional Hospital South where emergency room physicians ran a battery of tests, including an MRI and CT, but the tests did not reveal a diagnosis. Because Joanie had been scuba diving the day before, she was transferred to another local hospital for hyperbaric therapy, a common treatment for decompression sickness in scuba divers.
When Joanie's condition did not improve, another MRI was taken. In some cases, it can take up to 48 hours for stroke damage to appear, and this time, Joanie's MRI revealed she had indeed suffered a stroke.
A Determined Spirit
"I just looked out the hospital window at the water and said to myself, 'I WILL walk again,'" Joanie says. "I was ready to get started, so I asked to be transferred back to Memorial Regional Hospital South."
Once admitted to Memorial Rehabilitation Institute at Memorial Regional Hospital South, Joanie began an intensive, personalized rehabilitation program.
"I was determined to leave the hospital within one week," said Joanie. "It was like someone had unplugged the cord that connected my brain to my legs. I tried as hard as I could to take a step, mentally screaming at my legs, 'you know what to do!' but they just wouldn't move. The therapist would physically lift one foot and place it down, then the other. Finally, the connection was made. My feet remembered."
In addition to regaining use of her arms and legs, the rehabilitation team would help Joanie practice daily, practical tasks.
"For example, I walk my dogs every morning, so I literally practiced bending over and pretending to clean up after my dogs," says Joanie. "I was dizzy and lost my balance. I realized that I needed to re-learn even the simplest tasks."
Once discharged, Joanie continued her daily therapy at home. She had her sights set on mastering even bigger goals.
Every day I ran on the treadmill, gripping the handles to keep from falling," says Joanie. "I watched underwater videos as I ran, swearing to myself that one day, I would dive again."
Determination and a positive spirit paid off. A follow-up angiogram showed two torn arteries in her neck, a possible explanation for her stroke. Once the arteries healed, doctors gave Joanie the green light to dive again.
"I bawled my eyes out the first time I dove again," says Joanie. "It's overwhelming to think of all I have accomplished. I couldn't have done it without the amazing support of the rehabilitation team, my family and friends."
An Advocate and an Inspiration
Because of her amazing recovery and attitude, Joanie was asked to serve on both the hospital's Patient Advisory Council board and as a patient representative on the quarterly Physician's Quality Control Panel.
"It's a huge responsibility," said Joanie. "I'm honored to be able to give back to Memorial and advocate for its patients."
Most importantly, Joanie hopes her story will inspire others to find courage and to cherish every day.
"My perspective has changed the most since my stroke. I even had wrist bands engraved with the words 'Got Balance,' a metaphor for not only how I feel physically, but for my life in general," says Joanie. "I completed a half marathon and recently returned from a dive trip in Indonesia. I truly have my life back "thanks to Memorial!"
Guiding Mother's Inspirational Recovery
It was a typical summer day when Claudia and her mother were driving in their family's car to take her two young daughters to dance lessons. As they approached the dance studio, they were involved in a horrific car accident, requiring the "Jaws of Life" rescue tools to extricate her and her family from the car. Claudia's mother and her two small children were shaken, but thankfully their injuries were not life threatening. Claudia, however, was unconscious and in critical condition.
Claudia was quickly transported by emergency medical responders to Memorial Regional Hospital Level 1 Trauma Center. A CT scan of her brain revealed Claudia had suffered a traumatic brain injury. There was evidence of bleeding throughout the brain and she suffered from a fractured clavicle and multiple fractures of her pelvis. Claudia required a tracheostomy to help her breathe and later a gastric tube to provide her with nutrition. She remained in the intensive care unit on a ventilator for several days in a semicomatose state.
Once she was weaned from the ventilator and stabilized, she was transferred to Memorial Rehabilitation Institute at Memorial Regional Hospital South to begin her recovery.
When Claudia arrived on the rehabilitation unit just two weeks after her accident, she was unable to move her right arm and leg. She exhibited severe memory loss and had difficulty following two-step directions.
"I could not eat, dress, stand or walk without help," says Claudia. "I was not able to care for myself and needed 24-hour nursing supervision. Thankfully, the rehabilitation nurses and staff gave me the great care I needed and so much more."
