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Our patients and their stories
These stories of healing and recovery demonstrate how a positive attitude and expert medical care become the ingredients for success.
Kenny Kids: Making lives work through play
Bailey Kircher is a fun 5-year-old from Owatonna. Until recently, autism made it nearly impossible for her to express herself to her parents and siblings. Bailey receives therapy twice a week at Courage Kenny Kids™, part of Courage Kenny® Rehabilitation Institute – Owatonna.
Attitude of gratitude
Cancer survivor Marlene Miller's positive attitude has enabled her to experience joy in her journey through cancer diagnosis, surgery, treatment and rehabilitation. Yes, that's right, "joy" is the word she uses.
Complex regional pain syndrome
Getting her life back
Imagine not being able to use your dominant hand. You can't work. You can't do household chores. You can't even hold your grandchildren. That's what Linda Zeien's life was like after a fall in August 2010 left her with an injured shoulder and a swollen right hand that caused intense pain if she even thought about touching it or moving it.
Getting better slowly
Sarah Hlusak was young and healthy, so when she felt tired after the Cesarean section delivery of her second daughter she attributed it to caring for two young girls. When paralysis set in and her heart began to race, she was admitted to Mercy Hospital's Intensive Care Unit.
Enthusiasm of 7-year-old inspired others
In March 2011, Benedict Luis Villarosa, age 7, had sudden onset of left side loss of movement, facial droop, impaired speech and uncontrollable jerking in his left extremities. Villarosa underwent a craniotomy and resection of a cavernous malformation and was later referred to Courage Kenny Rehabilitation Institute (SKRI) - Cambridge for outpatient physical, occupational and speech therapies. On just his third visit he exclaimed, "Therapy is so much fun. I couldn't wait to get here!"
Polio survivor plays the cards he was dealt: A look back at Sister Kenny's polio treatment
In 1952, at the peak of the polio epidemic, 12-year-old Arvid Schwartz spiked a fever, complained of muscle fatigue and ultimately experienced paralysis. The family doctor urged he immediately go to the Elizabeth Kenny Institute in Minneapolis. "I didn't know when or if I would return," explains the now 69-year-old Schwartz.
Spinal cord injury
Profile of an artist: Susan Fink
Susan Fink, artist and former Sister Kenny patient, broke her neck and injured her spinal cord in a cross-country skiing accident. When she arrived at Sister Kenny she was only able to move the big toe on her right foot.
Spinal cord injury survivor wakes up to a 'good day'
A motorcycle crash in Fargo broke Nick Fischer's back and left him paralyzed from the waist down. His positive attitude and determination to succeed are helping on the road to recovery. After hearing his diagnosis he had two questions "Can I get my laptop to check emails?" and "when does rehab start?"
Tom Paulus: One step at time
Tom Paulus is thankful he never heard the news his family did in April 2007. After suffering serious injuries from a three-story fall during a construction accident, doctors told his family that he would most likely be paralyzed from the waist down for the rest of his life.
Joe Stone: Life came crashing down
A year after a paralyzing accident, West St. Paul's Joe Stone tackles a grueling mountain ride.
Stroke recovery: The power of not taking no for an answer
Michael Frickstad fell ill while golfing with co-workers from St. Michael-Albertville High School. A physically active adult, he didn't think much of it — just a bad headache. Frickstad went home, took some extra strength Tylenol® and got to bed early. He hasn't been the same since.
Teen strokes on the rise: Bailey's story
Bailey Carlson attends physical therapy five days a week. Her hands and wrists often get tired during exercises, but she's come a long way after having a stroke when she was 16 years old.
We all feel like our world is spinning out of control sometimes, but for most of us it's a figure of speech. When Lila Renstrom's world started spinning, it wouldn't stop. She was experiencing vertigo.
Getting her life back
Innovative treatment for complex regional pain syndrome
Imagine not being able to use your dominant hand. You can't work. You can't do household chores. You can't even hold your grandchildren.
That's what Linda Zeien's life was like after a fall in August 2010 left her with an injured shoulder and a swollen right hand that caused intense pain if she even thought about touching it or moving it.
Following surgery that included inserting a plate in her wrist, and traditional therapy, Zeien's condition did not improve. Her pain continued to worsen, and her stress and worry deepened.
Fortunately, Mark Rotty, MD, Zeien's boss at Allina Medical Clinic-Hastings, where Zeien is a certified medical assistant, encouraged her to go to United Pain Center for medical treatment and to Courage Kenny Sports & Physical Therapy Center – Fort Road for physical therapy and hand therapy.
