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Reaching for a goal

February 1, 2011

Catawba County is thousands of miles away from Tucson, Ariz., where Rep. Gabrielle Giffords was seriously injured in a Jan. 8 shooting rampage.

But as Giffords recovers, her therapy mimics the therapy received by many Catawba County patients, who struggle every day to recover from once life-threatening conditions.

Giffords is currently undergoing treatment for her injuries at a Houston inpatient rehabilitation center, much like the rehabilitation center at Catawba Valley Medical Center in Hickory.

Dr. Jeanette Larson, a neurologist in Hickory, said traumatic brain injuries, like the one sustained by Giffords, take months of physical, occupational and recreational therapy.

Mimi Stachowski, CVMC's director of inpatient rehabilitation, said the hospital's program hasn't had a shooting victim that she knows of, but many of the same therapeutic activities are the same for patients with varying injuries. Patients require training for stability, balance, dexterity and stamina, and they can gain all those qualities at CVMC's rehabilitation facilities.

Alleged gunman Jared Loughner shot Giffords at point-blank range in the back of her skull as she spoke with constituents outside of a Tucson, Ariz., grocery store. The bullet entered through the left rear of her head and exited through the left front of her forehead.

"When a bullet goes through, you don't know what it's going to hit along the way," Larson said.

The bullet's pathway can damage many of Giffords' day-to-day functions, from seeing and speaking to maintaining the personality she had before the accident.
The brain's frontal lobe, near where the bullet exited Giffords' head, controls functions such as decision making and reasoning. That means re-learning a lot of daily activities that were once second nature.

"Patients are going to have to learn to do a lot of things," Larson said.

Therapists start with the basics, such as teaching patients how to express immediate needs and pain. They use sign language to communicate, because some patients may not have the ability to communicate verbally.

As patients learn to communicate, they meet with a neuropsychologist, who assesses every aspect of a patient's intelligence, from dexterity to the speed of information processing.

"That information can be used to guide the therapy forward," Larson said.

That point in care also gives therapists and doctors insight into other previously unknown disabilities. Larson said it's difficult to understand the extent of memory loss when patients communicate non-verbally, so a neuropsychologist's patient evaluation is an important step in determining future treatment.

CVMC offers an inpatient rehabilitation facility with 10 beds for people to receive constant treatment and therapy. Like Giffords, these people receive constant care for their injuries in a hospital setting.

Therapy activities range from simply walking from one location to another to re-learning how to speak and communicate with others.

Many of CVMC's patients suffered strokes and have difficulty walking, talking and doing other daily tasks.

Vanisha Gibson, 57, of Newton, is recovering from a stroke at CVMC's inpatient rehab center. She works with physical and occupational therapists to regain her balance by using video games and stability balls.

"I never did the (video game) Wii before," Gibson said. "So I had to learn how to do it during therapy."

Larson estimated Giffords will spend about two months in an inpatient rehab facility before undergoing outpatient care for about six months.

CVMC also offers the outpatient rehab component, which allows patients to receive treatment then return to their homes or other assisted-living facility.

Although Larson thinks Giffords will sustain some permanent injuries, she's optimistic for her recovery. She said the fact that Giffords was communicating with doctors shortly after the shooting is a good sign for her continued improvement.

Giffords had no complications from her post-shooting surgery, such as additional bleeding or pneumonia, further increasing her changes for partial recovery from her injuries.

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