Claudia stayed in the rehabilitation unit for almost a month. During that time her two young daughters were never far from her mind as she worked tirelessly to regain her independence.
Motivation Drives Success
"Many of us at Memorial Rehabilitation Institute are mothers, too, so we could empathize with how important it was to Claudia to recover quickly so she could return to caring for her children," says Madeleine Morel, PT, Physical Therapist for Memorial Rehabilitation Institute at Memorial Regional Hospital South. "For every patient, the inspiration to recover may be something different. This is one of the reasons we offer a holistic approach to addressing the physical, cognitive, social and psychological needs of patients to help them achieve their goals and maximize their independence."
Claudia worked with her therapists for three to four hours per day, regaining her balance, strengthening her muscles and improving her memory and problem-solving skills.
By the time she was ready to return home, Claudia was able to move both her right arm and leg and was walking household distances using forearm crutches (Lofstrands) for assistance. She was able to perform all of her basic self-care with supervision for balance and had regained her memory.
"Best of all, I could put both arms around my daughters and reflect back on how blessed I am to have survived such a terrible event," Claudia says. "The care I received both at Memorial Regional Hospital Trauma Center and at Memorial Rehabilitation Institute at Memorial Regional Hospital South helped me to regain my independence and achieve my goal of returning home to care for my family again."
“Because of the care I received at Memorial, I'm able to care for my family again.” – Claudia, patient
Stroke Victim’s Family Credits Memorial ‘Angels’ with His Recovery
Just two days after a routine elective surgery at another South Florida Hospital, 65-year-old Gary suddenly went into respiratory failure. His condition was critical. Tests revealed Gary had developed a life-threatening postoperative complication. He had a pulmonary embolism as a result of a massive clot in his lungs.
Gary was treated immediately for the clot but continued to decline. Eventually, he suffered a cardiac arrest. The medical team performed CPR and Gary was stabilized, although his condition remained critical. Medical staff noted that Gary was not moving normally and further testing revealed that he had suffered a hemorrhagic stroke on the left side of his brain. In addition, he developed acute renal failure requiring dialysis. Because he was unable to eat well, Gary had to have a gastric tube inserted to help provide him nutrition.
What had initially seemed to be a minor procedure had now changed the course of Gary and his family’s lives. An accountant and active family man, Gary was now bedridden. His devoted wife, Raquel, and sister-in-law, Roxana, never left his side.
“I was devastated to see my vibrant, active husband now confused, unable to speak, swallow, walk or do any of his normal activities,” says Raquel. “I was determined to seek the best rehabilitative care possible for my husband.”
The family turned to Memorial Healthcare System.
Nearly two months after his surgery, Gary was admitted to Memorial Rehabilitation Institute at Memorial Regional Hospital South. Initially, he was very agitated and placed in a special bed that helped to calm him and keep him protected. He had a one-on-one caregiver assigned to watch him and help prevent any self-injuries.
The multidisciplinary medical team at Memorial Rehabilitation Institute created a comprehensive and personalized plan of care for Gary. It included intensive physical, occupational and speech therapy to address his deficits in mobility and self-care activities that his stroke and other complications had caused.
“Gary was very weak and debilitated,” says Raquel. “He became easily agitated by loud noises or quick movements but the rehabilitation team gave him the support, medical care and reassurance we needed. They really advocated for his care.”
The team was determined that this previously active man would receive high-quality care to help give him every chance of returning home to his family and lifestyle. Slowly, Gary began to respond to the treatment.
“Within the four weeks that Gary received treatment in the rehabilitation unit, he made great progress,” says Janice Cohen, MD, Physiatrist for Memorial Rehabilitation Institute at Memorial Regional Hospital South. “When he arrived, Gary required the assistance of two caregivers to complete all of his bathing, dressing and toileting and he was unable to walk. By the time he was ready for discharge, he was able to walk more than 200 feet while his wife held his hand.”
Soon Gary was completing all of his self-care activities with his wife close-by in case he needed anything. He began eating regular food and had started to regain some weight. Initially, he was unable to speak. By the time he was discharged, he was able to repeat basic words and comprehend most discussions.
