Mike's story
Mike McGarrity, a young father, tax preparer, golfer and self-professed Pearl Jam fan, was enjoying his wife Steph’s fortieth birthday party. However, the celebratory event took a serious turn when the young dad fell down a flight of stairs. Unconscious but breathing, he was rushed to the emergency room.
Mike had sustained a traumatic brain injury.
At Holy Spirit Hospital, Mike was put on a ventilator and feeding tube. Additionally, a drain was inserted into his skull to alleviate the buildup of fluid on his brain. His doctors also decided to perform a tracheotomy—they inserted a tube through his throat and into his windpipe to protect his airway and help him breathe. Mike could no longer speak.
After 16 days, Mike was stable enough for Steph to consider next steps. She chose Select Specialty Hospital (SSH) – Harrisburg for Mike, a critical illness recovery hospital where medically complex patients relearn how to move, speak, eat, breathe and think again. At SSH-Harrisburg, Mike’s physician-led, interdisciplinary team developed a personalized treatment plan that would prepare him for the next stage of his recovery journey.
Following SSH-Harrisburg’s mobility protocol, Mike’s physical and occupational therapists made sure that he was sitting upright in his bed at least twice every day to help rebuild his core muscles and make breathing a little easier. His respiratory therapist began breathing trials, gradually reducing the amount of time that Mike was on the ventilator.
After eight days, Mike was liberated from the ventilator, and he began breathing on his own. Two weeks later a major milestone occurred: his respiratory therapist was able to cap Mike’s trach tube.
A short while later, SSH-Harrisburg physicians recommended an intensive inpatient rehabilitation program to help him regain his mobility and independence.
For his next level of care, Mike transitioned to Penn State Health Rehabilitation Hospital where his physician-led rehabilitation team assessed Mike’s minimally conscious state and mapped out a care plan to help him regain fuller functioning capabilities. The team would first need to increase his awareness, then work on rebuilding his strength, coordination and communication skills to get him back to independence.
His physical therapy team got to work, establishing foundational goals of increasing Mike’s strength, balance and ability to walk. Mike's body was stiff, making even the most basic movements difficult. To start, physical therapists focused on increasing Mike’s awareness and flexibility by repeatedly getting him upright.
During the early stage of his therapy, it was important that Mike develop his sitting balance, achieved by giving him simple, one-step commands. His therapists employed the Functional Electrical Stimulation bike, which stimulated Mike’s leg muscles to propel his pedaling action by working his same muscle group used in walking. These treatment sessions progressively improved Mike’s muscle strength.
To work on his lower body strength and balance, many therapy sessions included standing exercises -- squats, side stepping, moving over obstacles and some therapy mat activities. As Mike advanced, his physical therapy increased in difficulty with steady completion of agility ladder drills, obstacle courses and lunges onto a foam surface – all in an effort to boost his core strength and coordination.
Next, his physical therapy team shifted to helping Mike regain his ability to walk. As his strength and flexibility increased, Mike began using an overhead harness system called LiteGait. It supported his body weight while he relearned how to walk. Mike took to it quickly and gradually progressed to walking with the assistance of two, and later, one physical therapist.
Mike also used a wearable robotic device, the exoskeleton, during this phase of therapy. The exoskeleton supports and retrains patients to use the proper gait and cadence for walking. In 98 days, Mike made astounding progress, walking up to 500 feet independently.
Occupational therapy sessions were designed to empower Mike to reclaim his independence in daily tasks. His occupational therapists concentrated on overall upper extremity strength, pinch, grip strength, fine motor coordination, reaction time and endurance. Creative exercises were designed to increase Mike’s balance, strength, endurance and range of motion in his arm. Activities such as reaching exercises progressed to tossing beanbags and grabbing cones, building his upper body strength and coordination for actions he’d need back home, such as eating, bathing and dressing. Through repetition and hard work, Mike was well on the way to being able to manage all his self-care needs.
Meantime, speech language pathologists (SLPs) worked to reignite Mike’s communication skills and cognitive abilities. Initially non-verbal and reliant on a feeding tube, Mike tackled the basics in his speech therapy sessions -- following commands and recognizing pictures. Mike was able to swallow ice chips and small amounts of water, helping to coordinate and strengthen his swallow response. Then, with the approval of dietary staff, he was able to enjoy some of his favorite foods brought in by his family.
Importantly, within 2 weeks, Mike was speaking -- first in simple sentences which, in time, would become more complex. His SLP sessions included breathing exercises and speech tasks, improving both Mike’s breathing and the volume of his speech. Speech therapy also boosted Mike’s cognitive skills by working with him on processing, memory, flexibility in thinking, calculations and reasoning.
Indeed, Mike’s family became an extension of the care team during his stay, attending therapy sessions and through the hospital’s care partner program, learning how to support him upon his return home.
Throughout Mike’s inpatient recovery, there were countless moments of triumph, from recognizing familiar photos to remembering his email password. One of the most heartwarming moments for his care team was when Steph saw him walking independently and said he had the "same strut" he had before the injury. His personality was breaking through.
Driven by his desire to get home to his toddler son and family, Mike completed 14 weeks of inpatient rehabilitation and was ready to return home.
However, Mike knew his work was not done. Once discharged from the hospital, Mike signed up for the Penn State Health Rehabilitation Hospital comprehensive outpatient day program to build on his gains.
In the outpatient program, Mike wanted to continue to improve his mobility, increase his upper body strength and further refine his speech. The outpatient care team created a tailored plan of recovery that included more physical, occupational, speech and recreational therapy.
To help with his mobility, Mike’s physical therapists challenged him with balance exercises and transfers from a sitting position to the floor. Mike completed balance exercises and floor transfers with the goal of returning to play with his son. In addition, upper extremity exercises helped increase his range of motion and coordination in his arms.
In occupational therapy, Mike relearned how to use his hands and arms to do daily tasks like using feeding utensils, dressing and reaching for daily objects. Each day, Mike achieved a higher level of function for daily self-care and self-feeding.
Anxious to get back to his hobbies and golf, Mike also worked on eye-hand coordination skills with his occupational therapist. After some practice, he was able to maintain a grasp on a putting club and was able to hit the ball on the putting green one-handed. Mike also enjoyed playing corn hole as part of his therapy. In the beginning, it was difficult, but soon he was tossing beanbags a short distance and was getting his arm swinging properly to do it.
Concurrently, Mike's speech therapist concentrated on enhancing his short-term memory, problem-solving skills, word articulation, and breath support for voice clarity and volume. Mike worked on word retrieval, listening processing, articulation and reasoning for fine-tuning his fluency of speech and expressing more complex thoughts. His speech therapists remarked that they saw significant improvements in his day-to-day communications with family and caregivers.
To bolster his social skills, confidence and mental abilities, Mike completed community outings with his recreational therapist. These day trips included mini-golf and shopping at an outdoor sporting store.
After three months in the outpatient day program, Mike planned to continue refining his physical skills at home with the help of a personal trainer and the ongoing support of his family.
Toward the end of his rehabilitation journey, Mike and his family expressed their gratefulness for the expert care they received throughout the Select Medical continuum of care. He couldn’t wait to get back to quality time with family and friends – and a few rounds of golf.
A die-hard Notre Dame football fan, Mike channeled a similar fighting spirit into his recovery, motivating himself and others with the mantra: "Play like a champion today."