AROUND THE MEMORIAL HERMANN REHABILITATION SYSTEM
TIRR Memorial Hermann-Greater Heights
Evelyn Suber: Like Family
In July 2013, Evelyn Suber was hospitalized for dehydration – the result of a serious viral infection. At some point during the two weeks she was ill, she noticed numbness in her legs.
A month later, when the numbness persisted, neurologist Suresh Roongta, M.D., admitted her to Memorial Hermann Greater Heights Hospital for evaluation. Dr. Roongta prescribed a course of steroids to treat inflammation and ordered a series of tests, including x-rays, blood tests, an MRI and a lumbar puncture. Because she had difficulty walking, she was admitted to the inpatient rehabilitation unit. On evaluation she had 75 percent mobility and no need of a full rehabilitation program, and by the time she was discharged, she was walking.
The following December she felt sluggish at work and decided to leave early. “I remember it took me a long time to walk from the building through the parking garage to my car,” says Suber, who was 53 at the time. “I was uncomfortable all night. I called Dr. Roongta and was able to get in to see him the next day.”
When Suber began having spasms in Dr. Roongta’s office, he arranged for her to be admitted through the emergency department at Memorial Hermann Greater Heights Hospital. The tests she underwent during her previous hospitalization suggested acute transverse myelitis, a rare acquired neuro-immune spinal cord disorder. Transverse myelitis presents with the rapid onset of weakness as a result of acute inflammation of gray and white matter in one or more adjacent spinal cord segments, usually thoracic. Its causes may include multiple sclerosis, neuromyelitis optica, autoimmune or postinfectious inflammation, vasculitis and certain medications.
By the time she was admitted to the hospital, the spasms were occurring every five minutes. “My sensitivity to touch was heightened, and I was in a lot of pain from the spasms. My legs felt like they were on fire,” she says. “Suddenly I went from being very hot to very cold. I raised myself up from the hospital bed to go to the restroom, and when my feet hit the floor, I fell. Sometime between 3 and 6 that afternoon I became paralyzed from the waist down.”
Under Dr. Roongta’s care, Suber took a 10-day course of corticosteroids and underwent plasmapheresis, a process in which whole blood is removed from the body, filtered into its component parts and returned to the body in an attempt to remove antibodies that attack the immune system. After five treatments, Suber could move her toes and legs, but still had no feeling from the waist down. She was admitted to TIRR Memorial Hermann Inpatient Rehabilitation-Greater Heights.
“I would sit there at night and try to think of reasons to get out of a long day of therapy, but when they came to my room, I was already dressed and ready to go,” she says. “I had to start at 5 a.m. to be ready by 8. They taught me exercises and I saw improvement that encouraged me to try harder to maximize the benefits of therapy. Every day I could do more. I realized that if I did everything they asked and tried my best, my recovery would be better than anything I could imagine.”
Mary Lynn Cortez, PT, oversaw Suber’s physical therapy program under the direction of physiatrist Anand Allam, M.D. “When Evelyn first came to inpatient rehabilitation, she presented like a paraplegic, with no movement from the mid-thoracic spine down to her feet,” Cortez says. “She had a difficult time sitting on the edge of the bed or a mat, so we worked on regaining strength in her trunk, improving her balance and transferring from bed to a wheelchair. It was a huge functional change for her, going from being able to walk to not being able to move her legs. During her first stay with us, she learned how to control her body without being able to feel her legs and trunk. When she came back to rehabilitation after plasmapheresis, she made very quick progress.”
By the time Suber was discharged from inpatient rehabilitation in mid-January 2014, she had regained a great deal of function and independence but was still unable to walk. She left the unit in a wheelchair.
After two months of therapy at TIRR Memorial Hermann Outpatient Rehabilitation-Greater Heights, she developed Stevens-Johnson syndrome, a rare and serious condition of the skin and mucus membranes that usually results from a drug reaction. She was hospitalized for two weeks.
“The hospitalization was an enormous setback,” she says. “I had to regain my balance all over again.”
