It’s June 25, 2021. Sarah Kelly uploads a handful of photos to her Facebook page, writes a few heartfelt sentences, and hits “post.”
The photos form a collage on her Facebook page and tell the story of her past few years. Some of the photos are hard to view. They include the twisted remains of a car, Sarah lying in a hospital bed wearing a neck brace and Sarah in a wheelchair. The photos also include an X-ray image of a spinal cord – Sarah’s spinal cord – broken in half and positioned at a nearly 90-degree angle.
The responses to Sarah’s Facebook post tell a different story.
Inspiration. Amazing. Determination. Strength. Hero. These are just a few of the many words that repeatedly fill the comments beneath Sarah’s post. It doesn’t take much reading to see that Sarah has a lot of people in her corner, rooting for her.
“Over the last four years, my life has changed drastically,” part of her post explains.
It has changed. So much so, to call it a drastic change is still an understatement.
It’s been four long years for Sarah. Four years filled with hard work, sweat, smiles, tears, good days, bad days, milestones, setbacks, opportunities and successes. It’s been four challenging years. But most importantly, it’s been four rewarding years.
On the night of June 25, 2017, Sarah was driving home to Tallahassee after an evening out with her friends in Thomasville, Ga. It had been raining, the roadway was slick, and she lost control of her vehicle on US-319 about nine miles north of the Florida-Georgia state line, near Pebble Hill Plantation. Sarah overcorrected and her vehicle slid across two lanes, through the grass median, across two more lanes, and into a tree near the road.
Sarah wasn’t wearing her seatbelt, and when she regained consciousness following the accident, she was lying across what was once her center console, amidst the wreckage. Shortly after, a good Samaritan found Sarah in her vehicle off the roadway and called 9-1-1. Sarah was rushed to Archbold Medical Center in Thomasville, where she remained in the intensive care unit for 10 days.
She was lucky to be alive but suffered a fractured neck, broken clavicle, broken ribs, a thoracic spinal column break and spinal cord compression. Sarah’s accident changed her life in seconds and her injuries left her paralyzed from the chest down, but she never saw it as an option to dwell on her newfound situation.
“You just kind of pick it up and you go,” Sarah says.
Two weeks after the accident, Sarah was transferred from Archbold to the Shepherd Center in Atlanta for inpatient rehabilitation and physical therapy. It was going to be a long road back, but she made progress, and by December of that year Sarah was back home in Tallahassee. Shortly after, she began weekly physical therapy in the Outpatient Neurological Rehab unit at Tallahassee Memorial Rehabilitation Center (TMRC).
Allison Anderson, PT, DPT, is a physical therapist in Outpatient Neurological Rehab at TMRC and had a front-row seat to witness Sarah adjusting to her new lifestyle.
“She was challenging to work with at first. It was a very big life change, and there were a lot of things happening for Sarah all at once, so it was very emotional in the beginning,” Allison says. “Naturally, like most of my patients at first, she was very angry, she was very upset, and I just walked her through understanding that everything is different, but it doesn’t have to be that way indefinitely.”
Allison wasn’t Sarah’s first physical therapist at Tallahassee Memorial HealthCare (TMH), but due to Allison’s expertise and experience working spinal cord injury patients, she quickly became involved in Sarah’s recovery and physical therapy, observing and critiquing Sarah’s therapy sessions early in the process.
Sarah’s injury also required the use of several rehabilitation services aside from physical therapy, including speech therapy for breath support, occupational therapy and case management for the coordination of her care and services at TMRC. Neurological rehabilitation patients often go from total independence to needing a large support team to begin their recovery and rehabilitation.
By spring of 2018, four months into Sarah’s physical therapy at TMRC, Sarah and Allison began working together. At that point, Sarah was still adjusting to her injury, and couldn’t hold herself up by the arms on a mat – but that would soon start to change.
“She was a hard worker, she stayed as long as I needed her to stay and she pushed her body as hard as I needed her to,” Allison says of her first days working with Sarah. “She never missed an appointment and whenever someone canceled their appointment, she would show up take advantage of that extra time.”
Allison says that the number one goal of almost all the spinal cord injury patients she works with, including Sarah, is to walk again. However, from a physical and occupational therapy standpoint, many things need to happen first to condition the body for walking again.
“Sarah let me take the reins and say, ‘We’re going to get you there, but there are so many precursors to walking again,’” Allison says.
However, thanks to hard work and a great team effort, by the second year of Sarah’s physical therapy with Allison, she was getting there.
For almost any healthcare professional, helping patients recover and reach their goals is extremely gratifying. For Allison, the thing she loves the most about her work as a physical therapist is a patient’s smile – not just because she likes seeing a happy patient, but because it’s an indicator of the progress they’re making.
“I love seeing that first real smile. Not the smile they have when I meet them, and everything is new and different for them. I say I always see polite smiles when patients first come in,” Allison says. “Recovery is slow. It could take months to wiggle a toe, but when you wiggle that toe and I see that smile and we know we’re getting somewhere, that makes everything completely worth it.”
Sarah’s smile moment came when she took her first step after her injury.
“If Sarah has a good day and she’s up and walking on her walker, she has the most amazing smile,” Allison says. “I remember the day she took her first step following her accident. Sarah lifted her foot and placed it back down, and we all stopped, and I was like, ‘Did anyone else just see that?’ We all started hugging and crying, and we looked crazy, but it came out of nowhere. That was the first big smile I got from her, and it was about six months after we started, so that makes it worth it.”
