Dawn's Story
Dawn Yale, 68, often reinforced to her granddaughter, Arianna, who lives with her, to call for help if needed. The 9-year-old took it heart, and that simple advice may have saved Dawn’s life.
After being hospitalized with pneumonia, Dawn returned to her home in Nanticoke, Pennsylvania, on oxygen for the first time. Although she had finished her antibiotics, she still wasn’t feeling like herself.
“One day I just didn’t feel right,” she says. “I’ve always told Arianna that if anything seemed wrong to just call 911. Well, that day she did.” Emergency responders rushed Dawn to nearby Wilkes-Barre General Hospital, where doctors diagnosed her with acute respiratory failure. Her condition quickly worsened, and she was placed on a ventilator. Eventually, she also needed a tracheostomy (trach) to help her breathe and a feeding tube to support her nutrition.
“I don’t remember what happened from my house until I woke up in the hospital,” says Dawn, recalling how she immediately tried to reach for her breathing tube. “Luckily, my hands were restrained.”
After a month in the hospital, Dawn’s condition had stabilized, but she couldn’t breathe, walk, talk or eat on her own. Unable to find the appropriate care close to home, she made the difficult decision to transfer to Select Specialty Hospital – Harrisburg, more than 100 miles from home.
“I really wanted to stay close to my family, but there weren’t any beds available nearby,” she explains. “Select was discussed with me. I thought about it being two hours away but decided this is the place to help me get better, to get back home."
As soon as she arrived, Dawn’s physician-led multidisciplinary team developed a personalized plan to help her rebuild her strength and regain independence.
Under the guidance of a pulmonologist, the respiratory therapy team led daily spontaneous breathing trials that gradually increased in length so her lungs could get stronger. Pharmacy provided guidance on medication to ease Dawn’s apprehension so she could fully participate in therapy.
“I would get so anxious that I couldn’t do it when they started taking me off the ventilator,” Dawn remembers. “But once they gave me anxiety medication, it was the game changer. That is when I knew I was going to get better and go home.”
Within three days, Dawn was successfully taken off the ventilator – a major milestone that motivated her to keep pushing forward.
Her team also introduced the Passy-Muir speaking valve, a device that attaches to the hub of the trach and allows a patient to speak by closing off the airway after inhale allowing the air to move over the vocal chords to create sound. This allowed her to speak, to communicate.
Despite her distance from home, Dawn was never alone. Her husband, Willard, and Arianna made the trip to visit, and her four sisters also stayed in touch.
“My sisters are my rock. When I got my voice back, we could talk and FaceTime—they are my cheerleaders,” Dawn said. Combined with therapy, all the talking further strengthened Dawn’s lungs and within a week and a half, the trach was removed.
At the same time, Dawn worked closely with her speech-language pathologist to strengthen her throat muscles so she could swallow safely. She was discouraged when she didn’t pass her first swallow test, but her therapist continued to encourage her.
“The second time I was tested, I was glad they used an X-ray,” she says. “This way I knew I wasn’t going to inhale anything in my lungs and get pneumonia for a third time.”
Within one week of her arrival and following the success of the second swallow study, Dawn returned to a diet of easy-to-chew foods and thin liquids, along with high protein shakes.
Meanwhile, her physical and occupational therapy teams focused on restoring her strength, range of motion and balance. Physical therapy started with basic beside exercises such as sitting on the edge of the bed and lifting and lowering her feet to strengthen her core and leg muscles. Next, Dawn progressed to standing, and a few days after that, walking with a walker.
“They helped me gain enough strength to stand and had me walking around the halls. They also helped me with my posture so I wouldn’t fall,” Dawn said. “That is what I needed to get home.”
Occupational therapy worked with her on daily self-care tasks, such as grooming and using the toilet. They also taught her ways to manage the fatigue from her long illness such as taking frequent breaks and using energy-savings techniques during tasks.
Three weeks after arriving at Select Specialty Hospital, Dawn had made tremendous progress. She was strong enough to transfer to an inpatient rehabilitation hospital to continue her recovery before heading home.
Grateful for the care she received, Dawn credits the staff for helping her reach her goals.
“You can tell these people know what they’re doing. I give so much credit to the nurses and the respiratory folks,” she said. “It’s a great hospital, a great place to be.”