Sylvia's Story
When Sylvia Markley turned 90, she celebrated with a birthday block party, complete with an Elvis impersonator. For those who know Sylvia, this was no surprise as she lives by the motto, “You have to keep moving.”
A native of Nebraska and long-time medical office manager, Sylvia was initially a snowbird who eventually became a permanent resident of a 55+ RV community in Mesa, Arizona. Now, her two children, Todd and Marilyn, are also snowbirds, spending three months each year with their mom in Arizona.
Aside from some cardiac issues that required the placement of several stents and a pacemaker, Sylvia has always been active and healthy. So when she began experiencing pain and weakness in her legs over the course of several days, her daughter, a nurse, was concerned. Marilyn visited her mother several times a day to check her vital signs, which were normal. When Sylvia became unable to walk, couldn’t move her legs and was in significant pain, a family member picked her up, carried her to the car and headed directly to the emergency room at Banner Baywood Medical Center.
There, testing showed Sylvia was not only experiencing arrhythmias, or an irregular heartbeat, but that her creatine kinase (CK) enzymes were elevated. An enzyme found primarily in muscle cells, elevated CK levels indicate damage to muscle tissue. Further testing resulted in a diagnosis of rhabdomyolysis, a rare and serious condition that occurs when muscle tissue breaks down, leading to the release of muscle fiber contents into the blood. These substances are harmful to the kidneys, which, in Sylvia’s case, resulted in extreme swelling. She went from 94 pounds prior to her hospital admission to 123 pounds while in the hospital – all of which was fluid retention.
Unable to roll in bed, move her legs or get out of bed, Sylvia would spend the next 15 days in the hospital being treated for the rhabdomyolysis, which was complicated her swelling. As her discharge date approached, her treatment team thought that a skilled nursing facility might be the best option for Sylvia. Marilyn, however, was insistent that her mother would make a better recovery in an inpatient rehabilitation hospital, hoping that Sylvia would be able to get back to the same level of mobility and independence she enjoyed before her hospitalization.
Sylvia arrived at Banner Rehabilitation Hospital East with the ultimate goal of returning home. Her illness had left her weakened, with reduced endurance and struggling with shortness of breath. She required assistance to go from lying in bed to sitting to standing and could only walk 50 feet with a walker before needing to sit down and take a break.
In physical therapy, Sylvia and her therapists focused on helping to re-build her endurance so she could improve her walking and overall mobility. Because she has to go up four stairs to get into her home, therapists had Sylvia practice going up and down steps, including how to turn sideways. Her physical therapy sessions also included walking in between the parallel bars while stepping over obstacles and practicing walking forward and sideways. Time was spent walking outdoors as well to navigate different surfaces and terrains.
Occupational therapists worked with Sylvia on becoming more independent in her daily tasks. They introduced her to adaptive equipment such as a reaching device as well as a sock aid to help put on socks more easily. Sylvia also spent time in the activities of daily living suite, which mimics a home environment. There, they had Sylvia work on transferring in and out of the tub while using a shower bench. Therapists also had Sylvia utilize the car simulator, which provides patients the opportunity to practice getting in and out of a car.
Sylvia worked with speech therapists to improve her memory and problem solving skills, with the goal of staying mentally sharp for her age. She openly accepted education for memory strategies and had no hesitation to implement them. “Sylvia was always smiling every time I walked in the room,” her therapist said. “She was always willing to do whatever was presented to her during therapy sessions. We could always count on Sylvia to share a smile during therapy.”
After two weeks at Banner Rehabilitation Hospital East, Sylvia’s walking improved and she was able to complete many personal care tasks with just a bit of help. She was looking forward to returning home, getting back to her routine and continuing to get stronger with the help of home health care three times a week.
Sylvia’s daughter had high praise for her mother’s experience. “I’m amazed at how good it was. We are very grateful, thankful and blessed,” Marilyn said. “The hospital was so clean and the food was excellent and always hot. Mom ate everything – even desserts. We appreciated the landscaping; all of the flowers blooming was so beautiful and calming for my mother and me.”