Helen's story
After 18 years working for a large medical supply company, Helen Morrow, 81, called it quits. The avid Kansas City Jayhawks fan was looking forward to spending time with her grandchildren and cheering on her grandson at his sports games. Heart surgery to address long-standing valve problems was also part of her future plans, but first, she hoped to enjoy a well-earned break.
But just two months into retirement, Helen began having trouble breathing. A relative drove her to Ascension Saint Thomas Hospital West in Nashville, Tennessee, where doctors said her planned surgery couldn’t wait. Her condition was worsening.
Helen underwent a complex heart surgery to replace both her aortic and mitral valves, repair her tricuspid valve and close a small hole in her heart called a patent foramen ovale. The surgery was extensive, and her chest could not be closed right away. Instead, doctors used a wound vacuum to help with healing.
Helen developed respiratory failure and couldn’t come off the ventilator. Doctors placed a tracheostomy -- a slit in her windpipe – which attached to a tube and connected to her ventilator. It was more comfortable than a tube down her throat. Helen also had a feeding tube for nutrition and when her kidneys began to fail, she needed continuous renal replacement therapy, a gentler treatment for critically ill patients. During this time, Helen also developed atrial fibrillation, a fast and irregular heart rhythm that required treatment.
After 36 days in the hospital, Helen stabilized but still needed the ventilator to breathe. She was unable to walk or eat on her own and struggled with confusion. On the advice of her surgeon, her family decided to transition Helen to Select Specialty Hospital – Nashville West, a critical illness recovery hospital.
Upon arrival, a physician-led multidisciplinary team developed a plan to help her regain independence. At that point, there was nothing Helen wanted more than to get off the vent and back to her normal life.
Guided by a pulmonologist, the respiratory therapy team began breathing trials in which Helen’s ventilator settings were lowered for increasing amounts of time so that her lungs had to do more of the work. Within five days, Helen was freed from the ventilator but she still required supplemental oxygen through the tracheostomy.
Helen’s spirits lifted the day she was able to speak again, thanks to a Passy Muir valve. The device connected to her tracheostomy and pushed air through her vocal cords which allowed her to speak.
Over the next 25 days, Helen continued to practice breathing until she no longer needed the air provided through the tracheostomy and it, too, was removed.
“When I got my trach removed, it was a huge milestone,” said Helen, who was equally motivated by her ability to talk and her improving cognition. She was grateful for family who supported her daily.
“They have helped me remember things when I couldn’t and kept me motivated,” she said.
The physical and occupational therapy teams focused on improving Helen’s mobility and independence. Physical therapy concentrated on general mobility exercises, starting with in-bed and edge-of-bed movements to rebuild strength in her legs and core. Two months after being hospitalized, Helen was able to stand for the first time. Meantime, occupational therapy used weights and bands to help her to strengthen her upper body so she could perform daily self-care tasks such as brushing her teeth and combing her hair.
The combined efforts of the multidisciplinary team were instrumental in Helen’s progress. Five weeks after arriving at Select Specialty Hospital, she was breathing independently, speaking and sitting at the edge of the bed. She couldn’t yet walk or eat, but was optimistic she’d regain her ability to do both when she transitioned to her next stop in recovery, an inpatient rehabilitation.
“The staff have been very helpful and encouraging,” she said. “They have explained everything well and taken time to help me progress and move forward.”