From August until September 2014, she continued working on her mobility at TIRR Memorial Hermann Outpatient Rehabilitation-The Woodlands. In mid-September she had a relapse of transverse myelitis and was readmitted to TIRR Memorial Hermann Inpatient Rehabilitation-Greater Heights under the care of physiatrist Natasha Rose, M.D., who is medical director of the facility.
“From day one I was put into physical therapy with Mary Lynn Cortez,” Suber says. “Each time I had a relapse I lost more muscle tone. This time I was paralyzed from the chest down. I had no feeling and no sensation of temperature in the affected parts of my body, and I was very weak on the right side. I progressed from bed to transfers to moving around in a wheelchair. One day I got up and decided I wasn’t using that wheelchair anymore, so I went to therapy with my walker. The therapists asked, ‘Where’s your wheelchair?’ So they taught me the right way to use the walker. A couple of weeks later I woke up and thought, ‘I’m not using the walker anymore’ and went to therapy with a cane. It took me forever to walk there. Whatever I wanted to do, they made sure I had the proper training and education. The improvements I saw through physical therapy and occupational therapy gave me hope and the courage to continue. I got to know all my therapists well, and each time I accomplished something we all rejoiced together. They were like family.”
From October 2014 to May of 2015, Suber continued outpatient rehabilitation at TIRR Memorial Hermann-Greater Heights. Today, she can stand, walk and drive. "I visit friends. I go anywhere I want to go," she says. In February 2016, she returned to her job as a tax consultant.
Cortez remembers her former patient for her work ethic and great attitude. “Evelyn never gave up. She was willing to do whatever we asked her to do to reach her goals at that moment in time,” she says. “Her dedication to coming to inpatient and outpatient therapy contributed to her great outcome.”
Suber says the team at TIRR Memorial Hermann-Greater Heights and TIRR Memorial Hermann-The Woodlands were a critical part of her recovery. “They were always doing something extra,” she says. “When they asked me what I wanted to accomplish, I’d tell them I trusted them and would do whatever they asked. If it weren’t for them, I would still be laying in bed. They saw my potential and together we went for it.”
Top-ranked Rehabilitative Care Now Available in the Greater Heights Area
Last September, the inpatient rehabilitation unit at Memorial Hermann Greater Heights Hospital became the newest facility in the TIRR Memorial Hermann Rehabilitation Network.
“People in the Greater Heights area can now access top-quality rehabilitation services close to home rather than traveling to the Texas Medical Center,” says Christine Adair, OT, M.O.T., director of rehabilitation services at TIRR Memorial Hermann-Greater Heights. “We’ve enhanced our services and clinical skills, and are now aligned with TIRR Memorial Hermann’s rehabilitation program and standards.”
Adair was a member of the brain injury and stroke team at TIRR Memorial Hermann for nine years before moving to the Greater Heights facility in January 2014 to lead the transition team. Later that same year, she was joined by TIRR Memorial Hermann leadership Wesley Tidwell, who assumed the role of vice president of operations of Memorial Hermann Greater Heights Hospital, and Cori Ponter, PT, NCS, who assumed the role of manager of therapy services.
“The inpatient transition complements TIRR Memorial Hermann Outpatient Rehabilitation, which has been in place at Memorial Hermann Greater Heights Hospital since 2012,” Adair says. “On the inpatient side we did much more than change our name. We worked on the transition for more than a year, rolling out new programs and improving the quality of care we provide. We triage to the Texas Medical Center when necessary. If a physician refers to us, we make sure the patient gets to the location that that best meets his or her needs.”
TIRR Memorial Hermann-Greater Heights provides inpatient and outpatient rehabilitation services, including physical therapy, occupational therapy and speech therapy in service areas such as neurorecovery, cancer rehabilitation, cognitive rehabilitation, neuropsychology, swallowing and voice therapy, and functional vision rehabilitation. In 2016, the outpatient facility will expand its services to include pediatric rehabilitation and an outpatient medical clinic.