Maria's Story
Instead of spending her weekend completing projects around the house or tending to her yard, Maria Mares was confined to her couch and bed while she suffered through a cold. The 59-year-old electrical engineer technician had her two daughters, Christina and Jenna, and her dog, Piper, to keep her company, but as the hours passed, she felt worse. On Monday morning, Maria stepped out of her bedroom to face the day and collapsed to the floor.
When Christina found her mother unresponsive and having difficulty breathing, she called 911 and Maria was rushed to St. Joseph Warren Hospital. There, a breathing tube hooked to a ventilator was passed through her mouth and into her airway to help her breathe. The diagnosis was pneumonia in both lungs.
The pneumonia was further complicated when Maria went into diabetic ketoacidosis. Unaware that she was diabetic, Maria's body didn’t have the insulin it needed, and her blood grew steadily more acidic as her body switched over to burning fat for energy. The combination resulted in respiratory failure and 25 days in the ICU. Two days before she left the ICU, doctors surgically inserted a tracheostomy tube into Maria’s airway. While still on the ventilator, this would continue to provide breathing support while being a more comfortable -- a longer-term solution.
Once stable, the hospital provided Maria and her daughters with choices for the next stop on her journey back home. After careful consideration, they chose to transition Maria to Select Specialty Hospital – Boardman, a critical illness recovery hospital. “Select Specialty Hospital had the highest rating,” Maria said. “We definitely made the right choice.”
When she arrived at Select Specialty Hospital, Maria wasn’t yet breathing without the machine, was being fed through a tube and couldn’t move. She also needed maximum assistance with all self-care activities. “I couldn’t even use the restroom on my own,” she said. “I just wanted to walk, eat and care for myself. I wanted to breathe on my own again and get back to normal.” Maria’s physician-led care team implemented a personalized treatment plan to help her reach those goals.
To begin, the nursing staff implemented mobility protocols, making sure that Maria was sitting upright at least twice a day. From this position, it was easier for her to breathe, and she began to rebuild her balance and core muscles. The nurses also made sure that she was comfortable, explained procedures and monitored her vitals. “They treated me like I was part of their family. Even when they weren’t assigned to me, they checked on me,” Maria said.
To free her from the ventilator, Maria’s respiratory therapist began spontaneous breathing trials. For six days, the support she received from the machine gradually decreased, testing her ability to breathe on her own and helping her lungs grow stronger. On the seventh day, Maria watched as they switched the ventilator off and wheeled it from the room. She didn’t need it anymore – a big milestone.
Meanwhile, Maria was working with a speech-language pathologist to get her voice back. By attaching a speaking valve to her tracheostomy tube, air was routed over her vocal cords, and Maria could once again speak with her family. The speech-language pathologist also began testing Maria’s ability to return to a regular diet. They began with swallowing exercises like swallowing hard by activating all the muscles in her throat or swallowing while sticking her tongue out. Then they performed a modified barium swallow study. Maria drank liquid infused with barium that appeared white on a fluoroscopy x-ray. After watching how her muscles worked, they determined that she was strong enough to skip straight to eating a regular diet with thin liquids.
“I was excited to eat,” Maria said. “Excited to remember what everything tasted like.”
While she was learning to breathe, speak and eat again, Maria was also strengthening her body through physical and occupational therapy. Her therapists began with passive range of motion exercises, moving her limbs in every direction – bending her elbows and knees, flexing her wrists and raising her arms and legs.
Three days after she began therapy, Maria was able to stand with the help of two therapists. It was only for a moment, and it drained her stamina quickly, but it was another major milestone in her recovery. As she grew stronger, Maria was able to sit on the edge of her bed and practice the range of motion exercises on her own. Her first steps came 12 days after she arrived. “When I was able to walk around the nurses’ station, I knew I was getting better,” Maria said.
Her occupational therapist focused on practicing daily life skills and upper body strength. Maria spent time brushing her teeth, combing her hair and getting dressed. Each movement strengthened her body, fostered independence and improved her balance.
Throughout her time at Select Specialty Hospital, Maria’s daughters played a special role in her recovery. They visited regularly, kept her spirits high and encouraged her to keep trying even when things were tough. “They were a great support team,” Maria said.
A little over two weeks after arriving, Maria was breathing on her own, eating a regular diet, walking more than 300 feet with the help of a rolling walker and helping to care for herself. It was time for her to move on to the next level of care at a skilled nursing facility.
“I’m looking forward to going home and resuming my normal activities like sitting in my own chair, sleeping in my own bed and seeing my dog, Piper,” Maria said. “The nurses, aides, therapists ... everyone was amazing. They gave me the confidence to keep trying. It was a great support system.”