Bruce's Story
Bruce McDavitt intended to enjoy his retirement by playing guitar with his band, gardening and golfing. However, after the last of a series of falls resulted in a fracture of one of his vertebrae, the 68-year-old needed to wear a cervical collar to protect and immobilize the injury. Bruce would have to wait until he healed before he could dive into his hobbies again.
Two days after being discharged, Bruce’s recovery was cut short when he lost consciousness and fell again. An ambulance transported Bruce to McLaren Lapeer Region Hospital, where doctors ran a series of tests to make sure he hadn’t experienced a stroke. They diagnosed aspiration pneumonia, meaning Bruce had inhaled food, liquid or saliva into his lungs. They had to intubated Bruce, place him on a ventilator and drain excess fluid in his lungs.
After a week in the hospital, doctors removed the breathing tube. Three days later it became clear that Bruce was working hard to breathe and they reintubated him. Then a tracheostomy tube was surgically inserted into his windpipe and attached to the ventilator to help him breathe. Bruce also needed a feeding tube to provide nutrition.
Bruce lay in the ICU for 21 days before he was stable enough to move on to the next level of care. After speaking with a clinical liaison, Bruce’s niece, who was handling his affairs, decided to transition him to Select Specialty Hospital – Flint.
He arrived on a ventilator, unable to breathe, speak, eat or move on his own. “I was toast, I was out of it, I didn’t know if I was going to make it,” Bruce recalled. He wanted to get off the ventilator, get stronger and take care of himself again. He also wanted to play his guitar again. The physician-led multidisciplinary care team at Select Specialty Hospital developed a personalized treatment plan to help Bruce work toward those goals.
To begin, the nursing team ensured Bruce was sitting upright twice a day. This position made it easier for his lungs to work and began rebuilding his core strength and balance. They managed his medication, the drain in his lung and made sure he wasn’t developing pressure wounds from his prolonged time in bed. They also kept Bruce informed of what was happening with his treatment, and that he cognitively understood.
Bruce began respiratory therapy with spontaneous breathing trials—carefully regimented ventilator liberation protocols administered by his respiratory therapists. Over seven days, the ventilator support was gradually reduced until Bruce was breathing on his own again. Two days later his tracheostomy tube was removed. On the same day that he came off the ventilator, a speech-language pathologist helped Bruce regain his voice by attaching a speaking valve to his tracheostomy tube. The valve forced air over his vocal cords and allowed Bruce to communicate verbally with his care team and family.
During this time, Bruce was also strengthening his swallowing muscles in anticipation of resuming a regular diet. He practiced swallowing hard, swallowing with his tongue sticking out and swallowing after holding his breath for a short time. Two weeks after he arrived at Select Specialty Hospital, Bruce was cleared to begin eating a pureed diet and drinking thin liquids.
Meanwhile, Bruce was also working with physical and occupational therapy to strengthen his body. Physical therapy focused on his lower body with resistance and range of motion exercises such as pushing against his therapists' hands with his feet, lifting his legs and flexing his toes and ankles. After five days, Bruce was strong enough to try standing for the first time with assistance. Three days later he took his first steps in almost a month.
Occupational therapy concentrated on Bruce’s upper body strength and self-care activities. By using similar resistance and range of motion exercises to his physical therapy, Bruce regained strength in his arms. As he regained control of his body, Bruce was able to practice brushing his teeth and hair, getting dressed and showering.
Throughout his stay, Bruce had a steady stream of visitors to provide him with support and motivation. His niece, Kathy, the drummer from his band, Russ, and his neighbor, Kevin, all made sure that he was in high spirits. Bruce’s care team also provided a support system that he was grateful for, saying, “They were my friends ... they helped me gain confidence and motivated me to get up and move, get stronger, stand, walk and go up and down stairs again.”
After 25 days at Select Specialty Hospital, Bruce was able to breathe on his own, speak to his care team and family and was beginning to return to a regular diet. Bruce could also perform his daily self-care activities, walk 135 feet with a cane and tackle short flights of stairs. It was time for him to move on to the next level of care at a skilled nursing facility, where he would continue growing stronger in anticipation of going home, “having a 24-oz t-bone steak and getting back into music and gardening.”
As discharge day approached, Bruce shared: “The people at Select Specialty Hospital are caring, kind, knowledgeable and patient.”