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Re-educated, Rejuvenated, Reunited
Halsted 3’s inpatient rehabilitation unit marks a decade of success with former patients.

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"The reunion is so rewarding," says OT Stacy Bittner. "It's equally great for therapists as for patients—they're so thankful, and we feel like we contributed to their success."

In medicine, intimacy is a necessity between patient and caregiver. But in rehabilitation, patients spend hours of every day in the company of therapists, nurses and doctors practicing the skills of daily life—fastening a button, taking a step, tying a shoelace—that have been lost to illness.

Often, a special bond forms between patients and the staff of Halsted 3, who have held reunions every year since the unit opened in 1998. This year was no exception. As many as 70 people from across the country made the pilgrimage on June 26 to share their progress and give thanks to the rehab team. All have battled serious medical problems—strokes, brain tumors and organ transplants, to name a few.

Among the first to arrive are George Chronakis and his wife, Barbara, of Cherry Hill, N.J. Walking wasn’t possible for Chronakis back in 2003, when he was a patient on the unit. Nor was speaking, or holding a fork. Chronakis had been diagnosed with a paralyzed diaphragm, a rare condition that compromises the phrenic nerve, which makes the diaphragm move so that lungs can fill with air and empty. Two days after his surgery, he suffered a pulmonary embolism. More surgery followed, during which Chronakis lapsed into a coma.

Besides not being able to perform basic functions, Chronakis lost his memory, experienced circulatory problems and had the use of only one lung. Five years later, the robust, loquacious man with a lilting accent hands out his new business card. A former accountant, he has switched to a career in real estate because of periodic memory lapses. Back for his third reunion, Chronakis is exuberant: “I wouldn’t be here today without these people. They taught me how to live again—step by step—and they never gave up on me.”

Rehab is a delicate balance of therapy and rest. The treatment team focuses on patient’s capabilities, not their disabilities, says R. Samuel Mayer, director of Physical Medicine and Rehabilitation. At Halsted 3 and the two other inpatient rehab sites—Johns Hopkins Bayview and Good Samaritan Hospital—skills as banal as how to get up from a chair are practiced daily, from 7:30 a.m. to 4 p.m., with the unit’s 20 full-time nurses, four OTs, four PTs, a speech therapist and a recreational therapist. Special emphasis is placed on self-care and activities of daily living in the OT kitchen—cooking, washing dishes, doing laundry—and socializing with other patients. At the same time, a psychologist and social worker help patients and families deal with emotional adjustment and plans for posthospital care.

Over the years, the unit has seen a steady increase in admissions (516 last year versus 450 in 1998). The staff, says Mayer, has become more focused on patients’ goals, resulting in better outcomes and shorter lengths of stay, which now average eight days. Eighty percent of these patients go home and rejoin their communities.

During the daily grueling routine, patients get to know their roommates and other patients well. They often work side by side, making breakfast in the OT kitchen for “Breakfast Club” or lifting weights together in the gym. Though some patients require further assistance in a subacute facility, while they’re at Hopkins, the team addresses virtually every physical and psychological concern to help restore their function.

For staff, that approach is counterintuitive. Vickie Singbeil, a nurse on the unit since its inception, recalls the learning curve when rehab came of age a decade ago. “Nurses are trained to do things for patients,” she says, “but in rehab, you have to sit on your hands while they work. We have to show them how to do things at home, and we want everyone to go home. In acute care, it’s always rush, rush, rush to help patients get better. Here you watch them help themselves.”

Ilene Passamano, who flew in from Florida for the reunion, is one such patient. Passamano had been on the unit for five months following complications from non-Hodgkin’s lymphoma. Alongside her, sits a 94-year-old woman who’d suffered a stroke in 1998. She is back for her 10th reunion, and though she speaks only Polish, her ability to walk cane-free and her frequent smiles tell the story.

Testimonies pour out—and some get personal for staff. Rehab nurse Donna Myers relates that three years before, her husband was on the unit with Guillain-Barré syndrome, unable to walk. Today he uses a cane. And a year ago, during a CPR training class, Sue Verrillo, the unit’s nurse manager, suffered subarachnoid hemorrhage and became a rehab patient. She’s been back to work full time since January.

“People asked me if I was sure I wanted to come here,” says Verrillo. “Absolutely, I said. Now I know personally the quality of care my staff gives every patient, and I couldn’t be more grateful.”

For more info on inpatient rehab, visit hopkinsmedicine.org/rehab or call 410-502-7156.


                     


—Judy Minkove

 

 

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