Gary returned home with his wife and received outpatient therapy. He continues to improve his vocabulary and is now able to speak in sentences.
“The staff at the Rehabilitation Institute at South Florida are our angels,” says Raquel. “The excellent care we received has helped us put our lives back together again.”
Matt, Spinal Cord Injury Patient
Penny, Orthopedic Condition Patient
College Student Learns to Walk Again After Near-Fatal Crash
A young college student living in Orlando, 25-year-old Samir enjoyed partying and hanging out with his friends. At a party for a friend leaving for military duty, Samir made a tragic mistake that nearly cost him his life. After consuming several alcoholic drinks, Samir and a friend left the party. Samir declined his friend's offer to stay the night and drove himself home. Just miles away from his house, Samir's car struck a utility pole. He was unresponsive at the accident scene, and medics rushed Samir by helicopter to an Orlando hospital.
Samir suffered multiple fractures to his legs, arms, neck, spine and pelvis, as well as a traumatic brain injury and spinal cord injury . While hospitalized in Orlando, he was unresponsive in a coma and on a ventilator. His family was told that his condition was life threatening.
"The doctors told my parents that I may never walk again and that I could remain in a vegetative state so they should consider taking me off the ventilator," says Samir. "My family refused to take me off of life support and stayed by my side, hoping for a miracle."
After more than two months in a coma, Samir began to show signs of recovery.
"My family specifically requested that I be transferred to Memorial Rehabilitation Institute at Memorial Regional Hospital South to be near my family and to receive the best care in South Florida," says Samir. "Without a doubt, they made the best decision for me."
Determination and Support: A Powerful Combination
With no motor function in his arms or legs, but now under the care of a multidisciplinary team of physicians, nurses, therapists and other specialists, Samir's hard road to recovery began.
"In the beginning, I couldn't talk, feed myself, put my socks on or take a shower," says Samir. "But, I had the support of my family, friends and the entire rehabilitation team. Everyone gave me such great care and attention that I felt really special. I realize now that they treat all their patients that way at Memorial."
Samir's personalized inpatient rehabilitation plan included daily sessions for speech, occupational, recreational and physical therapy.
"The biggest challenge I faced was learning to walk again," says Samir. "I'd imagine myself walking in the mall with friends, or along the beach. Even though my muscles were too weak to stand, the therapists kept me working hard and step-by-step my motor function improved."
Committed to making a full recovery, Samir, his family and the rehabilitation team worked together to help him reach his goals.
"My dad and I made a bet. He said he'd buy me an iPod if I could walk out of the hospital by myself," says Samir. "I was determined to do it. Not for the iPod, but for myself and those who believed in me."
After five months of hospitalization and intensive rehabilitative care, Samir was ready to declare victory and make the most of his second chance at life.
"I remember the first time I took the elevator and walked outside, they couldn't wipe the smile off my face," Samir says. "Since the hospital requires that patients be discharged in a wheelchair, I guess I technically lost the bet. But, I had learned to walk, talk and smile again at Memorial. I'd won."
Inspired by his rehabilitative experience and the therapists at Memorial Regional Hospital South, Samir is now living with family in South Florida and attending college again with a new goal.
"I want to be a speech therapist," says Samir. "My Memorial rehabilitation team encouraged, uplifted and inspired me. I hope I can share my story and help others the way Memorial helped me. That would be my greatest reward."
Rehabilitation Team Helps Patient ‘Go the Distance’
Sixty-two-year-old Howard had been experiencing shortness of breath and swelling in his legs for more than two months when his wife insisted on taking him to the emergency room at Memorial Regional Hospital. An evaluation by the emergency room physician revealed he was a very sick man. Howard was experiencing acute congestive heart failure and had muscle weakening of the heart, medically termed, cardiomyopathy.
Howard underwent a cardiac catheterization and was diagnosed with severe three-vessel disease requiring a triple artery bypass graft and mitral valve repair. Following surgery, Howard developed respiratory failure and an altered mental status. He required a tracheostomy to stabilize his breathing. While in the intensive care unit, Howard continued to experience complications including atrial flutter and atrial fibrillation as well as sick sinus syndrome, a type of heart rhythm disorder, for which he underwent placement of a dual-chamber defibrillator.