United Pain Center provided Zeien with relief from her pain through medical treatment, while Courage Kenny Sports & Physical Therapy Center provided an innovative therapy approach for her condition: complex regional pain syndrome (CRPS).
Complex regional pain syndrome – a chronic pain condition
Complex regional pain syndrome is a chronic pain condition associated with dysfunction in the central and peripheral nervous systems. Typical features include changes in the color and temperature of the skin of the affected limb or body part, accompanied by intense pain, skin sensitivity, sweating and swelling.
The key symptom of complex regional pain syndrome is continuous, intense pain that is at a higher level and lasts longer than expected after injury. The pain also becomes worse over time instead of improving, which describes exactly what Zeien was experiencing.
If not treated effectively, a patient with complex regional pain syndrome could lose the use of the affected extremity altogether.
The Fort Road location is one of two Courage Kenny Sports & Physical Therapy Center sites that specialize in complex regional pain syndrome treatment. The other is in Minneapolis. Gradually, therapists throughout the Courage Kenny Sports & Physical Therapy Center system are being educated in this new approach.
Treatment for complex regional pain syndrome
Research has shown that rehabilitation for persons with complex regional pain syndrome is most effective when it incorporates graded sensory and motor activities. Sensory re-education has been shown to decrease the hypersensitivity of complex regional pain syndrome.
"We start with laterality training, using picture flashcards, showing the right hand or left hand doing motions. The patient grades the motions 1-4 on perceived level of difficulty," said Patrice Schober-Branigan, OTR/L, CHT, Zeien's hand therapist. The patient then determines which is the right hand and which is the left in the photos. Emphasis is placed on both accuracy and speed.
"The picture card activity is a gentle way to exercise the part of the brain that deals with movement, because representation of hand movement within the cerebral cortex becomes less precise in cases of complex regional pain syndrome," said John Hoops, PT, Zeien's physical therapist.
"Even thinking about moving my right hand was painful," said Zeien. "I had to do the picture exercises at least five to eight times a day."
"In the next phase of the treatment, Linda had to practice movement with her imagination," continued Hoops, "like athletes do in training – to exercise the part of the brain involved in the movement without experiencing pain. The imaging segment takes a few weeks before moving on to the next part of the treatment."
Schober-Branigan also fabricated custom splints to gently assist in correcting Zeien's finger contractures at nighttime. An edema glove helped decrease swelling.
The mirror box
The next step in Zeien's treatment was use of a mirror box to create a visual that looks like the painful hand moving, while the patient actually views a reflection in the mirror of the uninjured hand moving.
"The patient looks into the mirror, not directly at the hand. The reflected image looks like the involved hand moving normally without pain. This visual input to the central nervous system helps to disconnect pain from movement in the nervous system," explained Schober-Branigan. Eventually the mirror exercise involves movement of both hands. This therapy approach is also used with foot injuries.
"It took a few weeks for me to see improvement," said Zeien. "It was gradual. I could imagine what my hand could do. That 'memory' was important to me."
Zeien's therapists are now also making customized sound CDs for patients to use at home to image pain-free, relaxed movements. These can help patients use their "pre-motor" skills to gradually increase their physical exercises and normal movement.
In addition, patients are also given specific sensory re-education activities to do daily with a family member at home. These assist the patients in gradually regaining a more accurate cortical mapping of their extremity, which in turn, decreases the severe skin hypersensitivity and tolerance for touch.
Zeien also needed therapy for her shoulder injury, as a full recovery requires that all parts of the body be addressed. During each therapy visit, in addition to hand therapy, time was devoted to hands-on mobilization of Zeien's shoulder joint. She was assigned home exercises and did them diligently, which contributed to her successful recovery.
Zeien returned to work on December 20, 2010, easing into the routine by starting just before the holidays, when it would be quieter. She had to prepare both medically and physically for this return. Zeien was now free of pain, and her re-established work routine helped her realize that the anxiety and stress caused by complex regional pain syndrome had also gone away.
At the beginning of her therapy in October 2010, Zeien completed a self-report of her level of functional abilities, called the DASH (Disabilities of Arm, Shoulder and Hand). Her score at that time was 85 percent disability, where 0 would represent perfect normal use of the arm and hand. In a follow-up DASH in April 2011, Zeien’s score had improved to just 11 percent disability.
"I can't give these guys credit enough," said Zeien. "Early diagnosis combined with the research, knowledge and skills for complex regional pain syndrome treatment that I received from Courage Kenny have enabled me to return to work in my nursing career and to my family life!"
