Frank's story
Frank Sykes, 69, awoke with excruciating abdominal pain and was rushed by ambulance to UPMC-Williamsport. Frank, a retiree from Texas who moved to Pennsylvania to care for his father, had a complex medical history that included chronic obstructive pulmonary disease, lung cancer and high blood pressure. Two months earlier, he’d undergone surgery to reverse a colostomy. Tests revealed he now faced an obstruction.
At the hospital, he underwent multiple surgeries and developed complications including anemia, pneumonia and respiratory distress. He was intubated, meaning he couldn’t breathe on his own. A ventilator pushed air through a tube down his throat and into his windpipe to keep him alive.
He spent nearly two months in the hospital; 36 of those days were in the intensive care unit. Although the medical team was able to stabilize Frank, they couldn’t get him strong enough to breathe on his own.
His daughter, Hope, in Texas, faced the decision of where should her father – who also could not eat, think, speak or move on his own – go next for care. She weighed the options of what would give him a better chance to get his life back, a critical illness recovery hospital or a nursing home?
Hope chose Select Specialty Hospital – Camp Hill.
Before Frank arrived, he transitioned to a tracheostomy, which is an incision in his windpipe, and the ventilator pushed air through a tube in the tracheostomy. For most patients, tracheostomies improve comfort, are safer than intubation and also make it easier to liberate from a ventilator. Frank also had a feeding tube for nutrition. Hope’s goal for Frank was that he gain alertness and orientation and could breathe and eat on his own.
The physician-led team of nurses and therapists at Select Specialty Hospital put together a plan to restore his quality of life. Respiratory therapists gradually reduced his ventilator settings so he was helping to breathe and monitored how he did. They gave him short bursts of time off the machine, retraining his lungs and airways. Each day he did better. Not only did Frank get strong enough to breathe on his own, but by the end of his three weeks, his tracheostomy was gone. That was a big moment in his journey.
Physical and occupational therapists focused on improving his mobility, strength and endurance through stretching, resistance and range of motion exercises. Speech therapists worked with him on tongue movements to retrain his reflexes to swallow – and eventually eat – again.
The night before his discharge from Select Specialty Hospital, Frank spoke to Hope on the phone for the first time since his ambulance ride to the acute care hospital two and a half months earlier. Reflecting on his experience at Select Specialty Hospital, Frank said, “You all saved my life.” He encouraged families that are facing the agonizing decision of where to turn for care when a loved one is stable enough to leave a hospital but still dependent on a ventilator to consider a critical illness recovery hospital to give patients more time and specialized care. Following his successful recovery journey at Select Specialty Hospital, Frank was ready for more intensive therapy to regain his physical strength and coordination and to refine his cognitive and swallowing skills. For that, Frank chose Penn State Health Rehabilitation Hospital for inpatient rehabilitation. There, his physician-led interdisciplinary team put together a care plan that included physical, occupational and speech therapy.
In physical therapy (PT), Frank worked to strengthen his muscles and coordination using a recumbent bicycle and stepper. In two and a half weeks, he advanced from walking 30 feet with staff assistance to walking 150 feet with a walker. Frank also progressed to stepping from a curb with just supervision for assistance, if needed.
Meantime, occupational therapy (OT) worked to restore Frank’s ability to live independently by teaching him to safely transfer positions, groom and complete other everyday tasks. OT guided Frank through upper body strengthening exercises with therapy bands and weights and had him pedal with his arms on a therapy arm bike. Frank also worked to go from sitting to standing and took regular walks during his therapy sessions to prepare him to get around with his walker.
Speech therapy focused on improving Frank’s swallowing and sharpening his cognitive skills. Following his time at Select Specialty Hospital, Frank was on a modified diet of pureed solids and thickened liquids due to weakness in his throat muscles from his prolonged hospitalization.
After two weeks of inpatient speech therapy exercises that included external electrical stimulation to his throat to strengthen his swallowing muscles, Frank completed a specialized swallow study called a fiber optic endoscopic evaluation of swallowing (FEES). During FEES, a small flexible camera inserted through the patient’s nose allows the therapist to see the movement of the swallowing muscles while eating and drinking. This test showed improvement in Frank’s swallowing abilities as a result of his intensive therapy, and he was cleared to return to his regular diet. His speech language pathologists also challenged him with cognitive exercises to tune up his memory and problem solving skills to ensure he was ready for the everyday tasks at home such as managing his medications and finances.
After 20 days of inpatient rehabilitation, Frank was ready to move on and check off his goal: returning home to live independently once again, where he looked forward to enjoying the simple pleasure of sitting back in a favorite chair and drinking a regular Coke.