Sarah began gradually putting more focus on walking again during her physical therapy appointments. She was starting to bear weight again and began feeling more sensation below her injury, just below her sternum. Her transfers to and from her wheelchair became easier with practice, she was going back to school full time, going to the gym almost every day, going to physical therapy weekly and quickly gaining endurance and stability.
Roughly two years following Sarah’s accident, she was able to drive again with the use of hand controls. It was a huge milestone – but one that didn’t come easy.
To understand how Sarah reached her milestone of driving again, it’s important to understand Sarah’s perspective on her injury. Whereas many patients with spinal cord injuries who can drive often drive wheelchair-accessible vans, Sarah doesn’t, despite admitting that a van would be easier for her.
“I don’t want things to be easy for me. I don’t want to be comfortable in this injury,” Sarah says. “I want to always stay very uncomfortable, because if I’m comfortable in this then I’m going to settle for where I am. I don’t want to settle.”
Sarah drives a Nissan Rogue instead of a van. This requires her to transfer into and out of her driver’s seat from her wheelchair by herself, while having to disassemble and reassemble her wheelchair, and place it in or out of her vehicle. It’s an arduous process, but one that has become easier with time and practice.
“It used to take me 30 minutes,” Sarah says. “And Allison worked with me while I got upset and threw things, but we worked at it for months and now I can do it in less than a couple of minutes.”
Allison says that finding what works for patients is key when it comes to helping them accomplish their rehabilitation goals. Not every patient is going to have the same goals and not every patient is going to complete similar tasks the same way.
“We practiced getting into the car probably 25 different ways until we found a way that worked for her,” Allison says. “But all of those attempts let us know what we needed to work on while she was here. She whittled away at every single task until she got into her car by herself.”
Driving again helped Sarah immensely. It was life-changing. It’s something that’s often taken for granted, but having personal transportation opens a lot of doors. Sarah now has a position as the director of human resources at Senior Life Insurance. She drives 45-minutes to and from her office in Thomasville every weekday. Because of her job and her ability to work, she’s currently in the process of buying a house, an opportunity that that’s not afforded to many in her situation.
But for as far as Sarah has come from her initial injury, her rehabilitation is still a work in progress.
More recently, during Sarah’s third year of physical therapy, there were setbacks, such as Lymphedema, which is a buildup of lymph fluid in the body and a common secondary condition of spinal cord injuries.
The COVID-19 pandemic also created barriers to Sarah’s recovery, at one point limiting her access to the gym due to statewide business closures.
As frustrating as it has been for both Sarah and her physical therapy team, Allison says it has pushed Sarah to work even harder at her recovery. Sarah and her team have worked through the past year and are getting to the point where they’re now focusing on her goal of walking and becoming functionally independent.
Today, watching Sarah work through exercises with Allison and other members of her physical therapy team – such as Will Potts, PT, DPT – it doesn’t seem like these are people who knew each other only through their weekly physical therapy appointment together. They come across as friends or even family.
They joke with one another. They laugh together. They focus together. They work together toward goals. Toward Sarah’s goals.
In addition to helping Sarah physically recover, understanding the mental support that physical therapists and caretakers provide is important. For almost any patient with a spinal cord injury, recovery is as much a mental challenge as it is a physical one. On a given day, Allison is paying as much attention to Sarah’s mindset as she is to Sarah’s body.
“If something in my therapy isn’t working, she’ll say, ‘let’s pivot’ and work on something else,” Sarah says. “If my walks aren’t working, she’ll say, ‘let’s work on core,’ and then mentally, I feel really good about the day and what I’ve accomplished.”
As much as treatment and physical therapy for spinal cord patients is about recovering and accomplishing goals, the team in Outpatient Neurological Rehab also works to build a community of patients who share common experiences and can motivate one another.
The team serves as a bridge in connecting patients like Sarah – who have found a lot of progress in their recovery – and new patients with spinal cord injuries, who are often struggling to adapt to their injury and new way of life. It often helps these patients to receive encouragement from someone who has experienced what they’re going through.
“To meet more people who are in the same situation and understand [what I’ve gone through] and for them to have phenomenal attitudes despite what they’re going through, has been extremely encouraging,” Sarah explains. “Because I may come in extremely stressed out or mad, there may be another patient here who may be frustrated too, and we’ll encourage each other. Allison, Will and the entire team have been great in helping with that.”
Sarah’s support system, which largely exists between her family, friends, physical therapy team and other patients in Outpatient Neurological Rehab, plays a huge role in her recovery and success.
“I’ve had the support no matter where I go. If I didn’t, I wouldn’t be as mentally or physically strong as I am right now,” Sarah says. “To have the team here care just as much to see us succeed just like they would their own family is a blessing, because they don’t have to. They choose to be personable; they choose to want to create a relationship with you and they choose to push you to be the best person you can be.”
While Sarah’s recovery and rehabilitation from her injuries will likely require a lifetime of work, her life is returning more closely to what she might call “back to normal” every day. And Sarah’s ability to maintain positivity has helped her to find the silver lining from her injury.
“It’s been a very frustrating journey, but it’s been very rewarding,” Sarah says. “I’ve seen a side of me that I never would have been able to see before.”
To learn more about Outpatient Neurological Rehab and the Tallahassee Memorial Rehabilitation Center, visit TMH.ORG/Rehab.