Getting better slowly
Sarah Hlusak was young and healthy. So when she felt tired after the Cesarean section delivery of her second daughter, Alison, in February 2007, she attributed it to caring for two young girls.
"After my C-section, I felt drained. But I assumed that it was because my oldest daughter, Anna, was only 20 months old," she explained. "Looking back, I think that some of my symptoms were starting to appear."
About 14 weeks after the birth of her daughter, Sarah noticed that her feet and hands felt numb. "On one particular morning, it was really difficult to climb stairs." said Hlusak. "I ignored it because I didn't realize all the things that could go wrong with the body."
A day later, the annoying numbness led to greater difficulty walking and Hlusak and her husband, Chris, headed to the Emergency Department at Mercy Hospital in Coon Rapids, where she was admitted.
After a number of tests to rule out other conditions, her doctor made the diagnosis: Guillain-Barré Syndrome (GBS). An autoimmune disorder, GBS is a mysterious ailment that affects everyone differently.
Five days after Hlusak's numbness began, paralysis set in and her heart began to race, so she was admitted to Mercy Hospital's Intensive Care Unit. "Then, I started to get scared," explained Hlusak.
After 13 days of ups and downs, Hlusak's doctors considered her stable enough to begin physical therapy and she chose Courage Kenny Rehabilitation Institute at Abbott Northwestern Hospital.
"The staff at Courage Kenny welcomed me and gave me a detailed overview of my treatment program," said Hlusak. "My care team and I set goals to achieve before being discharged, including self-care and being able to care for my daughters."
An intensive routine each day gave her increased strength. But even more importantly, the physical and moral support of her care team helped give her confidence that she would get past GBS, even when a relapse in her GBS symptoms turned a two-week hospitalization into an extended stay.
"The doctors, therapists and other professionals went out of their way to help me maintain my dignity," recalled Hlusak. "The compassion and empathy they showed to me were not part of their job description. I was truly overwhelmed and humbled by all they did for me." While not in therapy, Hlusak was visited by her family who helped to keep her spirits up.
In mid-July 2007, Hlusak was discharged, but her recovery was far from over. Five months later, she returned to her job on a part-time basis. "I had a revelation that patient care is not just a science, it's also an art and the staff and physicians at Courage Kenny have it mastered," she said.
Now back at work full-time, Hlusak is happy with how far she has come and looks back on her experience with gratitude for her family—and the care she received at Courage Kenny. "I don't wish my experience with GBS on anyone," she said. "But the revelations I had were invaluable. You never realize the importance of relationships
until you go through something like this."
Courage Kenny Foundation, Possibilities Magazine, summer 2008 Reviewed by: Karl J. Sandin
, MD, MPH, medical director, Courage Kenny Rehabilitation InstituteFirst Published:
Polio survivor plays the cards he was dealt
In 1952, at the peak of the polio epidemic, 12-year-old Arvid Schwartz spiked a fever, complained of muscle fatigue and ultimately experienced paralysis. The family doctor summoned to the Schwartz's farmhouse in Wood Lake, Minn., urged he immediately go to the Elizabeth Kenny Institute in Minneapolis.
For Schwartz's dad, the three-hour drive to the Institute was like traveling to foreign territory. His life revolved around family and their farm and he had only visited Minneapolis once before in his life.
Room 201 and hot packs
After a week in isolation lying on his back, Schwartz was moved to room 201 with a dozen or so other young boys. The daily therapy ritual included hot packs and muscle reeducation known as the Kenny Method. Schwartz vividly recalls the hot packs, particularly the dreaded smell of wet wool. Pieces of wool were heated in a tub of near-boiling water, removed with tongs, run through a wringer and placed carefully, but directly on the patient's skin. To retain heat, the wool was layered with plastic wrap and a top layer of wool or cotton secured by a safety pin.
"Once your body absorbed the heat, the wraps would be removed and therapists would stretch your stiff muscles — it was quite painful," recalls Schwartz.
Horseplay and letters from Wood Lake fill the time
While the therapy was demanding, there was always time for horseplay. Raucous spitball fights between the stir crazy boys would often erupt after "lights out" and draw the unsolicited attention of nurses.
Every Sunday Schwartz's parents made the seven-hour round trip to visit Arvid. "Here was a man who had never driven to the Twin Cities and now made the trip every weekend. I'll never forget that effort and I really appreciate my parents for that," adds Schwartz.