Throughout his difficult medical course, his wife remained at his side, giving him the encouragement he needed to pull through.
Once the doctors felt he was medically stable, Howard was transferred to Memorial Rehabilitation Institute at Memorial Regional Hospital South. The multiple procedures and surrounding complications had left Howard with significant loss of mobility, unable to perform basic self-care without assistance. He also suffered memory loss and was unable to follow commands accurately.
“My ultimate goal was to walk out of the hospital,” says Howard. “I was a train wreck. It was a painful and difficult journey, but my Memorial rehabilitation team of doctors, nurses, therapists and specialists helped me go the distance.”
Small Steps Lead to Great Strides
Howard worked tirelessly with therapists for three to four hours per day to regain his strength and function. After less than two weeks in the rehabilitation unit, Howard had relearned how to get in and out of bed, walk, bathe and dress again. His began to regain his memory and was able to return home with his wife using a rolling walker to walk. He continued to receive therapy and today is feeling better than ever.
A few months after he was discharged home, Howard returned to Memorial to visit the rehabilitation staff. In fact, he visits often.
“Howard looks like a different person,” says Beverly Straus, OTR/L, Occupational Therapist for Memorial Rehabilitation Institute at Memorial Regional Hospital South. “In fact, our team hardly recognized him the first time he visited as his condition had improved so much. It was amazing and incredibly rewarding to see him walk in and to listen to him speak. His recovery is a testimony to his strength and determination.”
“Returning ‘home’ to Memorial is an amazing experience,” says Howard. “Not only do I return to say ‘thank you,’ but I want them to see that all of their hard work and mine really paid off. Thanks to Memorial, I had the right combination of excellent rehabilitation care and support to help me get back to living my life to the fullest again.”
“Returning ‘home’ to Memorial is an amazing experience.” – Howard
Rehabilitation Institute Helps Civic Leader Get Back on His Feet
Energetic and always on the go, Billy Joel serves tirelessly in South Florida civic and community affairs. The healthy 75-year-old rarely misses a beat, but when he became seriously ill one weekend, he knew it was no ordinary stomach bug slowing him down. In fact, it was the beginning of a long journey that led him to Memorial Regional Hospital South to get him back up to speed.
When the stomach illness hit, Mr. Joel was so sick he had a fever of 104 degrees, was admitted to a hospital in Miami-Dade County and received antibiotics for five days. Doctors there diagnosed him with campylobacteriosis, which is caused by Campylobacter bacteria often found in undercooked meat.
While vacationing out of the country a few days earlier, Mr. Joel had eaten a hamburger that he suspects was the source. Most people recover from campylobacteriosis in two to five days without antibiotics, but in rare cases, it can cause severe complications.
"Four days after leaving the hospital, I was walking to my car, and my feet and legs gave out," Mr. Joel says. "I became paralyzed."
The paralysis eventually spread to Mr. Joel's waist, and he was diagnosed with Guillain-Barré syndrome. A rare disorder in which the body's immune system attacks the nerves, Guillain-Barré affects only 1 or 2 people per 100,000. The exact cause is unknown, but it often follows a stomach illness or respiratory infection.
Step by Step
To recover from Guillain-Barré, doctors recommended inpatient physical rehabilitation to help Mr. Joel regain strength and walk again. After researching and visiting area rehabilitation centers, he says he and his family chose the Memorial Rehabilitation Institute at Memorial Regional Hospital South because of its excellent reputation. He entered the Rehabilitation Institute in a wheelchair but was determined not to leave in one.
"Knowing Memorial, I made a request to go there," Mr. Joel says. "Everyone was fabulous. I said I'll leave with a cane, but not the wheelchair."
At Memorial, Mr. Joel says he found physicians, therapists and staff dedicated to helping him walk out on his own two feet. Leading the team was Bryce Epstein, MD, FAAPMR, who is board-certified in physical medicine and rehabilitation. Dr. Epstein developed a personalized plan of care specifically for Mr. Joel's condition.
