Cristine Chinea, 27, of Miami, was living the good life. She had just achieved her lifelong goal of purchasing her own property and had a satisfying and meaningful career working for the Miami court system helping to resolve child support. In her free time, Cristine enjoyed cleaning, socializing with friends, watching television and dining out.
Cristine was at work one day when she began to notice an unfamiliar sensation in her hands and feet. She felt a slight numbness accompanied by occasional pins and needles that would come and go. Throughout the rest of the day, she recalls tapping her feet on the ground and moving them to try to get the sensation to stop. Although Cristine was concerned, she decided to get some rest after work and see how she felt the following day. The next morning when she woke, Cristine went to take her first step out of bed and collapsed to the floor. She had no sensation in her legs and was unable to bear weight on them, much less walk. Cristine realized the severity of her symptoms and was rushed to Baptist Hospital.
There, Cristine’s doctors were baffled by her symptoms. For several days, they were unable to find the cause of her loss of function in her limbs. Tests ruled out one condition after another as Cristine waited and wondered what was happening to her body.
Cristine’s loved ones took to the internet for answers. They began to read about Guillain-Barre syndrome (GBS), an extremely rare neurological disorder where the body’s immune system attacks part of the nervous system. Only one in 100,000 people are diagnosed with the disease, categorizing it as rare. Cristine’s family began to suspect that the disease might be the culprit of Cristine’s sudden decline. Their suspicions were confirmed when, shortly afterward a doctor reviewed the results of a lumbar puncture test, a diagnosis of GBS was confirmed. While the news was not easy for Cristine and her family to digest, they were heartened to know that 70 percent of patients with GBS make a full recovery with proper rehabilitation.
Shortly after her diagnosis, Cristine arrived at West Gables Rehabilitation Hospital. She was unable to walk, had difficulty completing normal tasks, had limited ability to grasp and had a constant burning sensation in her extremities, requiring maximum assistance to get out of bed. Cristine was afraid of falling, which made performing certain exercises – both physically and mentally -- challenging. Upon admission, Cristine underwent a full assessment by her multi-disciplinary team to determine her needs and goals in order to create a care plan.
While Cristine had not previously been a fan of working out, she committed herself fully to therapy. She set goals to be able to walk with no adaptive equipment, regain strength and sensation in her limbs, gain weight and ultimately walking in high heels again.
Her physical therapy team began working with Cristine on her ability to stand as well as improving endurance. Therapists had Cristine practice walking straight without looking at her feet. Her team also got to work on improving her gait and ensuring she was using proper body mechanics while guiding her to sense her limbs in relation to the space around her. She also performed exercises that focused on motor planning and coordination. Once Cristine was stronger and more stable on her feet, she began to practice walking and stepping on and off curbs.
Occupational therapists worked on increasing Cristine’s strength to make transferring out of bed easier. They introduced a rolling walker in order to provide stability and ease stress on her body during ambulation. Cristine performed many different exercises in her therapy sessions, including using the parallel bar to promote balance and practice weight shifting and mirror therapy, which helped Cristine use her reflection to maintain proper posture. Stretching was implemented as a regular part of her routine to prevent stiffness and improve mobility. One of the primary focuses of occupational therapy was to improve Cristine’s hand strength and coordination so she could manipulate objects more easily – an important skill to independently perform activities of daily living.
Recreational therapists worked with Cristine to introduce her to activities that would decrease anxiety and boost her mood. She learned the importance of including leisure time in her schedule for a balanced lifestyle. Additionally, Cristine participated in recreational group therapy. She enjoyed spending time outside her room and most importantly, socializing and sharing her humor with others, which played an important role in her recovery. Throughout her time in recreational therapy, Cristine participated in art, baking, crafting, video gaming, yoga and beauty activities.
During her stay at West Gables Rehabilitation Hospital, Cristine not only built a strong bond with her therapy team, but made great improvements. By the time she was discharged after a two-month stay, Cristine was able to transfer out of her bed on her own using her rolling walker. She also gained the ability to walk 100 feet with a rolling walker. Cristine was also trained in using adaptive equipment to ensure she had the proper assistance at her family’s home while continuing her recovery with outpatient therapy.
After a month at home, however, Cristine felt as though she needed more rehabilitation in order to gain full independence and she decided to return to West Gables Rehabilitation Hospital, requesting the same therapy team.
During her second stay, Cristine was stronger and therefore able to set more challenging goals. She focused on walking while using a body-weight supported harness that assisted keeping her balance. She spent her time completing strengthening exercises and practicing daily skills such as cooking and cleaning in a simulated home environment. Therapists then took exercises to the next level by challenging Cristine to navigate over curbs, through narrow spaces and around obstacles, all while keeping her eyes straight ahead as opposed to looking down at her feet.
In order to improve symmetry, posture and body mechanics, therapists implemented mirror therapy so Cristine could self-correct her form while looking at her reflection. This significantly improved fine motor skills, helping her achieve greater independence when completing activities of daily living. By the time of her second discharge, Cristine was able to walk without the walker and with only minimal assistance by therapists holding her hands. She returned to her apartment independently, this time knowing she was strong enough to safely be alone.
As she reflects on her rehabilitation experience, Cristine says: “I learned that I am stronger than I thought, and I can overcome great challenges when I apply myself and have the support of my family by my side.”