Without a home telephone, letter exchanges were frequent between the Schwartz family, as well as classmates and teachers. To this day, Schwartz treasures those well preserved cards and letters. The $19.50 daily hospital charge, brings a hardy laugh, but Schwartz clearly respects that this now nominal expense posed a financial hardship for his family.
Going home and growing up
Eight months after his polio diagnosis, Schwartz returned home. He would never regain the use of his legs and was fitted for leg braces and "Kenny sticks." Three years later, he replaced those sticks with a pair of G.I. issued sticks—the same ones he uses today.
Schwartz graduated from high school in 1958 left Wood Lake to attend business school. Arvid met his wife, Judy, married and were blessed with two children. Always one for a challenge, Schwartz worked his way to treasurer and vice president of Group Health Plan (now HealthPartners). A farm boy at heart, Schwartz and his wife, own and operate a 2,000 acre farm operation near Green Isle, Minn.
Schwartz has a philosophy about life. "Life is like a deck of cards. You get dealt a hand and you have two choices. You can throw them in or play them. My choice has been to play them. With God's help, I think I've played my hand pretty well."
A balancing act: Physical therapy can help relieve vertigo
We all feel like our world is spinning out of control sometimes, but for most of us it's a figure of speech. One day, Lila Renstrom's world started spinning, and it wouldn't stop.
She was experiencing an episode of vertigo, the first of many to come. The feeling that everything was spinning was frightening. An ear, nose and throat specialist at Cambridge Medical Center determined that a disturbance in the fluid and crystals in the inner ear, a common cause of vertigo, was creating Renstrom's problems. Medicines didn't help, and the episodes continued.
Whirling and swirling
"The vertigo episodes overcome you and you can't function," Renstrom says.
She is active, volunteering with the Isanti County Food Pantry and her church in addition to spending time with her three grandchildren who live in the area. She was unable to drive, and it was hard for her to get to her daily activities. Some days all she could do was lie on the couch and stare at one spot to stop the spinning and nausea.
Renstrom was encouraged to try balance retraining and vestibular rehabilitation. Although skeptical, she decided to try it.
"It was the answer to prayer," she says.
With a series of diagnostic techniques, Physical Therapist Janet Becklin learned that Renstrom's left side indeed had a disturbance of the crystals in her inner ear. Becklin has special training and a special interest in helping people with vertigo and balance problems. Becklin instructed Renstrom in a series of body movements that she could do herself at home to fend off the attacks.
Although they are simple—rolling her body and putting her head in specific positions in a specific order—they are effective.
"When I feel the vertigo coming on, I do the five-minute sequence and it doesn't develop into a fullblown episode," Renstrom says. "It has given me my life back."
Becklin says that a lot of people with balance problems don't seek help and gradually stop their activities.
"Balance affects everything we do, and many people can find relief with simple training and exercises, without medicine or surgery," she says. "We often are able to help people in two or three visits."
Enthusiasm of 7-year-old inspired others
In March 2011, Benedict Luis Villarosa, age 7, had sudden onset of left side loss of movement, facial droop, impaired speech and uncontrollable jerking in his left extremities.
Villarosa underwent a craniotomy and resection of a cavernous malformation at Mayo Clinic. He was admitted to Mayo's inpatient rehabilitation unit as he continued to have left hemichorea, left hemiparesis, a gait disorder and a speech disorder.
After discharge from Mayo, Villarosa was referred to Courage Kenny Rehabilitation Institute (SKRI) - Cambridge for outpatient physical, occupational and speech therapies. Demonstrating strong verbal skills, he was quickly discharged from speech therapy.
Villarosa then entered the occupational therapy department by announcing himself to the receptionist in a very clear voice.
"When he first began occupational therapy with me," said Cheryl Sailer, OTR, "he had significant weakness and lack of coordination of his left upper extremity. He required assistance with some daily living skills and was unable to attend school due to his poor activity tolerance. Early on, he showed a strong motivation to be able to use his left hand again."
SKRI team members and patients alike were touched by this enthusiasm. According to Sailer, by Villarosa's third occupational therapy visit, she went to get him from the waiting room, and as soon as he saw her, he jumped up and exclaimed, "Therapy is so much fun. I couldn't wait to get here!"
"Luis knew that no matter what we did, he had to use his left hand," said Sailer. "He let me in on a little secret he learned: if he used his left hand for any game or activity, he was doing therapy. It became his job to think of as many activities as possible with which to use his left hand. With this motivation and this approach, he made significant and outstanding progress."