To develop his motor skills, Mr. Joel spent many hours on Determination Drive, a simulated environment that helped him practice everyday life skills. As part of his neurological rehabilitation, he practiced driving a MINI Cooper, as well as sitting on and standing up from a low park bench. Therapists also helped him use a treadmill, climb steps and regain strength.
Circle of Support
Another important part of Mr. Joel's recovery was the love and emotional support of his wife, three children, other family members and friends, who encouraged him every step of the way. After almost two weeks of therapy, Mr. Joel was dismissed from the Rehabilitation Institute with the ability to walk.
"I hired a private trainer for water therapy in the pool," he says. "I play tennis four days a week and go to the gym three days a week. I've lost 15 pounds, and I'm around the weight I was when my wife and I were married.
"I'm in better general health now than before I was sick," he says. "This all due to the care I had at Memorial. I'll always be grateful to them."
Heart of Gold — Knees of Steele
Three decades of firefighting duties took a heavy toll on Mark Steele's knees. As a 29-year veteran of the City of Hollywood Fire Rescue Department, the Division Chief has worked closely with hospitals across South Florida. So when his knees finally gave out, he knew exactly who he could trust – Memorial.
By age 49, several years after ACL (anterior cruciate ligament) replacement, Mark had developed degenerative arthritis in both knees. Cortisone and other injections no longer relieved the constant aches.
"My posture was changing to compensate for the pain. My legs started to bow, as if I rode a horse all day. I was wearing through shoes at awkward angles," he says.
The osteoarthritis had completely worn away the cartilage protecting the knees. "I couldn't sneak up on anyone because of the clicking of bone on bone," Mark says. "Every morning was a greater struggle to get out of bed."
Life and Limbs
Mark's trust in Memorial Healthcare System began long before he needed them. He had worked with Memorial's emergency medical services for years, and his daughter, Jordyne, is a paramedic at Memorial Regional Hospital South. Nonetheless, Mark was apprehensive about major surgery until he met with Johannes Blom, MD, an orthopedic surgeon on the staff of Memorial Regional Hospital South.
"Dr. Blom's tremendous confidence convinced me I could get back to 100 percent with a new set of knees. He took time to explain every aspect of the procedure and a timeline for recovery. And he introduced a level of respect I later experienced from every single person affiliated with Memorial."
So Mark kicked off the first week of 2012 with a five-hour procedure for bilateral knee replacement, opting to overhaul both knees at the same time. After four days in the fourth-floor orthopedic procedures unit at Memorial Regional Hospital South he moved to the fifth-floor inpatient rehabilitation unit.
"Two hours after surgery, a physical therapist had me up and going. Their enthusiasm and motivation is phenomenal. Throughout my entire rehab experience, there was never the option of 'Oh, no. I can't do it today,' the response is 'Yes, you can... and yes, you will!' and then you do."
"We have a sign that reads, 'Can't is not a word in this gym!' " says Becky Boyle, Rehab Manager at the Memorial Rehabilitation Institute. "Mark and his therapist clicked immediately and were challenging each other to push farther."
Mark underestimated the value of occupational therapy before he began his treatment sessions. Having been a firefighter and paramedic training instructor for a quarter-century, the roles were reversed when he was forced to relearn such everyday motions as how to walk and get in and out of an automobile. "You've got to let the therapists show you how to do things you never imagined," he says. "It is truly humbling."
Two months after surgery, Mark's healing is well ahead of schedule. He is biking and swimming and expects to be back to 100 percent in just a couple more weeks.
"It is so important to have this program and these people devoted strictly to orthopedics and rehab in the same place," Mark says.
His advice for anyone preparing for knee replacement: "Get your upper body in shape. Get ready for a huge amount of work, and be nice to people. You're going to need a lot of support."
And if he didn't already believe in karma, not a month after Mark was back on his feet, daughter Jordyne tore her ACL, and embarked on her own road to recovery after surgery at Memorial Regional Hospital South.
"Bad knees aside, we're lucky," he said. Memorial definitely runs in the family."