Mara Lopez is no stranger to adversity. In the last several years, she’s experienced many medical events, from an infected knee replacement and MRSA infection that led to a fusion of her leg to a major stroke that left her immobile and unable to care for herself.
The last year brought even more challenges for Lopez. She lost her husband unexpectedly in a car crash, and she also contracted a severe case of COVID-19. Among the lows, though, came an unexpected high. After more than two years of therapy from multiple providers, Lopez was referred to Encompass Health Rehabilitation Hospital of Henderson. While there, she stood for the first time since before her stroke, and found a team of clinicians that believed in her and her ultimate goal—to one day walk again.
Medical misfortunes
Lopez’s story begins more than three years ago with a hip replacement, followed by a knee replacement. While she recovered quickly and seamlessly from the hip replacement, her new knee became infected with MRSA. The situation was life-threatening, and ultimately resulted in the fusion of her left leg to remove the knee joint.
The procedure left Lopez predominantly bed bound, and when she wasn’t in bed, she was prone to falls. One night, though, Lopez knew something very different was happening.
“One night I looked at my husband and told him there was something seriously wrong,” Lopez said. “I had fallen out of bed and made jokes before about calling the cute paramedics. This time, I looked at him and said, ‘I’m not joking. Seriously, something is very wrong. Call the paramedics.’”
The stroke was severe, and Lopez underwent brain surgery.
“They told my husband to find somewhere to put me to die, that I wasn’t going to live,” Lopez said. “I stabilized, but my stroke was so severe and there was so much damage, they thought I wouldn’t have any cognitive function. They told him I wouldn’t be much more than a vegetable.”
Not only did Lopez survive, but she also had very little cognitive impact from the stroke. However, it severely affected her right leg. With her left leg fused, and the fact that she had been bedbound for some time before the stroke, doctors were unsure of what her recovery would look like.
Lopez spent the following two years in and out of various rehabilitation settings. In 2020, Lopez lost her husband in a car accident, and not long after, she contracted COVID-19. The experiences left her more determined than ever to keep pushing to achieve her goals and get the rehabilitation she needed.
To treat some lasting effects from the virus, Lopez went to a new skilled nursing facility. The team there told her that her needs would be better met at Encompass Health Rehabilitation Hospital of Henderson, where she found a team that believed in her and her ability to make progress.
“I went through over three years of people telling me I was never going to be able to accomplish anything,” Lopez said. “The therapists at Encompass Health said you’re determined, and with continued strength training, you should be able to get off the bed. They said we’ll take you as far as you can go.”
Achieving new firsts
When Lopez arrived at Encompass Health Henderson, her therapists knew that helping her achieve her goals of walking again would require a lot of hard work and time.
“A lot of people would look at her charts and say, ‘Oh, she’s been bedridden for a year. She’s not going to walk again,’” said Aaron McKenzie, occupational therapist. “But that was her goal, and that’s one of the main things we do on evaluation is try to personalize and customize the patient’s goals into the therapy treatment.”
Therapists worked with her to set smaller goals that would help increase her immediate quality of life while she continued to work toward her overarching goal of one day walking again.
The team started with working on her bed mobility and transfers, which would help her return home more independent than when she arrived. This was a big goal for Lopez, who hoped to return home with her daughter after a traumatic year, but did not want to put her daughter at risk of injury if she was unable to transfer by herself.
Another focus of her treatment plan was upper body strengthening.
“We had to keep her upper body strength and range of motion at a high level because she’d need her arms to do bed mobility and sit to stands, and to eventually support herself with a walker,” McKenzie said. “She was able to understand that and not just think, ‘Why aren’t we just strengthening my legs?’”
During her stay, Lopez was not only able to improve her ability to transfer and perform basic self-care in her bed, but she was also able to stand and take her first steps in years.
“For the time that I was there, for me to be able to pull myself up and start taking steps was really great,” she said. “Encompass took me from the bed to the real possibility that I could walk again.”
Lopez also connected with the nursing staff during her stay. Not only were they there to help her manage her medical needs, said Leishel Pasion, RN, but they were also there to help her process the many events she’d been through in a short time.
“For her to be able to go from pretty immobile to a lot more mobile was very rewarding to watch,” Pasion said. “It’s so important in my opinion to continue to motivate them, no matter what they have heard in the past. Regardless of anything medical, it’s our job to keep their spirits up, not just take care of them medically.”
Seeing Lopez progress, especially given the many difficulties she’d faced in the last few years exemplifies why Pasion is a rehabilitation nurse, she said, and Lopez exemplifies the importance of advocating for the care you feel you deserve.
“One of the biggest reasons I got into rehab nursing is that I love to see the progression they make,” she said. “That progression makes us feel as nurses that we really did something. When we can be a part of helping them progress, it makes us feel like we made a difference.”
Inspiring others
Although she has not achieved her long-term goal of walking again, Lopez is not discouraged. The progress she made at Encompass Health Henderson greatly improved her quality of life and allowed her to return home with her daughter. It also encouraged her to keep pushing forward.
“I’ve beaten MRSA; I’ve beaten the stroke; I’ve lived through COVID. There’s no reason I can’t walk,” she said.
One day, Lopez hopes to inspire and work with other stroke patients to show them that it’s worth it to fight for the care you need, and that no situations are truly hopeless if you have the right people behind you.
As far as McKenzie has concerned, Lopez has already done just that.
“We always try to tell stroke and brain injury patients that it could be years later, but we have the advanced technology and therapy modalities to help patients improve. They can improve their transfers—even if they aren’t getting more movement, they can get better quality of movement,” McKenzie said. “Mara is one of those patients that hold you over on the difficult days. She makes you remember why you chose your career—to work with people like Mara who can make strides and more progress to be able to get home again.”
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