Cincinnati native Shelby Holyoke, 83, is a retired baker and cake decorator. As someone who likes to “stay busy,” Shelby worked until she was 72. All those years of hard work on her feet damaged her left knee to the point where she could not walk and was wheelchair-bound for much of the last five years. She was reliant on the help of her daughter, with whom she resides, to help her with her personal care and mobility.
After Shelby was turned down by a surgeon who would not do a total knee replacement because of her other medical conditions, she resigned herself to living with the pain and never walking again. When she was referred to another surgeon who agreed to do the operation, Shelby finally saw a light at the end of a long, dark tunnel. Shelby’s surgeon required her to do exercises and take supplements prior to the procedure to ensure success. Knowing how much pain Shelby was in, her surgeon adjusted his schedule to fit her in as quickly as possible.
Shelby spent a week at St. Rose Sienna Hospital after her knee replacement. She had a terrible experience at another rehabilitation facility after a previous hip replacement, so she was nervous about the next step in her recovery. Shelby had been going to St. Rose Sienna Hospital “for years” and trusted them, so when the staff recommended Dignity Health Rehabilitation Hospital for inpatient rehabilitation, she knew she would be in good hands.
Upon admission, Shelby was dealing with significant post-surgery pain. She was unable to bend her knee past 75 degrees of flexion and could not stand unassisted, also requiring maximum assistance to get in and out of bed and for all of her personal care. Shelby was also struggling with her swallowing, especially when taking medication. Her goals for rehabilitation were clear: “I told my therapist on the first day that I want to walk again.” Shelby’s physician-led team of nurses and physical, occupational and speech therapists worked to devise a plan to get her moving.
Initially, Shelby was only able to walk three feet at a time with a walker and assistance from her therapists. Even as her post-surgical pain persisted, Shelby was eager and compliant. Her physical therapists focused on exercises to improve her range of motion while laying, sitting and standing so that she could bear weight and walk more normally. With hard work and help from her therapists, Shelby was able to progress to bending her knee up to 90 degrees and walking over 500 feet at a time while using a rolling walker.
In occupational therapy, Shelby’s team guided her in using a variety of adaptive equipment, including a leg lifter to get in and out of bed, a reacher and sock aid to facilitate dressing her lower body and grab bars to help with transfers in the bathroom. Shelby’s occupational therapists recommended that she continue using the adaptive equipment even after returning home to ensure she maintained her progress. While at Dignity Health Rehabilitation Hospital, Shelby participated in group therapy where she was taught relaxation techniques including tai chi, chair yoga and meditation. “The therapists here always made it fun,” she said, adding, “The group sessions were enjoyable because I could see that the other people were enjoying it too. We all talked and had fun.” Shelby incorporated these relaxation practices into her daily routine in order to assist with her pain management. By the time Shelby was discharged, she only required supervision to use her walker and to perform her personal care.
Because Shelby was struggling with swallowing medication, speech therapists conducted a swallowing assessment where she was given different foods and liquids with a variety of textures and consistencies. A video x-ray was then used to see how Shelby’s throat muscles moved as she swallowed. After the assessment was completed, speech therapists were able to identify the strategies that would help Shelby swallow efficiently and prevent future swallowing difficulties, including using multiple swallows for each bite and sip to avoid buildup of food and liquids in her throat. Once Shelby was aware of what she needed to do, she applied these strategies while eating and drinking and overcame the challenges.
During her initial evaluation with speech therapy, Shelby also expressed that she was struggling with her memory at times and wanted to work on improving it. Speech therapists educated her on memory strategies and how to incorporate them into her daily activities. Toward the end of her rehab stay, Shelby was able to quickly explain what she would do at home to help her remember things better. Her therapists also discussed activities that she could do at home to keep her mind active and stimulated, including reading, board games and puzzles.
During her time at Dignity Rehabilitation Hospital, Shelby’s family participated in training so they knew how to best help her once she was discharged. This included education on proper sequencing when getting in and out of a car and how to provide proper assistance if she needed it. Both Shelby and her daughter were also educated on proper positioning of her left leg when in bed and the importance of continuing range of motion exercises to improve flexibility in her knee and decrease swelling.
Shelby says that the day she walked down the hall was a turning point in her recovery. “I didn’t think I could do it, so we started in my room, just walking from the bed to the door. Then the therapist told me I was going to walk in the hallway. I couldn’t believe that I did it! After a bit, he asked me if I needed to sit down and rest, but I didn’t want to. I wanted to keep going. That’s when I realized I was going to walk again. I knew I could do it.”
She has high praise for her team at Dignity Health Rehabilitation Hospital, calling her experience “excellent,” adding, “I think if I hadn’t come here, I still wouldn’t be able to walk. Everyone was so nice. I would recommend this hospital to anyone.”
Shelby looked forward to going home and continuing to work on improving her walking and overall health. Her advice to others going through rehabilitation is “You have to be strong. You have to set your mind on what you want and just push it. You have to say you’re going to do it and just do it.”